Articles: covid-19.
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The first class at USUHS took its initial course in medical ethics in 1977. I directed this course until recently when COVID first emerged. In this piece, I review what these students were taught during the last 5 of 8 class sessions involving the military, genetic, reproduction, student ethics, and the Holocaust. I discuss here the content of these sessions, the rationales of these contents, key lessons learned, and future directions and challenges. This review provides readers with information regarding some of the faculty brought in to provide these lectures, and key points they emphasized. It also summarizes the more subtle points regarding ethics that it was hoped students would gain and use throughout their medical careers and lifetimes. ⋯ Medical ethics is now taught in all medical schools but at USUHS this education must include traditional core medical topics and military medical issues as well. A challenge posed throughout the course was whether to emphasize what ethical and professional behaviors would be expected of students in their later military careers or to challenge them to engage in original analysis of ethical questions that had no self-evident answers. The decision was made in most cases to encourage students having materials to discuss and debate in their discussion groups, especially since they would learn what was expected of them in their military roles from multiple other sources. The priming for these discussions in the presentations seemingly succeeded in engaging the students and in provoking relevant debate throughout all of these cases. This learning is highly important in that in the future in both medicine and the military new unanticipated ethical issues will continue to arise. Since there will be no self-evident best ethical answers to these issues, those tasked with and thus seeking to resolve them will have to depend on having the optimal ethical skills for approaching and resolving these issues. This course sought to initiate this process, engaging these students and moving them hopefully to want to increase their skills in analyzing ethical dilemmas as they continue to progress throughout their military careers.
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The first class at USUHS took its initial course in medical ethics in 1977. I directed this course until recently when COVID first emerged. In this piece, I review what these students were taught during the first 3 of 8 class sessions involving children, end-of-life care, and rersearch. This review provides readers with information regarding some of the faculty brought in to provide these lectures, and key points they emphasized. It also summarizes the more subtle points regarding ethics that it was hoped students would gain and use throughout their medical careers and lifetimes. ⋯ Medical ethics is now taught in all medical schools but at USUHS this education must include traditional core medical topics and military medical issues as well. A challenge posed throughout the course was whether to emphasize what ethical and professional behaviors would be expected of students in their later military careers or to challenge them to engage in original analysis of ethical questions that had no self-evident answers. The decision was made in most cases to encourage students to discuss and debate controversial issues in their discussion groups, especially since they would learn what was expected of them in their military roles from multiple other sources. The priming for these discussions in the presentations seemingly succeeded in engaging the students and in provoking relevant debate throughout all of these cases. This learning is highly important in that in the future in both medicine and the military new unanticipated ethical issues will continue to arise. Since there will be no self-evident best ethical answers to these issues, those tasked with and thus seeking to resolve them will have to depend on having the optimal ethical skills for approaching and resolving these issues. This course sought to initiate this process, engaging these students and moving them hopefully to want to increase their skills in analyzing ethical dilemmas as they continue to progress throughout their military careers.
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Opioid prescription policies may reduce availability of prescription opioids and decrease initiation of opioid analgesic misuse and possible opioid use disorder. Opioid use disorder prevalence may have decreased in recent years, but there are few studies on trends of opioid use disorder incidence. The objective of this study was to examine opioid use disorder incidence rates to detect population changes overall and within demographic subgroups over time. ⋯ This study found that the opioid use disorder incidence rate in Vermont decreased overall between July 2017 (policy start limiting opioid analgesic prescriptions) and December 2021, including during the COVID-19 pandemic, with the most pronounced decrease among adolescents and young adults.
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Scand J Trauma Resus · Dec 2024
A temporary hospital intensive care unit: a preparedness concept to increase intensive care capacity.
Norway faced the possibility of the most significant strain on its intensive care capacity in decades during the COVID-19 pandemic. All Regional Health Authorities in Norway were instructed to prepare for an increase in Intensive Care Units (ICU) capacity demands. To address the surge in demand for critical care, a gymnasium within Haukeland University Hospital premises was planned to be used as a 20-bed temporary ICU. A team-based care approach was trained, where non-ICU nurses received specialized training to support ICU procedures. Maintaining up-to-date medical devices and consumables stored for preparedness through a planned rotation system that feeds into daily use are important. While shortages of medical equipment, hospital beds, and intensive care facilities may occur, personnel shortages are likely to be more significant. ⋯ The concept demonstrates promising potential in enhancing preparedness and maintaining critical care surge capacity during pandemics or mass casualty incidents.
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Randomized Controlled Trial
The Effectiveness of a Specific Exercise Program in Alleviating Work-Related Neck and Upper Back Pain and Improving Mood State in Various Occupational Populations-A Randomized Controlled Trial.
Background and Objectives: The COVID-19 pandemic brought significant challenges across governmental, industrial, and social systems. Additionally, numerous studies have reported a sharp increase in both mental health issues and musculoskeletal disorders worldwide. This study aimed to investigate whether a specific exercise program could alleviate neck and upper back pain symptoms and improve mood state among healthcare and office employees during the post-COVID-19 period. ⋯ Similarly, the mood state of the EGs significantly improved compared with the control groups, as measured between pre- and post-intervention sessions. Conclusions: The COVID-19 period exacerbated stress and musculoskeletal strain, particularly for workers in demanding occupational roles. To mitigate these effects, exercise programs that can be applied while at work should be implemented, as they are effective in enhancing mood and managing neck pain in employees with physical exertion.