With recent advances in understanding racial, socioeconomic, and mental health issues in medicine and their relation to policy and legislation, medical professionals are increasingly involved in local and national advocacy efforts. At the frontlines of these initiatives are medical students who, in addition to completing required coursework and clinical training, devote themselves to serving patients through civic participation. The burgeoning evidence concerning health care disparities and inequity, along with greater awareness of racial and socioeconomic discrimination, have made advocacy an essential aspect of many students\' medical training. Every year, thousands of medical students join national medical advocacy organizations, in addition to regional, state, and local groups. Despite the rich history of medical student involvement in advocacy, there remains much speculation and skepticism about the practice as an essential component of the medical profession. From early initiatives pushing for national health insurance after World War II to encouraging antidiscrimination policies and practices, medical students have been collectively working to create change for themselves and their patients. Through efforts such as banning smoking on airplanes, creating safe syringe programs, and protesting against police brutality, many medical students work tirelessly in advocacy despite minimal educational support or guidance about the advocacy process. Given that medical student advocacy continues to grow and has shown measurable successes in the past, the authors believe that these efforts should be rewarded and expanded upon. The authors examine historical examples of medical student advocacy to suggest ways in which advocacy can be integrated into core medical school curricula and activities. They call attention to opportunities to support students\' development of knowledge and skills to facilitate legislative change, expansion of interprofessional collaborations and credit, and curricular updates to promote social and health equity.

UNASSIGNED: Medicine-related problems are common in older people living in residential aged care facilities (RACFs). Recognising the significant medicine-related problems, the Australian government has announced a $345 million funding package to employ on-site pharmacists in RACFs starting in 2023. The new on-site pharmacists are to provide a range of clinical services to reduce medicine-related adverse events, promote quality use of medicines, and improve clinical governance and education. Underpinning these services, the authors argue that pharmacists play the critical role as resident advocates.
UNASSIGNED: This study aims to demonstrate how pharmacists can enhance their advocacy responsibility within and beyond the clinical environment to not only reduce medicine-related adverse events but also improve residents\' overall health and quality of life.
UNASSIGNED: This study uses a case series methodology to demonstrate pharmacists\' diverse roles in advocating for residents and their families. The case studies were based on participants enrolled in the Reducing Medicine-Induced Deterioration and Adverse Reactions (ReMInDAR) trial, a randomised controlled trial testing the effects of a regular pharmacist service across the Australian RACFs.
UNASSIGNED: Pharmacists\' advocacy ranged from persistence in follow-up with a resident\'s general practitioner (GP) to ensure the GP was aware that a patient was experiencing bleeding and bruising while on an anticoagulant, to advocating for a new bed for a resident with peripheral oedema who had been sleeping in his chair due to fear of falling out of his current bed.
UNASSIGNED: Our trial focussed on pharmacists serving as the residents\' advocate to improve their overall health and quality of life, rather than just addressing a list of medicine-related problems. The pharmacist model used in the ReMInDAR trial supports pharmacists to work to their full scope of practice, helps guide the Australian government\'s new on-site pharmacist program, and serves as an exemplar pharmacist in aged care model internationally.

This paper documents policy decisions and transformations in response to the COVID-19 pandemic in Botswana and utilizes the multi-sectoral approach (MSA) in providing this analysis.
A desk review of the different government gazette documents was conducted to trace health policy evolutionary developments and their impact on the general lives of the people of Botswana.
Revealed the actors, roles in this policy transformation and the conditions that enhanced the smooth implementation of the policies are discussed.
The paper concludes by making some recommendations for the country\'s preparedness and anticipatory guidance for any other pandemic or disaster that may arise.
This paper highlights the importance of the multisectoral approach in addressing crises such as pandemics. It also demonstrates the need for countries to have well-defined guidelines to allow decision making in the delivery of efficient health services to the general population during pandemics.

Patients with underlying psychiatric conditions are vulnerable to the experience of sexual violence. Barriers and facilitators to disclosure exist, at the level of the individual, healthcare system, legal system and society in general. Management requires a trauma-informed approach with a focus on avoidance of stigma, optimisation of pre-existing psychiatric conditions and appropriate treatment of psychological sequalae. Preventive strategies by the patient, practitioner and healthcare system, may assist to reduce the risk of future sexual violence.

