UNASSIGNED: The rapid spread and mutation rate of severe acute respiratory syndrome corona virus (SARS-CoV2) demands continuous monitoring in terms of genomic and serosurvival. The current study is designed to track the seroprevalence of health care workers (HCWs) postvaccination, as they may be more susceptible to contracting the SARS-CoV-2 infection compared to the general population.
UNASSIGNED: The objective was to identify the seroprevalence rate for SARS-CoV-2 immunoglobulin G (IgG) antibody (N, S1, S2) amongst HCWs of various levels of exposure working in a tertiary care teaching hospital in Puducherry.
UNASSIGNED: The present study followed a nonprobability consecutive sampling technique, which involved 216 study participants HCWs from the hospital. IgG antibody levels were measured using EUROIMMUNE Anti SARS-COV-2 ELISA KIT (IG g) ELISA at two points: firstly, 2 weeks after the second dose of vaccination, followed by 2 weeks after the booster dose.
UNASSIGNED: Out of the total 216 participants enrolled in the survey, there were 140 males and 76 females, and the maximum number of candidates studied were in the 41-50 age group. Almost 46.7% of the HCWs who participated in the study were seropositive for SARS-CoV-2 in the case of those who were high-risk exposed, while only 30.4% were amongst those who were low-risk exposed. The proportion of study participants who became seropositive increased considerably after the booster dose (65.7%), from 38.0% when tested three months after infection.
UNASSIGNED: A significant increase in antibody titres amongst high-risk HCWs postboost vaccination demands continuous monitoring of soluble IgG levels for recommendations of vaccination schedules.

UNASSIGNED: Over the previous decades, violence against physicians has risen. To comprehend the issue connected with it, we need to know the nature of violence and doctor\'s views on the current state of safety at their disposal. The purpose of the study was to assess the incidence and nature of violence against doctors in tertiary health care centers in Karnataka, India.
UNASSIGNED: The objectives were to collect data from three tertiary care centers, evaluate the incidence of violence against doctors in tertiary care centers, and evaluate the nature of violence against doctors in tertiary care centers.
UNASSIGNED: From the list of all tertiary care centers in Dakshina Kannada, three tertiary care hospitals were randomly chosen. Approval of the Ethical Committee from the Institutional Ethics Committee (IEC) of KVG Dental College and permission from chosen hospitals were obtained. A pre-validated questionnaire was handed over to the available physicians and surgeons in these hospitals to be filled. The total number of participants in the study was 330.
UNASSIGNED: Nearly half (48.02% of physicians) reported experiencing violence during working hours. The Department of Obstetrics and Gynaecology recorded 43.2% of instances, while surgery, medicine, and other departments reported 23.6%, 22.8%, and 10.4%, respectively.
UNASSIGNED: Violence against physicians continues to be a huge issue that must be addressed through decisive measures by the police and hospitals. This impacts the healthcare system in the nation and often cripples it owing to the loss of human resources and working hours.

Background Contemporary medical education emphasizes that postgraduate clinicians should look at their daily experiences as an opportunity to learn and advance their knowledge and practice of medicine. This is the concept of reflective practice. Internal medicine trainees (IMT) in the UK are encouraged to record written reflections in their electronic portfolios but it is not a mandatory requirement. There is literature suggesting that the level of engagement with these written reflections is varied and that when these are produced, they can be superficial. Thus, the aim of this research was to ascertain what percentage of trainees engaged in written reflections and the factors that affected the likelihood they would reflect. There are no studies that have attempted to quantify de novo engagement with reflective practice and to quantify the significance of different theorized barriers to reflection. Methods This study was in the form of a quasi-experimental cross-sectional study. A 15-item survey was sent out to the IMT in the northwest deanery of England (n=592). The survey remained open for approximately three months with periodic reminders sent out to the trainees. The survey was closed to further responses when the number of responses reached the predetermined sample size of 240 (5% margin of error at a confidence interval of 95%). The data were analyzed by chi-square testing and represented using descriptive statistics. Results There were 243 responses to this survey. A total of 81.5% (n=198) wrote reflections in their portfolio and 19.5% (n=45) did not write any reflections. The main content of written reflections were clinical outcomes (positive and negative), teaching, and new learning. Several background factors had a statistically significant influence on the likelihood that trainees would write reflections in their portfolios. These included their stage of training, years practicing medicine, location of primary medical training, first exposure to reflective practice, and whether they have ever been tutored on reflection. Concerns about legal or General Medical Council (GMC) use of reflective notes against trainees also significantly impacted on reflection. The main perceived barriers to written reflections were the fact that trainees felt they had no time to properly reflect and the lack of perceived benefits from reflections. Conclusion Most trainees wrote reflections in their portfolios, but the majority did not perceive any benefits in doing this. The varied backgrounds of trainees seem to have an impact on their likelihood to reflect and strategies to increase engagement would need to address this.

