Sexual Harassment in Academic Medicine Affects Both Women and Men

MedicalResearch.com Interview with:

Sabine Oertelt-Prigione, MD, MSc Professor (Strategic Chair) of Gender in Primary and Transmural Care Department of Primary and Community Care Radboud University Medical Center

Dr. Oertelt-Prigione

Sabine Oertelt-Prigione, MD, MSc
Professor (Strategic Chair) of Gender in Primary and Transmural Care
Department of Primary and Community Care
Radboud University Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This publication is a part of the WPP (Watch, Protect, Prevent) Study conducted between 2014 and 2017 at Charité – Universitaetsmedizin in Berlin, Germany. The project was designed to achieve three goals: a) acquire information about the prevalence of sexual harassment in academic medicine, b) develop and implement specific preventative measures and c) design and adopt a workplace policy against sexual harassment. The two latter goals have been achieved and this manuscript describes the findings that prompted their adoption.

In our study we carefully dissected the harassment experiences of physicians working in our tertiary referral center. Verbal harassment throughout medical careers appears as a very common phenomenon that almost 70% of women and men experience at some point. Physical harassment is less common. While colleagues appear as the main perpetrators for both sexes, women report more frequently harassment by their superiors. Among the structural factors potentially associated with harassment, we only identified strong hierarchies. 

MedicalResearch.com: What should readers take away from your report?

Response: First, we show that although the perpetrator profiles differ, both women and men in our study sample are significantly affected by sexual harassment. Second, our results display a gradient of harassment experiences and their prevalence, i.e. the verbal and non-physical forms are more common than physical forms. We argue that tolerance of non-physical forms of misconduct will increase the risk for physical forms by fostering a belief of impunity. Third, in our sample, strong hierarchies associated with an increased likelihood of experiencing harassment in both females and males.

Overall, this data shows that sexual harassment is not an action perpetrated by a single individual, but has a systemic dimension, which needs to be addressed through cultural change. Only measures targeting communication culture, formal structures and interactions in academic medicine will lead to change. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: The investigation of sexual harassment is a complicated matter and should be addressed in detail. In order to design effective prevention measures, we need to know exactly what people have experienced. Hence, a simple question such as “Have you ever experienced sexual harassment?” within a statutory survey will most likely not help much in defining further steps.

The connection between communication patterns, hierarchies and harassment was very apparent in our sample and this area needs further investigation.

Last, the fact that men are also significantly affected emphasizes that this is not a women´s issue but a phenomenon that needs to be addressed to improve the working conditions for all healthcare providers.

Disclosures: Sabine Oertelt-Prigione received funding from the German Ministry of Education and Research, the Charité Foundation, the Hans Boeckler Foundation and the Equal Opportunities Program of the City of Berlin. She has provided expert testimony on the issue of sexual harassment to the German Federal Antidiscrimination Agency and the German Parliament. She is a pro-bono expert advisor for ASTIA.

Citation:

Jenner S, Djermester P, Prügl J, Kurmeyer C, Oertelt-Prigione S. Prevalence of Sexual Harassment in Academic Medicine. JAMA Intern Med. Published online October 03, 2018. doi:10.1001/jamainternmed.2018.4859 

Oct 3, 2018 @ 6:20 pm

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Children with Emotional and Behavioral Issues May Benefit From Drumming Lessons

MedicalResearch.com Interview with:
Dr. Marcus Smith PhD Reader in Sport and Exercise Physiology University of Chichester Co-founder, Clem Burke Drumming ProjectDr. Marcus Smith PhD

Reader in Sport and Exercise Physiology
University of Chichester
Co-founder, Clem Burke Drumming Project

MedicalResearch.com: What is the background for this study?

Response: The research group first started to examine rock drumming from a scientific perspective in 1999 through collaboration with Clem Burke, drummer with the iconic band ‘Blondie’. In 2008 the Clem Burke Drumming Project (CBDP) was formed (visit clemburkedrummingproject.org for further information) where academics from different disciplines came together to not only explore the physiological demands of rock drumming but also the potential use of rock drumming as an intervention in research studies. Rock drumming is attractive to the scientist in that it is a unique activity that requires the coordination of multiple limbs to produce the required drumming pattern. Inherent demands relating to timing, tempo and volume must also be met. Therefore, the ability to manipulate these facets of drumming performance in a research setting is very appealing. In relation to potential research populations drumming has a universal fascination regardless of age, gender, culture, language competency and ethnicity. Anecdotal evidence suggests that drumming is a ‘cool’ activity that has a unique ‘language currency’ in terms of stimulating communication within and between those who can and cannot play the drums.

