Letteratura scientifica selezionata sul tema "Gateway entry medical steudents"

"Sepsis occurs especially in people with a compromised immune system. Hosts become immunocompromised by chronic conditions, HIV, neoplasms, diabetes, as well as immunosuppressive and cytotoxic treatments. This first research direction aims at conducting an etiopathogenic study on a representative group of patients diagnosed with severe sepsis with oral gateway, following the prevalence and incidence of each clinical entity in the corroborative context of a range of factors influencing the final results, outlining with the real image of a complex pathology on the territory of Moldova is very accurate, aspects with a profound impact in the therapeutic approach both for severe sepsis and for the prophylactic methods of oral pathology. For the clinical study, a representative group of patients was studied: 94 patients hospitalized in the Galați Infectious Diseases Clinic between 2018 and 2019. Patients included in the study group, anchored in the territory of immunosuppression, have a general condition affected by: diabetes mellitus, chronic hepatitis, liver cirrhosis, alcoholism, neoplasms, chronic renal failure, anemia. Age is an important factor in the evolution of sepsis. This study also highlighted a phenomenon described in the literature, namely that there is an increased incidence of sepsis in patients of extreme age."

The purpose of this retrospective observational study was to identify the impact of COVID-19 on emergency medical services (EMS) processing times and transfers to the emergency department (ED) among patients with acute stroke symptoms before and during the COVID-19 pandemic in Busan, South Korea. The total number of patients using EMS for acute stroke symptoms decreased by 8.2% from 1570 in the pre-COVID-19 period to 1441 during the COVID-19 period. The median (interquartile range) EMS processing time was 29.0 (23–37) min in the pre-COVID-19 period and 33.0 (25–41) minutes in the COVID-19 period (p < 0.001). There was a significant decrease in the number of patients transferred to an ED with a comprehensive stroke center (CSC) (6.37%, p < 0.001) and an increase in the number of patients transferred to two EDs nearby (2.77%, p = 0.018; 3.22%, p < 0.001). During the COVID-19 pandemic, EMS processing time increased. The number of patients transferred to ED with CSC was significantly reduced and dispersed. COVID-19 appears to have affected the stroke chain of survival by hindering entry into EDs with stroke centers, the gateway for acute stroke patients.

Background: Aggressive marketing has resulted in exponential growth of energy drink sales in recent years. Despite growing concerns about the negative health effects of energy drinks, they are increasingly popular among young people. Little is known about temporal associations between energy drink consumption and other drug use, though some researchers have suggested that energy drink consumption reflects an entry into a drug-using lifestyle. Aims: The purpose of this study was to evaluate whether energy drink use among adolescents who have never tried substances is associated with a risk of initiating tobacco (i.e. cigarettes, e-cigarettes, and hookah) and alcohol use. Methods: A school-based longitudinal study of 3071 adolescents ages 9–17 years was conducted in six federal states of Germany. Data analyses involved two assessment waves that took place approximately 12 months apart: baseline (fall-winter of school year 2016–2017), and 12-month follow-up (fall-winter of school year 2017–2018). Results: Multilevel models revealed that energy drink use at baseline was associated with cigarette (odds ratio for energy drink ever use, 3.15 (95% confidence interval, 2.07–4.78 )), e-cigarette (odds ratio, 4.32 (95% confidence interval, 2.87–6.51)), hookah smoking (odds ratio, 3.15 (95% confidence interval, 2.06–4.82)), and alcohol use (odds ratio, 2.26 (95% confidence interval, 1.75–2.93)) initiation within 12 months. Conclusions: These results raise the possibility that energy drinks may potentially act as a gateway drug to other substances. However, inferences regarding whether this association is or is not causal cannot yet be made.

Background: Innervation of larynx is much more complicated than previously been thought. Laryngopharynx is the common gateway for many specialists like oral surgeons, ENT surgeons, anaesthetists, UGI endoscopists and bronchoscopists. The sub-mucosal neural network can be anaesthetised by topical application or injection of local anaesthetics. In this study destination of the internal laryngeal nerve and its penetration into the intrinsic muscles of larynx are analysed.Methods: A total of 40 en bloc cadaveric specimens were investigated in the department of anatomy, Madras Medical College, Chennai and from Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Kanchipuram. Conventional anatomy dissection method was used in the identification of internal laryngeal branch of superior laryngeal nerve and its branches.Results: Irrespective of the number of divisions at the point of entry into thyrohyoid membrane, 4 branches were constantly traceable. The branches were traced by 2 approaches- (A) those supplying the mucus membrane- (i) to the junction of aryepiglottic fold and lateral border of epiglottis; (ii) to the posterior surface of interarytenoideus; (iii) to the posterior surface of posterior arytenoideus; and (iv) descending to apex of the pyriform fossa behind cricothyroid junction; (B) penetration into intrinsic muscles- (i) a branch terminated after entering interaryteoideus; and (ii) another terminated after entering the posterior cricoarytenoideus muscle.Conclusions: The knowledge of variation into branches and area of supply of internal laryngeal nerve is essential for anatomists and clinicians. It is not a nerve to be neglected as the knowledge of its branches is very much essential for the surgeons operating in this area of air and food passage.

