Muslim patients’ expectations and attitudes about Ramadan fasting during pregnancy

ObjectiveTo investigate Muslim women’s attitudes concerning Ramadan fasting during pregnancy and determine how healthcare providers can better serve this population.MethodsA cross‐sectional study targeted Muslim patients with active obstetric records within the University of Michigan Health System who received care at clinics in metro Detroit (MI, USA) during Ramadan in 2013. Patients aged 18–50 years were approached between July 7 and August 15, and asked to complete a written survey on perceptions of fasting, influences on decision making, and healthcare expectations.ResultsAmong the 37 women who completed the survey, 26 (70%) did not fast in their current or most recent pregnancy during Ramadan. Overall, 23 (62%) women believed that fasting was harmful to themselves, their fetus, or both. Seven (19%) women reported consulting others about fasting during pregnancy, with the most influential individuals being Muslim scholars, followed by family/relatives and healthcare providers. The most important characteristics desired in a physician included being respectful of Islamic beliefs and possessing knowledge about Ramadan.ConclusionMost women chose not to fast during pregnancy. Although few consulted healthcare providers, pregnant Muslim women valued their opinions. Healthcare providers need to educate themselves about which topics to discuss with Muslim patients to provide care on an individual basis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135168/1/ijgo321.pd

Rééducation sensitive chez des personnes présentant de l’hypoesthésie tactile et de la névralgie à la main suite à des neuropathies focales

Introduction: Les neuropathies focales (NF) peuvent entraîner de l’hypoesthésie tactile et de la douleur neuropathique spontanée (névralgie). La méthode de rééducation sensitive de la douleur décrite par Spicher et collaborateurs (MRSD) propose un traitement innovant des symptômes sensitifs des NF. Objectifs : Chez des patients présentant une hypoesthésie tactile et de la névralgie à la main découlant d’une NF : 1) Décrire l’utilisation de la MRSD, 2) Vérifier son applicabilité, 3) Vérifier s’il y a une corrélation entre la durée requise de traitement et les caractéristiques cliniques initiales (hypoesthésie tactile, intensité douleur) des patients. 4) Décrire les changements dans l’hypoesthésie tactile et la douleur suite à la MRSD, et 5) Vérifier s’il y a une corrélation entre ces changements de sensibilité tactile et de la douleur. Méthodologie: Une étude par série de cas rétrospective a été effectuée à partir des données de patients collectées au Centre de Rééducation Sensitive de Fribourg (Suisse) entre juillet 2004 et Octobre 2018. Résultats: Sur 58 patients inclus dans l’étude, 42 ont complété la MRSD avec une durée requise moyenne de traitement de 124 ±104 jours. Cette durée de traitement était corrélée (rSpearman=.395) avec la sévérité des symptômes sensitifs (hypoesthésie tactile, douleur) avant la thérapie. On observe une diminution importante (p<.001) de l’hypoesthésie tactile et de la douleur entre le début et la fin du traitement. La diminution de l’hypoesthésie était modérément corrélée (rSpearman=.336) avec la diminution de la douleur. Conclusion: La MRSD est applicable au traitement de l’hypoesthésie tactile avec névralgie à la main découlant d’une NF.Introduction: Focal neuropathies (FN) can lead to tactile hypoesthesia and spontaneous neuropathic pain (neuralgia). The Somatosensory Rehabilitation Method described by Spicher and collaborators (SRM) proposes an innovative approach to treating sensory symptoms in patients with FN. Objectives: In patients with tactile hypoesthesia and hand neuralgia arising from FN: 1) Describe the use of SRM, 2) Verify its applicability, 3) Determine if there is a correlation between the duration of treatment and patients’ clinical characteristics (tactile sensitivity and pain intensity) before therapy. 4) Describe changes in tactile hypoesthesia and pain measures subsequent to treatment with SRM, and 5) Determine if there is a correlation between changes in tactile sensitivity and changes in pain intensity in patients treated with SRM. Methodology: A retrospective case series study was carried out using data from patients admitted to the Somatosensory Rehabilitation Centre of Fribourg (Switzerland) from July 2004 and October 2018. Results: Of 58 patients included in the study, 42 completed SRM until the end of the therapy with an average duration of treatment of 124 ± 104 days. The duration of treatment was moderately correlated (rSpearman= 0.395) with the severity of sensory symptoms (tactile hypoesthesia and pain intensity) before therapy. There was a significant decrease (p <.001) in tactile hypoesthesia and pain intensity between the beginning and the end of treatment. The decrease in tactile hypoesthesia was moderately correlated (rSpearman=0 .336) with the decrease in pain. Conclusion: SRM can be used for treating tactile hypoesthesia and hand neuralgia arising from FN

Contemporary issues in women’s health

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135468/1/ijgo3.pd

Contemporary issues in women’s health

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135535/1/ijgo187.pd

The flipped classroom for medical students

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111810/1/tct12328.pd

Improving the medical school–residency transition

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138225/1/tct12576_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138225/2/tct12576.pd

Improving medical students’ competence at breast examination

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135217/1/ijgo173.pd

Evaluation of a simulation‐based curriculum for implementing a new clinical protocol

