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Residue studies were conducted in bell pepper crops (green and yellow bell pepper) to ensure the safe use of fenvalerate, profenofos, and novaluron (under open field and protected conditions) in randomized block design (RBD) following three applications at a 10-day interval over two consecutive years, 2021 and 2022. A robust analytical method was developed using quick, easy, cheap, effective, rugged, and safe (QuEChERS) extraction and gas chromatography-tandem mass spectrometry (GC–MS/MS) for the determination of pesticide residues in bell pepper samples. The half-lives for fenvalerate were 2.47–2.87 and 2.50–3.03 days on bell pepper under open field conditions, whereas the corresponding values for bell pepper under protected conditions were 3.84–4.58 and 4.17–4.71 days, during 2021 and 2022, respectively. Profenofos displayed half-lives of 2.03–2.65 and 2.15–2.77 days in open field conditions and 3.05–3.89 and 3.16–3.78 days in protected conditions during 2021 and 2022, respectively. Similarly, novaluron had half-lives of 2.87–3.49 and 3.24–3.75 days under protected conditions in 2021 and 2022, respectively. The maximum residue limits (MRLs) were calculated to be 0.6 mg/kg for fenvalerate, while for profenofos it was 0.7 mg/kg on bell pepper under open field conditions at double doses, at the proposed pre-harvest interval (PHI) of 3 days. Likewise, for bell peppers grown under protected conditions, MRLs at the PHI of 3 days were determined to be 0.8 mg/kg for fenvalerate, 0.3 mg/kg for novaluron, and 1.5 mg/kg for profenofos. A dietary risk assessment study indicated that the percentage of acute hazard index (% aHI) was significantly lower than 100, and hazard quotient (HQ) values were below 1, signifying no acute or chronic risk to consumers. These findings underscore the safety of consuming bell peppers treated with fenvalerate, profenofos, and novaluron under the protected and open field conditions. [ABSTRACT FROM AUTHOR]

The Fall armyworm (FAW), Spodopterafrugiperda, was first reported in a few regions of Burkina Faso in 2017. Since then, it has continued to spread and damage maize crops in the country, thereby threatening food security. This study, conducted three years later, aimed to assess the pest status on major rainy season crops, and the effects of cropping systems, crop diversity, and phenology in 11 localities of Sudanian and Sudano-Sahelian zones in Burkina Faso. Two sampling periods, the first conducted at the beginning of the rainy season and the second at the end of the season, were considered. Maize was the most FAW-infested crop, mainly as monocrops (84–88% of surveyed fields). Sorghum, pearl millet, cowpeas, and peanuts were the secondary infested crops, more infested when intercropped with maize. Maize fields were more FAW-affected in the Sudanian zone, whereas the secondary infested crops were significantly more affected in the Sudano-Sahelian zone. The highest field infestation rates were recorded during the second survey period, coinciding in most cases (> 90%) with the flowering and post-flowering of maize. Then, FAW attacks were found in vegetative, flowering, and post-flowering cereal organs. Despite the technical recommendations, most farmers (57.30 ± 10.34 and 66.78 ± 6.74% in the Sudanian and Sudano-Sahelian zones, respectively) did not apply insecticide in infested maize fields. Thus, in 3 years, the FAW has become an important pest of cereals, specifically maize, in the main agricultural zones of Burkina Faso. These results should be taken into account to develop effective control actions against FAW. [ABSTRACT FROM AUTHOR]

Background: Decision aids have been shown to be effective in assisting the decision-making process in healthcare settings. This study aimed to examine the feasibility and acceptability of a linguistically appropriate printed decision aid for cervical cancer screening in South Asian women and to preliminarily estimate its effects on decisional conflicts, clarity of values, risk perception, the screening decision and screening uptake. Methods: This was a pilot randomised controlled trial. Forty-eight South Asian women aged 25 to 64 years were recruited and allocated to either the intervention group or control group. The participants in the intervention group read a linguistically appropriate printed decision aid. Results: All of the participants in the intervention group agreed that the decision aid was useful in aiding their decision-making. These participants showed significantly greater improvement in decisional conflicts, clarity of values and risk perceptions than those in the control group (all p < 0.05). The screening uptake rate was significantly higher in the intervention group than in the control group (p < 0.001). Conclusions: The decision aid was feasible and acceptable among South Asian women, and it resulted in reduced decisional conflict and increased screening uptake compared with usual care. To improve the convenience of using decision aids, they could be developed in various forms, such as printed and mobile application forms, to meet individual requirements. Trial Registration: The trial was registered at the Chinese Clinical Trial Registry on 23 October 2021 (ChiCTR2100052225). [ABSTRACT FROM AUTHOR]

