Southern medical journal
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Southern medical journal · Sep 2022
Impact of a Hemoglobin Trigger Communication Tool on Perioperative Transfusion in Cardiac Surgery.
Blood transfusion represents an important and potentially modifiable risk in the daily practice of cardiac surgery. The risk profile and increasing cost of transfusion led us to study the effect of different maneuvers, interventions, or surgical techniques to minimize transfusion while maintaining patient safety. This study compares postoperative outcomes before and after incorporating a verbal hemoglobin (Hb) trigger during the surgical timeout in which the surgeon and anesthesiologist preemptively agree on a threshold for packed red blood cell (PRBC) administration in the perioperative period. ⋯ Implementation of a verbal Hb trigger during the surgical timeout was associated with a reduction in FP administration and duration of mechanical ventilation, but not a decrease in PRBC transfusion and mortality.
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Southern medical journal · Sep 2022
Perceptions, Coping Strategies, and Mental Health of Residents during COVID-19.
Since the inception of the coronavirus disease 2019 (COVID-19) pandemic, the United States has been the leader in cases and deaths. Healthcare workers treating these severely ill patients are at risk of many deleterious consequences. Residents, in particular, may be affected by physical as well as psychological consequences. Because data are sparse on perceptions, coping strategies, and the mental health of residents during COVID-19, we explored these issues in survey data from a community-based academic program in the southeastern United States. ⋯ During COVID-19, residents in a southern community-based program with an academic affiliation reported effective coping strategies, predominantly acceptance, self-distraction, and use of emotional support. They reported concerns about becoming infected and, if they did, that their illness would likely be serious. Finally, they have not experienced depression, anxiety, or reported stress. The findings may be restricted in generalizability to a southern community-based program with an academic affiliation.
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Southern medical journal · Sep 2022
Fetal Maturation and Intrauterine Survival in Asian American Women by Ethnicity.
Although there are multiple ethnic subgroups of the Asian race, this population is usually treated as homogenous in public health research and practice. There is a dearth of information on fetal maturation and perinatal outcomes among Asian American women compared with their non-Hispanic (NH) White counterparts. This study aimed to determine whether fetal maturation, as captured by gestational age periods, influences the risk of stillbirth in Asian American fetuses, in general, as well as within different ethnic subgroups: Asian Indian, Korean, Chinese, Vietnamese, Japanese, and Filipino, using NH Whites as referent. ⋯ Our study suggests the existence of differential maturation of the fetoplacental unit as explanation for the decline in intrauterine survival advantage with advancing gestational age among Asian American subgroups.
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Southern medical journal · Sep 2022
Effects of the COVID-19 Crisis on Resident Well-Being in a Community Teaching Hospital.
The coronavirus disease 2019 (COVID-19) pandemic has been an unexpected crisis that continues to challenge the medical community at large. Healthcare environments have been forced to change dramatically, including for medical residents, who are vital members of the innovative emergency response teams. Articles have previously been published on the effects of crises on the well-being of healthcare practitioners; however, there is a paucity of literature targeting medical residents' experiences and general wellness during devastating events. The objective of our study aimed at understanding the emotional impact of the COVID-19 pandemic on residents' stress, academics, and support systems. ⋯ This study provides insight on resident well-being during the initial months of the pandemic and identifies areas that could be improved. Our results demonstrated that the pandemic affected many aspects of residents' well-being and education, and the lessons learned can help guide healthcare institutions when implementing wellness activities for trainees during subsequent crises.
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Southern medical journal · Sep 2022
Likelihood of Adolescents Trying Conventional or Electronic Cigarettes Varies with Their Use and Perception of Harm and Addictiveness of Other Tobacco Products, Including Cigars.
Developing a comprehensive understanding of tobacco product use among adolescents requires information about the use of conventional cigarettes; electronic cigarettes (e-cigarettes); other tobacco products such as cigars, little cigars, and cigarillos (CCLCs); and smokeless tobacco. In particular, the use of products other than cigarettes may have important implications for additional smoking-related behaviors and the health of students and adolescents. ⋯ More than 10% of middle school and high school students have used CCLCs. The majority of students in this subgroup also have used either conventional cigarettes or e-cigarettes. Understanding possible harm with cigarette use is significantly associated with the reduced use of conventional and e-cigarettes, and using CCLCs independently contributes to the increased risk of using conventional and e-cigarettes. The frequent use of several tobacco products makes surveys in this age group more complicated and indicates that educational efforts and public policies regarding tobacco need to include all tobacco products.