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Objective: To determine if personal health of spine surgeons worldwide influences perceptions, healthcare delivery, and decision-making during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A cross-sectional study was performed by distributing a multidimensional survey to spine surgeons worldwide. Questions addressed demographics, impacts and perceptions of COVID-19, and the presence of surgeon comorbidities, which included cancer, cardiac disease, diabetes, obesity, hypertension, respiratory illness, renal disease, and current tobacco use. Multivariate analysis was performed to identify specific comorbidities that influenced various impact measures. Results: Across 7 global regions, 36.8% out of 902 respondents reported a comorbidity, of which hypertension (21.9%) and obesity (15.6%) were the most common. Multivariate analysis noted tobacco users were more likely to continue performing elective surgery during the pandemic (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.46–4.72; p = 0.001) and were less likely to utilize telecommunication (OR, 0.51; 95% CI, 0.31–0.86; p = 0.011), whereas those with hypertension were less likely to warn their patients should the surgeon become infected with COVID-19 (OR, 0.57; 95% CI, 0.37–0.91; p = 0.017). Clinicians with multiple comorbidities were more likely to cite personal health as a current stressor (OR, 1.32; 95% CI, 1.07–1.63; p = 0.009) and perceived their hospital’s management unfavorably (OR, 0.74; 95% CI, 0.60–0.91; p = 0.005). Conclusion: This is the first study to have mapped global variations of personal health of spine surgeons, key in the development for future wellness and patient management initiatives. This study underscored that spine surgeons worldwide are not immune to comorbidities, and their personal health influences various perceptions, healthcare delivery, and decision-making during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

First aid (FA) skills, including Cardiopulmonary Resuscitation (CPR) are the foundation of first responder care. Best practice guidelines to educate FA trainees are lacking. The current structure of FA training programs is based on pedagogy, derived indirectly from hospital-based and Emergency Medical Services training models. Most FA training programs focus on educating the participant to function as the sole provider of care; however there may be instances when individuals providing FA find themselves suddenly engaged as functioning members of teams caring for an individual in need. Findings indicate that patients are safer and receive higher quality care when providers work as a highly effective team. As a result, teamwork training programs have been integrated into multiple health training programs. Teamwork training has been found to reduce medical errors, promote patient safety, enhance positive patient outcomes, and improve communication in a variety of medical settings; however the impact of team-based training in FA education is unknown. We describe the development of a semester long, undergraduate-level, FA educational course incorporating team-based training. Results of this project may impact the methods by which individuals receive FA education. Further investigation into the use of teamwork training as the foundation for FA training is indicated to determine the outcomes for the acutely ill and injured. [ABSTRACT FROM AUTHOR]

The article discusses the aspects of chaplains in the spiritual beliefs and values of patients and families. Topics include collaborative partnerships of chaplains and clinical ethics consultants (CECs), analysis of pastoral care services in U.S. hospitals, and standards of the Association of Clinical Pastoral Education (ACPE).

Presents a discussion with the leaders of the Gates Foundation's Global Health Program, Gordon Perkin and William Foege. How the Bill & Melinda Gates Foundation has committed money to help prevent and eradicate disease in developing countries; How the monetary gifts have helped revitalize a number of global health initiatives and refocused attention on medical care in developing nations.

The article reports on the hypertension treatment trial, called the Systolic Blood Pressure Intervention Trial (SPRINT), that was halted by U.S. health officials following evidence of more aggressive treatment of high blood pressure.

The article reports on the nearly 15 million dollars in U.S. medical debt owed by about 9,000 people that was written off by British television comedian John Oliver. It reveals the percentage of working age people who struggle to pay medical bills and points out the lack of debt industry regulation. Information is provided on the debt-buying company founded by Oliver, called Cenral Asset Recovery Professionals (CARP), and the transfer of medical debt portfolio to nonprofit RIP Medical Debt.

Relates the author's experience of pediatric rotation work as a first-year family practice resident. Davy, admitted with massive hepatosplenomegaly at 17 months old; Calling in the senior resident after three tries; Means of escape from a nurse; Empathy and sympathy of a complete, well-rounded physician; Never again making a patient suffer because of own weaknesses.

The article discusses the study that was published in "Neurology" which found out that severe deficiency in Vitamin D is linked to a higher risk for dementia.

This article focuses on the health care system in Serbia, which is being rebuilt and reformed after more than ten years of turmoil. Statements by Snezana Simic, former acting Minister of Health in the country are presented. The political and economic struggles faced by Serbia after the breaking up of Yugoslavia, including civil war, United Nations sanctions, international isolation, and a bombing in 1999 by the North Atlantic Treaty Organization. The health care system, which has primary, secondary and tertiary care centers, is described as having potential but being underfunded and inefficient.

The article profiles Brian Day, president of the Canadian Medical Association. Day, a Vancouver, British Columbia-based orthopedic surgeon, is a leading supporter in expanding private health care in Canada. Day believes that Canada's public health system has severely rationed its services and should consider adopting a style similar to France or Germany. Day doesn't favor an American style system, but is looking towards a two-tiered system. Canada has laws banning private insurance coverage for basic health services.