Purpose of Review: This review seeks to integrate scholarly discussions of nonconsensual medicalized genital procedures, combining insights from the literature on obstetric violence with critiques based on children's rights. In both literatures, it is increasingly argued that such interventions may constitute, or be experienced as, violations of patients' sexual boundaries, even if performed without sexual intent. Recent Findings: Within the literature on obstetric violence, it is often argued that clinicians who perform unconsented pelvic exams (i.e., for teaching purposes on anesthetized patients), or unconsented episiotomies during birth and labor, thereby violate patients' bodily integrity rights. Noting the intimate nature of the body parts involved and the lack of consent by the affected individual, authors increasingly characterize such procedures, more specifically, as sexual boundary violations or even "medical sexual assault." Separately, critics have raised analogous concerns about medically unnecessary, nonconsensual genital cutting or surgery (e.g., in prepubescent minors), such as ritual "nicking" of the vulva for religious purposes, intersex genital "normalization" surgeries, and newborn penile circumcision. Across literatures, critics contend that the fundamental wrong of such procedures is not (only) the risk of physical or emotional harm they may cause, nor (beliefs about) the good or bad intentions of those performing or requesting them. Rather, it is claimed, it is wrong as a matter of principle for clinicians to engage—to any extent—with patients' genital or sexual anatomy without their consent outside of certain limited exceptions (e.g., is not possible to obtain the person's consent without exposing them to a significant risk of serious harm, where this harm, in turn, cannot feasibly be prevented or resolved by any less risky or invasive means). Summary: An emerging consensus among scholars of obstetric violence and of children's rights is that it is unethical for clinicians to perform any medically unnecessary genital procedures, from physical examination to cutting or surgery, without the explicit consent of the affected person. "Presumed" consent, "implied" consent, and "proxy" consent are thus argued to be insufficient. [ABSTRACT FROM AUTHOR]

Multiple aspects of the physiological and nutritional mechanisms involved with silicon (Si) absorption by quinoa plants remain poorly investigated, as well as the best way of supplying this element to crops. Thus, this study aimed at evaluating whether the application of Si increases its uptake by quinoa plants and consequently the use efficiency of N and P, as well as the levels of phenolic compounds in the leaves, crop productivity and the biofortification of grains. For this purpose, the concentration of 3 mmol L−1 of Si was tested, according to the following procedures: foliar application (F), root application in the nutrient solution (R), combined Si application via nutrient solution and foliar spraying (F + R), and no Si application (0). The provision of Si through the leaves and roots promoted the highest uptake of the element by the plant, which resulted in an increased use efficiency of N and P. Consequently, such a higher uptake favored the productivity of grains. The optimal adoption of the application of Si through leaves and roots promoted the highest Si concentration and ascorbic acid content in quinoa grains. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic restricting clinical practice and exacerbating the lack of medical staff. There is currently a lack of young residents who are deciding on further training in gynecology and obstetrics.Design: review and prospective, cross-sectional study.Setting: the aim of this study was to investigate if structured mentoring programs can counteract this deficiency.Population: medical students took part from Germany in the clinical phase.Methods: An anonymous questionnaire was developed and distributed to students from January to October 2020. Epidemiological data, questions about mentoring experiences, necessity and their expected influence on career planning were collected and statistically evaluated.Main Outcome Measures: structured mentoring-programs can influence the choice of subject. In particular, men are still underrepresented. Research on the topic of mentoring during in the field of gynaecology and obstetrics is completely lacking.Results: A representative number of 927 medical students took part in the survey. 22% (170/906) of the students had already participated in a mentoring program with a significantly higher proportion of men (69%; 117/170; p < 0.001). Of these, 94% (453/170) said this was helpful. 6% (55/906) wanted to pursue a career in gynecology and obstetrics. When asked about their appreciation for structured mentoring programs in gynecology and obstetrics, 95% (880/906) would participate and 94% agreed (871/906) that this could have an impact on their choice of specialist and career planning.Conclusions: An active provision of mentoring programs and more content can be a way of counteracting the shortage of residents in gynecology and obstetrics. [ABSTRACT FROM AUTHOR]