BACKGROUND: While the number of emergency patients worldwide continues to increase, emergency doctors often face moral distress. It hampers the overall efficiency of the emergency department, even leading to a reduction in human resources.
OBJECTIVE: This study explored the experience of moral distress among emergency department doctors and analyzed the causes of its occurrence and the strategies for addressing it.
METHODS: Purposive and snowball sampling strategies were used in this study. Data were collected through in-depth, semi-structured interviews with 10 doctors working in the emergency department of a tertiary general hospital in southwest China. The interview data underwent processing using the Nvivo 14 software. The data analysis was guided by Colaizzi\'s phenomenological analysis method.
RESULTS: This study yielded five themes: (1) imbalance between Limited Medical Resources and High-Quality Treatment Needs; (2) Ineffective Communication with Patients; (3) Rescuing Patients With no prospect of treatment; (4) Challenges in Sustaining Optimal Treatment Measures; and (5) Strategies for Addressing Moral Distress.
CONCLUSIONS: The moral distress faced by emergency doctors stems from various aspects. Clinical management and policymakers can alleviate this distress by enhancing the dissemination of emergency medical knowledge to the general public, improving the social and economic support systems, and strengthening multidisciplinary collaboration and doctors\' communication skills.

BACKGROUND: Large language models (LLMs) have demonstrated impressive performances in various medical domains, prompting an exploration of their potential utility within the high-demand setting of emergency department (ED) triage. This study evaluated the triage proficiency of different LLMs and ChatGPT, an LLM-based chatbot, compared to professionally trained ED staff and untrained personnel. We further explored whether LLM responses could guide untrained staff in effective triage.
OBJECTIVE: This study aimed to assess the efficacy of LLMs and the associated product ChatGPT in ED triage compared to personnel of varying training status and to investigate if the models\' responses can enhance the triage proficiency of untrained personnel.
METHODS: A total of 124 anonymized case vignettes were triaged by untrained doctors; different versions of currently available LLMs; ChatGPT; and professionally trained raters, who subsequently agreed on a consensus set according to the Manchester Triage System (MTS). The prototypical vignettes were adapted from cases at a tertiary ED in Germany. The main outcome was the level of agreement between raters\' MTS level assignments, measured via quadratic-weighted Cohen κ. The extent of over- and undertriage was also determined. Notably, instances of ChatGPT were prompted using zero-shot approaches without extensive background information on the MTS. The tested LLMs included raw GPT-4, Llama 3 70B, Gemini 1.5, and Mixtral 8x7b.
RESULTS: GPT-4-based ChatGPT and untrained doctors showed substantial agreement with the consensus triage of professional raters (κ=mean 0.67, SD 0.037 and κ=mean 0.68, SD 0.056, respectively), significantly exceeding the performance of GPT-3.5-based ChatGPT (κ=mean 0.54, SD 0.024; P<.001). When untrained doctors used this LLM for second-opinion triage, there was a slight but statistically insignificant performance increase (κ=mean 0.70, SD 0.047; P=.97). Other tested LLMs performed similar to or worse than GPT-4-based ChatGPT or showed odd triaging behavior with the used parameters. LLMs and ChatGPT models tended toward overtriage, whereas untrained doctors undertriaged.
CONCLUSIONS: While LLMs and the LLM-based product ChatGPT do not yet match professionally trained raters, their best models\' triage proficiency equals that of untrained ED doctors. In its current form, LLMs or ChatGPT thus did not demonstrate gold-standard performance in ED triage and, in the setting of this study, failed to significantly improve untrained doctors\' triage when used as decision support. Notable performance enhancements in newer LLM versions over older ones hint at future improvements with further technological development and specific training.