The impetus for our research study came from parents of autistic children contacting us to express their belief that drumming was having a positive effect on their child’s physical and psychological behaviour. A review of the literature showed a range of anecdotal evidence in support of such statements (Freidman 2000) and an increase in empirical drumming based research being undertaken (Bungay 2010). More recent studies have reported psychosocial benefits such as enhanced communication (Maschi et al. 2010; 2012), emotional processing and tension reduction (Flores et al. 2016; Maschi et al. 2010; 2012), group cohesion and connectedness (Blackett et al. 2005), concentration, psychomotor coordination and posture (Chen et al. 2017). The majority of this work was undertaken with adolescents with very little work focused on younger age groups. Continue reading

Helping Soccer Coaches Teach How To ‘Read The Field’

“Girl Playing Soccer” by Bold Content is licensed under CC BY 2.0MedicalResearch.com Interview with:
Craig Pulling. MSc, PGCE, BA (Hons), FHEA
Head of Physical Education
University of Chichester

MedicalResearch.com: What is the background for this study?

Response: Successful perceptual-cognitive skill in team-sports such as football requires players to pick up task-relevant information during the control of action in complex and dynamic situations. It has been proposed that players could perform visual exploratory activity (VEA) to be able to recognise important cues in the playing environment. VEA is defined as:

“A body and/or head movement in which the player’s face is actively and temporarily directed away from the ball, seemingly with the intention of looking for teammates, opponents or other environmental objects or events, relevant to perform a subsequent action with the ball” (Jordet, 2005, p.143).

Research has suggested that VEA is an important facet of skilled performance in youth and adult football. However, it is currently unknown whether such evidence is commensurate with the views of coaches and whether coaching practices are utilised to develop VEA in training.

In order to further current understanding on VEA and coaching practices, the present study developed an online survey to examine:
(i) when VEA should be introduced in coaching;
(ii) how VEA is delivered by coaches and
(iii) how coaches evaluate VEA.

Further, this study aimed to explore whether distinct groups of football coaches existed who differed in their approach to the delivery of VEA training and, if so, whether there were differences in the demographics of the coaches across these differentiated groups.

Continue reading

Medical Residents and Program Directors Have Different Perceptions of New Parent Leave and Breastfeeding Policies

MedicalResearch.com Interview with:

Prof-Lia E. Gracey

Prof. Gracey

Lia E. Gracey, MD, PhD
Department of Dermatology
Baylor Scott & White Health
Austin, Texas 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The co-authors and I were interested in this issue as new parent leave (or the lack thereof) is increasingly being examined in many professions.  As a mother who had children during dermatology residency, I felt the pressure to take a short new parent leave to avoid having to make up time at the end of my training.

I came back to work only 3 ½ weeks after having my first baby. Anecdotally, other new parent residents (both men and women) reported similar concerns and we noticed a lack of data about new parent leave policies in dermatology residency training programs.

We distributed surveys to dermatology residency program directors and residents and were struck by a basic lack of awareness by residents for whether their institution even offered new parent leave.  Less than 50% of surveyed residents were aware of a written new parent leave policy for their residency program, yet over 80% of program directors stated they had a policy in place. We also found discrepancies between resident and program director perceptions of sufficiency of new parent leave and the availability of pumping facilities for breastfeeding mothers.  Continue reading

How Do Students Choose Where To Sit in a Classroom?

MedicalResearch.com Interview with:
“Lecture Hall” by Sholeh is licensed under CC BY 2.0Dr. David P. Smith, NTF, BSc, PhD, SFHEA

Senior Lecturer in Biochemistry / Course Leader MSc Molecular and Cellular Biology and National Teaching Fellow
Sheffield Hallam University, in the UK

MedicalResearch.com: What is the background for this study?

