How to Be a Successful Businesswoman in Dermatology

Successful businesswomen in dermatology know what type of practice they want and create a plan to make it happen. They align their business with their life and surround themselves with people who support their goals. They accept support but know how to delegate. They do the hard work required to be successful, gaining knowledge and strength from the experience. When they make mistakes, they learn from them. They try to make the most of each patient's experience, while acknowledging that relationships with family, friends, and colleagues, as well as personal growth, are of utmost significance outside of their practices.

Factors Associated with Incomplete Telemedicine Visits at an Virtual Urgent Care Center

Virtual care utilization has exponentially grown since the onset of the pandemic. However, unknown are the factors associated with incomplete virtual care visits. The purpose of this study is to investigate the factors associated with telemedicine call drops. We utilized an on-demand virtual urgent care service to examine the differences between completed and uncompleted visits. We conducted a cross-sectional study of 22,721 telemedicine encounters. We found that older adults were associated with higher rates of completing telemedicine visits, with higher odds with telephone visits. This study adds new knowledge about the factors that may lead to unsuccessful virtual care visits, which is of interest to policy makers.

Handgrip strength is positively associated with successful aging in older adults: A national cross-sectional study in China

OBJECTIVES

Muscle strength gradually decreases with advancing age. This study aimed to explore the relationship between handgrip strength and successful aging and its specific dimensions in older adults using a nationally representative sample.

METHODS

A total of 5269 adults aged 60 and older were included in this study. Handgrip strength was measured using a dynamometer and was organized into quartiles by sex. Successful aging was defined by Rowe and Kahn's conceptual model including the following five dimensions: (a) no major diseases; (b) freedom from disability; (c) high cognitive function; (d) good psychological status; and (e) active social engagement in life. Logistic regression models were used to examine the association between handgrip strength and successful aging and its specific dimensions.

RESULTS

The prevalence of successful aging was found to be 35.1 % in Chinese older adults. Compared to older adults with handgrip strength in the first quartile, those with handgrip strength in the second quartile, third quartile, and fourth quartile had a higher probability of successful aging (adjusted odds ratio (OR): 1.40 (95 % CI: 1.16, 1.69) to 2.06 (95 % CI: 1.70, 2.50)). We further found that the association between handgrip strength and successful aging was related to different ages.

CONCLUSION

This study suggested that there is a close association between handgrip strength and successful aging. Older adults who have greater handgrip strength can successfully deal with the challenges of aging. For older people, keeping a high level of muscle strength in late life may be helpful to the constant successful aging.

Risk factors for residual dizziness in patients with benign paroxysmal positional vertigo after successful repositioning: a systematic review and meta-analysis

PURPOSE

To investigate the risk factors for residual dizziness (RD) in patients with benign paroxysmal positional vertigo (BPPV) after successful repositioning.

METHODS

Searches were performed in PubMed, Embase, Cochrane library, Web of Science, Chinese National Knowledge Infrastructure, and Sino Med up to March 7, 2021 and references of relevant articles were screened. Data from eligible studies were meta-analyzed using Stata version 16.0 and Review Manager 5.4.

