A mixed-method study on physicians' perceptions of pay for performance: impact on professionalism, morality and work-life balance.

Background: Pay-for-performance system (P4P) has been in operation in the Turkish healthcare sector since 2004. While the government defended that it encouraged healthcare professionals' job motivation, and improved patient satisfaction by increasing efficiency and service quality, healthcare professionals have emphasized the system's negative effects on working conditions, physicians' trustworthiness, and cost-quality outcomes. In this study, we investigated physicians' accounts of current working conditions, their status as a moral agent, and their professional attitudes in the context of P4P's perceived effects on their professional, social, private, and future lives.

The combination of Qing Kailing injection and clindamycin injection leads to systemic adverse reactions: Case report.

Rationale: It is imperative to be cautious about the potential systemic allergic reaction caused by the combined use of Qing Kailing Injection (QKI) and clindamycin as it may be life-threatening.

Patient Concerns: A 48-year-old female with a history of hypertension was admitted to a private hospital with a fever and cough. She was diagnosed with lung infection and received QKI infusion, followed by clindamycin infusion.

Expert Opinion on Multiple Myeloma Treatment in Brazil in the Bispecific Antibody Era.

Multiple myeloma treatment has evolved rapidly with the development of novel targeted therapies. The paper outlines multiple myeloma epidemiology, current treatments, and recent advances, highlighting the role of bispecific antibodies. Brazilian authorities have approved 3 bispecific antibodies (teclistamab, elranatamab, and talquetamab) for relapsed/refractory multiple myeloma patients who have received at least three prior therapies.

Intrapartum hydration assessment and management: A cross-sectional survey of Australian and New Zealand maternity units.

Background: Hydration assessment and management during labour play an important role in maternal and newborn outcomes. Studies indicate that clinical practice is inconsistent, with limited consensus evident in clinical guidelines. Current practices in fluid management across public and private maternity units within Australia and New Zealand remain unknown.

Accelerating the Future of Oncology Drug Development: The Role of Consortia in the Delivery of Precision Oncology Early Phase Clinical Trials.

Purpose: Over the past 15 years, the landscape of early phase clinical trials (EPCTs) has undergone a remarkable expansion in both quantity and intricacy. The proliferation of sites, trials, sponsors, and contract research organizations has surged exponentially, marking a significant shift in research conduct. However, EPCT operations suffer from numerous inefficiencies, such as cumbersome start-up processes, which are particularly critical when drug safety and the recommended phase II dose need to be established in a timely manner.

Sleep Disturbance and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury and Orthopedic Injury.

Objective: Sleep disturbance (SD) is common after pediatric mild traumatic brain injury (mTBI) and may predict increased postconcussive symptoms (PCS) and prolonged recovery. Our objective was to investigate the relation of SD with PCS in children with mTBI and those with orthopedic injury (OI).

Setting: Emergency departments (EDs) at 2 children's hospitals in the Midwestern United States.

Use and Costs of Supplemental Benefits in Medicare Advantage, 2017-2021.

Importance: Nearly all Medicare Advantage (MA) plans offer dental, vision, and hearing benefits not covered by traditional Medicare (TM). However, little is known about MA enrollees' use of those benefits or how much they cost MA insurers or enrollees.

Objective: To estimate use, out-of-pocket (OOP) spending, and insurer payments for dental, hearing, and vision services among Medicare beneficiaries.

Comparison of opportunities and perceptions towards neurosurgery between the public and private sector in Pakistan: a national survey of medical students and recent graduates.

Public and private medical institutes must adhere to the same standards of quality set by the Pakistan Medical & Dental Council (PMDC). However, studies have noted varied learning environments. The current study aims to assess opportunities and compare the differences in perceptions between the two sectors.

Veterans' experiences of somatic experiencing and prolonged exposure therapies for post-traumatic stress disorder: A qualitative analysis.

Purpose: Despite the proliferation of research into evidence based treatment for military PTSD there is little evidence for treatment assignment criterion and military based PTSD still demonstrates low remission rates.

Method: Thirty participants in a randomized control trial comparing Prolonged Exposure (PE) and Somatic Experiencing (SE) were interviewed on their experiences in therapy and their responses assessed using a descriptive phenomenological analysis approach to delineate the central tenets of the two therapeutic approaches.

Results: Results indicated that participants from both therapies covered themes of the experience of change, the experience of the therapeutic relationship and the therapeutic process.

Characteristics and outcomes of out-of-hospital-cardiac-arrest in rural and suburban areas of Sindh, Pakistan: A cross-sectional study.

Background: Despite extensive research on OHCA in urban centres worldwide, there is a significant gap in knowledge regarding these events in less urbanized regions, especially in Low-Middle-Income Countries (LMICs).

Aim: To determine the characteristics and outcomes of adult out-of-hospital cardiac arrest (OHCA) in rural and suburban districts of Sindh, Pakistan.

Methods: Data of OHCA patients (>18 years) was collected retrospectively from January 2020 to December 2022, from the medical records of district and tehsil hospitals of the province of Sindh Data analysis was performed using the Statistical Package Software for the Social Sciences (SPSS) Statistics 29.

Exploration of interprofessional collaboration for the diagnosis of infections and antibiotic prescription in nursing homes using multiple case study observational research.