Response: Lectures are not going to go away, when done well they can be an effective method for teaching large groups of students. To make the lecture experience more effective we wanted to find out why students chose to sit in a given location such that we can better interact with them during taught sessions. We also wanted to find out the reasons they made this choice and if this choice of location had an effect on finial attainment (marks).  Continue reading

Parenting Educational Intervention Can Reduce Childhood Obesity

MedicalResearch.com Interview with:

Ian M. Paul, M.D., M.Sc. Professor of Pediatrics and Public Health Sciences Chief, Division of Academic General Pediatrics Vice Chair of Faculty Affairs, Department of Pediatrics Penn State College of Medicine Hershey, PA 17033-0850

Prof. Paul

Ian M. Paul, M.D., M.Sc.
Professor of Pediatrics and Public Health Sciences
Chief, Division of Academic General Pediatrics
Vice Chair of Faculty Affairs, Department of Pediatrics
Penn State College of Medicine
Hershey, PA 17033-0850

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: 20-25% of 2-5 year old children are overweight or obese in the US, and these children have increased risk of remaining overweight across the lifecourse. To date, research efforts aimed at preventing early life overweight have had very limited success.

In our randomized clinical trial that included 279 mother-child dyads, a responsive parenting intervention that began shortly after birth significantly reduced body mass index z-score compared with controls at age 3 years. Continue reading

Why Do So Few Women Enter or Complete Surgical Residency?

MedicalResearch.com Interview with:

Erika L. Rangel, MD,MS Instructor, Harvard Medical School Trauma, Burn and Surgical Critical Care Department of Surgery, Center for Surgery and Public Health  Brigham and Women’s Hospital  Harvard T. H. Chan School of Public Health Boston, Massachusetts

Dr. Rangel

Erika L. Rangel, MD,MS
Instructor, Harvard Medical School
Trauma, Burn and Surgical Critical Care
Department of Surgery, Center for Surgery and Public Health
Brigham and Women’s Hospital
Harvard T. H. Chan School of Public Health
Boston, Massachusetts

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Although women make up half of medical student graduates in 2018, they only comprise a third of applicants to general surgery. Studies suggest that lifestyle concerns and perceptions of conflict between career and family obligations dissuade students from the field.

After entering surgical residencies, women residents have higher rates of attrition (25% vs 15%) and cite uncontrollable lifestyle as a predominant factor in leaving the field. Surgeons face reproductive challenges including stigma against pregnancy during training, higher rates of infertility, need for assisted reproduction, and increased rates of pregnancy complications. However, until recently, studies capturing the viewpoints of women who begin families during training have been limited. Single-institution experiences have described mixed experiences surrounding maternity leave duration, call responsibilities, attitudes of coworkers and faculty, and the presence of postpartum support.

Earlier this year, our group presented findings of the first national study of perspectives of surgical residents who had undergone pregnancy during training. A 2017 survey was distributed to women surgical residents and surgeons through the Association of Program Directors in Surgery, the Association of Women Surgeons and through social media via twitter and Facebook. Responses were solicited from those who had at least one pregnancy during their surgical training.

39% of respondents had seriously considered leaving surgical residency, and 30% reported they would discourage a female medical student from a surgical career, specifically because of the difficulties of balancing pregnancy and motherhood with training (JAMA Surg 2018; July 1; 153(7):644-652).

These findings suggested the challenges surrounding pregnancy and childrearing during training may have a significant impact on the decision to pursue or maintain a career in surgery. The current study provides an in-depth analysis of cultural and structural factors within residency programs that influence professional dissatisfaction.

We found that women who faced stigma related to their pregnancies, who had no formal maternity leave at their programs, and who altered subspecialty training plans due to perceived challenges balancing motherhood with the originally chosen subspecialty were most likely to be unhappy with their career or residency. Continue reading

Few Programs Dedicated To Preventing Mistreatment of Medical Trainees

MedicalResearch.com Interview with:
“Doctors with patient, 1999” by Seattle Municipal Archives is licensed under CC BY 2.0Dr. Laura M. Mazer, MD
Goodman Surgical Education Center
Department of Surgery
Stanford University School of Medicine
Stanford, California

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: There are numerous articles that clearly document the high prevalence of mistreatment of medical trainees. We have all seen and experienced the results of an “I’ll do unto you like they did unto me” attitude towards medical education. Our motivation for this study was to go beyond just documenting the problem, and start looking at what people are doing to help fix it.

Unfortunately, we found that there are comparatively few reports of programs dedicated to preventing or decreasing mistreatment of medical trainees. In those studies we did review, the study quality was generally poor. Most of the programs had no guiding conceptual framework, minimal literature review, and outcomes were almost exclusively learner-reported.

