Explore the vast range of titles available.

Aim Despite remarkable theoretical evidence of positive outcomes of patient and family‐centred care, it is rarely performed in the intensive care setting. The aim of this review was to assess the barriers to patient and family‐centred care among healthcare providers, patients and family members in adult intensive care units. Design A systematic review of both qualitative and quantitative studies. Methods The search strategy sought for published peer‐reviewed research papers limited to English language from conception to 2018. The review protocol was registered in the CRD Prospero database (CRD42018086838). Literature search was carried out in four databases: EMBASE, Cochrane Library, PubMed and Scopus where keywords “barriers,” “patient and family centered care,” “patient‐centered care” and “intensive care unit” appeared in any part of the reference. Hand search of reference lists of identified papers was also done to capture all pertinent materials. Each study was assessed by three independent reviewers against the inclusion criteria. Evidence was graded according to sampling quality, quantity and measurement of intended outcomes. Screening of studies and citations resulted in seven studies that were included in the analysis. Results Barriers to patient and family‐centred care broadly fall under four categories; lack of understanding of what is needed to achieve patient and family‐centred care, organizational barriers, individual barriers and interdisciplinary barriers.

Background HIV and Hepatitis C Virus (HCV) infections are responsible for a significant burden of mortality and morbidity, particularly in developing countries. This study sought to determine the prevalence of HIV and Hepatitis C among injecting drug users in Afghanistan, Iran, and Pakistan. Methods This review conforms to the Preferred Reporting Guidelines for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases including PubMed, Scopus, Web of Science/Knowledge, SID.ir, and MAGIRAN were searched. Studies that were published from 2003 up to 2018 were considered for analysis. Studies were screened for inclusion in duplicate, and also, that data were narratively synthesized. Results We report on data from 79 articles. The total number of participants in studies that assessed the prevalence of HIV among injecting drug users included 68,926 participants, while those from studies that assessed HCV prevalence were 23,016 participants. Overall HIV and HCV prevalence among injecting drug users in the three selected countries were 9.1% (95% CI 6.9–12.0%) and 48.3% (95% CI 43.9–52.7%), respectively. Iran had the highest HIV prevalence of 11.0% among injectable drug users (95% CI 8.4–14.2%), while Afghanistan had the lowest HIV prevalence of 3.1% (95% CI 1.5–6.3%) among three selected countries. In Pakistan, the prevalence of HIV was 8.6% (95% CI 4.8–15.0%). Regarding HCV prevalence, Pakistan had the highest while Afghanistan had the lowest, 54.4% (95% CI 33.5–73.9%) and 37.3% (95% CI 35.2–39.4%), respectively. HCV prevalence in Iran was 47.7% (95% CI 43.4–52.0%). Conclusion Injecting drug users form a special cohort of persons at risk of HIV and Hepatitis C infections. The prevalence of HIV and Hepatitis noted from our findings is significantly high. Awareness of the grave risk of spreading HIV and Hepatitis C associated with sharing needles is recommended among this sub-group of drug users.

Background Medical education plays significant role in shaping the future of healthcare, and understanding the career outcomes of medical graduates provides valuable insights into the effectiveness of educational programs. With no published data using alumni surveys in the South Asian region, we set out to conduct a survey to gain insights into the career trajectories, professional milestones, and accomplishments of 35 graduating classes from one of Pakistan’s largest Academic Medical Centers (AMC). Methods An online survey was distributed to 2,177 alumni of the Aga Khan University (AKU), Pakistan who graduated from 1988 to 2021. This cross-sectional survey explored graduates’ higher education, training, practice settings, and four key outcomes: awards, leadership roles, research impact, and contributions to healthcare and educational innovations. A multipronged approach leveraging outreach from leadership, social media engagement, peer-to-peer appeals, event-based promotion, and targeted text reminders to maximize survey participation was employed. Data were analyzed using descriptive statistics, chi-square tests for association, and multivariable logistic and multinomial regression to assess independent predictors of career outcomes. Results 1,201 alumni (55.2%) responded to the survey, demonstrating the effectiveness of this multifaceted approach. After the exclusion of missing data, 862 responses were analyzed. Both genders were equally represented (49.8%). Most participants had completed residency (82.0%) and fellowship (56.0%) training. Nearly half (48.5%) were employed in an academic setting. A proportion (57.7%) of alumni had received awards, and nearly one-third of the respondents (31.6%) were involved in developing healthcare or educational innovations. Over half of the respondents (53.7%) had served in leadership roles, and a number had been involved in research (68.9%), with 18.6% receiving grant funding. While an overwhelming 95% of female respondents were employed, they had lower odds of serving in a leadership role and research involvement than their male counterparts. Conclusion The findings of this study serve as a testament to the effectiveness of AKU’s educational programs in preparing graduates to make significant contributions to healthcare and society. Continuous quality improvement initiatives, fostering a culture of giving back within its alumni, and creating opportunities for females through diverse endeavors can pave the way for sustained and heightened accomplishments among its graduates.

