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In Antarctica, it is extremely difficult to organise medical evacuations in winter. Antarctic physicians are often alone and must be prepared to perform surgery and dentistry, even if they are not specialists. This scoping review summarises epidemiological data on the types of surgical procedures performed in Antarctica and identifies gaps in the literature in this area. We searched PubMed and Google Scholar, without language restriction, for papers published between 1 January 1904, and 1 February 2022. Of the 35 papers on 12 Antarctic programs, very few were retrospective observational epidemiological studies; the majority were medical reports. The search identified 41 surgical procedures or reasons for surgical consultation, 19 different reasons for medical evacuations, and 12 causes of death that may have required surgical management. The diagnostic classifications used and the prevalence of each reported surgical speciality were heterogeneous. The most cited specialities were orthopaedics, dentistry, and digestive surgery. Telemedicine was integrated into on-site care or medical evacuation decisions. The current literature is poor, and most studies do not apply to surgical issues. The heterogeneous data collection methodologies limit their interpretation. A standardised diagnostic classification and detailed and systematic epidemiological registers will help define the contours of surgical management in Antarctica. [ABSTRACT FROM AUTHOR]

When the COVID-19 pandemic struck and China reported the first case to the World Health Organization in December 2019, there was no evidence-based treatment to combat it. With the catastrophic situation that followed, materialised by a considerable number of deaths, researchers, doctors, traditional healers, and governments of all nations committed themselves to find therapeutic solutions, including preventive and curative. There are effective treatments offered both by modern medicine and traditional medicine for COVID-19 today. However, other therapeutic proposals have not been approved due to the lack of effectiveness and scientific rigour during their development process. Proponents of modern medicine prefer biomedical therapies while in some countries, traditional treatments are used regularly because of their availability, affordability and satisfaction they bring to the population. In this paper, we propose a transactional medicine approach where the interaction between traditional and modern medicine produces a change. With this approach, the promoters of traditional medicine and those of modern medicine will be able to acquire knowledge through the experience produced by their encounters. Transactional medicine aims to be a model for decolonising medicine and recognising the value of both traditional and modern medicine in the fight against COVID-19 and other global emerging pathogens. [ABSTRACT FROM AUTHOR]

Health literacy has pushed the frontiers of self-care in recent decades, particularly among older adults. However, not much is known about self-medication for minor ailments and chronic conditions among older adults in developing countries. This paper addresses this knowledge gap by examining the prevalence, patterns, and associated factors of self-medication among older adults (aged 50 years and more) in Ghana. The study employed a cross-sectional survey within four communities in the Bosomtwe District, Ghana. Using the purposive, snowballing, and convenient techniques, 384 older adults were involved in the study. Multivariate logistic regressions were used to estimate the factors associated with self-medication. Up to 54.4% of the respondents had self-medicated at least 3 months before the survey, while 60.2% self-medicated at least once every month. Open markets (43%) were the dominant drug sources, while quick relief (26.6%) and cheap cost (22.7%) were the reasons for self-medication. Females (AOR: 2.626, CI: 0.015-0.030, p = 0.022), tertiary graduates (AOR: 1.825, CI: 0.007-0.045, p = 0.045) and uninsured older adults (AOR: 3.293, CI: 0.015-0.026, p = 0.007) were more likely to self-medicate. Furthermore, those with no past illness (AOR: 0.036, CI: 0.007-0.033, p = 0.013) and without non-communicable disease (AOR: 0.008, CI: 0.001-0.012, p = 0.020) were less likely to self-medicate. Policy recommendations targeting the educated, uninsured, female older adults as well as stiffening the sale of medicines without prescription will be necessary for reducing the prevalence of self-medication among older adults. Subjects: Health & Development; Aging; Aging and Health; Health Education and Promotion [ABSTRACT FROM AUTHOR]

The mural of the Royal College of Physicians of Edinburgh contains a unique symbol of an eye placed in the palm of a hand. The symbol is known by many names—the Eye of Providence, the All-Seeing Eye, and the Eye of Horus—and has been a central symbol of religious and medical organizations across many cultures, including Egyptian, British, Indian, and American. The symbol is also representative of the Hamsa. In Arabic cultures, the Hamsa is a palm-shaped amulet that is popular in jewelry and wall hangings. It is a symbol of protection against evil. Both symbols have an important history with regards to medical practice. This paper examines the history of the Eye of Providence and the Hamsa with regard to their use and meaning within the medical profession. [ABSTRACT FROM AUTHOR]