Background: Antibiotic resistance in nursing homes (NHs) is inconsistently tackled by antimicrobial stewardship programmes. The literature on individual determinants of antibiotic prescriptions (APs) in NHs is extensive. However, less is known about the structural determinants of AP in NHs.

Understanding the scale and nature of avoidable healthcare-associated harm for prisoners in England: protocol for a retrospective cross-sectional study.

Introduction: Around 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.

Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study.

Background: Accurate estimates of incremental cost (IC) attributable to antimicrobial resistance (AMR) provide information of immense public health importance to the policy makers. Here, we present the IC from patient perspective for treating antimicrobial-resistant pathogens in India.

Methods: This cohort study was conducted in eight hospitals including government (GH), private (PH) and trust hospitals (TH), considering their ownership, geographical location and categories of cities.

Cohort profile: the potentially preventable burden of community-acquired pneumonia in South African adults in the era of widespread PCV13 immunisation and antiretroviral therapy roll-out, before and during the COVID-19 pandemic - the multicentre, multimethod PotPrev Study.

Purpose: In the setting of an established childhood pneumococcal vaccination programme with immediate initiation and treatment of antiretroviral therapy (ART) for people living with HIV (PLWH), the risk of adult pneumococcal community-acquired pneumonia (CAP) is not recently described. We aimed to investigate CAP incidence, recurrence, mortality, risk factors and microbiology before and during the COVID-19 pandemic.

Participants: Adults aged ≥18 years were enrolled in three South African provinces from March 2019 to October 2021, with a brief halt during the initial COVID-19 lockdown.

Move to improve - Prescribing physical activity and deprescribing paracetamol for low back pain: Protocol for a hybrid type III feasibility study.

Introduction: People experiencing low back pain (LBP) could potentially benefit from multimedia educational resources that integrate self-management strategies and improve awareness of the benefits of staying active and about medications that offer limited benefits, such as paracetamol. Primary care waiting rooms are potential spaces for presenting health promotion resources to improve health literacy through the dissemination of easily accessible health information. This feasibility study aims to explore the feasibility of conducting a large-scale trial to investigate the benefits of multimedia educational resources delivered at outpatient physiotherapy waiting rooms of public hospitals to support patients to participate in physical activity and reduce paracetamol intake for LBP.

Physician's perception and practices on antimicrobial resistance in a tertiary care hospital in Bangladesh: a cross-sectional study.

Background: Antimicrobial resistance (AMR) is a global health and development concern. Antimicrobial misuse and overuse are key contributors to the emergence of drug-resistant infections.

Objective: The current study aimed to determine the level of perception and practices of physicians regarding AMR in a tertiary-level hospital.

Detecting early cognitive deficits in preclinical Alzheimer's disease using a remote digital multi-day learning paradigm.

Remote, digital cognitive testing on an individual's own device provides the opportunity to deploy previously understudied but promising cognitive paradigms in preclinical Alzheimer's disease (AD). The Boston Remote Assessment for NeuroCognitive Health (BRANCH) captures a personalized learning curve for the same information presented over seven consecutive days. Here, we examined BRANCH multi-day learning curves (MDLCs) in 167 cognitively unimpaired older adults (age = 74.

The interaction of structured data using openEHR and large Language models for clinical decision support in prostate cancer.

Background: Multidisciplinary teams (MDTs) are essential for cancer care but are resource-intensive. Decision-making processes within MDTs, while critical, contribute to increased healthcare costs due to the need for specialist time and coordination. The recent emergence of large language models (LLMs) offers the potential to improve the efficiency and accuracy of clinical decision-making processes, potentially reducing costs associated with traditional MDT models.

Association Between Obesity and Thrombosis During Pregnancy and the Postpartum Period: A Case-Control Study From a Tertiary Care Center in Kerala, India.

Background Obesity is postulated to be a high-risk factor for thrombosis along with the inherent hypercoagulability of pregnancy. The Confidential Review of Maternal Deaths (CRMD) found that thrombosis was one of the major causes of maternal deaths in Kerala. This study investigates the major risk factor - obesity and its association with thrombosis in our study setting, along with other risk factors.

Generation of Trauma Rush Call in Managing Patients With Road Traffic Injuries Visiting the Emergency Department: A Retrospective Analysis.

Background: Road traffic injuries (RTIs) are currently the ninth most common cause of mortality and are expected to increase in the future. RTIs rank in the top three reasons why young people die. Because of the high incidence and mortality risk, proper trauma care has been prioritized for RTI patients who present to the emergency department.

A Phase III, Double-Blind, Randomized, Multicenter, Clinical Trial to Evaluate the Efficacy and Safety of a Fixed-Dose Combination of Metformin Hydrochloride and Myo-Inositol Compared to Metformin in Patients With Polycystic Ovary Syndrome.

Background Polycystic ovary syndrome (PCOS) poses a significant health concern among reproductive-aged women and is characterized by ovarian dysfunction, hyperandrogenism, and insulin resistance. This study aims to assess the efficacy and safety of metformin and myo-inositol combination therapy compared to metformin monotherapy in patients with PCOS. Materials and methods This was a phase III, double-blind, randomized controlled clinical trial.