Naturlig konservering av kjøtt

Bearbeidete kjøttprodukter som skinker og pølser tilsettes vanligvis det omdiskuterte stoffet natriumnitritt for konservering. Etter tre års arbeid har danske forskere nå funnet frem til forskjellige urter og bær som fungerer som et naturlig alternativ til konservering

Kansas Family Physicians Perceptions of Parental Vaccination Hesitancy

Introduction. In the past few decades, patients expressing the idea that vaccines are unsafe or unneeded have been experienced increasingly by physicians and other healthcare providers. Discussions with patients regarding their reasons for vaccine refusals are important, as it may provide information that can be utilized in an intervention to increase vaccination rates and combat the spread of diseases that are making a resurgence in the United States. The main objective of this study was to explore the perceptions of family physicians as to why parents in Kansas may be vaccine hesitant. Methods. An electronic survey was distributed to family physicians in the State of Kansas via the University of Kansas School of Medicine-Wichita Family Medicine Research and Data Information Office (FM RADIO). Several aspects of physician perceptions regarding patients’ vaccine hesitancy were measured in this study, including vaccines that are most often refused, reasons for refusing vaccinations, as well as what responses physicians employ when presented with vaccine concerns. Results. The majority of physicians surveyed have experienced vaccine hesitancy or refusal in their practice, and the human papillomavirus (HPV) and flu vaccines were reported to be the primary vaccines refused for children. In addition, physicians reported frequently employing various practices in response to vaccine refusals, including requiring parents to sign a form (40%) and dismissing families from their practice (1.5%). Physician perceptions on the reasons as to why parents/guardians refuse vaccinations also were measured, and the most common response was that parents possess a fear of long-term complications for their children as a result of vaccines (74%). Additionally, the three most commonly refused vaccines were HPV, influenza, and measles, mumps, and rubella. Conclusion. Physicians must not only deal with time constraints that vaccine hesitant discussions require, but also must try and implement discussions or interventions suited to the varying reasons why parents/guardians refuse vaccines to convince parents of their safety. The results suggested that vaccine refusals by parents/guardians seemed to be affecting Kansas family physicians’ clinics in more than one way. This study could be a useful tool to help physicians better understand why vaccine refusals occur and be able to combat unwarranted concerns about vaccines

Transgender Health Medical Education Intervention and its Effects on Beliefs, Attitudes, Comfort, and Knowledge

Introduction. Transgender health disparities have been well documentedin the literature in recent years, as have the lack of transgenderhealth issues in medical education programs across the country. Methods. A prospective study was conducted with an hour-longdidactic lecture on transgender health being given to faculty, medicalstudents, and residents at the University of Kansas School of Medicine-Wichita. The didactic lecture included educational informationand presentations by transgender persons. A pre-intervention andtwo post-intervention survey was given to assess attitudes, comfortlevel, knowledge, and beliefs regarding the treatment of transgenderedpersons and associated health concerns. A second post-interventionsurvey was given at 90 days. The question of what attendees plannedto do differently as a result of the intervention was asked. Results. The intervention provided a significant positive increase inattitudes, comfort levels, and knowledge with respect to transgenderhealth issues between the pre- and post-intervention surveys,however, did not provide a significant positive increase in beliefs ontransgender health issues. There was no significant change in attitude,comfort levels, knowledge, or beliefs from the post-survey after 90days. Four categories of what attendees planned to do differently as aresult of the intervention also were identified. Conclusions. A didactic lecture on transgender health issues canpositively change attitudes, comfort levels, and knowledge on transgenderhealth issues significantly with the changes sustaining after 90days. Beliefs tend to be much harder to change.Kans J Med 2018;11(4):106-109

Pediatric COVID-19 Vaccination: A Description of Adverse Events or Reactions Reported in Kansans Aged 6 to 17

Introduction. There have been widespread concerns about the safety of the COVID-19 vaccines, particularly when it comes to pediatric populations, and it is important to provide information for parents and guardians to make informed decisions. This study sought to identify the adverse events and reactions (AERs) associated with the COVID-19 vaccines in Kansans aged 6 to 17. Methods. The US Department of Health and Human Services’ “Vaccine Adverse Event Reporting System” (VAERS) database was searched from May 11th, 2021, to April 30th, 2022, for AERs related to COVID-19 vaccines in adolescents ages 6 to 17. Results were grouped by vaccine manufacturer and patient gender. Results. 159 individuals reported a total of 409 AERS, with an average of 2.6 per person (± 1.7; median = 2; range 1 to 10). Females (n = 95) reported 237 AERs, with an average of 2.5 each (±1.7; median = 2; range 1 to 8); while males (n = 64) reported 172 AERs, with an average of 2.7 each (±1.8; median = 2; range 1 to 8). The most common adverse event associated with Pfizer vaccination was syncope/fainting. Conclusions. COVID-19 vaccines have undergone intensive monitoring and safety regulations since the onset of the coronavirus. With over 591 million doses administered, there is compelling evidence that the COVID-19 vaccines are safe and effective. Informing the public about the potential AERs of the COVID-19 vaccines in children can help to alleviate vaccine hesitancy and strengthen vaccination confidence

