25 research outputs found
International Stem Cell Collaboration: How Disparate Policies between the United States and the United Kingdom Impact Research
As the scientific community globalizes, it is increasingly important to understand the effects of international collaboration on the quality and quantity of research produced. While it is generally assumed that international collaboration enhances the quality of research, this phenomenon is not well examined. Stem cell research is unique in that it is both politically charged and a research area that often generates international collaborations, making it an ideal case through which to examine international collaborations. Furthermore, with promising medical applications, the research area is dynamic and responsive to a globalizing science environment. Thus, studying international collaborations in stem cell research elucidates the role of existing international networks in promoting quality research, as well as the effects that disparate national policies might have on research. This study examined the impact of collaboration on publication significance in the United States and the United Kingdom, world leaders in stem cell research with disparate policies. We reviewed publications by US and UK authors from 2008, along with their citation rates and the political factors that may have contributed to the number of international collaborations. The data demonstrated that international collaborations significantly increased an article's impact for UK and US investigators. While this applied to UK authors whether they were corresponding or secondary, this effect was most significant for US authors who were corresponding authors. While the UK exhibited a higher proportion of international publications than the US, this difference was consistent with overall trends in international scientific collaboration. The findings suggested that national stem cell policy differences and regulatory mechanisms driving international stem cell research in the US and UK did not affect the frequency of international collaborations, or even the countries with which the US and UK most often collaborated. Geographical and traditional collaborative relationships were the predominate considerations in establishing international collaborations
Political Priorities, Voting, and Political Action Committee Engagement of Emergency Medicine Trainees: A National Survey
Political Priorities, Voting, and Political Action Committee Engagement of Emergency Medicine Trainees: A National Survey
Trust and gender: An examination of behavior and beliefs in the Investment Game
How does gender influence trust, the likelihood of being trusted and the level of trustworthiness? We compare choices by men and women in the Investment Game and use questionnaire data to try to understand the motivations for the behavioral differences. We find that men trust more than women, and women are more trustworthy than men. The relationship between expected return and trusting behavior is stronger among men than women, suggesting that men view the interaction more strategically than women. Women felt more obligated both to trust and reciprocate, but the impact of obligation on behavior varies.Trust Trustworthiness Gender Expectations
Effect of physician gender and race on simulated patientsâ ratings and confidence in their physicians : A randomized controlled trial
Importance Women and black physicians encounter workplace challenges because of their gender and race. It is unclear whether these individuals are assessed with lower patient satisfaction or confidence ratings compared with white male physicians.
Objective To examine whether physician gender and race affect participant ratings in scenarios in which physician competence is challenged.
Design, Setting, and Participants This randomized trial enrolled a geographically diverse sample of 3592 online respondents in the United States who were recruited from 2 crowdsourcing platforms: Amazon Mechanical Turk (nâ=â1741) and Lucid (nâ=â1851). A 2âĂâ2 factorial design for the gender and race of simulated physicians was conducted between March 9 and July 25, 2018. Participants were excluded before intervention if they were younger than 18 years, were pregnant, or had a history of cancer or abdominal surgical procedures.
Interventions A clinical vignette was presented to the participant with a picture of the emergency department physician. Participants were randomly assigned to physicians with different gender and race, with 823 assigned to black women, 791 to black men, 828 to white women, and 835 to white men. A contradictory diagnosis from an online symptom checker introduced doubt about the clinical diagnosis.
Main Outcomes and Measures A composite outcome (range, 0-100, with 0 representing low patient confidence and satisfaction and 100 representing the maximum on the composite scale) measured participant (1) confidence in the physician, (2) satisfaction with care, (3) likelihood to recommend the physician, (4) trust in the physicianâs diagnosis, and (5) likelihood to request additional tests.
Results Among 3277 adult participants, complete data were available for 3215 (median age, 49 years [range, 18-89 years]
Results Among 3277 adult participants, complete data were available for 3215 (median age, 49 years [range, 18-89 years; 1667 [52%] female; 2433 [76%] white). No significant differences were observed in participant satisfaction and physician confidence for the white male physician control physicians (mean composite score, 66.13 [95% CI, 64.76-67.51]) compared with white female (mean composite score, 66.50 [95% CI, 65.19-67.82]), black female (mean composite score, 67.36 [95% CI, 66.03-68.69]), and black male (mean composite score, 66.96 [95% CI, 65.55-68.36]) physicians. Machine learning with bayesian additive regression trees revealed no evidence of treatment effect heterogeneity as a function of participantsâ race, gender, racial prejudice, or sexism.
Conclusions and Relevance No significant differences were observed for simulated patientsâ evaluations of female or black physicians, suggesting that bias in favor of white male physicians is negligible in survey-based measures of patient satisfaction
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Political Priorities, Voting, and Political Action Committee Engagement of Emergency Medicine Trainees: A National Survey
Introduction: Medicine is increasingly influenced by politics, but physicians have historically had lower voter turnout than the general public. Turnout is even lower for younger voters. Little is known about the political interests, voting activity, or political action committee (PAC) involvement of emergency physicians in training. We evaluated EM traineesâ political priorities, use of and barriers to voting, and engagement with an emergency medicine (EM) PAC.