This case discusses a 62-year-old woman with de novo metastatic lung adenocarcinoma (PD-L1 >50% with a KRAS G12C mutation, ALK and EGFR negative) who was on pembrolizumab for 1 year without any significant toxicity, only low-grade dermatitis and hypothyroidism. She was transitioned to pembrolizumab every 6 weeks at 4 mg/kg and began to develop oral sores shortly thereafter. The sores proved refractory to nystatin and mouth rinses containing corticosteroids, and the patient was ultimately diagnosed with autoimmune-triggered lichen planus. Unfortunately, her symptoms also proved refractory to typical treatments for lichen planus and worsened to the point where she began to develop cutaneous lesions and difficulty swallowing. Unfortunately, she also developed a keratoacanthoma that required excision. The pembrolizumab was stopped, and the patient\'s symptoms improved with 5 days of systemic prednisone, metronidazole, and triamcinolone oral paste. Her NSCLC remains stable off active treatment for 6 months. This case study is on rare auto-immune toxicity as well as a keratoacanthoma from anti-PD-(L) 1 blockade, accompanied by sustained treatment response after cessation of the offending drug.

This article analyses patient advocacy for ovarian cancer patients\' access to a group of new targeted cancer treatments, so-called poly (adenosine diphosphate ribose) polymerase (PARP) inhibitors. Ovarian cancer is often detected in its advanced stages and has relatively poor survival rates. Based on ethnographic fieldwork with the Gynae Cancer Group, a Swedish patients\' group, this article examines ovarian cancer patient advocates\' engagement with biomedicine as a rarely considered topic in the social sciences. Adopting a modified version of the science and technology studies perspective on evidence-based activism, I analyse how ovarian cancer patient advocates engage in the \'epistemic activities\' of framing, producing and mobilising \'credentialed\' and \'experiential\' knowledge. I show how patient advocates, alone and together with professionals and the media, engage in epistemic activities to \'act upon\' ovarian cancer patients\' anticipated limited time and poor prognosis: patient advocates mobilise around PARP inhibitors as offering hope, access to these drugs as an urgent matter and ovarian cancer care as unequal. The article contributes to the sociological literature on novel cancer treatments and patient advocacy through its ethnographic tracing of cancer advocacy tropes and knowledge practices, centred on the temporal figure of \'the patient running out of time\'.

BACKGROUND: Healthcare provision for the multimorbid elderly is complex. Care and Case Managers (CCMs) can help to coordinate and structure outpatient care for these patient groups. This approach will be realized in the project RubiN (\"Continuous Care in Regional Networks\"), which is funded by the Federal Joint Committee. The aim of the present qualitative study was to explore the motivation to work as a CCM.
METHODS: As part of the qualitative study framework, semi-structured interviews with CCMs were conducted as part of a joint kick-off event. The interviews were focused on the reasons and motivation for participating in the RubiN project. The transcribed interviews were analyzed using qualitative content analysis.
RESULTS: Eight of 20 CCMs agreed to take part in the interviews. One of the main motivations for taking part in RubiN was to shift away from working conditions that were perceived as stressful and towards an activity that was experienced as appreciative. The CCMs felt that their professional expertise was recognized by other service providers, and that appreciation of their role increased through their active involvement in the care of geriatric patients.
CONCLUSIONS: Care and Case Management as a practical application with extensive coordination services for geriatric patients may contribute to an increase in appreciation and recognition through establishing a separate area of responsibility and scope as well as working in an interdisciplinary team.

Most PhD students have no idea what patent law is, if it is a career they might want to pursue, and how to get into the profession. Here, a recent law school graduate with a PhD in the life sciences explains everything from how to get into law school to what patent law actually is. Most importantly, he explains why he believes it is a more attractive career choice after your PhD than academia or industry.

Community-level benefits of screening for active tuberculosis (TB) disease remain uncertain. Project Axshya (meaning free of TB) conducted advocacy, communication, social mobilization, and active case finding among vulnerable/marginalized populations of India. Among 15 districts of Jharkhand state, the project was initiated in 36 subdistrict level administrative units - tuberculosis units (TUs) in a staggered manner between April 2013 and September 2014, and continued till the end of 2015. Seven TUs did not implement the project. We assessed the relative change in the quarterly TB case finding indicators (n = 4) after inclusion of a TU within the project. By fitting four multilevel models (mixed-effects maximum likelihood regression using random intercept), we adjusted for secular (over previous five quarters) and seasonal trends, baseline differences within Axshya and non-Axshya TUs, and population size and clustering within districts and within TUs. After inclusion of a TU within the project, we found a significant increase [95% confidence interval (CI)] in TU-level presumptive TB sputum examination rate, new sputum-positive TB Case Notification Rate (CNR), sputum-positive TB CNR, and all forms TB CNR by 12 (5.5, 18.5), 1.1 (0.5, 1.7), 1.3 (0.6, 2.0), and 1.2 (0.1, 2.2) per 100,000 population per quarter, respectively. Overall, the project resulted in an increase (95% CI) in sputum examination and detection of new sputum-positive TB, sputum-positive TB and all forms of TB patients by 22,410 (10,203, 34,077), 2066 (923, 3210), 2380 (1162, 3616), and 2122 (203, 4059), respectively. This provides evidence for implementing project Axshya over and above the existing passive case finding.

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