Analyzation of the use of Mobile Health (mHealth) applications in different user groups in order to evaluate the potential that mHealth provides for the prevention of non-communicable diseases (NCD). Cross-sectional online survey with 1119 participants in Switzerland. Forty percent used mHealth applications. Most participants used mHealth to promote their health (70%), influence a specific aspect of their health (59%) and monitor their fitness level (61%). mHealth was used more often by people suffering from NCD (p<0.05) and participants older than fifty years did not use mHealth less than younger participants (p>0.05). Trust in the collected data was high (93%), however, participants rarely relied on scientific recommendation for choosing mHealth applications (14%) and only the minority discussed the data with a physician (19%). The majority saw advantages in using mHealth for the prevention of NCD (62%) and providing patients with the possibility to control their lifestyle changes (59%). mHealth is used across all age groups and significantly more often by people suffering from NCD. However, the collected data is not evaluated systematically. We suggest the inclusion of mHealth into the health care plan to increase patient empowerment to beneficially affect the development of NCD. [ABSTRACT FROM AUTHOR]

The complement system is a vital component of the innate immune system, though its role in bacteremia is poorly understood. We present complement levels in Staphylococcus aureus bacteremia (SAB) and Gram-negative bacteremia (GNB) and describe observed associations of complement levels with clinical outcomes. Complement and cytokine levels were measured in serum samples from 20 hospitalized patients with SAB, 20 hospitalized patients with GNB, 10 non-infected hospitalized patients, and 10 community controls. C5a levels were significantly higher in patients with SAB as compared to patients with GNB. Low C4 and C3 levels were associated with septic shock and 30-day mortality in patients with GNB, and elevated C3 was associated with a desirable outcome defined as absence of (1) septic shock, (2) acute renal failure, and (3) death within 30 days of bacteremia. Low levels of C9 were associated with septic shock in patients with GNB but not SAB. Elevated IL-10 was associated with increased 30-day mortality in patients with SAB. Complement profiles differ in patients with SAB and those with GNB. Measurement of IL-10 in patients with SAB and of C4, C3, and C9 in patients with GNB may help to identify those at higher risk for poor outcomes. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Latin America is the scenario of great inequalities where about 32 million human beings live with diabetes. Through this review, we aimed at describing the current state of the prevalence, awareness, treatment, and control of diabetes mellitus and completion of selected guidelines of care across Latin America and identify opportunities to advance research that promotes better health outcomes.Recent Findings: The prevalence of diabetes mellitus has been consistently increasing across the region, with some variation: higher prevalence in Mexico, Haiti, and Puerto Rico and lower in Colombia, Ecuador, Dominican Republic, Peru, and Uruguay. Prevalence assessment methods vary, and potentially underestimating the real number of persons with diabetes. Diabetes unawareness varies widely, with up to 50% of persons with diabetes who do not know they may have the disease. Glycemic, blood pressure, and LDL-C control and completion of guidelines to prevent microvascular complications are not consistently assessed across studies, and the achievement of control goals is suboptimal. On the other hand, multiple interventions, point-of-care/rapid assessment tools, and alternative models of health care delivery have been proposed and tested throughout Latin America. The prevalence of diabetes mellitus continues to rise across Latin America, and the number of those with the disease may be underestimated. However, some local governments are embedding more comprehensive diabetes assessments in their local national surveys. Clinicians and public health advocates in the region have proposed and initiated various multi-level interventions to address this enormous challenge in the region. [ABSTRACT FROM AUTHOR]

