Resident Unions: Why Now and Will They Change Medical Education and Health Care?

During the COVID-19 pandemic, resident unions proliferated. While unionization resulted in increased compensation and benefits, the process of union negotiations may have created adversarial relationships between residents and their institutions' leadership, whom residents depend on for supervision and the development of clinical expertise. Such adversarial relationships could affect the learning environment, which is critical to the delivery of high-quality care.

Interfacility Patient Transfers During COVID-19 Pandemic: Mixed-Methods Study.

Introduction: The United States lacks a national interfacility patient transfer coordination system. During the coronavirus 2019 (COVID-19) pandemic, many hospitals were overwhelmed and faced difficulties transferring sick patients, leading some states and cities to form transfer centers intended to assist sending facilities. In this study we aimed to explore clinician experiences with newly implemented transfer coordination centers.

The effects of bystander interventions for foreign body airway obstruction on survival and neurological outcomes: Findings of the MOCHI registry.

Introduction: Foreign body airway obstruction (FBAO) is a life-threatening condition. We aimed to quantify the impact of bystander FBAO interventions on survival and neurological outcomes.

Methods: We conducted a Japan-wide prospective, multi-center, observational study including all FBAO patients who presented to the Emergency Department from April 2020 to March 2023.

Ambulance Traffic Crashes in Japan: Characteristics of Casualties and Efforts to Improve Ambulance Safety.

Background: An ambulance traffic crash not only leads to injuries among emergency medical service (EMS) professionals but also injures patients or their companions during transportation. We aimed to describe the incidence of ambulance crashes, seating location, seatbelt use for casualties (ie, both fatal and nonfatal injuries), ambulance safety efforts, and to identify factors affecting the number of ambulance crashes in Japan.

Methods: We conducted a nationwide survey of all fire departments in Japan.

Temporal trends in critical care utilization and outcomes in allogeneic hematopoietic stem cell transplant recipients.

Historically, the prognosis of allogeneic hematopoietic stem cell transplant (allo-HCT) recipients who require intensive care unit (ICU) admission has been poor. We aimed to describe the epidemiological trends of ICU utilization and outcomes in allo-HCT patients. We conducted a retrospective cohort study including adults (≥ 18) undergoing allo-HCT between 01/01/2005 and 31/12/2020 at Mayo Clinic, Rochester.

Five Domains of a Conceptual Framework of Continuing Professional Development.

Continuing professional development (CPD) for health professionals involves efforts at improving health of individuals and the population through educational activities of health professionals who previously attained a recognized level of acceptable proficiency (licensure). However, those educational activities have inconsistently improved health care outcomes of patients. We suggest a conceptual change of emphasis in designing CPD to better align it with the goals of improving health care value for patients through the dynamic incorporation of five distinct domains to be included in learning activities.

Food choking incidents in the hospital: Incidents, characteristics, effectiveness of interventions, and mortality and morbidity outcomes.

Aim: Foreign body airway obstruction (FBAO) due to food can occur wherever people eat, including in hospitals. We characterized in-hospital FBAO incidents and their outcomes.

Methods: We searched the Japan Council for Quality Health Care nationwide in-hospital adverse events database for relevant events from 1,549 institutions.

How Academic Medicine Can Amplify Truth Amid the Noise of Misinformation, Inaccuracies, and Lies.

Inaccurate statements and lies from public figures and political and government leaders have the power to exacerbate dangerous upheavals in our political, health care, and social environments. The widespread misinformation, inaccuracies, and lies about the COVID-19 pandemic (about the origin of the virus, the severity of illness, vaccination, and "cures," to name a few) illustrate the potentially disastrous consequences of false information. Academic medicine must recognize the dangers of such lies and inaccuracies, particularly those related to health, and must understand their sources in traditional and social media and how and why many in the public accept them.

Preceding anti-spike IgG levels predicted risk and severity of COVID-19 during the Omicron-dominant wave in Santa Fe city, Argentina.

The SARS-CoV-2 Omicron variant has increased infectivity and immune escape compared with previous variants, and caused the surge of massive COVID-19 waves globally. Despite a vast majority (~90%) of the population of Santa Fe city, Argentina had been vaccinated and/or had been infected by SARS-CoV-2 when Omicron emerged, the epidemic wave that followed its arrival was by far the largest one experienced in the city. A serosurvey conducted prior to the arrival of Omicron allowed to assess the acquired humoral defences preceding the wave and to conduct a longitudinal study to provide individual-level real-world data linking antibody levels and protection against COVID-19 during the wave.

Driving Ambulances Safely: Findings of Ten Years of Japanese Ambulance Crash Data.

Objective: Rules and regulations for ambulance operations differ across countries and regions, however, little is known about ambulance crashes outside of the United States. Japan is unique in several aspects, for example, routine use of lights and sirens during response and transport regardless of the urgency of the case and low speed limits for ambulances. The aim of this study was to describe the incidence and characteristics of ambulance crashes in Japan.

What the COVID-19 Pandemic Can Teach Health Professionals About Continuing Professional Development.

The world's health care providers have realized that being agile in their thinking and growth in times of rapid change is paramount and that continuing education can be a key facet of the future of health care. As the world recovers from the COVID-19 pandemic, educators at academic health centers are faced with a crucial question: How can continuing professional development (CPD) within teams and health systems be improved so that health care providers will be ready for the next disruption? How can new information about the next disruption be collected and disseminated so that interprofessional teams will be able to effectively and efficiently manage a new disease, new information, or new procedures and keep themselves safe? Unlike undergraduate and graduate/postgraduate education, CPD does not always have an identified educational home and has had uneven and limited innovation during the pandemic. In this commentary, the authors explore the barriers to change in this sector and propose 4 principles that may serve to guide a way forward: identifying a home for interprofessional continuing education at academic health centers, improving workplace-based learning, enhancing assessment for individuals within health care teams, and creating a culture of continuous learning that promotes population health.

Screening for Excessive Alcohol Consumption in Emergency Departments: A Nationwide Assessment of Emergency Department Physicians.

Objective: To assess current screening practices for excessive alcohol consumption, as well as perceived barriers, perceptions, and attitudes toward performing this screening among emergency department (ED) physicians.

Design: A brief online assessment of screening practices for excessive drinking was disseminated electronically to a representative panel of ED physicians from November 2016 to January 2017. Descriptive statistics were calculated on the frequency of alcohol screening, factors affecting screening, and attitudes toward screening.

CT imaging of extraglottic airway device-pictorial review.

Compared to intubation with a cuffed endotracheal tube, extraglottic airway devices (EGDs), such as laryngeal mask airways, are considered less definitive ventilation conduit devices and are therefore often exchanged via endotracheal intubation (ETI) prior to obtaining CT images. With more widespread use and growing comfort among providers, reports have now described use of EGDs for up to 24 h including cases for which clinicians obtained CT scans with an EGD in situ. The term EGD encompasses a wide variety of devices with more complex structure and CT appearance compared to ETI.

Extraglottic Airway Device Misplacement: A Novel Classification System and Findings in Postmortem Computed Tomography.

Study Objective: Extraglottic airway devices are frequently used during cardiac arrest resuscitations and for failed intubation attempts. Recent literature suggests that many extraglottic airway devices are misplaced. The aim of this study is to create a classification system for extraglottic airway device misplacement and describe its frequency in a cohort of decedents who died with an extraglottic airway device in situ.

COVID-19: Lessons From the Disaster That Can Improve Health Professions Education.

COVID-19 has disrupted every aspect of the U.S. health care and health professions education systems, creating anxiety, suffering, and chaos and exposing many of the flaws in the nation's public health, medical education, and political systems.