Geriatric Medical Education and Training in the United States

Medical education in geriatrics is an important requirement to ready the profession to provide comprehensive health care to the world's and also Taiwan's aging population. The predoctoral curricula and postdoctoral training programs in the United States were developed and supported by government agencies and professional education societies. Geriatric medical education in American medical schools has improved in the past 20 years, yet is still facing many challenges. The purposes of this paper are to review the current progress of, and propose some main principles and policies for the development of geriatric medical education and current progress in the United States. Geriatric medical education should be mandatory to adequately prepare medical students, residents, fellows, and practicing physicians to treat the elderly. The current progress and practice of geriatric medical education at the University of Texas Health Science Center at San Antonio are presented as an example

Students’ Perceptions of Online Learning to Inform Jesuit Education

A small group of faculty, staff, and administrators, known as the Online Learning Community (OLC) were collectively interested in enriching online learning at a Jesuit university. With a culture at this Jesuit and Mercy university driven by face-to-face (F2F) learning, the first step was to assess students’ perceptions of online learning from students who have taken online courses at the university. The survey, guided by best instructor practices in online learning and Jesuit philosophy, traditions, and concepts, was designed to explore students’ perceptions, experiences, and practices in online learning. Students (N=484) self-enrolled in the study and included students from all the colleges in the university and across four campuses. The most notable response in the data was students’ (72%) desire for more online learning opportunities at the host university. The freedom and flexibility afforded in online classes was prevalent in students open-ended statements about online learning but additionally emphasized the importance of instructor qualities of being organized in course delivery, availability, and effective communication skills. In this study, OLC members sought to place students’ perceptions at the core of efforts to inform online learning at this Jesuit and Mercy university. The findings enrich and demonstrate linkages with core Jesuit traditions and concepts

A call to action: A need for initiatives that increase equitable access to COVID-19 therapeutics

Structural racism is endemic in the United States and causes inequitable health outcomes that have been amplified throughout the COVID-19 pandemic. Non-Hispanic Black, Hispanic/Latino, and Native American individuals have been disproportionately affected, and are twice as likely to be hospitalized or die from COVID-19 or related morbidities when compared to White Americans. Social determinants of health inequities contribute to these disparate outcomes, given that minoritized individuals are more likely to occupy essential worker roles and to live in high-density settings. Despite their higher risk of severe COVID-19 illness, racially and ethnically minoritized individuals are less likely to receive potentially lifesaving COVID-19 therapeutics.3 While several state health departments attempted to implement race-conscious interventions and narrow the disparities, these efforts have been met with fallacious claims of ‘reverse racism’ and the reversal of the proposed implementations

DNA repair systems and the pathogenesis of Mycobacterium tuberculosis: varying activities at different stages of infection

Mycobacteria, including most of all MTB (Mycobacterium tuberculosis), cause pathogenic infections in humans and, during the infectious process, are exposed to a range of environmental insults, including the host's immune response. From the moment MTB is exhaled by infected individuals, through an active and latent phase in the body of the new host, until the time they reach the reactivation stage, MTB is exposed to many types of DNA-damaging agents. Like all cellular organisms, MTB has efficient DNA repair systems, and these are believed to play essential roles in mycobacterial pathogenesis. As different stages of infection have great variation in the conditions in which mycobacteria reside, it is possible that different repair systems are essential for progression to specific phases of infection. MTB possesses homologues of DNA repair systems that are found widely in other species of bacteria, such as nucleotide excision repair, base excision repair and repair by homologous recombination. MTB also possesses a system for non-homologous end-joining of DNA breaks, which appears to be widespread in prokaryotes, although its presence is sporadic within different species within a genus. However, MTB does not possess homologues of the typical mismatch repair system that is found in most bacteria. Recent studies have demonstrated that DNA repair genes are expressed differentially at each stage of infection. In the present review, we focus on different DNA repair systems from mycobacteria and identify questions that remain in our understanding of how these systems have an impact upon the infection processes of these important pathogens

Recommendations for a core outcome set for measuring standing balance in adult populations: a consensus-based approach

Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally

Gaming disorder: its delineation as an important condition for diagnosis, management and prevention

Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%–15% among young people in several Asian countries and of 1%–10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11

The effect of mobile retailing effect on consumption experiences: a dynamic perspective

The emerging retail culture is characterized by the extensive use of mobile technologies, high connectivity, ubiquitous computing and contactless technologies, which enable consumers to experience shopping differently. In fact, innovative mobile technologies provide new tools (apps) which are able to separate the moment of purchase from the moment of effective consumption, by allowing consumers to make purchases by mobile phone and collect them at home or at a store (a pick-up boutique or collection point), in addition to the traditional in-store service (purchase in the store and collect/consume in the store). The aim of this paper is to understand the extent to which mobile technologies have an impact on consumer behaviour, with emphasis on the drivers motivating consumers to adopt the consumer experience of mobile shopping. To achieve this goal we used a qualitative approach involving 29 consumers in the Italian market, where mobile shopping is still at an early stage. The findings shed a light on the extent to which consumers are moving from e-channels to mobile channels and take into account the effect of these technological innovations in retail settings from a cognitive standpoint, where studies are limited. The implications for researchers and practitioners are then discussed, with emphasis on retailers need to develop new mobile service competences, and integrate and synthetize physical retail settings with mobile opportunities and functionalities