Medical data is one of the most rewarding and yet most complicated data to analyze. How can healthcare providers use modern data analytics tools and technologies to analyze and create value from complex data? Data analytics, with its promise to efficiently discover valuable pattern by analyzing large amount of unstructured, heterogeneous, non-standard and incomplete healthcare data. It does not only forecast but also helps in decision making and is increasingly noticed as breakthrough in ongoing advancement with the goal is to improve the quality of patient care and reduces the healthcare cost. The aim of this study is to provide a comprehensive and structured overview of extensive research on the advancement of data analytics methods for disease prevention. This review first introduces disease prevention and its challenges followed by traditional prevention methodologies. We summarize state-of-the-art data analytics algorithms used for classification of disease, clustering (unusually high incidence of a particular disease), anomalies detection (detection of disease) and association as well as their respective advantages, drawbacks and guidelines for selection of specific model followed by discussion on recent development and successful application of disease prevention methods. The article concludes with open research challenges and recommendations. [ABSTRACT FROM AUTHOR]

Technology adoption literature generally focuses on behavioral and structural changes necessary for successful adoption. Little explored in that literature is the factors impacting the level of adoption which will be achieved within the organization. This healthcare industry research demonstrates that higher levels of technology adoption in organizations require the influences of both internal absorptive capabilities and external institutional pressures impacting the organization. We surveyed U.S. healthcare employees to assess top management beliefs, top management participation, absorptive capacity, institutional pressures, and level of electronic medical records (EMR) adoption in clinics and hospitals. Our results indicate no direct influence of mimetic and coercive pressures on the level of EMR adoption. Normative and mimetic pressures indirectly influence EMR adoption level through top management participation. Absorptive capacity enhances top management beliefs and participation associated with EMR adoption process, resulting in higher levels of EMR adoption in U.S. hospitals. [ABSTRACT FROM AUTHOR]

Background: Mobile- and Internet-delivered (collectively, digital) interventions are widely used by persons with diabetes (PWD) to assist with self-management and improve/maintain glycemic control (hemoglobin A1c [A1c]). However, evidence concerning the acceptance and benefits of such interventions among disadvantaged/vulnerable PWD is still quite limited.Purpose Of Review: We reviewed studies published from 2011-April 2019 evaluating the impact of diabetes self-management interventions delivered via mobile device and/or Internet on glycemic control of disadvantaged/vulnerable adults with type 2 diabetes (T2D). Included studies reported ≥ 50% of the sample having a low socioeconomic status and/or being a racial/ethnic minority, or living in a rural setting or low-/middle-income country (LMIC). We identified 21 studies evaluating a digital intervention among disadvantaged/vulnerable PWD.Recent Findings: Although many digital interventions found within-group A1c improvements (16 of 21 studies), only seven of the seventeen studies with a control group found between-group differences in A1c. Three studies found reductions in emergency room (ER) visits and hospitalizations. We synthesize this information, and provide recommendations for increasing access, and improving the design and usability of such interventions. We also discuss the role of human support in digital delivery, issues related to study design, reporting, economic value, and available research in LMICs. There is evidence suggesting that digital interventions can improve diabetes control, healthcare utilization, and healthcare costs. More research is needed to substantiate these early findings, and many issues remain in order to optimize the impact of digital interventions on the health outcomes of disadvantaged/vulnerable persons with diabetes. [ABSTRACT FROM AUTHOR]

Purpose: African-Americans have prostate cancer mortality rates that are double their White counterparts. To reduce prostate cancer disparities, it is suggested that men engage in shared decision making about prostate cancer screening with their healthcare provider after learning about the benefits and harms of these screenings. While researchers have developed decision aids to support African-American's screening decisions, there is some uncertainty whether these aids lead to shared decision making. The goal of the current study was to investigate the efficacy of iDecide, a computerized decision aid, for promoting African-American men's engagement in shared decision making.Methods: Six months after their use of iDecide, a prostate cancer screening decision aid, 76 participants were surveyed to determine whether they spoke with a provider about screening, what this conversation entailed, and if shared decision making occurred.Results: While iDecide is an effective tool for enhancing African-American's intention to engage in shared decision making, there is no evidence this aid increased their likelihood of discussing prostate cancer with a provider or participation in shared decision making.Conclusion: Future research should employ stronger research designs and assess the various contexts that can affect the relationship between decision-aid use and shared decision making among African-Americans. [ABSTRACT FROM AUTHOR]

