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6% (CI95% 38.4-89.5).
One dose of BNT162b2 vaccine against SARS-CoV-2 offers early protection after twelve days of administration. These data could be considered to adapt strategies and consider postponing the second dose in situations of limited vaccine supply in order to achieve the maximum number of people covered with a first dose.
One dose of BNT162b2 vaccine against SARS-CoV-2 offers early protection after twelve days of administration. These data could be considered to adapt strategies and consider postponing the second dose in situations of limited vaccine supply in order to achieve the maximum number of people covered with a first dose.
Multidisciplinary teamwork has become the standard in care for oncological patients and their treatment trajectory when comprehensive, holistic, and high-quality cancer care is needed. Working together from a variety of perspectives is difficult to achieve and has well-known pitfalls, such as miscommunication and poor coordination.
To describe and synthesize the factors influencing and the processes underlying optimal multidisciplinary teamwork.
An integrative review was conducted, guided by the framework of Whittemore and Knafl. The systematic search for literature published since 2010 in 3 databases (PubMed, Web of Science, and Scopus) yielded 49 articles.
Eighty-eight percent of the included studies focus on multidisciplinary team meetings, rather than on the wider notion of multidisciplinary teamwork. We identified influencing factors on the basis of structural features of the team, hospital, and health system, as well as process features of multidisciplinary teamwork in multidisciplinary team meetings.
To improve multidisciplinary teamwork, the focus needs to be on the process of collaboration throughout the cancer care trajectory of the patient. A more integrated, interdisciplinary approach should be aimed for to recognize the role and contribution of all disciplines involved.
A cultural change is needed toward interdisciplinary practice in hospitals to reach partnership between all involved professionals as part of a participatory, collaborative, and coordinated approach.
A cultural change is needed toward interdisciplinary practice in hospitals to reach partnership between all involved professionals as part of a participatory, collaborative, and coordinated approach.In 2020, the National Resident Matching Program (NRMP) sponsored the inaugural "Single Match"-the first time that seniors and graduates of U.S. MD-granting and DO-granting schools participated in one Match. In honor of the Single Match milestone, the authors examine the NRMP's history, reflecting on the organization's efforts since the 1950s to support learners and the graduate medical education community by fostering a responsive, robust matching program while remaining true to its founding principles to provide parity of experience for applicants and reduce coercive practices. The chaos and stress associated with the pre-Match days in the 1920s and 1930s that led to the call for a national clearinghouse are highlighted as are significant NRMP accomplishments, from the organization's incorporation as a 501(c)(3) in 1953 as a simple internship placement system through the first Single Match. Recognizing that the current transition to residency is not without its stressors, the authors note that the NRMP remains committed and willing to continue to evolve and identify innovative and meaningful ways to address learner needs and improve the transition to residency.Physician workforce planning must address multiple concerns such as having sufficient numbers and adequate geographic distribution of physicians and pressures for physicians to adapt to new models of care and payment. Though there are national workforce planning tools, planning tools for local areas have been scarce. MLN8237 This article describes a dynamic simulation model developed as a pilot project to support physician workforce planning in 2 metropolitan areas, Cleveland and Albuquerque (February 2014-June 2016). This model serves as a prototype for planning tools that could be used by medical educators and local health systems to project the effect of different policies on physician supply and demand. System dynamics and group model building approaches were used to develop the model with the participation of local stakeholders to create the model's causal structure. The model included determinants of the demand for primary and specialty care for the local population and projected the effects of births and deaths, aging, level of chronic illness present, and migration on demand. Physician supply was disaggregated by primary versus specialty care, age, sex, and work setting and projected based on completions of local residency programs, physician migration in and out of the area, and retirements. Feedback relationships between supply and demand (e.g., adequacy of care affecting the distribution of chronic illnesses, demand for care influencing in- and out-migration of physicians) were also included and had important effects on the results produced by the model. Scenarios were simulated that projected increased demand for care (e.g., through expanded insurance coverage) and increased supply (e.g., through practice incentives to encourage in-migration) and a combination of these. An expanded advanced practice registered nurse and physician assistant capacity scenario was also simulated. In Albuquerque, the combination scenario yielded the greatest increases in local physician supply.Public health crises palpably demonstrate how social determinants of health have led to disparate health outcomes. The staggering mortality rates among African Americans, Native Americans, and Latinx Americans during the COVID-19 pandemic have revealed how recalcitrant structural inequities can exacerbate disparities and render not just individuals but whole communities acutely vulnerable. While medical curricula that educate students about disparities are vital in rousing awareness, it is experience that is most likely to instill passion for change. The authors first consider the roots of health care disparities in relation to the current pandemic. Then they examine the importance of salient learning experiences that may inspire a commitment to championing social justice. Experiences in diverse communities can imbue medical students with a desire for lifelong learning and advocacy. The authors introduce a three-pillar framework that consists of trust building, structural competency, and cultural humility. They discuss how these pillars should underpin educational efforts to improve social determinants of health.
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