Continue reading

Medical Textbooks Riddled With Undisclosed Conflicts of Interest

MedicalResearch.com Interview with:

Brian J. Piper, PhD, MS Department of Basic Sciences Geisinger Commonwealth School of Medicine Scranton, PA 18509

Dr. Piper

Brian J. Piper, PhD, MS
Department of Basic Sciences
Geisinger Commonwealth School of Medicine
Scranton, PA 18509

MedicalResearch.com: What is the background for this study?

Response: The authors of this study are biomedical scientists, health care providers and educators who teach medical and pharmacy students. It is a standard practice in reputable medical journals like the New England Journal of Medicine to disclose conflicts of interest (CoI). Reputable sources like the Cochrane Library also disclose CoIs and analyze for their potential impact on the evidence base. Unfortunately, textbooks, which can be highly influential in the training of medical professionals, usually do not disclose their conflicts of interest.

A prior study in this quantitative bioethics area found that more than one-quarter of a team-authored pharmacology textbook, Goodman and Gilman’s Pharmacological Basis of Therapeutics, had an undisclosed patent (PLoS One, 2015; 10: e0133261).  The goal of this investigation was to determine whether there were undisclosed CoIs in textbooks used in the training and as a reference for allopathic physicians, osteopathic physicians, dentists, pharmacists, nurses and other allied healthcare providers.  Continue reading

Most Pediatricians are Women, But Men’s Opinions are Valued More

MedicalResearch.com Interview with:

Julie Silver, MD Associate Professor and Associate Chair Department of Physical Medicine and Rehabilitation at Harvard Medical School and staff physician at Massachusetts General Brigham and Women’s and Spaulding Rehabilitation Hospitals

Dr. Silver

Julie Silver, MD
Associate Professor and Associate Chair
Department of Physical Medicine and Rehabilitation at Harvard Medical School and
Staff physician at Massachusetts General
Brigham and Women’s and Spaulding Rehabilitation Hospitals 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are many documented disparities for women in medicine that include promotion and compensation. For physicians in academic medicine, both promotion and compensation may be directly or indirectly linked to publishing. Similarly, opportunities that stem from publishing such as speaking engagements, may be affected by a physician’s ability to publish.

For more than twenty years, there have been reports of women being underrepresented on journal editorial boards and gaps in their publishing rates. For example, a report titled “Is There a Sex Bias in Choosing Editors?” by Dickersin et al was published in JAMA in 1998 and made a compelling case for bias. Moreover, the authors noted that “a selection process favoring men would have profound ramifications for the professional advancements and influence of women”. Despite a steady stream of reports over the years, gaps have not been sufficiently addressed, and in 2014 Roberts published an editorial in Academic Psychiatry titled “Where Are the Women Editors?”. The 2017 review by Hengel titled “Publishing While Female” highlights many of the gaps, disparities and barriers for women in medicine.

Conventional reasons for disparities, such as there are not enough women in the pipeline or women do not want to conduct research or pursue leadership positions, are simply not valid. Therefore, it is important to look at other barriers, such as unconscious (implicit) bias that may affect the editorial process.

In this study, we analyzed perspective type articles from four high impact pediatric journals. We selected pediatrics, because most pediatricians are women, and therefore there are plenty of highly accomplished women physicians. We found that women were underrepresented among physician first authors in all of the journals (140 of 336 [41.7%]).

We also found that underrepresentation was more pronounced in article categories that were described as more scholarly (range, 15.4%-44.1%) versus narrative (52.9%-65.6%).  Continue reading

Visual Problems Common in Children with Dyslexia

MedicalResearch.com Interview with:

Aparna Raghuram, OD, PhD Optometrist, Department of Ophthalmology Instructor, Harvard Medical School

Dr. Raghuram

Aparna Raghuram, OD, PhD
Optometrist, Department of Ophthalmology
Instructor, Harvard Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Developmental dyslexia is a specific learning disability of neurobiological origin whose core cognitive deficit is widely believed to involve language (phonological) processing. Although reading is also a visual task, the potential role of vision has been controversial, and experts have historically dismissed claims that visual processing might contribute meaningfully to the deficits seen in developmental dyslexia.