Abstract In the scientific field, data acquisition using commercial or self-developed sensors is a necessity for many research activities. Data security and data privacy are important requirements in all types of IoT applications, especially in the medical context. IoTree42 is a powerful, OpenSource platform that closes the gap between cost-efficiency, the ease of use and digital sovereignty. The flexible and user-friendly design makes the platform ideal for the originally conceived research context. Nevertheless, it can be used for smaller budget-oriented setups and industrial applications with thousands of sensors and actuators likewise. The platform was developed with security in mind by minimizing interfaces and the use of stable software components and transport protocols. IoTree42 utilizes lightweight OpenSource software cast into a flexible backend, allowing the deployment not only on full-fledged servers but also on single board computers like the Raspberry Pi. Data is transmitted with low overhead via MQTT, a robust protocol optimized for machine to machine communication. The transmission technology between all components is freely selectable. Besides data acquisition, IoTree42 enables control of actuators and automation through interfaces with visual programming tools. This allows for remote interventions without requiring prior programming experience. The incoming data can conveniently be visualized in dashboards or easily be exported for further analysis. The network consists of a central server and satellites (gateways) arranged in a star topology. Sensors and actuators connect to the gateway. The initial setup of the server and the gateways is automated, well documented, and can be done within minutes. Thanks to the increasing usage and the contribution of the community, the pool of code examples for sensors is growing and lowers the entry hurdle for users without programming background. IoTree42 is a fast-growing, multi-user, hardware and cloud agnostic, easy to deploy, privacy compliant and competitive solution compared to commercial IoT alternatives.

Abstract Background Gateway courses are increasingly popular widening participation routes into medicine. These six year courses provide a more accessible entry route into medical school and aim to support under-represented students’ progress and graduation as doctors. There is little evidence on the performance of gateway students and this study compares attainment and aptitude on entry, and outcomes at graduation of students on the UK’s three longest running gateway courses with students studying on a standard entry medical degree (SEMED) course at the same institutions. Methods Data were obtained from the UK Medical Education Database for students starting between 2007 and 2012 at three UK institutions. These data included A-levels and Universities Clinical Aptitude Test scores on entry to medical school and the Educational Performance Measure (EPM) decile, Situational Judgement Test (SJT) and Prescribing Safety Assessment (PSA) scores as outcomes measures. Multiple regression models were used to test for difference in outcomes between the two types of course, controlling for attainment and aptitude on entry. Results Four thounsand three hundred forty students were included in the analysis, 560 on gateway courses and 3785 on SEMED courses. Students on SEMED courses had higher attainment (Cohen’s d = 1.338) and aptitude (Cohen’s d = 1.078) on entry. On exit SEMED students had higher EPM scores (Cohen’s d = 0.616) and PSA scores (Cohen’s d = 0.653). When accounting for attainment and aptitude on entry course type is still a significant predictor of EPM and PSA, but the proportion of the variation in outcome explained by course type drops from 6.4 to 1.6% for EPM Decile and from 5.3% to less than 1% for the PSA score. There is a smaller significant difference in SJT scores, with SEMED having higher scores (Cohen’s d = 0.114). However, when measures of performance on entry are accounted for, course type is no longer a significant predictor of SJT scores. Conclusions This study shows the differences of the available measures between gateway students and SEMED students on entry to their medical degrees are greater than the differences on exit. This provides modest evidence that gateway courses allow students from under-represented groups to achieve greater academic potential.

Abstract Background Widening participation (WP) for underrepresented students through six-year gateway courses helps to widen the demographic representation of doctors in the UK. ‘Most students from gateway courses graduate, even though many enter with lower grades than standard entry medicine students.’ This study aims to compare the graduate outcomes of gateway and SEM cohorts from the same universities. Methods Data from 2007–13 from the UK Medical Education Database (UKMED) were available for graduates of gateway and SEM courses at three UK medical schools. Outcome measures were passing an entry exam on the first attempt, Annual Review of Competency Progression (ARCP) outcome and being offered a level one training position from the first application. The univariate analysis compared the two groups. Logistic regressions, predicting outcomes by course type, controlled for attainment on completion of medical school. Results Four thousand four hundred forty-five doctors were included in the analysis. There was no difference found in the ARCP outcome between gateway and SEM graduates. Gateway graduates were less likely to pass their first attempt at any membership exam than graduates of SEM courses (39% vs 63%). Gateway graduates were less likely to be offered a level 1 training position on their first application (75% vs 82%). Graduates of gateway courses were more likely to apply to General Practitioner (GP) training programmes than SEM graduates (56% vs 39%). Conclusions Gateway courses increase the diversity of backgrounds represented within the profession and importantly the number of applications to GP training. However, differences in cohort performance are shown to continue to exist in the postgraduate arena and further research is required to ascertain the reasons for this.