‘Just the Way it Was’- Perspectives on Sexual Harassment in Medical School and #MeToo of Women Graduating Prior to 1975

Introduction.The purpose of this study was to assess gender-based mistreatment during medical education recalled by women who attended medical school between 1948 and 1975 and their perspectives on the #MeToo movement. Methods. Qualitative analysis of video-recorded structured interviews. Results.The 37 participants graduated in classes of 2-20% women. They described pervasive, multi-faceted gender-based mistreatment during training. Twenty (54%) disclosed personal experience of serious sexual mistreatment. Interviewees stressed that attitudes and behaviors toward women and trainees, now regarded as unacceptable, were previously widely accepted or tolerated. The majority (86%) expressed overall positive opinions of their training. Twenty-eight (76%) supported the #MeToo movement, four (11%) had negative opinions, and five (13.5%) were ambivalent or unwilling to comment. Seventeen (46%) were concerned that #MeToo damaged working relationships, twelve (32%) were concerned about overreach, and eight (22%) about false accusations. Conclusions.This group of older female physicians reported extensive experience of gender-based mistreatment and strong support of #MeToo. Nevertheless, about one quarter of the group did not support the #MeToo movement and even supporters expressed high rates of concern about the movement going too far, falsely accusing men of inappropriate behavior, and damaging working relationships. The interviewees did not want their medical training to be characterized as entirely negative, or to be portrayed as victims

Adjusting for outcome risk factors in immigrant datasets: total or direct effects?

Background When quantifying differences in health outcomes between immigrants and non-immigrants, it is common practice to adjust for observed differences in outcome risk factors between the groups being compared. However, as some of these outcome risk factors may act as mediators on the causal path between the exposure and outcome, adjusting for these may remove effects of factors that characterize the immigrants rather than removing a bias between immigrants and non-immigrants. Methods This study investigates the underlying conditions for which adjusting for outcome risk factors in regression models can lead to the estimation of either total or direct effect for the difference in health outcomes between immigrants and non-immigrants. For this investigation, we use modern tools in causal inference to construct causal models that we believe are highly relevant in an immigrant dataset. In these models, the outcome risk factor is modeled either as a mediator, a selection factor, or a combined mediator/selection factor. Unlike mediators, selection factors are variables that affect the probability of being in the immigrant dataset and may contribute to a bias when comparing immigrants and non-immigrants. Results When the outcome risk factor acts both as a mediator and selection factor, the adjustment for the risk factor in regression models leads to the estimation of what is known as a “controlled” direct effect. When the outcome risk factor is either a selection factor or a mediator alone, the adjustment for the risk factor in regression models leads to the estimation of a total effect or a controlled direct effect, respectively. In all regression analyses, also adjusting for various confounding paths, including mediator-outcome confounding, may be necessary to obtain valid controlled direct effects or total effects. Conclusions Depending on the causal role of the outcome risk factors in immigrant datasets, regression adjustment for these may result in the estimation of either total effects or controlled direct effects for the difference in outcomes between immigrants and non-immigrants. Because total and controlled direct effects are interpreted differently, we advise researchers to clarify to the readers which types of effects are presented when adjusting for outcome risk factors in immigrant datasets.publishedVersio

Time and Financial Costs for Students Participating in the National Residency Matching Program (the Match©): 2015 to 2020

Introduction. The purpose of this study was to provide information to assist students, faculty, and staff in making critical career-determining decisions regarding the residency NRMP “Match©” process. Methods. A 47-item survey questionnaire was developed and piloted on a regional medical school campus in 2015. The revised questionnaire was distributed each year from 2016 to 2020 to fourth-year medical students after rank lists had been submitted. The questionnaire incorporated a request for comments about the interviewing experience and suggestions to improve the process. This narrative feedback was coded using a thematic analysis. Results. The overall response rate was 86.1% (897/1,042). Annual response rates ranged from 70.0% in 2020 to 97.0% in 2018. Respondents’ average age was 27.3 (± 2.7) years and 50.0% (448/897) were male. Most applied to family medicine (164/897; 18.2%) and internal medicine (140/897; 15.6%). Eight specialties had fewer than ten applicants over the six-year period. The number of students applying to individual specialties fluctuated annually, but no specialty showed a consistent upward or downward trend over the study period. Conclusions. This study found huge differences in numbers of applications, expenses, and days interviewing. Students crave more guidance, a more efficient system, transparent communication with programs, and less pressure during the process. Reducing escalating volumes of applications is central to improving the system. Despite efforts to inform applicants better, student behavior is unlikely to change until they feel safe in the belief that lower and more realistic numbers of applications and interviews are likely to result in securing an appropriate residency position

