Search Results (194)

Background: Quality care of individuals with sickle cell disease (SCD) is dependent upon education of the providers on their care team. Previous studies demonstrate lack of resident and provider comfort regarding care of patients with SCD, yet none have assessed these in medical students. Objective: This study aims to evaluate the adequacy of the research instrument for measuring medical students’ knowledge, confidence, and comfort regarding SCD and related complications prior to wider distribution. Methods: A self-assessment survey was distributed to medical students at two universities to evaluate their knowledge, confidence, and comfort in general SCD topics, in all clinical settings, and regarding common complications. Results: Of the 98 responses, knowledge (p < 0.001) and confidence (p = 0.02) were significantly different between topics, including epidemiology and genetics, pathophysiology, and treatment options. For “treatment options”, there were significant differences in knowledge (p = 0.02) and confidence (p = 0.02) between medical students at different levels of training. Students felt least knowledgeable and least comfortable with care of pregnant women and most knowledgeable and most comfortable with acute pain management. Caring for patients with specific SCD-related conditions increased knowledge and comfort across all domains. Conclusions: This instrument was adequate for measuring knowledge, confidence, and comfort in caring for those with SCD across all clinical settings. We identified a lack of knowledge, confidence, and comfort regarding treatment for those with SCD starting early in medical careers, which improves after caring for patients with various complications. Thus, educating and providing SCD patient experiences is crucial for medical student management confidence related to SCD. Full article

Background/Objectives: Senior nurses in Taiwan shoulder layered responsibilities shaped by professional roles, gendered expectations, and family duty. Although Taiwan faces a persistent shortage of experienced clinical nurses, limited research has explored how long-serving nurses sustain identity and commitment across decades of caregiving. This study examines how senior staff nurses understand their journeys of becoming—and remaining—nurses within a culturally and emotionally complex landscape. Methods: Interviews were conducted between May 2019 and September 2023 in locations chosen by participants, with most sessions face-to-face and others undertaken via video conferencing during COVID-19. This narrative inquiry involved in-depth, multi-session interviews with five female senior staff nurses born in the 1970s to early 1980s. Each participant reflected on her life and career, supported by co-constructed “nursing life lines.” Thematic narrative analysis was conducted using McCormack’s five-lens framework and Riessman’s model, with ethical rigor ensured through reflexive journaling and participant validation. Results: Three overarching themes emerged: (1) inner strength and endurance, highlighting silent resilience and the ethical weight of caregiving; (2) support and responsibility in relationships, revealing the influence of family, faith, and relational duty; and (3) role navigation and professional identity, showing how nurses revisit meaning, self-understanding, and tensions across time. Participants described emotionally powerful moments, identity re-connection, and cultural values that shaped their paths. Conclusions: These narratives offer a relational and culturally embedded understanding of what it means to sustain a career in nursing. Narrative inquiry created space for reflection, meaning-making, and voice in a system where such voices are often unheard. Identity was not static—it was lived, reshaped, and held in story. Full article

Osteochondritis Dissecans (OCD) is a joint condition characterized by damage to the surface of the joint and the underlying subchondral bone, leading to early-onset osteoarthritis. It predominantly affects the knee, elbow, and ankle, with higher prevalence in juveniles actively participating in sports, which complicates the condition due to slow healing processes and prolonged restrictions on physical activities. This review aims to summarize current knowledge on OCD in athletes, with emphasis on sport-specific risk factors, diagnosis, and treatment, to support clinical decision-making and future research. We conducted searches in the PubMed and Embase databases, covering the period from 2014 to 2024. The keywords used in the search covered most common sports in combination with term osteochondritis dissecans. This review examines the impacts of various sports on the development of OCD, analyzing prevalence and risk factors, with a focus on sports-specific risks across athletic disciplines like football, basketball, baseball, and gymnastics. The significance of early detection, intervention, and sport-specific conditioning is underscored to prevent the condition and manage it effectively. Moreover, the review highlights the positive prognosis for athletes, particularly adolescents, recovering from OCD, with a high rate of return to sport. Understanding the sports-specific risks, ensuring early intervention, and adopting a cautious, stepwise return to sport are critical for managing OCD effectively, thereby safeguarding the health and careers of athletes. Full article