ObjectiveTo evaluate the implementation of a new clinical protocol utilizing on‐unit simulation for team training.MethodsA prospective observational study was performed at the obstetrics unit of Von Voightlander Women’s Hospital, Michigan, USA, between October 1, 2012 to April 30, 2013. All members of the labor and delivery team were eligible for participation. Traditional education methods and in‐situ multi‐disciplinary simulations were used to educate labor and delivery staff. Following each simulation, participants responded to a survey regarding their experience. To evaluate the effect of the interventions, paging content was analyzed for mandated elements and adherence to operating room entry‐time tracking was examined.ResultsIn total, 51 unique individuals participated in 12 simulations during a 6‐month period. Simulation was perceived as a valuable activity and paging content improved. Following the intervention, the inclusion of a goal time for reaching the operation room increased from 7% to 61% of pages and the proportion of patients entering to operating room within 10 minutes of the stated goal increased from 67% to 85%.ConclusionThe training program was well received, and the accuracy of the communication and the goal set for reaching the operating room improved.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135397/1/ijgo333.pd

Current communication practices between obstetrics and gynecology residency applicants and program directors

Importance: In order to equitably improve the residency application process, it is essential to understand the problems we need to address. Objective: To determine how obstetrics and gynecology (OBGYN) applicants and faculty communicate applicants\u27 interest to residency programs, and how program directors report being influenced by these communications. Design, Setting, and Participants: This survey study was conducted with email surveys of OBGYN application stakeholders in 2022. Included participants were OBGYN applicants, clerkship directors, and residency program directors in medical education associations\u27 email listservs. Exposures: Surveys sent by the American Association of Medical Colleges, Association of Professors of Gynecology and Obstetrics, and Council on Resident Education in Obstetrics and Gynecology. Main Outcomes and Measures: Whether applicants themselves, or faculty on their behalf, communicated to residency programs, and the influence program directors reported placing on these communications for their decision-making. Descriptive statistics and χ2 tests were used to analyze differences. Results: A total 726 of 2781 applicants (26.1%) responded to the survey and were included in analysis (79 of 249 [31.7%] clerkship directors; 200 of 280 [71.4%] program directors). The self-reported racial and ethnic demographics of the 726 applicant respondents were 86 Asian (11.8%), 54 Black (7.4%), 41 Latinx (5.6%), 1 Native Hawaiian or Pacific Islander (0.1%), 369 White (52.2%), 45 with multiple racial identities (6.2%), and 91 (21.5%) preferring not to answer. The majority of applicants (590 [82.9%]) sent communications at some point in the application process. Applicants who identified as White (336 [88.7%]) or Asian (75 [87.2%]) were more likely than those who identified as Black (40 [74.1%]) or Latinx (33 [80.5%]) to reach out to programs (P = .02). There were also differences in type of medical school, with 377 of 427 MD applicants (88.3%), 109 of 125 DO applicants (87.2%), and 67 of 87 International Medical Graduate applicants (77.7%) reporting sending communications (P = .02). Approximately one-third (254 applicants [35.7%]) had faculty reach out to programs on their behalf. White (152 [40.1%]) and Asian (37 [43.0%]) applicants were more likely to have faculty reach out compared with Black (6 [11.1%]) and Latinx (12 [29.3%]) applicants (P = .01). Program directors reported that preinterview communications from faculty they knew (64 [32.2%]) and other program directors (25 [12.6%]) strongly influenced their decisions, and otherwise rarely reported that communications strongly influenced their decisions. Conclusions and Relevance: The current state of communications may increase inequities in residency application processes; differences between faculty communications for applicants from different racial and ethnic backgrounds are particularly concerning given that program directors are more likely to weigh communications from faculty in their decision-making. A centralized, equitable means for applicants to signal their interest to programs is urgently needed

Procedures of recruiting, obtaining informed consent, and compensating research participants in Qatar: findings from a qualitative investigation

Abstract Background Very few researchers have reported on procedures of recruiting, obtaining informed consent, and compensating participants in health research in the Arabian Gulf Region. Empirical research can inform the debate about whether to adjust these procedures for culturally diverse settings. Our objective was to delineate procedures related to recruiting, obtaining informed consent, and compensating health research participants in the extremely high-density multicultural setting of Qatar. Methods During a multistage mixed methods project, field observations and qualitative interviews were conducted in a general medicine clinic of a major medical center in Qatar. Participants were chosen based on gender, age, literacy, and preferred language, i.e., Arabic, English, Hindi and Urdu. Qualitative analysis identified themes about recruitment, informed consent, compensation, and other research procedures. Results A total of 153 individuals were approached and 84 enrolled; the latter showed a diverse age range (18 to 75 years); varied language representation: Arabic (n = 24), English (n = 20), Hindi (n = 20), and Urdu (n = 20); and balanced gender distribution: women (n = 43) and men (n = 41). Primary reasons for 30 declinations included concern about interview length and recording. The study achieved a 74% participation rate. Qualitative analytics revealed key themes about hesitation to participate, decisions about participation with family members as well as discussions with them as “incidental research participants”, the informed consent process, privacy and gender rules of the interview environment, reactions to member checking and compensation, and motivation for participating. Vulnerability emerged as a recurring issue throughout the process among a minority of participants. Conclusions This study from Qatar is the first to provide empirical data on recruitment, informed consent, compensation and other research procedures in a general adult population in the Middle East and Arabian Gulf. This investigation illustrates how potential research participants perceive research participation. Fundamentally, Western ethical research principles were applicable, but required flexibility and culturally informed adaptations.http://deepblue.lib.umich.edu/bitstream/2027.42/109514/1/12910_2013_Article_251.pd