UNASSIGNED: This study provides an understanding of the chronic low back pain (CLBP) beliefs and management practices of physicians/doctors and physiotherapists in Ghana, and the mechanisms underlying their beliefs and practices.
UNASSIGNED: Thirty-three individual semi-structured interviews, involving eighteen physio-therapists and fifteen physicians involved with CLBP management, were carried out. Interviews were audio recorded, transcribed, and analysed using Straussian grounded theory principles and critical realist philosophy.
UNASSIGNED: Five categories were derived: The predominance of bio-medical/mechanical beliefs, maladaptive beliefs, maladaptive practices, limited involvement of physiotherapists and other healthcare professionals (HCPs) and evidence-based beliefs and practices. The predominant mechanisms underlying the HCPs beliefs and practices were: the healthcare environment (professional roles/identity hinged around paternalistic and biomedical care, fragmented CLBP management, limited physiotherapy/HCPs\' knowledge) and sociocultural environment (sociocultural/patients\' expectations of passive therapy and paternalism).
UNASSIGNED: The CLBP beliefs and practices of HCPs involved with CLBP in Ghana is modelled around a professional identity that is largely hinged on paternalism and bio-medical/mechanical understandings. Lack of collaboration and sociocultural expectations also play a significant role. There is the need for a reconstitution of Ghanaian HCPs\' CLBP beliefs and management approaches to align with evidenced-based approaches (e.g., imaging should not be universally prescribed, biopsychosocial and patient-centred care).
The burden of low back pain is substantial globally, with an increasing burden identified in low-to-middle income countries.This study highlights a predominance of non-evidence-based understandings around chronic low back pain and its management among Ghanaian healthcare professionals, although some evidence-based approaches were also identified.Ghanaian healthcare professionals need to engage with current evidence for chronic low back pain management, incorporate psychological factors and consider non-specific chronic low back pain as a possible diagnostic label.Professional, structural, and sociocultural inclinations towards paternalism, passive therapies, biomedical and fragmented approaches to chronic low back pain management need to be addressed.

BACKGROUND:  There is a continuous rise in the total number and percentage of elders globally, and as such, they are expected to utilize healthcare services more often. Therefore, this study aimed to determine doctors\' and students\' current knowledge and attitudes toward elders and compare those findings with other studies worldwide. The specific objectives of this study were to determine and compare the differences in attitudes between medical students and doctors regarding geriatrics. This comparison will focus on the following four key domains: social values, resource distribution, compassion, and medical care. Another objective was to assess the knowledge of medical students and doctors regarding geriatric topics. This assessment will help determine the necessity for interventions such as educational programs and workshops on geriatrics.
METHODS: This cross-sectional questionnaire-based study was conducted by disseminating a Google Forms survey to medical students and doctors. The survey included the University of California, Los Angeles (UCLA) Geriatrics Attitudes Scale and the UCLA Geriatrics Knowledge Test. Data was analyzed using SPSS version 29.0.2.0 (Armonk, NY: IBM Corp.).
RESULTS:  A total number of 126 medical students and 72 doctors filled out the survey. Both medical students and doctors demonstrated moderate scores on the attitudes scale, with overall average scores of 2.92 out of 5 and 2.93 out of 5, respectively. As for knowledge, medical students achieved an average score of 41%, while doctors attained an average score of 43%.
CONCLUSIONS:  This study provides significant insights regarding the knowledge and attitudes of students and doctors and attitudes towards geriatrics. The moderate attitudes score and poor knowledge score across both groups indicate the need for medical educators in Oman to further emphasize and teach about geriatrics in medical curricula.