We study the impacts of telehealth adoption on geographic competition among urban and rural healthcare providers. We consider a quasinatural experiment: states’ entry into the Interstate Medical Licensure Compact, wherein the entry events facilitate healthcare providers to adopt telehealth technology. By analyzing a representative sample of providers, we first establish the Compact entry shock’s validity and its positive effect on the supply of medical services. We then report evidence that there are service and payment shifts from rural providers to urban providers (i.e., urban providers are more likely to benefit from the Compact entry financially). Relying on patients’ telehealth reimbursement claim data, we observe two mechanisms contributing to the revenue redistribution: the substitution and gateway effects of telehealth. Finally, we show that telehealth readiness and service quality moderate the impact of telehealth adoption. These findings speak to both potentially positive and negative consequences for welfare.

Abstract Background UK medical schools vary in terms of factors such as mission, specific curricula and pedagogy. As relatively little is understood about the impact of these differences at a post-graduate level, we examined the relationship between medical school and MRCS success. Method Using the UKMED database we analysed data on UK medical graduates who attempted MRCS Part A (n = 9729) and MRCS Part B (n = 4644) between 2007-2017. Univariate analysis characterised the relationship between medical school and first attempt MRCS success. Logistic regression modelling identified independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P &lt; 0.001). Trainees from standard-entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses ((Part A (Odds Ratio (OR) 3.72 [95% Confidence Interval (CI) 2.69-5.15]); Part B (OR 1.67 [1.02-2.76])). Non-graduates were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]). Russell Group graduates were more likely to pass MRCS Part A (OR 1.79 [1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])). Conclusions Medical programme and medical school are associated with MRCS success. Further research is needed to tease out the relationship between individual factors, medical school and MRCS performance.

Les étudiants « passerelle », qui se réorientent en médecine après un parcours académique etprofessionnel différent ont pour la première fois fait l’objet d’un travail qui vise à décrire leur profil sociodémographique, leurs caractéristiques psychologiques, et les facteurs motivationnels qui sous-tendent leur choix de réorientation vers les études de médecine. Au travers d’une étude qualitative basée sur 42 entretiens semi-dirigés, et d’une étudequantitative réalisée auprès de 718 étudiants en médecine des facultés de Rennes, Nantes, Angers, Tours, et Brest, ce travail de thèse nous montre tout d’abord que les étudiants « passerelle » ont un profil socio-démographique comparable à celui des étudiants en médecine français. Ils sont principalement motivés par un intérêt intrinsèque pour la médecine, etont des attentes plus élevées que les autres étudiants par rapport à la dimension humaine et altruiste du métier de médecin. Les attentes telles que le prestige et la reconnaissance sociale sont au second plan.Ils ont pour principaux traits de personnalité (modèle HEXACO) l’honnêteté-humilité et la conscienciosité, ce qui est aussi le cas des autres étudiants en médecine. Nos résultats montrent qu’ils sont plus extravertis, et qu’ils ont un score d’honnêteté-humilité plus élevé que les autres étudiants. Les valeurs les plus importantes pour eux sont axées vers la transcendance de soi, et l’ouverture au changement. Il semble que les valeurs d’affirmationde soi soient moins importantes pour eux que pour les autres étudiants. Nous avons mis en évidence deux profils de personnalité parmi les étudiants en médecine, dont un profil « altruisme et engagement élevé » qui se distingue par un niveau plus élevé d’honnêteté-humilité, de conscienciosité, d’agréabilité et d’extraversion, au sein duquel les étudiants « passerelle » qui n’avaient pas tenté le concours de la première année de médecine en post baccalauréat semblent être plus nombreux
Gateway-entry medical students bypass the traditional first-year selection process for medical school, gaining admission after completing a master’s degree, a PhD, or specific undergraduate degrees. Very little is known about these gateway medical students. This study aims at describing their socio-demographic profile, their personal psychological characteristics, and the motivational factors driving their shift towards medical studies, while also examining the personality traits that may differentiate them from their peers. Through a qualitative study based on 42 semi-structured interviews, and a quantitative study carried out on 718medical students from the faculties of Rennes, Nantes, Angers, Tours and Brest, this study reveals several key findings. Firstly, gateway students exhibit a sociodemographic profile similar to that of their French medical counterparts. They are primarily motivated byan inherent interest in medicine and hold greater expectations regarding the humanistic and altruistic facets of the medical profession compared to other students. While factorssuch as the prestige and social recognition associated with being a doctor also influence theirchoice, these are secondary considerations. Their main personality traits (HEXACO model) arehonesty-humility and conscientiousness. However, they tend to exhibit higher levels of extroversion and honesty-humility compared to their counterparts. Their core personal values emphasize selftranscendence and openness to change. Furthermore, our analysis identifies two distinct personality profiles among medical students, with a notable "high altruism and commitment" profile characterized by elevated levels of honesty-humility, conscientiousness, agreeableness, and extroversion. Interestingly, a higher proportion of gateway students (those who had not attempted the first-year medical entrance examination after completing high school) fall within this profile