To evaluate the current communication skills of resident physicians and identify areas for improvement. Using a cross-sectional design, data from medical students, residents, fellows, and faculty were assimilated at one of the largest academic medical centers in a low-and-middle-income country via a self-administered, validated survey with a 5-point LIKERT scale. One-way ANOVA was used to compare intra-group means, followed by the Bonferroni test, with a p-value <0.05 considered significant. Heat maps using means were generated and color-coded to signify the level of communication skills expertise. A total of 320 participants (119 residents, 34 fellows, 78 medical students and 89 attendings) completed the survey. Most residents (58%) reported not having received formal communication skills training. Major barriers impeding effective patient-resident communication were long working hours, inadequate time, and difficulty understanding patients' language (  < 0.001). Residents' self-evaluation of communication skills was significantly higher than observer evaluations from faculty, fellows, and students, reflecting a lack of self-awareness and overestimation of communication expertise. Observer cohorts rated residents moderately on para-verbal communication skills while giving the lowest ratings for breaking bad news (mean 2.8, p-value <0.001) and residents' experience in dealing with workplace conflicts (mean 2.8, p-value = 0.023). Our study identified a clear and critical need for a structured, longitudinal, competency-based communication skills program for residents. Targeted efforts towards bridging the gaps in communication skills identified in this study can improve trainee communication skills expertise and augment patient satisfaction rates to improve the quality of care in developing countries.

Background Students have long been admitted into medical colleges using standardized tests/interviews. However, limited evidence exists on their association with academic achievement during medical education. Moreover, the relationship between its individual components and subsequent academic achievement remains unexplored. This study aims to determine the association between medical students’ demographics and admission scores with their academic performance during medical college. Methods This cross-sectional study was conducted in 2023 at one of the oldest private medical colleges in a South Asian low- and middle-income country, where data for medical students graduating with a Bachelor of Medicine, Bachelor of Surgery (MBBS) degree in 2018–2022 were retrieved electronically. Through an extreme groups approach (EGA) sampling, factors leading to students falling within the top 20% scorers in preclinical, clinical, procedural, and non-procedural clerkships were identified. Binary logistic regression models assessed the association between demographics and admission scores with their academic performance in medical college. Results From data of 418 students, EGA sampling included a total of 168 and 169 students for comparison between the top and bottom 20% scorers in preclinical and clinical rotations, respectively. Female sex (adjusted OR:4.10, 95% CI:1.94,8.65) and higher biology, physics, and mathematical reasoning scores on the university’s admission test independently predicted preclinical academic achievement. Female sex and higher mathematical reasoning scores significantly predicted academic achievement in clinical, procedural, and non-procedural clerkships. Higher biology scores also independently predicted achievement in non-procedural clerkships (adjusted OR:1.03, CI:1.01,1.06). Prior schooling from the British education system was significantly associated with higher mean percentage for admission scores and clinical clerkships for applicants compared to the local education system. Conclusion Higher scores on medical college admission tests can predict medical students’ academic achievement during undergraduate studies. Understanding the specific test components associated with students’ success can refine the selection process, ultimately fostering efficient healthcare professionals.