Background: Cardiorespiratory fitness (CRF) assessment provides key information regarding general health status that has high clinical utility. In addition, in the sports setting, CRF testing is needed to establish a baseline level, prescribe an individualized training program and monitor improvement in athletic performance. As such, the assessment of CRF has both clinical and sports utility. Technological advancements have led to increased digitization within healthcare and athletics. Nevertheless, further investigation is needed to enhance the validity and reliability of existing fitness apps for CRF assessment in both contexts.Objectives: The present review aimed to (1) systematically review the scientific literature, examining the validity and reliability of apps designed for CRF assessment; and (2) systematically review and qualitatively score available fitness apps in the two main app markets. Lastly, this systematic review outlines evidence-based practical recommendations for developing future apps that measure CRF.Data Sources: The following sources were searched for relevant studies: PubMed, Web of Science®, ScopusTM, and SPORTDiscus, and data was also found within app markets (Google Play and the App Store).Study Eligibility Criteria: Eligible scientific studies examined the validity and/or reliability of apps for assessing CRF through a field-based fitness test. Criteria for the app markets involved apps that estimated CRF.Study Appraisal and Synthesis Methods: The scientific literature search included four major electronic databases and the timeframe was set between 01 January 2000 and 31 October 2018. A total of 2796 articles were identified using a set of fitness-related terms, of which five articles were finally selected and included in this review. The app market search was undertaken by introducing keywords into the search engine of each app market without specified search categories. A total of 691 apps were identified using a set of fitness-related terms, of which 88 apps were finally included in the quantitative and qualitative synthesis.Results: Five studies focused on the scientific validity of fitness tests with apps, while only two of these focused on reliability. Four studies used a sub-maximal fitness test via apps. Out of the scientific apps reviewed, the SA-6MWTapp showed the best validity against a criterion measure (r = 0.88), whilst the InterWalk app showed the highest test-retest reliability (ICC range 0.85-0.86).Limitations: Levels of evidence based on scientific validity/reliability of apps and on commercial apps could not be robustly determined due to the limited number of studies identified in the literature and the low-to-moderate quality of commercial apps.Conclusions: The results from this scientific review showed that few apps have been empirically tested, and among those that have, not all were valid or reliable. In addition, commercial apps were of low-to-moderate quality, suggesting that their potential for assessing CRF has yet to be realized. Lastly, this manuscript has identified evidence-based practical recommendations that apps might potentially offer to objectively and remotely assess CRF as a complementary tool to traditional methods in the clinical and sports settings. [ABSTRACT FROM AUTHOR]