Background/Objectives: Clinical Research Nurses (CRNs) have emerged as pivotal actors in the conduct, coordination, and oversight of clinical trials globally. Over the past three decades, the role of the CRN has evolved in response to the increasing complexity of research protocols, ethical standards, and regulatory frameworks. Originating as task-oriented support figures, CRNs have progressively assumed broader responsibilities that include patient advocacy, protocol integrity, ethical vigilance, and interprofessional coordination. By mapping the global literature on CRNs, this review will examine how their role has been defined, implemented, and evaluated over the past three decades. Methods: A scoping review was conducted using JBI methodology and PRISMA-ScR guidelines. The search covered the peer-reviewed and gray literature from 1990 to 2024 across major databases. Data analysis combined traditional extraction with topic modeling, Multiple Correspondence Analysis, and k-means clustering to identify key themes. Results: From the 128 included studies, four major themes emerged: clinical trial management, role perception and team integration, professional competencies and development, and systemic barriers. Despite formal competency frameworks, CRNs face inconsistencies in role recognition, unstable contracts, and limited career pathways. Emotional strain and professional isolation are recurrent. Over time, their functions have evolved from task execution to broader responsibilities, including advocacy and ethical oversight. However, no studies reported patient-level outcomes, revealing a critical gap in the evidence base. Conclusions: CRNs play a vital but undervalued role in clinical research. Persistent structural challenges hinder their development and visibility. Enhancing institutional support and generating outcome-based evidence are necessary steps toward fully integrating CRNs into research infrastructures. Full article

Context: A plethora of actors like individual and professional characteristics, religiosity, personality-related factors, personal experience of death, and empathy form the attitude of health professionals in patient care in clinical settings and euthanasia. Objectives: The aim of the study was to measure the attitudes of health professionals toward euthanasia. In addition, we examined how individual and professional characteristics, religiosity, death perspectives, and empathy may predict health professionals’ attitudes toward euthanasia. Methods: We collected socio-demographic characteristics and attitudes toward euthanasia and the end of life as well as empathy dimensions from 465 health professionals working in health services in Greece. Multiple linear regression was applied to test the association of the attitudes about euthanasia with (1) demographic and professional variables, (2) perceptions about death, and (3) empathy. Results: Findings of the study revealed that health professionals’ attitudes towards euthanasia are significantly associated with their age, the target group of their patients, religious beliefs, and their attitudes about the end of life. Meanwhile, empathy was an insignificant predictor of ATE (p > 0.05). Conclusions: Working in clinical settings with patients, especially at the end of their lives, will always include ethical issues for health professionals. Training and supporting new generations of health professionals in patient care and bioethics are crucial in order to face these ethical issues during their professional careers. Full article

Fifty million Americans, nearly 15% of the population, live below the federal poverty level, often facing civil legal issues without representation. Historically Black Colleges and Universities (HBCUs) have long served as economic engines and vital resources for their communities. HBCU law schools uphold this legacy by preparing students for legal careers while instilling a commitment to service, particularly for underserved citizens who lack access to quality legal representation. This research examines the dual mission of HBCU law schools—educating students and serving local communities—through a systematic document analysis of publicly available materials and literature on law school clinical programs. The findings identify four key community performance indicators that define the community impact of HBCU law schools: advocacy, engagement, client outcomes, and representation. These indicators reflect a shared commitment across all institutions to addressing systemic inequities through clinical legal education, reinforcing the role of HBCU law schools as both training grounds for future attorneys and essential pillars of justice in their communities. Full article

