Chronic Use of Non-Medical Abdominal Compressors: Medical and Psychological Implications

The popularity of waist cinchers, shapewear, abdominal binders, corsets, and waist trainers has increased in the population. Although corsets have been part of western fashion since the 18th century, abdominal compressors remain in style even today. In 2018, sales for shapewear worldwide were estimated at 2.26 billion USD. 1 Despite its popularity, shapewear safety and medical effects have not been widely studied. In 1968, “Pantygirdle Syndrome” was described, attributing vulvitis, urethritis, and urinary tract infections to materials used from the “pantygirdle”. 2 The article describes that the girdle caused gastrointestinal symptoms with diaphragmatic and stomach displacement causing gastro-esophageal reflux disease that resolved with girdle loosening. 3 Physicians related abdominal compression garments to the development of dyspnea, syncope, GERD, esophagitis, colon infarction, leg thrombophlebitis, varicose ulcers, and deep vein thrombosis. 6 Despite commentary, evaluation, and recognition of medical side effects with chronic use of shapewear and abdominal compression garments, there is a paucity of literature that describes who wears shapewear, for which reasons, and associated adverse effects from shapewear use. The purpose of this study is to describe the population of women that choose to wear shapewear and aims to: Better understand modern-day usage of modern forms of shapewear Assess why women wear shapewear and their shapewear usage habits Assess for medical associations and potential complications with acute and or chronic abdominal compression Evaluate if certain psychological conditions increase the use of shapewear or other abdominal compressor

Medical Student Perspectives on Opioid Use Disorders: An Innovative MAT Waiver Training Integration during IM Clerkships

The opioid epidemic in the US has become a major issue in healthcare. In 2017, there was an estimated 72,306 drug overdose related deaths and Emergency Departments (ED) nationally saw a 30% increase in opioid related overdoses. Innovative programs can help ensure patients are offered optimal treatment options. Most primary care physicians self-report they lack the skills to identify and appropriately treat substance abuse disorders (SUDs). Studies have suggested that the best solution is to improve medical school curricula, which translates to better educated future physicians. Unfortunately, due to timing and exposure constraints, most medical school programs do not provide the necessary information to successfully manage and treat SUDs in practice. To prescribe buprenorphine, an 8-hour Medication Assisted Treatment (MAT) training must be completed. Only 35,604 of the approximate 800,000 US physicians (\u3c3%) are registered to prescribe buprenorphine. We implemented an innovative approach to provide students with the skills to understand how to prescribe buprenorphine and build confidence to medically manage opioid use disorders in the future. By completing the training students will be eligible for a their MAT waiver upon obtaining their permanent license. Prior to integrating the training into the internal medicine clerkship, a preliminary study similar in nature was performed that focused on first and second year medical students perspectives. The results were analyzed and presented, and based on the positive results of the study, it was decided to implement the study into the internal medicine clerkship during the third year of medical school

Knowledge and Attitude Changes Towards Opioid Use Disorder and Naloxone Use Among Medical Students

Background: Overdose is the leading cause of preventable death in the USA. There have been efforts to distribute naloxone as a tool for harm reduction to those who need it; however, negative attitudes of healthcare workers and lack of knowledge may impact distribution. Medical schools have begun training students in opioid overdose prevention and treatment; initial studies found trainings improve student knowledge in responding to overdoses, but it remains unclear whether the traditional curriculum contributes to this knowledge. The present study aimed to evaluate baseline medical student knowledge about opioids, opioid overdoses, and naloxone use. Objective (Summary) – The present study aimed to evaluate baseline medical student knowledge about opioids, opioid overdoses, and naloxone use. As a point of focus, the study aimed to identify how people’s knowledge in areas and attitudes towards patients differed depending on their medical school training. Variables such as volunteering clinical experiences and whether students were in the pre-clinical or clinical portion of their training were noted with the aim of identifying the best way to complement the curriculum at Wayne State University School of Medicine for training professionals capable of understanding and treating a population dealing with SUDs. Methods: We distributed 15-minute online surveys via the email lists of all 4 classes at the Wayne State University School of Medicine as part of a wider initiative on Opioid Overdose Prevention and Response Training. Student participation was voluntary and confidential. These baseline surveys included questions about past experiences and knowledge of opioid use disorder (OUD) and overdoses, clinical experiences, and attitudes towards patients with OUD. These were assessed with the validated Opioid Overdose Knowledge (OOK), Opioid Overdose Attitudes, and Medical Conditions Regard Scales (adapted for Substance Use Disorders [SUDs]). Results: 252 students (29.0% M1, 25% M2, 21.8% M3, 24.2% M4) completed the survey. We found differences in total knowledge (OOKS) across class years (M1 44.68 ± 4.86, M2 48.05 ± 4.62, M3 47.24 ± 5.22, M4 49.37 ± 4.29; F(3,251)=11.8; pF(3,251)=4.2; p=.006). Notably, students in the final year of training scored lower on certain subscales of the Medical Conditions Regard Scale, indicating less willingness to work with patients with SUDs. We also identified interest in medication treatment and naloxone trainings should these opportunities arise. Conclusions: The results highlight how gradual exposure to knowledge and activities concerning OUD through clinical experience improve student knowledge and overall attitudes regarding opioid overdose. Improving this knowledge-base earlier in the undergraduate medical curriculum by complementing volunteering opportunities with additional training sessions such as the buprenorphine-waiver training program or in-house naloxone training is believed to improve attitudes, knowledge, and confidence prior to starting clinical rotations. Unfortunately, results also showed more negative attitudes among students with more clinical experience (M4s) towards patients with SUDs. This indicates a need for further training during clinical years and education of best ways to respond positively when working with this patient population. These findings support a continued, integrated curriculum on OUD and naloxone in medical education with a need for an improved focus on methods to improve students’ attitudes toward patients with OUD