Consistency Between State Medical License Applications and Recommendations Regarding Physician Mental Health.
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SUBMITTER: Saddawi-Konefka D
PROVIDER: S-EPMC8132137 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC10498334 | biostudies-literature
Project description:BackgroundThroughout the COVID-19 pandemic, there has been worldwide debate regarding whether open surgery should be performed in preference to laparoscopic surgery due to the theoretical higher risk of viral aerosolization by the release of pneumoperitoneum. We aimed to assess the consistency of national and international surgical society recommendations regarding the choice of surgical approach; assess the quality of evidence of viral emission in surgical aerosol; and assess the quality of evidence comparing aerosol generation by different surgical energy devices.MethodsA systematic review of PubMed, Medline, Embase and Cochrane databases was performed. Three search strategies were employed. Twenty-eight studies were included in the final analysis and quality appraised. Confidence in review findings was assessed using the GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) tool.ResultsWorldwide recommendations regarding open versus laparoscopic surgery are consistent, with a majority recommending that surgical approach is decided on a case-by-case, risk minimization approach. There is limited, low-quality evidence that viral particles can be emitted in surgical aerosol. There is a paucity of literature on the quantity of aerosol produced by different surgical energy devices, and no evidence to support the use of certain surgical instruments to minimize aerosol production.ConclusionsThere is considerable consistency among worldwide recommendations regarding the choice of surgical approach, although the evidence base is lacking. To inform clinical recommendations, further research examining viral emission, transmission, infectivity and amount of surgical aerosol produced is required.
| S-EPMC8250243 | biostudies-literature
Project description:BackgroundState medical licensing boards ask program directors (PDs) to complete verification of training (VOT) forms for licensure. While residency programs use Accreditation Council for Graduate Medical Education core competencies, there is no uniform process or set of metrics that licensing boards use to ascertain if academic competency was achieved.ObjectiveWe determined the performance metrics PDs are required to disclose on state licensing VOT forms.MethodsVOT forms for allopathic medical licensing boards for all 50 states, Washington, DC, and 5 US territories were obtained via online search and reviewed. Questions were categorized by disciplinary action (investigated, disciplined, placed on probation, expelled, terminated); documents placed on file; resident actions (leave of absence, request for transfer, unexcused absences); and non-disciplinary actions (remediation, partial or no credit, non-renewal, non-promotion, extra training required). Three individuals reviewed all forms independently, compared results, and jointly resolved discrepancies. A fourth independent reviewer confirmed all results.ResultsMost states and territories (45 of 56) accept the Federation Credentials Verification Service (FCVS), but 33 states have their own VOT forms. Ten states require FCVS use. Most states ask questions regarding probation (43), disciplinary action (41), and investigation (37). Thirty-four states and territories ask about documents placed on file, 36 ask about resident actions, and 7 ask about non-disciplinary actions. Eight states' VOT forms ask no questions regarding resident performance.ConclusionsAmong the states and territories, there is great variability in VOT forms required for allopathic physicians. These forms focus on disciplinary actions and do not ask questions PDs use to assess resident performance.
| S-EPMC6570450 | biostudies-literature
Project description:There is a national opioid misuse and overdose crisis. Consensus guidelines seek to inform practice and reduce risk; however, effect on clinician attitudes and knowledge remains unclear.We surveyed 228 medical students and physicians in Wisconsin to assess their knowledge regarding at-risk patients, alternatives to opioids, and best treatment practices for opioid addiction. We also assessed attitudes about prescribing naloxone, relapse likelihood, and responsibility for the crisis.Enhancement of opioid-related education is both necessary to address knowledge gaps and desired by students and physicians.
