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The Journal of Continuing Education in... Jul 2022Midcareer women faculty face unique career challenges that may benefit from mentorship and sponsorship, yet such programs focused on the needs of this career phase are...
Midcareer women faculty face unique career challenges that may benefit from mentorship and sponsorship, yet such programs focused on the needs of this career phase are scarce in academic medicine. Many midcareer faculty require intentional and individual career planning to choose a path from the broad array of options in academic medicine. Ambiguous promotion criteria, increased workloads because of service or citizenship tasks, and a lack of sponsorship are among the barriers that inhibit midcareer faculty's growth into the high-visibility roles needed for career advancement. In addition, issues faced by women midcareer faculty members may be further exacerbated by barriers such as biases, a disproportionate share of family responsibilities, and inequities in recognition and sponsorship. These barriers contribute to slower career growth and higher attrition among women midcareer faculty and ultimately an underrepresentation of women among senior leadership in academic medicine. Here, we describe how a mentoring program involving individuals (eg, mentors, mentees, and sponsors) and departments/institutions (eg, deans and career development offices) can be used to support midcareer faculty. We also provide recommendations for building a mentoring program with complementary support from sponsors targeted toward the specific needs of women midcareer faculty. A robust midcareer mentoring program can support the career growth and engagement of individual faculty members and as a result improve the diversity of academic medicine's highest ranks.
Topics: Faculty, Medical; Female; Humans; Leadership; Medicine; Mentoring; Mentors
PubMed: 35180741
DOI: 10.1097/CEH.0000000000000419 -
Transfusion Clinique Et Biologique :... Nov 2020This essay aims to discuss some aspects of blood transfusion in the perspective of the changes that occurred over time as well as modifications of the paradigms that...
This essay aims to discuss some aspects of blood transfusion in the perspective of the changes that occurred over time as well as modifications of the paradigms that transformed the activities and the organization of blood transfusion services. Without specific knowledge, pioneers envisioned precision and personalized medicine, rendering transfusion medicine operational. Transfusion medicine is like The Picture of Dorian Grey: always young despite being old and sometimes appearing old-fashioned. Over the years, the transfusion medicine discipline has evolved, and major progress has been achieved, despite some troublesome periods (for example, the tainted blood scandal, and-at the time being-the offending plasma market and the selling of human parts). Transfusion medicine has at all times implemented the rapidly developing biomedical technologies to secure blood components. The safety of blood components has now reached an exceptional level in economically wealthy countries, especially compared to other health care disciplines. Strengthening of the safety has mandated that blood donors and recipients are unrelated, an issue which has eased preservation and fractionation practices; blood is no longer arm-to-arm transfused and neither is whole blood, the commonest component. However, it is interesting to note that a revival is occurring as whole blood is back on stage for certain specific indications, which is one among the many paradoxes encountered while studying this discipline.
Topics: Blood Component Transfusion; Blood Donors; Blood Transfusion; Humans; Transfusion Medicine
PubMed: 33035654
DOI: 10.1016/j.tracli.2020.10.001 -
JAMA Network Open Sep 2023Military medicine in the US was established to treat wounded and ill service members and to protect the health and well-being of our military forces at home and abroad....
IMPORTANCE
Military medicine in the US was established to treat wounded and ill service members and to protect the health and well-being of our military forces at home and abroad. To accomplish these tasks, it has developed the capacity to rapidly adapt to the changing nature of war and emerging health threats; throughout our nation's history, innovations developed by military health professionals have been quickly adopted by civilian medicine and public health for the benefit of patients in the US and around the world.
OBSERVATIONS
From the historical record and published studies, we cite notable examples of how military medicine has advanced civilian health care and public health. We also describe how military medicine research and development differs from that done in the civilian world. During the conflicts in Afghanistan and Iraq, military medicine's focused approach to performance improvement and requirements-driven research cut the case fatality rate from severe battlefield wounds in half, to the lowest level in the history of warfare.
CONCLUSIONS AND RELEVANCE
Although innovations developed by military medicine regularly inform and improve civilian health care and public health, the architects of these advances and the methods they use are often overlooked. Enhanced communication and cooperation between our nation's military and civilian health systems would promote reciprocal learning, accelerate collaborative research, and strengthen our nation's capacity to meet a growing array of health and geopolitical threats.