There has been an emerging trend of podcast use in medical education over the past decade. With the increasing number of podcasts and learners' interest in trauma surgery, it is vital to validate the quality of these podcasts. To determine the quantity and quality of podcast episodes on trauma surgery. This cross-sectional study identified trauma surgery podcasts published globally on the Google, Apple, and Spotify platforms as of May 31, 2023. An initial screening excluded podcasts not fulfilling the inclusion criteria (published as of May 31, 2023, and covering clinical knowledge or mentorship on general trauma surgery). A 10-item checklist developed from a modified Delphi consensus method was created to assess the podcasts' credibility, content, and design as indicators of quality. Data extracted from each podcast episode included the duration, setting, host and guest credentials, and fulfillment of quality indicators. Data were analyzed on August 13, 2023. The quality of each podcast was assessed using the 10-question checklist. A score of at least 80% in credibility (4 of 5 points), 75% in content (3 of 4 points), and 100% in design (1 of 1 point) was required to classify a podcast episode as having good quality. The initial search identified 204 podcasts on trauma surgery, of which 55 podcasts met the inclusion criteria. All 55 podcasts were published after 2014, with the majority hosted by males (85% [61 of 72 hosts]), based in the US (91% [50 of 55 podcasts]), and focused on clinical knowledge (80% [44 of 55 podcasts]). Podcast hosts and guests predominantly held a Doctor of Medicine degree (83% [113 of 136]), with 72% [46 of 64] of guests identifying as practicing trauma surgeons. While all 55 podcasts had excellent quality in terms of content and design, 20% (11 of 55) of podcasts were rated poorly on credibility. Credibility was further reduced for 60% (33 of 55) of podcasts because of nondisclosure of conflicts of interest. In this cross-sectional study of trauma surgery podcasts, most had good-quality content and design, but there was a lack of explicit conflict of interest disclosure. Content producers need to disclose their conflicts of interest appropriately to ensure credibility and improve the quality of their podcasts.

To compare (i) the evidence-based practice (EBP) profiles and (ii) socio-demographic characteristics of nurses in 4 selected low-middle income countries (LMICs).A cross-sectional survey was conducted among 677 nurses from 4 hospitals in 4 countries (Afghanistan, Ghana, Iran, and Uganda).The findings revealed that there are significant differences between the 3 EBP subscales (that is, practice/use, attitude, and knowledge/skill) across the 4 countries (P < 0.05). No significant EBP differences were identified across age groups and gender in the subscales of practice, knowledge, and attitude. Practice and knowledge subscales were significantly associated with working schedules (that is, part-time and full-time) (P < 0.05). Analyses also revealed significant differences between attitude and knowledge subscales and working experience (P < 0.05).Nurses in the 4 countries have moderate practice, attitude, and knowledge/skills of EBP. Nurses in LMICs require continuous professional development programs and support to enhance their practice and knowledge regarding EBP in clinical settings.

Lumps in the groin frequently present to the accident and emergency department and can relate to a number of diseases that require different management. Kikuchi's disease, first described in Japan in 1972 is a form of histiocytic necrotising lymphadenitis. It was discovered as a result of patients who were previously diagnosed with lymphoma but then recovered too quickly for it to be lymphoma. There appears to be no association with other pathologies but it remains important to exclude any autoimmune diseases and other causes of lymphadenopathy. We present a single rare case of a 39-year-old Caucasian gentleman who presented with a tender right inguinal groin lump.

Lumps in the groin frequently present to the accident and emergency department and can relate to a number of diseases that require different management. Kikuchi's disease, first described in Japan in 1972 is a form of histiocytic necrotising lymphadenitis. It was discovered as a result of patients who were previously diagnosed with lymphoma but then recovered too quickly for it to be lymphoma. There appears to be no association with other pathologies but it remains important to exclude any autoimmune diseases and other causes of lymphadenopathy. We present a single rare case of a 39-year-old Caucasian gentleman who presented with a tender right inguinal groin lump.