Nevertheless, behavioral optometrists have for decades offered vision therapy on the premise that correcting peripheral visual deficits will facilitate reading. Yet there is a surprising dearth of controlled studies documenting that such deficits are more common in children with developmental dyslexia, much less whether treating them could improve reading.

In the present study, we simply assessed the prevalence and nature of visual deficits in 29 school aged children with developmental dyslexia compared to 33 typically developing readers. We found that deficits in accommodation 6 times more frequent in the children with developmental dyslexia and deficits in ocular motor tracking were 4 times more frequent.

In all, more than three-quarters of the children with developmental dyslexia had a deficit in one or more domain of visual function domain compared to only one third of the typically reading group.

Continue reading

Thousands of Students Sneak JUUL To Use School Hours

MedicalResearch.com Interview with:

Jon-Patrick Allem, Ph.D., M.A. Research Scientist Keck School of Medicine of USC

Dr. Allem

Jon-Patrick Allem, Ph.D., M.A.
Research Scientist
Keck School of Medicine of USC

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by JUUL? 

Response: The JUUL vaporizer is the latest advancement in electronic cigarette technology, delivering nicotine to the user from a device about the size and shape of a thumb drive.

JUUL has taken the electronic cigarette market by storm experiencing a year-over-year growth of about 700 percent.

In our most recent study, we wanted to document and describe the public’s initial experiences with JUUL. We collected posts to Twitter containing the term “Juul” from April 1, 2017 to December 14, 2017. We analyzed over 80,000 posts representing tweets from 52,098 unique users during this period and used text classifiers (automated processes that find specified words and phrases) to identify topics in posts.

Continue reading

Study Finds Serotonin Boosts Neural Plasticity By Speeding Up Rate of Learning

MedicalResearch.com Interview with:

Kiyohito Iigaya PhD Gatsby Computational Neuroscience Unit and Max Planck UCL Centre for Computational Psychiatry and Ageing Research University College London

Dr. Iigaya

Kiyohito Iigaya PhD
Gatsby Computational Neuroscience Unit and
Max Planck UCL Centre for Computational Psychiatry and Ageing Research
University College London

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Serotonin (5-HT) is believed to play many important roles in cognitive processing, and past experiments have not crisply parsed them.

We developed a novel computational model of mice behavior that follows reinforcement learning principles, which are widely used in machine learning and AI research.

By applying this model to experimental data, we found that optogenetic 5-HT stimulation speeds up the learning rate in mice, but the effect was only apparent on select subset of choices.

Continue reading

Sibling Closeness in Middle School Predicts Differences in College Graduation

MedicalResearch.com Interview with:
“siblings” by Britt Reints is licensed under CC BY 2.0Xiaoran Sun

Department of Human Development and Family Studies
The Pennsylvania State University
University Park, PA 16802.  

MedicalResearch.com: What is the background for this study?

Response: College graduation has significant implications for adult life outcomes including for employment, family formation, and health (IOM & NRC, 2015).

Investigating how sibling differences in college graduation emerge sheds light on why children growing up in the same family sometimes follow diverging paths in adulthood. Our study also responds to the call by researchers interested in policy and practice to conduct longitudinal research investigating the role of early family socialization processes in educational attainment (Pettit, Davis-Kean, & Magnuson, 2009). Despite siblings’ important role in child and adolescent development, previous research has focused on parenting and on the academic outcomes of individual children in the family.

Further, although sibling experiences, including their relationship characteristics and parental differential treatment, have been linked to sibling similarities and differences in domains such as risky behaviors (Slomkowski, Rende, Novak, Lloyd-Richardson, & Raymond, 2005), to date, there has been very little research on the role of sibling experiences in positive development, such as academic achievement.   Continue reading

Physician MOC Status Linked To Better Diabetes Performance Measure

MedicalResearch.com Interview with:
Bradley Gray, PhD
Senior Health Services Researcher
American Board of Internal Medicine

MedicalResearch.com: What is the background for this study?

Response: This study is part of an ongoing effort to improve and validate ABIM’s MOC process through the use of real data that is ongoing here at ABIM.

MedicalResearch.com: What are the main findings? 

Response: The paper examines the association between MOC status and a set of HEDIS process quality measures for internists twenty years past the time they initially certified. An example of one HEDIS performance measure we looked at was percentage of patients with diabetes that had twice annual HbA1c testing. The key findings of the paper are that physicians who maintained their certification had better scores on 5 of 6 HEDIS performance measures than similar physicians who did not maintain their certification.