Introduction: The escalating scarcity of skilled healthcare professionals is particularly pronounced within surgical specialties, where the prospect of attracting prospective medical practitioners poses formidable challenges. Throughout their academic journey, students exhibit diminishing enthusiasm and motivation to pursue careers in surgery, including trauma surgery. It is postulated that the caliber of teaching plays a pivotal role in influencing students’ subsequent specialization choices. Methods: This prospective observational study was conducted among a cohort of third-year medical students at the German University Medicine Greifswald. The methodology encompassed the utilization of a self-administered questionnaire to procure data. Results: The study encompassed 177 participants, of whom 34.7% expressed an inclination toward a career in surgery (22.7% in trauma surgery). Participants who reported a favorable impact from the examination course displayed a significantly heightened interest in clinical clerkships within trauma surgery (p < 0.001), and even expressed a contemplation of specializing in orthopedics and trauma surgery (p = 0.001). Logistic regression analysis highlighted that the convergence of practical training and positive role modeling emerged as the most influential factors augmenting the allure of trauma surgery. Conclusions: Evidently, students who gleaned substantial benefits from high-quality practical instruction in trauma surgery exhibited a significantly heightened likelihood of pursuing this domain in their future endeavors. Surgical academic institutions stand to leverage this insight in their strategic planning for attracting and retaining potential residents. Cultivating a positive affinity for trauma surgery should be instilled early in the curriculum, subsequently sustained through ongoing immersive engagement that encompasses professional as well as interpersonal dimensions. Full article

The impact of work engagement and burnout on medical activities, physicians’ performance, and quality of care has gained interest over the last decades. However, the effect of demographics, job-related, and organizational variables on burnout and work engagement in young endocrinologists has not been fully investigated. To assess the impact of demographics, job-related, and organizational variables on burnout and work engagement in young endocrinologists who joined the Italian Association of Clinical Endocrinologists. The levels of burnout and work engagement were assessed by the Maslach Burnout Inventory and the Utrecht Work Engagement Scale, respectively, as a part of an online survey of the “Associazione Medici Endocrinologi” addressed to young members (31–40 years). Eighteen MANOVAs were applied to analyze differences in burnout and work engagement based on demographic, job-related, and organizational factors. We collected responses from 160 young endocrinologists, mainly women (80.6%), aged 31–35 years (33.8%) and 36–40 years (66.2%). Most were in a stable relationship with (40%) or without (45%) children. Most of them worked in hospitals or local healthcare districts (35.6%), as independent contractors (31.9%), or as Ph.D. students or residents (25.6%). Multivariate analyses found no statistically significant differences in burnout and work engagement due to demographics (gender, age, and partnership) and job-related variables (type of job and contract). On the other hand, organizational variables (levels of conflict amongst colleagues, more than expected time spent working, and no involvement in team-building activities) were associated with higher emotional exhaustion, lower dedication, and less vigor. The novelty of the study is that both burnout and work engagement can be affected by organizational variables in early-career Italian endocrinologists, highlighting the need for supporting the healthcare system to overcome this gap. Full article

Background: The Coparenting Relationship Scale is a robust tool for assessing the quality of coparenting, with evidence of validity and reliability tested in diverse cultural and population contexts. Objective: The aim of this study was to evaluate the psychometric properties of the Coparenting Relationship Scale in Ecuadorian fathers and mothers in order to determine its validity and reliability in the specific cultural context of Ecuador. Method: An instrumental study was carried out by analyzing psychometric properties. The sample consisted of 867 participants from the province of Azuay, most of whom were women (66.8%), with a mean age of 35.4 years. Participants completed the Coparenting Relationship Scale. Results: The findings revealed adequate reliability of the scale in the Ecuadorian sample. In addition, factor analysis showed that the scale structure remained consistent in this sample, suggesting that the items grouped in the dimensions established by the original scale retain their validity in this specific context. Significant factor loadings consistent with the theoretical dimensions of the scale were observed, reinforcing its construct validity. The sixth model (M6), with three factors and 22 items, showed a good fit (χ²= 399.43, df = 206, χ²/df = 1.94, p = 0.136), with adequate fit indices (CFI = 0.990, GFI = 0.996), a low approximation error (RMSEA = 0.033, 95% CI = [0.028–0.038]), and good residual fit (SRMR = 0.047). Additionally, the ECVI was 0.623. Conclusions: The Coparenting Relationship Scale is a valid and reliable instrument for assessing coparenting dynamics in Ecuadorian parents, providing a solid basis for interventions and policies aimed at strengthening family well-being in Ecuador. Full article

