Medical Mentorship Deconstructed: An Analysis and Structural Recommendation for High Value Mentorship

Despite medical school admissions increasing, the numbers of prospective doctors are not enough to address the physician shortage, especially in rural areas. Many of these rural areas, such as California’s San Joaquin Valley (SJV), are impacted by the lack of interest in primary care, aging practitioners, and various other factors; leading to higher rates of death, disability, and chronic disease when compared to urban populations. An important aspect of increasing medical students and physician training from rural areas is utilizing mentorship to foster a continuous supply of rural medical students who plan to serve their communities and residents who decide to remain in rural areas after training. Mentorship in medicine is not a new concept ,with many studies showing that mentorship results in benefits for both the mentee and the mentor. Junior physicians who received mentorship were found to have increased skill development, job satisfaction, and career development while mentors who partook in mentorship programs also reported higher job satisfaction and increase in retention at their current institutions. Of all the obstacles that physicians experienced in their pursuit of receiving mentorship, access to health professionals who could serve as potential mentors, was listed as the most common and difficult barrier to overcome; with factors such as race and gender not significantly affecting the level of satisfaction of those who received mentorship. Although there are previous studies on the impact of mentorship including: 1) retention/supplementation of rural physicians and 2) the importance of mentorship for residents and practicing physicians, studies on high value mentorship for premedical students are lacking. Furthermore, the literature fails to describe best practices on developing and sustaining mentoring relationships. Previously, scholars in the field have described the skills and characteristics of effective mentors. Nonetheless, the topic of mentorship in medicine still remains a contested topic as to the critical time periods for mentorship

Suppression of Leukotriene B4 Generation by Ex-vivo Neutrophils Isolated from Asthma Patients on Dietary Supplementation with Gammalinolenic Acid-containing Borage Oil: Possible Implication in Asthma

Dietary gammalinolenic acid (GLA), a potent inhibitor of 5-lipoxygenase (5-LOX) and suppressor of leukotriene B(4) (LTB(4)), can attenuate the clinical course of rheumatoid arthritics, with negligible side effects. Since Zileuton, also an inhibitor of 5-LOX, attenuates asthma but with an undesirable side effect, we investigated whether dietary GLA would suppress biosynthesis of PMN-LTB(4) isolated from asthma patients and attenuate asthma. Twenty-four mild-moderate asthma patients (16–75 years) were randomized to receive either 2.0 g daily GLA (borage oil) or corn oil (placebo) for 12 months. Blood drawn at 3 months intervals was used to prepare sera for fatty acid analysis, PMNs for determining phospholipid fatty acids and for LTB4 generation. Patients were monitored by daily asthma scores, pulmonary function, and exhaled NO. Ingestion of daily GLA (i) increased DGLA (GLA metabolite) in PMN-phospholipids; (ii) increased generation of PMN-15-HETrE (5-LOX metabolite of DGLA). Increased PMN-DGLA/15-HETrE paralleled the decreased PMN generation of proinflammatory LTB(4). However, the suppression of PMN-LTB4 did not reveal statistically significant suppression of the asthma scores evaluated. Nonetheless, the study demonstrated dietary fatty acid modulation of endogenous inflammatory mediators without side effects and thus warrant further explorations into the roles of GLA at higher doses, leukotrienes and asthma

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Identifying and Addressing the Cultural Experiences/Challenges of Hmong Community and Their Interactions with Western Medicine: A Case Report and Review of Literature

Background: This literature review delves into the intricate relationship between Hmong culture and Western medicine. Originating from Southeast Asia, the Hmong people have a rich history of migration and have settled in various countries, including the United States, where their traditional practices, such as shamanism and herbal medicine, remain deeply rooted. The introduction of Western medicine has brought forth a clash of beliefs, leading to skepticism and resistance. Issues such as spiritual healing, medicinal usage, language barriers, and decision- making processes are explored, highlighting the importance of cultural competence for healthcare providers. Purpose: To identify the most common cultural experiences or challenges within the Hmong community as this group of people interacts and intertwines with Western Medicine Methods: A comprehensive literature review was conducted using google scholar, UpToDate, Lindell Library, and databases such as EBSCO. Studies from within the last five years were used in this research paper. Conclusions: The literature review and case study on Hmong immigrants highlight the importance of cultural sensitivity, effective communication, and collaboration between Western medicine and traditional beliefs. Culturally competent care can encourage trust with Hmong patients, improving treatment compliance and outcomes. Overcoming language barriers through interpreters is crucial. Integrating traditional and Western medicine offers more comprehensive treatment options, and empowering patient autonomy enhances satisfaction and compliance. Educating about Western medicine builds trust. Healthcare policy should consider cultural diversity for equitable services. Embracing cultural differences can lead to a more inclusive and patient-centered healthcare system