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Is More Supervision of Medical Residents Always Better for Patient Care?

MedicalResearch.com Interview with:
Kathleen M. Finn MD, MPhil
Christiana Iyasere MD, MBA
Division of General Internal Medicine
Department of Medicine
Massachusetts General Hospital, Boston

MedicalResearch.com: What is the background for this study?

Response: While the relationship between resident work hours and patient safety has been extensively studied, little research evaluates the role of attending supervision on patient safety. Beginning with the Bell Commission there have been increased calls for enhanced resident supervision due to patient safety concerns. At the same time, with the growth of the hospitalist movement more faculty physicians join daily resident work rounds under the assumption that increased supervision is better for patient safety and resident education. However, we know that supervision is a complex balancing act, so we wanted to study whether these assumptions were true. On the one hand patient safety is important, but on the other adult learning theory argues residents need to be challenged to work beyond their comfort level. Importantly, being pushed beyond your comfort level often requires appropriate space between teacher and learner. To investigate the role of attending supervision on patient safety and resident learning we studied the impact of two levels of physician supervision on an inpatient general medical team.

Twenty-two teaching faculty were randomized to either direct supervision of resident teams for patients previously known to the team vs usual care where they did not join rounds but rather discussed the patients later with the team. Faculty participated in both arms of the study, after completing the first arm they then crossed over to the other arm; each faculty member participated in the study for a total of 4 weeks.

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Female Residents Do Not Perceive Cardiology As Conducive To Work-Family Balance

MedicalResearch.com Interview with:

Pamela S. Douglas, MD, MACC, FASE, FAHA Ursula Geller Professor of Research in Cardiovascular Disease Duke University School of Medicine  Durham, NC 27715   

Dr. Douglas

Pamela S. Douglas, MD, MACC, FASE, FAHA
Ursula Geller Professor of Research in Cardiovascular Disease
Duke University School of Medicine
Durham, NC 27715    

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: For any profession to succeed, it needs to attract top talent. We surveyed internal medicine residents to find out what they valued most in their professional development, how they perceived cardiology as field and how these two areas are associated with  their choosing a career in cardiology or another specialty.

We found that trainees were seeking careers that had stable hours, were family friendly and female friendly, while they perceived cardiology to  have adverse work conditions, interfere with family life and to not be diverse. We were able to predict career choice with 89-97% accuracy from these responses; the predictors are mix of things that attract to cardiology and those that are deterrents.

For men, the attractors outnumber the deterrents, for women its just the opposite.

Continue reading

Allergic Rhinitis Can Impair Adolescent Sleep and School Performance

MedicalResearch.com Interview with:

Michael S. Blaiss, MD, FACAAI Executive Medical Director American College of Allergy, Asthma & Immunology Arlington Heights, IL 60005

Dr. Blaiss

Michael S. Blaiss, MD, FACAAI
Executive Medical Director
American College of Allergy, Asthma & Immunology
Arlington Heights, IL 60005

MedicalResearch.com: Is this research important? Why or why not?

Response: There has not been a comprehensive review of how allergic rhinitis impacts the adolescent population. Most studies put adolescents in with children and yet we know that how disease affects adolescents may be dramatically different than children. Adolescents is a difficult enough time with a chronic condition

MedicalResearch.com: What is the key take-home message?

Response: The symptoms associated with nasal and eye allergies can be different in adolescents compared with adults and children and lead to poor quality of life and impair learning in school. Adolescents with AR/ARC may experience difficulties falling asleep, night waking, and snoring, and generally have poorer sleep. Therefore health care providers need to aggressively control the adolescent’s allergic rhinitis.  Continue reading

SKINDER App Teaches Intuitive Visual Diagnosis of Melanoma

MedicalResearch.com Interview with:

SKINDER APP

Image from SKINDER APP

Michael SKolodneyMD, PhD
Section of Dermatology, Department of Medicine
West Virginia University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Melanoma is easily curable if recognized early.   Dermatologists are good at spotting melanomas because they develop an innate sense of how melanomas appear after examining thousands of malignant and benign lesions.  In contrast, most medical students are relatively disadvantaged by their limited dermatology exposure. We felt that too little experience, rather than lack of knowledge of the rules, is the primary barrier to development of pattern-recognition and intuition as a reliable tool for melanoma diagnosis in non-experts.  To remedy this problem, we developed a novel web-based application to mimic the training of a dermatologist by teaching medical students intuitive melanoma diagnosis in a highly condensed period of time.