This study examines efforts to integrate social medicine into global health education and its potential to guide the new practice of structural competency. The methods employ participant observation and interviews with program coordinators and participants in a social medicine course. Areas of success included: pedagogical innovation, conscientizing course participants, decentralising global health practice, and promoting reflexivity. Accompanying these successes were points of friction, including: inequities in personal risk and mobility limitations among course participants, as well as complexities and nuances in unintentionally reproducing hierarchies of knowledge. Specifically, further recommendations from our research include: (1) incorporating innovative pedagogical approaches, which highlight social medicine practices outside the global north, prioritising opportunities for cross-collaboration among practitioners from the global south; (2) framing social theory as a bidirectional flow: global south traditions must be included in teaching social theory; (3) practising structural humility by highlighting the perspectives and expertise of communities experiencing social and structural marginalisation, while including strategies in organising and direct pathways to political engagement. These conclusions highlight how social medicine-based training can both build from and move beyond the competencies explicitly specified by the structural competency model to create a global health practice inclusive of diverse thought from around the world. [ABSTRACT FROM AUTHOR]

Assertiveness is a constructive interpersonal behavior alternative to manipulation and aggression. Medical students (MSs) have daily interpersonal interactions with colleagues, patients and families. Yet, communication deficiencies due to hesitancy to speak-up assertively lead to adverse patient outcomes. This study aimed to assess levels of assertive behaviors (ABs), and to determine its predictors within a sample of first-year Tunisian MSs. This was a cross-sectional survey including 125 first-year MSs from Tunisia. ABs were measured by the Rathus assertiveness scale. Potential independent predictors of AB were evaluated using the following questionnaires: Rosenberg self-esteem scale, interpersonal communication skills inventory short-form-36quality of life questionnaire, and general health questionnaire. In addition, some MSs' characteristics were considered (eg; age, sex, living with family, assertiveness training, community work, personal medical field choice, smoking, and alcohol use). Univariate and multivariate analyses were performed. Among the 309 MSs, 125 (40.45%) responded to the survey. AB were found in 36.8% of MSs. Multiple linear regression models revealed that self-esteem global scores, sending clear messages, anxiety/depression and male sex were accountable for 31% in AB scores variance. Targeting self-esteem and interpersonal communication skills (sending clear messages) and identifying subgroups of students with anxiety/depression state would influence ABs. [ABSTRACT FROM AUTHOR]

Prior models of well-being have focused on resolving issues at different levels within a single institution. Changes over time in medicine have resulted in massive turnover and reduced clinical hours that portray a deficit-oriented system. As developments to improve purpose and professional satisfaction emerge, the Texas Medical Association Committee on Physician Health and Wellness (PHW) is committed to providing the vehicle for a statewide collaboration and illuminating the path forward. To describe the existing health and wellness resources in Texas academic medical centers and understand the gaps in resources and strategies for addressing the health and wellness needs in the medical workforce, and in student and trainee populations. Various methods were utilized to gather information regarding health and wellness resources at Texas academic medical centers. A survey was administered to guide a Think Tank discussion during a PHW Exchange, and to assess resources at Texas academic medical centers. Institutional representatives from all Texas learning health systems were eligible to participate in a poster session to share promising practices regarding health and wellness resources, tools, and strategies. Survey responses indicated a need for enhancing wellness program components such as scheduled activities promoting health and wellness, peer support networks, and health and wellness facilities in academic medical centers. Answers collected during the Think Tank discussion identified steps needed to cultivate a culture of wellness and strategies to improve and encourage wellness. The Texas Medical Association Committee on Physician Health and Wellness and PHW Exchange provided a forum to share best practices and identify gaps therein, and has served as a nidus for the formation of a statewide collaboration for which institutional leaders of academic medical centers have affirmed the need to achieve the best result. [ABSTRACT FROM AUTHOR]