COVID-19 Mitigation Behaviors in Hmong Americans

Introduction: The unique sociocultural context of Hmong people in United States has historically contributed to health and public health challenges for this community. This study was among the first to investigate contextual and sociocultural factors associated with COVID-19 illness and mitigation behaviors in Hmong Americans. The goals of this study were to: 1) describe COVID-19 health seeking and mitigation behaviors, and related information, motivation, and behavioral skills among Hmong American adults, and 2) to examine contextual and sociocultural factors that may be associated with masking, social distancing, group gatherings, and vaccination uptake in Hmong Americans. Methods: A cross-sectional web survey was conducted between April 8, 2021, to June 1, 2021, with Hmong Americans aged 18 and over. Descriptive statistics were used to summarize the overall characteristics and COVID-19 related behaviors of Hmong Americans. Chi-square and Fisher’s Exact Test were computed to describe COVID-19 mitigation behaviors by gender and generational status (a marker of acculturation). Results: The sample included 507 participants who completed the survey. Most of the participants reported participating in mitigation interventions to keep themselves safe from COVID-19. Mitigation behavior assessment shows that 88.9% (449 of 505) of the participants masked all the time, 55.3% (270 of 496) maintained 6 feet when leaving home all the time, 68.32% (345 of 505) avoided group gatherings or crowds the last 30 days, 72.3% (366 of 506) avoided public spaces, gatherings or crowds the last 30 days, and 69.17% (350 of 506) received the COVID-19 vaccine. Different patterns of behaviors surfaced for generation and gender. Hmong American women were more likely to avoid family (P=.005) and social gatherings (P=.009) and stay 6 feet from people outside their household (P=.005) compared to men. Third generation individuals were more likely to avoid gatherings of 10 or more (P=.010) and first-generation individuals were more likely to avoid public spaces, gatherings, or crowds (P=.003). Hmong community leaders were social influencers to masking (P=.029), social distancing (P=.022), group gatherings (P=.026), and vaccination (P=.037) for Hmong American men. Government officials and healthcare providers were social influencers for Hmong American women for masking and social distancing. Government officials were social influencers on masking behaviors for first generation individuals (P<.000), family were social influencers on social distancing for second generation individuals (P=.038), and family were social influencers for group gatherings (P=.041) and vaccination uptake (P=.011) in third generation individuals. Participants and their families trying to stay healthy reported seeking care from a medical doctor. However, when trying to prevent and treat COVID-19, participants reported preferring to use Hmong medicine and traditional approaches. Conclusion: Social influences play a significant role in COVID-19 mitigation behaviors including masking, social distancing, avoiding group gatherings, and vaccination uptake. Hmong Americans reported using both Western medical and traditional Hmong approaches to manage and treat symptoms of COVID-19. These findings have implications for identifying and implementing culturally appropriate health messages, future public health interventions, policy development, and ongoing research with this population

COVID-19 mitigation behaviors among English-Speaking Hmong Americans.

BackgroundCOVID-19 mitigation strategies such as masking, social distancing, avoiding group gatherings, and vaccination uptake are crucial interventions to preventing the spread of COVID-19. At present, COVID-19 data are aggregated and fail to identify subgroup variation in Asian American communities such as Hmong Americans. To understand the acceptance, adoption, and adherence to COVID-19 mitigation behaviors, an investigation of Hmong Americans' contextual and personal characteristics was conducted.MethodsThis study aims to describe COVID-19 mitigation behaviors among Hmong Americans and the contextual and personal characteristics that influence these behaviors. A cross-sectional online survey was conducted from April 8 till June 1, 2021, with Hmong Americans aged 18 and over. Descriptive statistics were used to summarize the overall characteristics and COVID-19 related behaviors of Hmong Americans. Chi-square and Fisher's Exact Test were computed to describe COVID-19 mitigation behaviors by gender and generational status (a marker of acculturation).ResultsThe sample included 507 participants who completed the survey. A majority of the Hmong American participants in our study reported masking (449/505, 88.9%), social distancing (270/496, 55.3%), avoiding group gatherings (345/505, 68.3%), avoiding public spaces (366/506, 72.3%), and obtaining the COVID-19 vaccination (350/506, 69.2%) to stay safe from COVID-19. Women were more likely to socially distance (P = .005), and avoid family (P = .005), and social gatherings (P = .009) compared to men. Social influence patterns related to mitigation behaviors varied by sex. Men were more likely compared to women to be influenced by Hmong community leaders to participate in family and group gatherings (P = .026), masking (P = .029), social distancing (P = .022), and vaccination uptake (P = .037), whereas healthcare providers and government officials were social influencers for social distancing and masking for women. Patterns of social distancing and group gatherings were also influenced by generational status.ConclusionContextual and personal characteristics influence COVID-19 mitigation behaviors among English speaking Hmong Americans. These findings have implications for identifying and implementing culturally appropriate health messages, future public health interventions, policy development, and ongoing research with this population