RESULTS

In this systematic review and meta-analysis of 4487 patients from 31 studies, the prevalence of RD was 43.0% (95% CI 39.0-48.0%). Age (MD 4.17; 95% CI 2.13-6.21, P = 0.000), female gender (OR = 1.28, 95% CI 1.11-1.47, P = 0.001), secondary BPPV (OR 1.88; 95% CI 1.27-2.77, P = 0.001), a longer duration of BPPV before treatment (MD 3.45; 95% CI 1.87-5.02, P = 0.000), abnormal ocular vestibular evoked myogenic potential (OVEMP, OR 4.34; 95% CI 2.78-6.78, P = 0.000), abnormal cervical vestibular evoked myogenic potential (CVEMP, OR 2.48; 95% CI 1.54-3.99, P = 0.000), higher Dizziness Handicap Index (DHI) score before treatment (MD 10.88; 95% CI 5.96-15.80, P = 0.000), anxiety (OR 9.58; 95% CI 6.32-14.52, P = 0.000), osteopenia (OR = 4.40, 95% CI 2.17-8.96, P = 0.000), onset in winter (OR 7.27; 95% CI 2.38-22.24, P = 0.001) and with a history of BPPV (OR 1.79; 95% CI 1.06-3.04, P = 0.03) are the risk factors for RD in patients with BPPV after successful repositioning. The affected side, location or type of semicircular involvement, hyperlipidemia, diabetes, hypertension, heart disease, migraine, sleep disorders, canalolithiasis/cupulolithiasis, the number of times the canalith repositioning procedures (CRPs) were performed and number of vertigo attacks did not correlate with the occurrence of RD.

CONCLUSIONS

Despite successful treatment, nearly half of the BPPV patients developed RD. RD seems to be a syndrome caused by multiple factors. The pathogenesis of most factors can be explained by psychological and/or physical disorders. Early recognition of these risk factors contributes to the prevention and treatment of RD.

Phenomenological insight into the motivation to quit smoking

INTRODUCTION

Quitting tobacco is often viewed as a difficult experience as the dependence includes sets of behavioral, cognitive, social, and physiologic phenomena that prevent most smokers from having a successful first attempt of quitting. The aim of this qualitative study was to gain insight into and understand the motivation for attempts to quit smoking in relation to the stages of the behavior change model.

METHOD

The study team based this qualitative study on Alfred Schütz's social phenomenology framework. The study team planned for fourteen in-depth interviews with patients registered at a Quit Smoking Clinic. Each in-depth session lasted 45-60 min and we audio recorded them with consent. Following full verbatim transcription, the study team carried out detailed thematic analysis using Nvivo software.

RESULTS

Out of a total of 14 patients, 10 agreed to participate (response rate 71.4%). Seven participants (70%) had successfully quit smoking, while the remaining 30% relapsed after the first quit attempt. The study team extracted from the data three key themes with eight child nodes: barriers to quitting smoking, reasons for quit attempt, and how to quit. Unsuccessful attempts were related to tobacco addiction and successful attempts were based on the need to improve one's health and family. The study explored two intrinsic (self-realization and healthy lifestyle) and two extrinsic motivations (family's health and role model for children) for attempting to quit.

CONCLUSION

The study highlights the importance of psychological support in successful quit attempts. Treatment providers should encourage behavior change through intrinsic goals, as such goals, compared to extrinsic goals, have a long-term and positive impact because they can activate autonomous motivation.

Characteristics of successful primary school-based experiential nutrition programmes: a systematic literature review

OBJECTIVE

Diet and nutrition in childhood has been associated with the risk of chronic disease later in life. The aim of this review was to identify key characteristics of successful experiential nutrition interventions aimed to change nutrition-related cognitive and behavioural outcomes in primary schoolchildren.

DESIGN

A systematic literature review was undertaken using search terms ('food security', 'school', 'nutrition' and 'program') applied to five scientific databases (CINAHL, Scopus, Web of Science, Medline and Academic Search complete), with outcomes defined as nutrition-related knowledge, attitudes and/or dietary behaviours.

PARTICIPANTS

Primary school-aged children exposed to interventions conducted, at least partially, on school grounds.

RESULTS

A total of 3800 articles were identified from the initial search and manual searching, of which sixty-seven articles were eligible for inclusion. Forty-two articles met the criteria of being successful, defined as achieving significant differences in outcomes of interest, accompanied by a demonstrated reach. Interventions included school gardens (n 9), food provision (n 5), taste testing (n 8), cooking classes (n 10) and multicomponent programmes (n 10). Nutrition education (when combined with taste testing), cooking-related activities and gardening interventions increased children's willingness to taste unfamiliar foods including new fruits and vegetables, improved their cooking and food preparation skills and increased nutritional knowledge.