| S-EPMC6098698 | biostudies-literature
Project description:BACKGROUND:Physician health program websites in 23 states provide many descriptions of possible physician impairment. This study sought to determine whether these descriptions are so broad that almost everyone might potentially be suspected of being impaired given these descriptions. METHODS:The authors randomly selected 25 descriptions of impairment and then presented them anonymously online to members of the general population in full-time employment through Amazon's Mechanical Turk (N = 199). Half of the respondents randomly received a narrowly worded version, and half received a broadly worded version of the survey questions. RESULTS:In the narrowly worded version of the survey, 70.9% of respondents endorsed at least one description of impairment, and 59.2% endorsed more than one. In the broadly phrased version, 96.9% endorsed at least one description, and 95.8% endorsed more than one. These respondents endorsed a median of 10 out of 25 (40%) descriptions. CONCLUSIONS:These findings call into question whether these descriptions really identify persons with poor performance or who pose a high risk of substantial, imminent harm to self or others in the workplace. They also demonstrate the extent to which these descriptions could potentially be misapplied and brand almost anyone as impaired.
| S-EPMC6107949 | biostudies-literature
Project description:Many adolescents and adults do not seek treatment for mental health symptoms. Smartphone applications (apps) may assist individuals with mental health concerns in alleviating symptoms or increasing understanding. This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. Ten key terms were searched in the Apple iTunes and Google Play stores: mental health, depression, anxiety, schizophrenia, bipolar, trauma, trauma in schools, post traumatic stress disorder (PTSD), child trauma, and bullying. A content analysis of the first 20 application descriptions retrieved per category was conducted. Out of 300 nonduplicate applications, 208 (70%) were relevant to search topic, mental health or stress. The most common purported purpose for the apps was symptom relief (41%; n = 85) and general mental health education (18%; n = 37). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21%; n = 43). Most app descriptions did not include information to substantiate stated effectiveness of the application (59%; n = 123) and had no mention of privacy or security (89%; n = 185). Due to uncertainty of the helpfulness of readily available mental health applications, clinicians working with mental health patients should inquire about and provide guidance on application use, and patients should have access to ways to assess the potential utility of these applications. Strategic policy and research developments are likely needed to equip patients with applications for mental health, which are patient centered and evidence based.
| S-EPMC5335803 | biostudies-literature
Project description:ObjectiveTo examine perceptions of medical doctor behavior in mental health (MH) utilization disparities.Data sourcesSecondary data analyses of the National Comorbidity Survey-Replication and the National Latino and Asian American Study (2001-2003).Study designSample included non-Hispanic whites (NHWs), blacks, Asians, and Latinos. Dependent variables were patient reports of providers' assessment of and counseling on MH and substance abuse (SA) problems, and recommendation for medications or specialty MH care. The initial sample consisted of 9,100 adults; the final sample included the 3,447 individuals who had been asked about MH and SA problems.Principal findingsBivariate analyses indicated that Asians were the least likely to report being assessed, counseled, and recommended medications and specialty care. In multivariate logistic regression analyses, there were no racial/ethnic differences in assessment of MH or SA problems. Compared to NHWs, black patients were less likely to report receiving a medication recommendation. Latinos were more likely to report counseling and a recommendation to specialty care. U.S.-born patients were more likely to report a medication recommendation.ConclusionsPerceptions of provider behavior might contribute to documented disparities in MH utilization. Further research is needed to determine other points in the treatment utilization process that might account for racial/ethnic disparities.