40-year-old Manjit Singh came from Punjab, India, to Seattle in 1985. Then Singh lost his landscaping job and with it his health insurance. Because they are new immigrants, his wife and daughter are not eligible for state-subsidised insurance. Singh has recently started working as a town car driver but the job does not provide insurance and his take-home pay is too little for him to buy coverage on his own.

The US health-care system again appears to be lurching towards crisis. While most US hospitals must provide indigent care, the uninsured are less likely to receive care and the same quality of care than insured patients, according to a 2002 report by the US National Academy of Sciences Institute of Medicine (IOM). How 19% of uninsured people with heart disease and 13% with hypertension did not have a regular health-care provider, the IOM found, and when uninsured patients developed acute cardiovascular disease, they were less likely to receive angiography and revascularisation procedures and more likely to die.But unless the US economy turns around and people grow more confident that they will be able to get jobs with health insurance, health care is likely to become a major political issue in next year's presidential election, especially as the Democrats are beginning to perceive health care as an issue on which President Bush is vulnerable.

Focuses on the agenda of the Republican Party after they regained control of the U.S. Congress following the 2002 elections. Rising health care costs and the number of uninsured as two issues that pose a challenge to Congress; Difficulty that the Republican party will encounter in trying to pass large reforms because of its narrow majority; U.S. President George W. Bush's re-election run and the desire of the Democrats for a prescription drug plan that are reasons a compromise on health care legislation will be reached.

Reports on the proceedings of the 2002 World Congress on Tuberculosis in Washington, D.C. Increased incidence of tuberculosis in Russia and sub-Saharan Africa; Optimism of attendees, who see progress in a global fight against tuberculosis following the recognition of this problem by such international institutions as the World Bank; Details of tuberculosis programs, such as Directly Observed Therapy, Shortcourse.

Focuses on a report by the United States Surgeon General David Satcher, 'Mental Health: Culture, Race, and Ethnicity.' Details of the report on the nation's four main ethnic and racial minorities, African Americans, Hispanic Americans, Asian Americans,and Pacific Islanders; Finding that members of these minorities face barriers that deter them from seeking care or leads to inadequate or inappropriate treatment.

Focuses on the report 'Crossing the quality chasm: a new health system for the 21st century,' released on March 1, 2001 by the United States National Academy of Sciences Institute of Medicine. Criticism of the fragmented and inefficient quality of health care in the U.S.; Problems of equity and cost that persist despite other reforms; Guidelines which the report sets forth.

Reports on the efforts of an activist group in the United States to stop a clinical trial in Latin America involving premature babies with respiratory distress syndrome (RDS). Plans to give some of the babies a placebo even though there are drugs available for the condition; How the test could gain U.S. approval since U.S.-approved treatments are not generally available in developing countries and would not be considered part of the local standard of health; Details of the trial which would test a surfactant treatment.

Finding that physicians in the United States do not have a regular physician themselves. Implications for their health and that of their patients; Preventive care measures including cancer screenings which these individuals fail to obtain; Percentage of those without a regular health-care provider; Types of doctors who were more and less likely to have a regular health care provider; Role of beliefs about health in the decision to obtain health care.

Reports that United States president Bill Clinton ordered that Medicare pay for the costs of routine care of patients participating in clinical trials. Clinton's push for legislation requiring private insurers to start covering care of patients in trials; Opinion that the fear of financial costs of the trials has kept people from enrolling.

Looks at the multi-billion dollar proposal by United States President Bill Clinton aimed at helping Americans without health insurance obtain it. How this proposal replaces Clinton's previously unsuccessful attempt to provide universal health care in 1994; Details of how the plan will expand joint state and federal programs for poor families by spending in small increments; Government aid to those qualified for Medicaid through tax credits and subsidies.

Reports that a lawsuit has been filed against 120 medical centers in the United States for deliberately submitting false billing claims worth more than $1 billion to Medicare in order to obtain reimbursement for treatments with medical devices not covered by the program; Partial disclosure of the suit's allegations; Inclusion of prestigious institutions in the whistleblower lawsuit.

Notes that less than half of United States schizophrenic patients under treatment are being given adequate pharmacological or psychosocial interventions. Study led by Anthony Lehman, Center for Mental Health Services, University of Maryland School of Medicine, Baltimore; Details of survey.

Discusses a report on the last days of 3,357 seriously ill and elderly patients in the United States. The conditions of the patients during their last three days of life; The treatment the patients received; Comments on the US health-care system from Joanne Lynn of the George Washington University Medical Center, Washington D.C.

Objective: To examine the association of predisposing characteristics and enabling characteristics with physical secondary conditions through health practices and health care use in people with spinal cord injury (SCI). Design: Cross-sectional survey mailed to adults in portions of the northeastern and northwestern United States. Participants: Two hundred seventy adults with SCI recruited through durable medical equipment supply companies. Main Outcome Measures: Self-reported health practices, health care use, and physical secondary conditions. Results: In the Andersen behavioral model, F increment tests supported findings that predisposing characteristics accounted for 12% of variance in secondary conditions, enabling characteristics accounted for 16%, and health practices and health care use accounted for another 13%. Path analysis revealed that health care use mediated self-efficacy and interpersonal support. Conclusions: Predisposing characteristics including self-efficacy, enabling characteristics, and health care use are associated with physical secondary conditions in complex ways. More research is needed on measures of health practices and their relation to secondary conditions. [ABSTRACT FROM AUTHOR]