BACKGROUND: One in four Canadians is a family caregiver. Family caregivers (carers, care-partners) are relatives or chosen family, friends, or neighbors who provide 75 to 90% of the care for people with physical or mental illness, disabilities, or frailty living in community homes and assist with 15 to 30% of the care in congregate care. However, a recent (2022) Statistics Canada population health study reports 44% of family caregivers are distressed. Family physicians and primary care teams are well-positioned to support family caregivers; yet, family caregiver needs assessments tend to be ad hoc and their most common needs remain unmet. Research recommends training healthcare professionals to enhance their knowledge and skills to support family caregivers.
METHODS: The objective of this sequential mixed methods research, a survey followed by qualitative interviews, was to explore family physicians\' desire and preferences for education about supporting family caregivers. 85 family physicians completed the online survey and eight took part in the interviews. Results from the survey and interviews were compared, contrasted, and interpreted together.
RESULTS: Primary care physicians expressed a desire to be better equipped to assess and support FCGs\' needs. Even though most physicians (61%) were very/confident about addressing family caregivers\' needs, 72% were highly/interested in education to support family caregivers of their patients. Topics with the most interest were assessing family caregivers needs in an organized way, assisting family caregivers to access resources, and address system and practice barriers to support family caregivers. The overarching theme running through the interviews was physicians hope for education to help change the patient-focused culture to inclusion of FCGs. The three themes reflect physicians\' conviction about including family caregivers in patient care: We need to take care of their caregivers, Practice and system barriers thwart including family caregivers, and Practical education might help.
CONCLUSIONS: This study of family physicians\' preferences for education to support family caregivers will inform the development of education about supporting family caregivers for family physicians and trainees.

A distinction can be drawn between healthcare, where compassion is evident, and the functional delivery of health services. Measures to curb the spread of COVID-19, such as personal protective equipment, telehealth, and visiting restrictions created barriers to service delivery and put pressure on healthcare. Through 37 qualitative interviews with NHS senior managers (n = 11), health professionals (n = 26), and 5 focus group discussions with members of the public (n = 26), we explored experiences of the everyday ethical tensions created as services were being re-established following the acute phase of the COVID-19 pandemic in England. Our analysis enriches an understanding of compassionate care as outlined in NHS operational documents - covering the emotional, moral, and relational components of healthcare beyond the functionalities of treatment. From this analysis, we consider the normative standards underpinning NHS healthcare, concluding that, wherever possible, offering compassionate healthcare to patients and their families should be facilitated, and health professionals should themselves be compassionately supported in the workplace. Our findings foreground the need to consider the consequences of the short-term adoption of a functional treatment approach, including strategies that support health professionals and inform the public, to avoid the long-term damage caused by the fracturing of compassionate healthcare.

Background Biomedical waste (BMW) management is an important practice that has to be followed by all healthcare workers (HCW) in health centres. COVID-19 had become a global threat, and the spread of the infection had increased drastically. Healthcare workers were already involved in managing COVID-19 patients. It is essential to have adequate knowledge, attitude and good practices among healthcare workers during the COVID-19 period. Hence, the present study was conducted to assess the knowledge, attitude and practices of COVID-19 biomedical waste management among doctors and nurses working in a private tertiary care centre in Puducherry. Methods A cross-sectional study was conducted to assess the knowledge, attitude and practice of BMW management among doctors and nurses who were working during the COVID-19 period. A total of 384 samples were recruited, and the study was conducted for a period of four months. Data were collected from a pre-validated, pre-tested questionnaire that assessed the knowledge, attitude and practices of biomedical waste management. Further analysis was done using Microsoft (MS) Excel (Microsoft® Corp., Redmond, WA) and the Statistical Package for Social Sciences (SPSS) software (IBM SPSS Statistics, Armonk, NY). Results Among the 384 participants, 152 (39.6%) had excellent knowledge, 143 (37.2%) had good knowledge and 89 (23.2%) had poor knowledge. Among the 111 doctors, 55 (49.5%) had excellent knowledge, and 36 (32.4%) had good knowledge. Among the 273 nurses, 107 (39.2%) had good knowledge and 97 (35.5%) had excellent knowledge. Of the study participants, 98.2% had a favourable attitude, and 89.6% had favourable practices towards biomedical waste management. Occupation and training received on BMW management were found to be predictors of knowledge regarding biomedical waste management. Conclusion From the present study, it is found that the knowledge of biomedical waste management needs to be improved among doctors and nurses, especially in situations such as the COVID-19 pandemic. In this study, a positive correlation was found between knowledge score and practice score, which states that increasing knowledge regarding biomedical waste management will improve practice towards biomedical waste management. Also, doctors and nurses who had already received training in biomedical waste management were found to have better knowledge than those who had not. Hence, the college administration should do various health education activities and training sessions to enhance biomedical waste management among doctors and nurses working in the hospital.