A principal strategic goal of the RCMI Coordinating Center (RCMI-CC) is to improve the health of minority populations and to reduce ethnic and geographic disparities in health by coordinating the development and facilitating the implementation of clinical research across the RCMI Consortium. To more effectively spur inter-institutional collaborative research, the RCMI-CC supports a Clinical Research Pilot Projects Program for hypothesis-driven clinical research projects proposed by postdoctoral fellows, early-career faculty and/or early-stage investigators from two or more RCMI U54 Centers. The purpose of this brief report is to summarize the Science Speed Dating sessions to facilitate cross-site collaboration at the RCMI Investigator Development Core (IDC) Workshop, held in conjunction with the 2024 RCMI Consortium National Conference. RCMI investigators and IDC Directors from 20 RCMI U54 Centers participated in two rounds of highly interactive small-group presentations of research ideas and resource needs in search of new collaborative and mentoring partnerships. Workshop participants expressed a high level of satisfaction with the speed-networking format and strongly agreed that the workshop was beneficial to their professional-development goals. Full article

Background/Objectives: Primary prevention, germline, familial, or other pre- or post-diagnostic and standard treatment-elevated progression or recurrence risk and mitigating adverse events from systemic treatment are all clinical opportunities to reduce the risk of lethal prostate cancer. This review attempted to provide a practical and realistic consensus via an international committee of experts who, in general, harbor career-long experience in this discipline. Methods: A PubMed review primarily utilizing the latest meta-analyses, systematic reviews, and methodologically robust epidemiologic recent data adjusting for multiple confounding variables was conducted. The goal of this committee was to highlight tangible options for clinicians and patients. Results: Behavioral patterns and metrics known to reduce cardiovascular morbidity, mortality, and all-cause mortality (premature death) appear to prevent numerous lethal common cancers, including prostate cancer. This practical approach allows for the greatest probability of patient success since cardiovascular disease (CVD) is the primary cause of death in men with and without prostate cancer, and a notable source of morbidity and mortality in men with advanced disease due to systemic conventional treatment as well as the inflammatory contribution of cancer itself. Heart-healthy dietary patterns, exercise, healthy weight/waist circumference, eliminating tobacco, minimizing alcohol exposure, and other behaviors to reduce the risk of CVD should be prioritized. CVD-preventive medications, including aspirin, GLP-1 agonists, metformin, statins, etc., should receive attention to improve compliance for those that already qualify for these agents and to increase the probability of enhancing the quality and quantity of life. Dietary supplements do not have favorable data currently to espouse their utilization to prevent lethal prostate cancer but may have an ancillary role in mitigating some adverse effects of treatment. Conclusions: Remarkably, heart-healthy lifestyle changes, metrics, and promising repurposed medications known to reduce cardiovascular events, promote longevity, and improve mental health could simultaneously prevent lethal prostate cancer. This serendipitous association provides clinicians and their patients a higher probability of success, regardless of their prostate cancer pathway or circumstance. Full article