Topics: Humans; Public Health; Military Medicine; Military Personnel; Afghanistan; Communication
PubMed: 37733341
DOI: 10.1001/jamanetworkopen.2023.35125 -
Basic & Clinical Pharmacology &... Jan 2021The means by which patients acquire their medications differ between countries, and a knowledge of this is essential when conducting and interpreting... (Review)
Review
The means by which patients acquire their medications differ between countries, and a knowledge of this is essential when conducting and interpreting pharmacoepidemiological studies. The aim of this paper is to provide an overview of how patients obtain medicines in Denmark, to relate these to nationwide registries available for research and to discuss the implications for research. Health services are predominantly tax-funded in Denmark, with dentistry and some medicine bought at community pharmacies being exceptions, involving partial reimbursement of charges. The paper gives an overview of prescription medicines acquired from community pharmacies (including magistral preparations), over-the-counter medicines, vaccinations and in-hospital medicine including so-called "free medicine" (in Danish: "vederlagsfri medicin"). "Free medicine" is medicines for a defined list of diseases and indications that is provided free of charge to patients in outpatient clinics. The paper also describes the content of the various Danish data sources about medicine use, summarizes their strengths and limitations, and exemplifies the ways of evaluating their completeness. An example is provided of the regional variation in the means by which medicines are acquired.
Topics: Ambulatory Care; Community Pharmacy Services; Denmark; Health Services Accessibility; Health Services Research; Healthcare Disparities; Humans; Immunization Programs; Inpatients; Nonprescription Drugs; Pharmacoepidemiology; Pharmacy Service, Hospital; Prescription Drugs; State Medicine; Vaccines
PubMed: 32657031
DOI: 10.1111/bcpt.13472 -
Frontiers in Public Health 2023
Topics: Data Science; Randomized Controlled Trials as Topic; Evidence-Based Medicine; Plant Extracts
PubMed: 36860391
DOI: 10.3389/fpubh.2023.1129399 -
Journal of Ethnopharmacology Mar 2021Traditional pharmacopeias have been developed by multiple cultures and evaluated for efficacy and safety through both historical/empirical iteration and more recently... (Review)
Review
ETHNOPHARMACOLOGICAL RELEVANCE
Traditional pharmacopeias have been developed by multiple cultures and evaluated for efficacy and safety through both historical/empirical iteration and more recently through controlled studies using Western scientific paradigms and an increasing emphasis on data science methodologies for network pharmacology. Traditional medicines represent likely sources of relatively inexpensive drugs for symptomatic management as well as potential libraries of new therapeutic approaches. Leveraging this potential requires hard evidence for efficacy that separates science from pseudoscience.
MATERIALS AND METHODS
We performed a review of non-Western medical systems and developed case studies that illustrate the epistemological and practical translative barriers that hamper their transition to integration with Western approaches. We developed a new data analytics approach, in silico convergence analysis, to deconvolve modes of action, and potentially predict desirable components of TM-derived formulations based on computational consensus analysis across cultures and medical systems.
RESULTS
Abstraction, simplification and altered dose and delivery modalities were identified as factors that influence actual and perceived efficacy once a medicine is moved from a non-Western to Western setting. Case studies on these factors highlighted issues with translation between non-Western and Western epistemologies, including those where epistemological and medicinal systems drive markets that can be epicenters for zoonoses such as the novel Coronavirus. The proposed novel data science approach demonstrated the ability to identify and predict desirable medicinal components for a test indication, pain.
CONCLUSIONS
Relegation of traditional therapies to the relatively unregulated nutraceutical industry may lead healthcare providers and patients to underestimate the therapeutic potential of these medicines. We suggest three areas of emphasis for this field: First, vertical integration and embedding of traditional medicines into healthcare systems would subject them to appropriate regulation and evidence-based practice, as viable integrative implementation mode. Second, we offer a new Bradford-Hill-like framework for setting research priorities and evaluating efficacy, with the goal of rescuing potentially valuable therapies from the nutraceutical market and discrediting those that are pseudoscience. Third, data analytics pipelines offer new capacity to generate new types of TMS-inspired medicines that are rationally-designed based on integrated knowledge across cultures, and also provide an evaluative framework against which to test claims of fidelity and efficacy to TMS made for nutraceuticals.