CONCLUSIONS

This review provides evidence that nutrition education programmes in primary schoolchildren that are experiential in nature are most likely to be successful if they include multiple strategies, have parental involvement and focus specifically on vegetable intake.

Treatment outcome of tuberculosis patient of Samtse General Hospital, Bhutan

Background

Tuberculosis (TB) is one of the major public health problems in Bhutan. Evaluation of treatment outcomes of TB and identification of the risk factors are important components for the success of National TB control program. Therefore, this study was undertaken to assess the TB treatment outcome and factors associated with it in Samtse General Hospital.

Methods

This was a retrospective, cross sectional study using the TB data from Samtse General Hospital from 2008-2019. A univariate and multiple logistic regression was used to check for associations between the outcome and other independent variables.

Results

The study included a total of 634 TB patients. Of this, 44.0% (279) were smear positive TB (PTB+), 36.1% (229) were extra pulmonary TB (EPTB) and 19.9% (126) were smear negative TB (PTB-). During the study period, 56.2% (356) of them completed treatment, 33.3% (211) were declared cured, 0.2% (1) had defaulted, 5.1% (32) died and 5.4% (34) had treatment failure. The mean treatment success rate (TSR) was 89.4% (567). The TSR was highest for EPTB with 96.9% (222/229), followed by PTB- at 88.1% (111/126) and lowest for PTB+ with 83.9% (234/279). Successful treatment outcome was observed in EPTB patients (AOR: 7.3; 95% CI: 2.46-21.36), patients in age 15-28 years (AOR: 3.4; 95% CI: 1.59-7.46) and 29-42 years (AOR: 9.1; 95% CI: 2.44-33.61).

Conclusion

The treatment outcome of TB in Samtse General Hospital is satisfactory and at par with the national level. Since, smear positive TB and elderly patients are prone to develop poor treatment outcome, they need to be monitored and followed up adequately.

Tips and guidelines for being a successful researcher

This article aims to share our experience with those who consider dedicating themselves to research. In this way, the characteristics, qualities or competences that, in our opinion, a good researcher should fulfill are listed, and therefore the keys that can help you achieve a successful research career. The intention of this article is not to simply list a series of theoretical recommendations but to share some personal suggestions based on our experience and, therefore, of an eminently practical nature. The fundamental qualities to be discussed are: Ethics and honesty. Curiosity, passion, enthusiasm and motivation. Persistence, dedication and discipline. Ambition and leadership. Compromise and responsibility. Organization and planning. Acquire knowledge of research methodology. Critical and positive attitude towards difficulties and failure. Prioritization of objectives and time management. The importance of a good mentor. Establishment of a network of collaborators and teamwork. Maintain a balance between clinical and research activity. Combine public and private investigation. Balance between professional and personal life. And, finally, humility, generosity and thanks. Research represents a fundamental pillar of medical activity and it is evident that the highest quality of care arises from the integration of excellent clinical practice and research activity. With the philosophy that most of the qualities to develop an excellent research activity depend on attitude, and can be learned, developed and improved, in this manuscript we share with the reader a series of recommendations that we consider essential to be a good researcher.

Induction du travail après une version par manœuvres externes pour siège réussie : un sur-risque de césarienne?

OBJECTIVE

To assess the effect of successful external cephalic version (ECV) on the risk of caesarean section (CS) during attempted vaginal delivery after induction of labour.

METHODS

A unicentric matched retrospective observational case-control cohort study with exposed and unexposed groups. All pregnant women who had an induction of labour after a successful external cephalic version (sECV) between 1998 and 2016 were included. A total of 88 cases were compared with 176 controls (spontaneous cephalic presentation), matching for the year of delivery, parity, gestational age, indication and mode of induction of labour. The main outcome measure was the risk of caesarean. A univariate analysis and a multivariate logistic regression analysis were performed.