Our application, which we call Skinder, teaches intuitive visual diagnosis of melanoma by quickly presenting the learner with thousands of benign and malignant skin lesions.  The user makes rapid binary decisions, by swiping right for benign or left for malignant, and receives instant feedback on accuracy. With this application, the learner can amass a mental repository of diagnostic experience in a short amount of time. To determine if intuitive visual diagnosis training is superior to a traditional rule-based approach, we compared our web-based application to a rules based approach, the publicly available INFORMED Skin Education Series.

Medical students were tested on the ability top differentiate melanomas from benign pigmented lesions before and after training with either Skinder of the Informed Skin Education Series. The pre-test mean for the Skinder group was 75% correct, compared to 74.7% correct for the INFORMED group. The post-test mean for the skinder application group was 86.3% correct, compared to 77.5% correct for the INFORMED group which was highly signifcant.

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When Do Organized Activities for Kids Become Too Much?

MedicalResearch.com Interview with:

Dr Sharon Wheeler PhD

Dr Sharon Wheeler PhD Lecturer in Sport, Physical Activity and Health Department of Sport and Physical Activity Faculty of Arts and Sciences Edge Hill University Lancashire

Dr. Wheeler

Lecturer in Sport, Physical Activity and Health
Department of Sport and Physical Activity
Faculty of Arts and Sciences
Edge Hill University
Lancashire

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is well-known that family background and parents’ investment in their children has a big impact on a number of outcomes, including how well people do at school, the jobs they get, and how they spend their leisure time. It is also known that it is middle-class parents who tend to work particularly hard to make sure their children get on in life.

This research starts to question whether parents’ investment in their children’s organised activities is having the desired impact. Parents initiate and facilitate their children’s participation in organised activities as it shows that they are a ‘good’ parent and they hope such activities will benefit their children in both short-term (keeping fit and healthy, developing friendship groups) and long-term ways (getting jobs, having lots of opportunities in the future).

The reality, which has been highlighted in this research, is that while children might experience some of these benefits, a busy organised activity schedule can put considerable strain on parents’ resources and families’ relationships, as well as potentially harm children’s development and well-being.

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Variety of Interventions Can Improve Childhood Self-Regulation Skills

MedicalResearch.com Interview with:
“Children Playing at Swyalana Lagoon” by Doug Hay is licensed under CC BY 2.0Dr Anuja Pandey

Population, Policy and Practice Programme,
UCL Great Ormond Street Institute of Child Health
London UK 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Evidence from longitudinal studies suggests that self-regulation skills can be a powerful predictor of positive health, educational, financial and social outcomes. Hence, self-regulation has received interest as an intervention target and a number of interventions have been evaluated in children and adolescents.

Our study summarised the evidence from 50 rigorously evaluated self-regulation interventions in children and adolescents including 23098 participants. We found that while most interventions were successful in improving self-regulation (66%), some of them did not produce a noticeable change (34%).Curriculum based approach was most commonly used to deliver interventions, and this involved training teachers, who implemented these interventions.  Continue reading

Grouping Students By Abilities Fosters Dependence and Caps Opportunities for Learning

MedicalResearch.com Interview with:
“Classroom” by frankjuarez is licensed under CC BY 2.0Dr Anna Mazenod

Institute of Education
University of London
UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this paper we report baseline findings from a large study of grouping practices in state-funded secondary schools in England. The study seeks to improve our understanding of how students are grouped for their English and mathematics classes, and the potential impact of different grouping practices on student outcomes and experiences of schooling. This paper draws on a survey of 597 teachers and 34 teacher interviews in schools where students are grouped by their attainment for the subject. It focuses on teacher perspectives on teaching and learning in the lower attainment groups.

We found that students in the lower attainment groups were typically constructed as learners who benefit from specific approaches to learning justified through discourses of nurturing and protection. Most teachers felt that students in the lower attainment groups were not able to access learning independently from their teachers in comparison with their peers in the higher attainment groups. Some teachers for example described students in the lower attainment groups as ‘more dependent on people’ and students in the higher attainment groups as ‘independent learners.’