Purpose: To report total fluid intake (TFI) and the intake of different fluid types in adults (≥ 18 years old) from Mexico, Argentina, Brazil and Uruguay. To compare intakes between countries and with recommended adequate intake (AI) of water from fluids.Methods: Cross-sectional data were collected using a validated liquid intake 7-day record (Liq.In7) in populations from Argentina (n = 1089), Brazil (n = 477), Mexico (n = 1677) and Uruguay (n = 554). Population characteristics, including age, gender, body mass index and socioeconomic level were recorded. Mean TFI was compared with the AI of water from fluids set by the USA Institute of Medicine.Results: The lowest TFI was recorded in Mexican women (1748 mL/day) and the highest in Argentinean men (2318 mL/day). Median daily TFI was significantly different between countries; Uruguay and Argentina had higher values than Mexico and Brazil. In the former, plain water contributed to only 25% of TFI, the remainder being predominantly from hot beverages. Approximately, a third of adults did not drink enough fluid to meet the recommended AI. High SSB consumption was reported, which was significantly different between countries (p < 0.05), the highest being in Mexico (median 25-75th percentiles): 531 (300-895 mL/day.Conclusions: This survey highlights the need to increase water consumption and reduce SSB intake in this region to avoid potential associated health risks. These findings may be useful information in monitoring public health policy strategies. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Successful interventions are needed to diagnose and manage type 2 diabetes (T2DM) in Latin America, a region that is experiencing a significant rise in rates of T2DM. Complementing an earlier review exploring diabetes prevention efforts in Latin America, this scoping review examines the literature on (1) policies and governmental programs intended to improve diabetes diagnosis and treatment in Latin America and (2) interventions to improve diabetes management in Latin America. It concludes with a brief discussion of promising directions for future research.Recent Findings: Governmental policies and programs for the diagnosis and treatment of diabetes in different Latin American countries have been implemented, but their efficacy to date has not been rigorously evaluated. There are some promising intervention approaches in Latin America to manage diabetes that have been evaluated. Some of these utilize multidisciplinary teams, a relatively resource-intensive approach difficult to replicate in low-resource settings. Other evaluated interventions in Latin America have successfully leveraged mobile health tools, trained peer volunteers, and community health workers (CHWs) to improve diabetes management and outcomes. There are some promising approaches and large-scale governmental efforts underway to curb the growing burden of type 2 diabetes in Latin America. While some of these interventions have been rigorously evaluated, further research is warranted to determine their effectiveness, cost, and scalability in this region. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B (HBV) induced hepatocellular carcinoma is the greatest cancer health disparity affecting Asian Americans, but the prevalence of screening to detect HBV is suboptimal. Aims: Our aims were to determine the effectiveness of electronic health record (EHR) prompts to increase ordering of HBV tests among primary care providers (PCPs) within an academic health system. Methods: We conducted a randomized, controlled trial between April and June 2011 among 76 PCPs caring for 175 outpatient adults with Chinese or Vietnamese surnames, with appointments with providers and no history of HBV testing. Providers were randomized to either receive an EHR prompt for HBV testing prior to patients' appointments or usual care. Primary outcomes were the proportion of patients (1) whose physician ordered a HBsAg test and (2) who completed testing. Secondary outcomes were (A) test results and (B) whether the physicians followed-up on the results. Results: HBsAg tests were ordered for 36/88 (40.9 %) of the intervention patients and 1/87 (1.1 %) of the control patients [ χ ( df = 1) = 41.48, p < 0.001]. Thirty intervention patients (34.1 %) and no control patients completed the HBsAg test [ χ ( df = 1) = 35.80, p < 0.001]. Four (13.3 %) of the completed tests were HBsAg-positive, 14 (46.7 %) were immune, and 12 (40 %) were unprotected from HBV. Two HBsAg-positive patients were referred to specialists, and 3 unprotected patients were vaccinated for HBV. Conclusions: EHR-based provider prompts significantly increased HBV testing in Chinese and Vietnamese patients when compared to 'usual care.' EHR prompts are a promising intervention that could significantly increase screening for HBV. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to investigate the effect of exogenous complement C3 administration on outcomes of sepsis and identify an optimal time for this therapy. Materials and methods: Colon ascendens stent peritonitis (CASP) was performed to induce sepsis in C57BL/6 mice, with sham-operated mice as control. Human purified C3 (HuC3, 1 mg) was administered via intraperitoneal injection, with 200 µl phosphate-buffered saline as control. Mice were categorized by the initiation time of HuC3 treatment. Survival, bacterial burden, vital organ damages, histology changes, and expression of C3 were compared between the groups. Results: CASP-induced sepsis caused rapid complement C3 depletion and severe organ damage. Vital organs suffered from substantial bacterial loads. Exogenous C3 applied in the early stage of sepsis was associated with attenuated organ injuries, enhanced bacterial clearance, and improved survival. Exogenous C3 application promoted the synthesis of C3 in the early stage of sepsis. It appears that 6 h post-CASP surgery is the optimal time for HuC3 therapy. Conclusion: The study confirmed the positive effect of exogenous C3 on treatment of polymicrobial sepsis. C3 supplementation prior to the appearance of complement depletion could protect vital organs and its administration in the early stage of sepsis should be encouraged . [ABSTRACT FROM AUTHOR]