Background: Resilience is a cornerstone attribute for nursing students, enabling them to adapt to stressful situations encountered during their educational journey and subsequent healthcare career. Objective: This qualitative study aimed to explore nursing instructors’ experiences promoting resilience among nursing students during clinical education. Methods: Focus groups were conducted with 27 instructors from four nursing colleges in Thailand. Data were analyzed using Braun and Clarke’s inductive thematic analysis approach, guided by the Unitary Caring Science Resilience-Building Model. Results: Two main themes emerged: (1) Challenges to Nursing Students’ Resilience and (2) Support Strategies for Enhancing Resilience. Challenges included bridging theory and practice, upholding confidence in clinical skills, adapting to new clinical environments, and managing expectations. Support strategies encompassed providing comprehensive preparation, fostering open communication, implementing peer support systems, and utilizing reflective practice. Conclusions: The findings highlight the complex interplay of factors affecting nursing students’ resilience and the multifaceted approaches instructors use to support it. This study underscores the need for a holistic approach to nursing education that addresses clinical competence and psychological well-being. Implications include curriculum redesign to bridge the theory–practice gap, enhanced instructor training in mentorship and resilience-building, implementation of comprehensive student support systems, and technology integration to support learning and resilience. Full article

Interventions have been designed to close achievement gaps in Science, Technology, Engineering, and Math (STEM) disciplines and to remedy the “leaky STEM pipeline”. However, there has been little focus on designing complementary interventions that seek to broaden the youth population who “enter the STEM pipeline”. The current work aims to broaden STEM engagement in youth by developing a STEM intervention using unrecognized forms of cultural capital. These novel, basketball-based interventions were designed to engage a naturally occurring population of youth with pre-existing interest in sports but low levels of pre-existing STEM interest, ranging from the 2nd to the 12th grades. These interventions utilized sports as a venue for informal STEM learning across three variations: a single-hour event, a one-day clinic, and a multi-day camp. Participants’ interest in pursuing a STEM career significantly increased across all three variations of the STEM intervention. Notably, these effect sizes were descriptively larger for programs of longer duration and were significantly stronger for students who reported playing basketball prior to the program. The current work introduces a novel STEM education intervention that has been shown to be repeatedly successful in utilizing students’ pre-existing interest in sports as a bridge to STEM engagement. Full article

This review offers a historical overview of the role of women in the modern dental profession, tracing their journey from the earliest pioneers to the present day and highlighting their significant achievements. The second main section presents a narrative analysis of the current situation, focusing on the main challenges faced by female dentists in advancing their careers in clinical practice, academia, and leadership roles. Finally, the discussion connects these issues with the Sustainable Development Goals (SDGs) of the 2030 Agenda and explores support models for women’s empowerment in the health sciences, with a particular emphasis on dentistry. Full article

Objectives: A dentist may assume incorrect working positions throughout their professional career, which can lead to musculoskeletal disorders (MSDs). This study aimed to quantify the prevalence of self-reported MSDs in dentists and the body region most affected, as well as to evaluate the most frequent working position, the area of work and the age group most frequently associated with MSDs. Methods: This is a cross-sectional observational study adhering to the STROBE and CHERRIES guidelines, approved by the local Ethics Committee. An online questionnaire (including the Nordic Musculoskeletal Symptoms Questionnaire) was applied to a convenience sample of Portuguese and Italian dentists. Data analysis was conducted with non-parametric comparisons (IBM© SPSS^® Statistics vs. 28.0, p < 0.05). Results: A total of 341 dentists (170 Portuguese, 171 Italian) aged 18–75 years participated. The prevalence of self-reported MSDs in Portugal and Italy was 78.8% and 81.9%, respectively. The most affected self-reported MSD body regions were the neck (65.3% Portuguese and 61.4% Italian dentists), shoulder (49.4% Portuguese and 39.2% Italian) and lumbar region (52.4% and 39.2%, respectively). The neck region was the one reported to cause the highest work absenteeism. The higher age group (41–50 years and higher) has a higher risk for self-reported MSD. Multivariate analysis highlighted increased practice time as a significant risk factor for MSDs in the previous year in both countries. Age group, practice duration and work position relative to the patient were significantly linked to MSD occurrence and work avoidance. Conclusions: Dentists showed a high prevalence of self-reported MSD despite performing clinical activity mostly seated. It was concluded that dentists older than 40 years and those who have been working for more than 20 years have a higher risk of MSD, and that endodontics is the area where they report feeling more discomfort. Dentists should be encouraged to take more breaks between appointments and regular exercise to prevent the development/progression of MSDs. Full article