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Physicians Passage of MOC Exam Linked to Fewer State Disciplinary Actions

MedicalResearch.com Interview with:

Dr. Furman S. McDonald MD MPH Lead author of the research and  Senior Vice President for Academic and Medical Affairs American Board of Internal Medicine (ABIM)

Dr. McDonald

Dr. Furman S. McDonald MD MPH
Lead author of the research and
Senior Vice President for Academic and Medical Affairs
American Board of Internal Medicine (ABIM)

MedicalResearch.com: What is the background for this study? Would you briefly explain how the MOC examination works?

Response: To earn Board Certification from the American Board of Internal Medicine (ABIM), doctors take an exam after completing a medical education training program accredited by the Accreditation Council for Graduate Medical Education to demonstrate they have the knowledge to practice in a specialty. Previously, ABIM conducted research that showed that physicians who passed a certification exam were five times less likely to be disciplined by a state licensing board than those who do not become certified.

After becoming board certified, physicians can participate in ABIM’s Maintenance of Certification (MOC) program, which involves periodic assessments and learning activities to support doctors in staying current with medical knowledge through their careers. ABIM has been in conversations across the medical community and many people have expressed interest in whether performance on the MOC exams doctors take is also associated with important outcomes relevant to patients.

For this study, my ABIM colleagues and I studied whether there was any association between Internal Medicine MOC exam performance and disciplinary actions by state licensing boards. We studied MOC exam results and any reported disciplinary actions for nearly 48,000 general internists who initially certified between 1990 and 2003.  Continue reading

Dark Skin Tones May Be Underrepresented in Medical Textbooks

MedicalResearch.com Interview with:

Patricia Louie, MA PhD Student, Department of Sociology University of Toronto Toronto, ON, Canada

Patricia Louie

Patricia Louie, MA
PhD Student, Department of Sociology
University of Toronto
Toronto, ON, Canada 

MedicalResearch.com: What is the background for this study?

 

Response: While most physicians believe that they treat patients equally, research shows that racial inequality pervades the U.S. health care system (Feagin and Bennefield 2014; Williams 2012). Because these inequities persist even after demographic and other socio-economic differences are taken into consideration scholars have started to look at the representation of race in the medical curriculum. The idea is that medical curriculum creates both implicit and explicit connections between race and disease. We build on this body of work by investigating the representation of race (White, Black and Person of Color) and skin tone (light, medium and dark) in the images of four preclinical anatomy textbooks – Atlas of Human AnatomyBates’ Guide to Physical Examination & History Taking, Clinically Oriented Anatomy, and Gray’s Anatomy for Students.  Skin tone is important.

The majority of medical imagery consists of decontextualized images of body parts where skin tone, which may be related to disease presentation, is the only phenotypical marker. If doctors associate light skin tones with White patients, this may also influence how doctors think about who is a “typical” patient, particularly for the type of disease that is shown in that image.

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Kids with Kidney Disease Likely To Experience Lower IQ and Educational Outcomes Into Adulthood

MedicalResearch.com Interview with:

L-R: Kerry Chen, Anita van Zwieten, Madeleine Didsbury, Germaine Wong

L-R: Kerry Chen, Anita van Zwieten, Madeleine Didsbury, Germaine Wong

Dr. Kerry Chen
Centre for Kidney Research, The Kids Research Institute
The Children’s Hospital at Westmead, Sydney School of Public Health,
The University of Sydney
Sydney, New South Wales, Australia

MedicalResearch.com: What is the background for this study?

Response: Chronic kidney disease is a major public health issue, with end-stage disease often requiring a combination of complex medication regimens, dialysis and/or transplant surgery. In children, the major causes of CKD are genetic and congenital. The consequences of CKD in children can be long-term and debilitating especially as they transition into adulthood, affecting their physical, intellectual and emotional well-being.

To better understand these changes, the Kids Health and Wealth Study (KCAD) is the largest longitudinal cohort study of children and adolescents with CKD in Australia and New Zealand. Spread across 5 paediatric nephrology centres so far, the KCAD Study takes a life-course approach to collecting and analysing data pertaining to the interactions between reduced renal function and associated clinical, socio-economic, quality of life, psychological, cognitive and educational outcomes in children, especially as they progress in CKD stage and also as they transition into adulthood.

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