RESULTS

The caesarean section rate was significantly higher after sECV (22% versus 13.1%; p = 0.039) especially for postdate pregnancy (55% versus 8.2%; p <0.05). For the univariate analysis, age (31 years and 4 months versus 24 years and 6 months; p <0.01) and maximal speed of oxytocin infusion (72 ml/h versus 68 ml/h; p = 0.04) were higher in the case group. The multivariate analysis showed that the risk of caesarean section was significantly increased after an sECV (aOR 1.946; 95% CI 1.017-3.772) and after the use of prostaglandins for ripening (aOR 1.951; 95% CI 1.097-3.468), and decreased for multipara (aOR 0.208; 95% CI 0.114-0.377).

CONCLUSION

Women who have a successful ECV are at increased risk of caesarean section after subsequent induction of labour.

Predicting Successful Trial of Labor After Cesarean Delivery: Evaluation of Two Scoring Systems

Background

Attempting vaginal birth after cesarean section (VBAC) places women at an increased risk of complications. Trial of labor after cesarean (TOLAC) calculators aim to predict the chance of successful vaginal birth after cesarean (VBAC) based on the patient's preexisting demographic and clinical factors.

Objective

To assess the rate of successful TOLAC using two calculators: FLAMM and the Grobman calculator, and to compare the performance of the two calculators in the successful prediction of VBAC.

Methods

Prospective cohort study in subjects with previous one caesarean section using well-defined inclusion and exclusion criteria.

Results

A total of 280 subjects with previous one cesarean section were enrolled. One hundred thirty-nine subjects consented for TOLAC, 90 (67%) underwent successful trial of vaginal birth, and 49 (32.8) required cesarean section. Cervical dilatation (p < 0.0001) and effacement (p < 0.0001), and any prior vaginal delivery (p < 0.02) were significantly associated with a successful outcome. At a cutoff score of 5, the sensitivity of the FLAMM score was 72% and specificity was 76%. For the Grobman calculator, the best sensitivity (69%) and specificity (67%) were seen at a cutoff score of 85%.

Conclusion

Both prediction models, the FLAMM and the "close to delivery" nomogram, recommended by Grobman et al. are easy to use and could successfully estimate the chances of vaginal birth in previous caesarean, in this small cohort. The decision for women opting for TOLAC can be individualized, and patient-specific chances of success can be predicted by the use of these prediction models.

Association between nighttime sleep and successful aging among older Chinese people

OBJECTIVE

This study aims to assess the association between sleep and successful aging among Chinese ≥60 years of age.

METHODS

Data were collected from the baseline survey of the China Health and Retirement Longitudinal Study. Two self-reported questions about sleep quality and duration were examined. Successful aging was defined following Rowe and Kahn's multidimensional model. To assess the adjusted association between sleep and successful aging, multivariable logistic regression was applied.

RESULTS

The average number of self-reported hours of sleep was 6.2 ± 2.0 among older Chinese people. Successful aging was related to sleep duration, with the proportion of those adults considered to be aging successfully falling into the following sleep duration categories (<6 h - 7.8%; 6 h - 16.3%; 7 h - 19.1%; 8 h - 14.7%; and ≥9 h - 12.8%). The plots between sleep duration and successful aging were an inverse U-shape. Participants who slept less than 6 h per day had lower odds ratios of successful aging [odds ratio (OR) = 0.52, 95% confidence interval (CI) 0.40-0.67] relative to those who slept for 7 h per day. Compared with those who reported poor sleep less than once a week, older people who reported poor sleep five to seven days a week showed a lower ratio of successful aging (OR = 0.29, 95% CI 0.21-0.39).

CONCLUSION

Older age, shorter or longer sleep, and poor sleep were related to lower odds of, rates of successful aging. Most older Chinese adults experience insufficient sleep and poor sleep quality, which could be an important influential factor in successful aging.