| S-EPMC4450928 | biostudies-literature
Project description:BackgroundDuring the COVID-19 pandemic, contact tracing apps have received a lot of public attention. The ongoing debate highlights the challenges of the adoption of data-driven innovation. We reflect on how to ensure an appropriate level of protection of individual data and how to maximize public health benefits that can be derived from the collected data.ObjectiveThe aim of the study was to analyze available COVID-19 contact tracing apps and verify to what extent public health interests and data privacy standards can be fulfilled simultaneously in the process of the adoption of digital health technologies.MethodsA systematic review of PubMed and MEDLINE databases, as well as grey literature, was performed to identify available contact tracing apps. Two checklists were developed to evaluate (1) the apps' compliance with data privacy standards and (2) their fulfillment of public health interests. Based on both checklists, a scorecard with a selected set of minimum requirements was created with the goal of estimating whether the balance between the objective of data privacy and public health interests can be achieved in order to ensure the broad adoption of digital technologies.ResultsOverall, 21 contact tracing apps were reviewed. In total, 11 criteria were defined to assess the usefulness of each digital technology for public health interests. The most frequently installed features related to contact alerting and governmental accountability. The least frequently installed feature was the availability of a system of medical or organizational support. Only 1 app out of 21 (5%) provided a threshold for the population coverage needed for the digital solution to be effective. In total, 12 criteria were used to assess the compliance of contact tracing apps with data privacy regulations. Explicit user consent, voluntary use, and anonymization techniques were among the most frequently fulfilled criteria. The least often implemented criteria were provisions of information about personal data breaches and data gathered from children. The balance between standards of data protection and public health benefits was achieved best by the COVIDSafe app and worst by the Alipay Health Code app.ConclusionsContact tracing apps with high levels of compliance with standards of data privacy tend to fulfill public health interests to a limited extent. Simultaneously, digital technologies with a lower level of data privacy protection allow for the collection of more data. Overall, this review shows that a consistent number of apps appear to comply with standards of data privacy, while their usefulness from a public health perspective can still be maximized.
| S-EPMC8195202 | biostudies-literature
Project description:BackgroundDespite the potential of digital mental health to provide cost-effective mental health care, its adoption in clinical settings is limited, and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing these perspectives and practices.ObjectiveThis study aims to characterize in depth the perspectives and practices of mental health professionals regarding the implementation of digital mental health and explore the factors affecting such perspectives and practices.MethodsA qualitative study using in-depth semistructured interviews with Portuguese mental health professionals (N=13)-psychologists and psychiatrists-was conducted. The transcribed interviews were thematically analyzed.ResultsMental health professionals deemed important or engaged in the following practices during the implementation of digital mental health: indication evaluation, therapeutic contract negotiation, digital psychological assessment, technology setup and management, and intervention delivery and follow-up. Low-threshold accessibility and professionals' perceived duty to provide support to their clients facilitated the implementation of digital mental health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programs inhibited digital mental health implementation by mental health professionals.ConclusionsThe publication of practice frameworks, development of evidence-based technology, and delivery of structured training seem key to expediting implementation and encouraging the sustained adoption of digital mental health by mental health professionals.
| S-EPMC9044148 | biostudies-literature
Project description:BackgroundSince 2020, physicians and psychotherapists in Germany can prescribe digital mental health services (dMHSs). However, even future healthcare professionals (HCPs), such as medical and psychology students, remain reluctant to use dMHSs, although they are a risk group for mental health issues themselves. Reasons include scepticism and lacking awareness of dMHSs, which can be addressed by acceptance-facilitating interventions (AFIs) such as information strategies. To date, though, little is known about their information needs.MethodsSemi-structured interviews with n = 21 students were conducted between August and September 2021. Students of legal age studying psychology or medicine at a German university could participate. Interview recordings were transcribed verbatim and content-analyzed according to Mayring, using deductive and inductive coding.ResultsMost students reported having little experience with dMHSs. Digital health has barely been raised in their study, even though it was perceived as crucial for personal needs as well as in preparation for their work as HCPs. Students favoured receiving information on and recommendations for dMHSs from their university via, e.g. social media or seminars. Among others, information about data safety, scientific evidence base and application scope were preferred. Additionally, information on costs as well as user reviews seemed to be essential components of information strategies because students were concerned that high costs or low usability would hinder uptake.ConclusionsThe results give first insights on how future HCPs would like to be informed on dMHSs. Future research should focus on systematic variations of AFIs' components mimicking real-world decision scenarios to increase the adoption of dMHSs.
| S-EPMC10226173 | biostudies-literature