Student Expenses in Residency Interviewing

Introduction. The student costs of residency interviewing areof increasing concern but limited current information is available.Updated, more detailed information would assist studentsand residency programs in decisions about residency selection.The study objective was to measure the expenses and time spentin residency interviewing by the 2016 graduating class of the Universityof Kansas School of Medicine and assess the impact ofgender, regional campus location, and primary care application. Methods. All 195 students who participated in the 2016 NationalResidency Matching Program (NRMP) received a 33 item questionnaireaddressing interviewing activity, expenses incurred, timeinvested and related factors. Main measures were self-reported estimatesof expenses and time spent interviewing. Descriptive analyseswere applied to participant characteristics and responses. Multivariateanalysis of variance (MANOVA) and chi-square tests comparedstudents by gender, campus (main/regional), and primary care/other specialties. Analyses of variance (ANOVA) on the dependentvariables provided follow-up tests on significant MANOVA results. Results. A total of 163 students (84%) completed the survey. Theaverage student reported 38 (1 - 124) applications, 16 (1 - 54) invitations,11 (1 - 28) completed interviews, and spent $3,500($20 - $12,000) and 26 (1 - 90) days interviewing. No significantdifferences were found by gender. After MANOVA and ANOVAanalyses, non-primary care applicants reported significantlymore applications, interviews, and expenditures, butless program financial support. Regional campus students reportedsignificantly fewer invitations, interviews, and daysinterviewing, but equivalent costs when controlled for primarycare application. Cost was a limiting factor in acceptinginterviews for 63% and time for 53% of study respondents. Conclusions. Students reported investing significant time andmoney in interviewing. After controlling for other variables, primarycare was associated with significantly lowered expenses.Regional campus location was associated with fewer interviewsand less time interviewing. Gender had no significantimpact on any aspect studied. KS J Med 2017;10(3):50-54

Prevalence of patients “at risk of malnutrition” and nutritional routines among surgical and non-surgical patients at a large university hospital during the years 2008–2018

Background & aims: Being “at risk of malnutrition”, which includes both malnutrition and the risk to be so, is associated with increased morbidity and mortality in both surgical and non-surgical patients. Several strategies and guidelines have been introduced to prevent and treat this, but the effects are scarcely investigated. This study aims to evaluate the long-term effects of these efforts by examining trends concerning: 1) the prevalence of patients «at risk of malnutrition» and 2) the use of nutritional support and diagnostic coding related to malnutrition over an 11-year period in a large university hospital. Moreover, we wanted to investigate if there was a difference in trends between surgical and non-surgical patients. Methods: From 2008 to 2018, Haukeland University Hospital, Norway, conducted 34 point-prevalence surveys to investigate the prevalence of patients «at risk of malnutrition», as defined by Nutritional Risk Screening 2002, and the use of nutritional support at the hospital. Diagnostic coding included ICD-10 codes related to malnutrition (E43, E44 and E46) at hospital discharge, which were extracted from the electronic patient journal. Trend analysis by calendar year was investigated using logistic regression models with and without adjustment for age (continuous), gender (male/female) and Charlson Comorbidity Index (none, mild, moderate or severe). Results: The number of patients included in the study was 18 933, where 52.1% were male and the median (25th, 75th percentile) age was 65 (51, 76) years. Of these, 5121 (27%) patients were identified to be «at risk of malnutrition». Fewer surgical patients (21.2%) were «at risk of malnutrition», as compared to non-surgical patients (30.9%) (p < 0.001). Adjusted trend analysis did not identify any change in the prevalence of patients «at risk of malnutrition» from 2008 to 2018. The percentage of patients «at risk of malnutrition» who received nutritional support increased from 61.6% in 2008 to 71.9% in 2018 (p < 0.001), with a range from 55.6 to 74.8%. This trend was seen for both surgical and non-surgical patients (p < 0.001 for both). Similarly, dietitians were more involved in the patients’ treatment (range: 3.8–16.7%), and there was increased use of ICD-10 codes related to malnutrition during the study period (range: 13.0–41.8%) (p < 0.001). These trends were seen for both surgical patients and non-surgical patients (p < 0.001), despite use being less common for surgical patients, as compared to non-surgical patients (p < 0.001). Conclusions: This large hospital study shows no apparent change in the prevalence of patients «at risk of malnutrition» from 2008 to 2018. However, more patients «at risk of malnutrition», both surgical and non-surgical, received nutritional support, treatment from a dietitian and a related ICD-10 code over the study period, indicating improved nutritional routines as a result of the implementation of nutritional guidelines and strategies.publishedVersio