Topics: COVID-19; Data Interpretation, Statistical; Data Science; Delivery of Health Care, Integrated; Humans; Medicine; Medicine, Traditional; Phytotherapy
PubMed: 33098971
DOI: 10.1016/j.jep.2020.113477 -
Molecules (Basel, Switzerland) Nov 2021Medicinal chemistry is facing new challenges in approaching precision medicine. Several powerful new tools or improvements of already used tools are now available to... (Review)
Review
Medicinal chemistry is facing new challenges in approaching precision medicine. Several powerful new tools or improvements of already used tools are now available to medicinal chemists to help in the process of drug discovery, from a hit molecule to a clinically used drug. Among the new tools, the possibility of considering folding intermediates or the catalytic process of a protein as a target for discovering new hits has emerged. In addition, machine learning is a new valuable approach helping medicinal chemists to discover new hits. Other abilities, ranging from the better understanding of the time evolution of biochemical processes to the comprehension of the biological meaning of the data originated from genetic analyses, are on their way to progress further in the drug discovery field toward improved patient care. In this sense, the new approaches to the delivery of drugs targeted to the central nervous system, together with the advancements in understanding the metabolic pathways for a growing number of drugs and relating them to the genetic characteristics of patients, constitute important progress in the field.
Topics: Chemistry, Pharmaceutical; Drug Design; Drug Discovery; Humans; Machine Learning; Precision Medicine
PubMed: 34834152
DOI: 10.3390/molecules26227061 -
Transfusion and Apheresis Science :... Apr 2020The prospect of cryopreservation of cellular components in the low and medium income (poor economics) part of the world absolutely needs a solid and sustainable... (Review)
Review
The prospect of cryopreservation of cellular components in the low and medium income (poor economics) part of the world absolutely needs a solid and sustainable infrastructure to build on in line with science, technology and globalization, based on rational thinking, standardization and harmonization of future advances we are currently witnessing in limited parts of the world. With the stepwise development of the healthcare stimulated by the 2012 UN Universal Health Coverage (UHC) program and supported by WHO Model List of Essential Medicines (EM) and Essential in vitro Diagnostics (ED), a slowly growing number of countries will reach a point where quality cryopreservation of cellular components becomes feasible as an advance for implementing specific health care visions, policies and strategies in line with the Sustainable Development Goals 2016-2030.
Topics: Delivery of Health Care; Humans; Transfusion Medicine; Universal Health Insurance
PubMed: 32144029
DOI: 10.1016/j.transci.2020.102752 -
PLoS Medicine Jul 2023
Topics: Humans; Anti-Bacterial Agents; Drug Resistance, Bacterial; Global Health
PubMed: 37399216
DOI: 10.1371/journal.pmed.1004264 -
International Journal of Cardiology Mar 2017For most of Medicine's past, the best that physicians could do to cope with disease prevention and treatment was based on the expected response of an average patient.... (Review)
Review
For most of Medicine's past, the best that physicians could do to cope with disease prevention and treatment was based on the expected response of an average patient. Currently, however, a more personalized/precise approach to cardiology and medicine in general is becoming possible, as the cost of sequencing a human genome has declined substantially. As a result, we are witnessing an era of precipitous advances in biomedicine and bourgeoning understanding of the genetic basis of cardiovascular and other diseases, reminiscent of the resurgence of innovations in physico-mathematical sciences and biology-anatomy-cardiology in the Renaissance, a parallel time of radical change and reformation of medical knowledge, education and practice. Now on the horizon is an individualized, diverse patient-centered, approach to medical practice that encompasses the development of new, gene-based diagnostics and preventive medicine tactics, and offers the broadest range of personalized therapies based on pharmacogenetics. Over time, translation of genomic and high-tech approaches unquestionably will transform clinical practice in cardiology and medicine as a whole, with the adoption of new personalized medicine approaches and procedures. Clearly, future prospects far outweigh present accomplishments, which are best viewed as a promising start. It is now essential for pluridisciplinary health care providers to examine the drivers and barriers to the clinical adoption of this emerging revolutionary paradigm, in order to expedite the realization of its potential. So, we are not there yet, but we are definitely on our way.
Topics: Cardiology; Genomics; Humans; Precision Medicine; Translational Research, Biomedical
PubMed: 28057368
DOI: 10.1016/j.ijcard.2016.12.097