Methods: Resident/medical student Emergency Medicine Residentsâ Association members were emailed a survey between OctoberâNovember 2018. Questions involved political priorities, perspective on single-payer healthcare, voting knowledge/behavior, and EM PACs participation. We analyzed data using descriptive statistics.
Results: Survey participants included 1,241 fully responding medical students and residents, with a calculated response rate of 20%. The top three healthcare priorities were as follows: 1) high cost of healthcare/price transparency; 2) decreasing the number of uninsured; and 3) quality of health insurance. The top EM-specific issue was ED crowding and boarding. Most trainees (70%) were supportive of single-payer healthcare: âsomewhat favorâ (36%) and âstrongly favorâ (34%). Trainees had high rates of voting in presidential elections (89%) but less frequent use of other voting options: 54% absentee ballots; 56% voting in state primary races; and 38% early voting. Over half (66%) missed voting in prior elections, with work cited as the most frequent (70%) barrier. While overall, half of respondents (62%) reported awareness of EM PACs, only 4% of respondents had contributed.
Conclusion: The high cost of healthcare was the top concern among EM trainees. Survey respondents had a high level of knowledge of absentee and early voting but less frequently used these options. Encouragement of early and absentee voting can improve voter turnout of EM trainees. Concerning EM PACs, there is significant room for membership growth. With improved knowledge of the political priorities of EM trainees, physician organizations and PACs can better engage future physicians
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Impact of a Best Practice Alert on the Implementation of Expedited Partner Therapy
Objectives: The objective of this study was to determine if an ED-based electronic health record (EHR) Best Practice Alert (BPA) increased the ordering of expedited partner therapy (EPT) for sexually transmitted infections (STI) in adult patients.Background: US EDs have reported increases in STI visits and positivity rates, mirroring record level increases in STI incidence in the general population. EPT is an evidence-based practice recommended by public health experts for treating sexual partners of STI patients. EDs typically evaluate patients for STIs without their sexual partner present, thereby providing opportunities for EPT. However, EPT is infrequently used in US EDs.Methods: This pilot study was part of a quality improvement initiative conducted between August and October 2021 in an academic tertiary care ED located in the Midwest. An EPT BPA was randomly displayed in the EHR to clinicians when they empirically treated adult ED patients for STIs with antibiotics. Differences in proportions of EPT ordering were calculated for STI visits between BPA exposed vs. unexposed, ED clinician type, and testing-confirmed vs. not confirmed STI status.Results: Of the 52 adult ED patients empirically treated for STIs during the study period, their mean age was 30 years old, 56% were female, 48% White and 40% Black, and 31% had Medicaid. Testing-confirmed STI prevalence was 27%. EPT was ordered less often during BPA unexposed (8%; 95% CI 1-25) than BPA exposed (42%; 95% CI 23-63) STI visits, for a mean difference of 35% (95% CI 13-56). EPT was ordered during 41% of STI visits involving residents, as compared to 7% of physician assistant visits (p=0.07). EPT was not ordered more often for testing-confirmed vs. not confirmed STI visits (21% vs. 26%; p=0.7).Conclusion: Displaying an EHR BPA greatly increased EPT ordering for patients empirically treated for STIs, although not consistently across all clinician types. Because suspected cases of STIs may be less common in some EDs depending on the populations they serve, BPAs may be a useful tool to bolster the implementation of EPT practices
Emergency Physicians and Personal Narratives Improve the Perceived Effectiveness of COVID- 19 Public Health Recommendations on Social Media: A Randomized Experiment
BackgroundContainment of the coronavirus disease 2019 (COVID- 19) pandemic requires the public to change behavior under social distancing mandates. Social media are important information dissemination platforms that can augment traditional channels communicating public health recommendations. The objective of the study was to assess the effectiveness of COVID- 19 public health messaging on Twitter when delivered by emergency physicians and containing personal narratives.MethodsOn April 30, 2020, we randomly assigned 2,007 U.S. adults to an online survey using a 2ĂÂ Ă ĂÂ 2 factorial design. Participants rated one of four simulated Twitter posts varied by messenger type (emergency physician vs. federal official) and content (personal narrative vs. impersonal guidance). The main outcomes were perceived message effectiveness (35- point scale), perceived attitude effectiveness (PAE; 15- point scale), likelihood of sharing Tweets (7- point scale), and writing a letter to their governor to continue COVID- 19 restrictions (write letter or none).ResultsThe physician/personal (PP) message had the strongest effect and significantly improved all main messaging outcomes except for letter writing. Unadjusted mean differences between PP and federal/impersonal (FI) were as follows: perceived messaging effectiveness (3.2 [95% CIĂÂ = 2.4 to 4.0]), PAE (1.3 [95% CIĂÂ = 0.8 to 1.7]), and likelihood of sharing (0.4 [95% CIĂÂ = 0.15 to 0.7]). For letter writing, PP made no significant impact compared to FI (odds ratioĂÂ = 1.14 [95% CIĂÂ = 0.89 to 1.46]).ConclusionsEmergency physicians sharing personal narratives on Twitter are perceived to be more effective at communicating COVID- 19 health recommendations compared to federal officials sharing impersonal guidance.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/166422/1/acem14188-sup-0001-DataSupplementS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166422/2/acem14188_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166422/3/acem14188.pd