The parallel expression of activation products of the coagulation, fibrinolysis, and complement systems has long been observed in both clinical and experimental settings. Several interconnections between the individual components of these cascades have also been described, and the list of shared regulators is expanding. The co-existence and interplay of hemostatic and inflammatory mediators in the same microenvironment typically ensures a successful host immune defense in compromised barrier settings. However, dysregulation of the cascade activities or functions of inhibitors in one or both systems can result in clinical manifestations of disease, such as sepsis, systemic lupus erythematosus, or ischemia-reperfusion injury, with critical thrombotic and/or inflammatory complications. An appreciation of the precise relationship between complement activation and thrombosis may facilitate the development of novel therapeutics, as well as improve the clinical management of patients with thrombotic conditions that are characterized by complement-associated inflammatory responses. [ABSTRACT FROM AUTHOR]

Background: To practice Evidence-Based Medicine (EBM), physicians must quickly retrieve evidence to inform medical decisions. Internal Medicine (IM) residents receive little formal education in electronic database searching, and have identified poor searching skills as a barrier to practicing EBM.Objective: To design and implement a database searching tutorial for IM residents on inpatient rotations and to evaluate its impact on residents' skill and comfort searching MEDLINE and filtered EBM resources.Design: Randomized controlled trial. Residents randomized to the searching tutorial met for up to 6 1-hour small group sessions to search for answers to questions about current hospitalized patients.Participants: Second- and 3rd-year IM residents.Measurements: Residents in both groups completed an Objective Structured Searching Evaluation (OSSE), searching for primary evidence to answer 5 clinical questions. OSSE outcomes were the number of successful searches, search times, and techniques utilized. Participants also completed self-assessment surveys measuring frequency and comfort using EBM databases.Results: During the OSSE, residents who participated in the intervention utilized more searching techniques overall (p < .01) and used PubMed's Clinical Queries more often (p < .001) than control residents. Searching "success" and time per completed search did not differ between groups. Compared with controls, intervention residents reported greater comfort using MEDLINE (p < .05) and the Cochrane Library (p < .05) on post-intervention surveys. The groups did not differ in comfort using ACP Journal Club, or in self-reported frequency of use of any databases.Conclusions: An inpatient EBM searching tutorial improved searching techniques of IM residents and resulted in increased comfort with MEDLINE and the Cochrane Library, but did not impact overall searching success. [ABSTRACT FROM AUTHOR]

To evaluate the effectiveness and efficiency of a search strategy to find evidence-based answers to questions related to the possible occupational etiology of diseases. A controlled trial of 70 occupational health physicians and 55 insurance physicians who were asked to answer one out of four ‘occupational disease case-vignettes’ following the steps of evidence-based medicine (EBM). The intervention group were given the search strategy as a tool. The intervention group scored significantly better than the control group in answering the main question of the case-vignette correctly (57% versus 37%) using more adequate search terms. The intervention group scored significantly better regarding satisfaction with the applied search strategy (28% very satisfied versus 8%). We found no differences in time spent in solving the case or in the intention of future practice of EBM. The introduction and application of specific search strategies can have a positive effect on the effectiveness of searching literature. Future initiatives for developing and testing specific search strategies in the field of occupational health should be encouraged. [ABSTRACT FROM AUTHOR]

The article reports on the reforms of internal medicine residency training. The challenges encountered by the educators in redesigning residency programs were described. The different types of ambulatory training which takes place in internal medicine residency program were identified. A description of the curriculum of the Federated Council on Internal Medicine was presented.

Purpose of Review: To review the current literature on use of telehealth at different stages of the hypertension control cascade in sub-Saharan Africa (SSA) and to discuss opportunities to harness technology infrastructure in SSA to improve population-level blood pressure control. Recent Findings: Despite the high burden of hypertension in SAA, strategies to improve awareness, diagnosis, and management are inadequate. In high-income countries, telehealth has increased patient access to high-quality care at reduced costs. Notwithstanding the limited evidence on the use of telehealth at the different stages of the hypertension control cascade in SSA, the few published interventions in this review reported reduction of blood pressure and increase in the proportion of individuals with controlled blood pressure. Summary: Telehealth use across the hypertension control cascade in SSA is promising. These under-resourced settings provide opportunity to better understand the demand for these interventions in order to achieve meaningful clinical outcomes. [ABSTRACT FROM AUTHOR]