Homme, Jason H.

Background Educational conferences play a crucial role in advancing global health by addressing challenges in diverse settings and fostering bidirectional knowledge exchange. Many new healthcare providers in Ghana lack hands-on experience in life-saving emergency skills, which is further compounded by limited resources and inadequate infrastructure. This highlights the need for targeted educational initiatives. Methods This paper describes a 3-day conference, the Young Doctors Conference, hosted by a non-governmental organization and aimed at improving emergency care skills for early-career healthcare professionals in Ghana. The conference includes interactive sessions on basic life support, newborn resuscitation, obstetric emergencies, point-of-care ultrasound, and communication case studies. An observational study was done using anonymous surveys that were conducted over four years to assess participants’ experiences and the conference’s impact. Results A total of 95 new physicians responded (out of 127), with over 90% reporting being ‘very satisfied’ with the conference. Common descriptors included “high quality,” “useful,” and “inspirational.” Furthermore, 100% of participants rated the quality of the conference as ‘very high’ or ‘high’. Basic life support training significantly increased comfort in managing cardiac arrest and breathing difficulties, while newborn resuscitation improved confidence in caring for critically ill infants. Additionally, 100% of participants stated they were ‘likely’ or ‘highly likely’ to attend again. Conclusions The Young Doctors Conference has been highly rated as an effective initiative in advancing emergency care communication and education. It serves as a valuable model for similar programs in other resource-limited settings, improving skills, communication, and confidence among early-career healthcare professionals. These findings highlight the need for ongoing hands-on education within Ghana’s healthcare system and how partnerships can fill these gaps. Future research is needed to examine long-term outcomes of this conference.

Objective This survey study assessed trainee attitudes and perceptions of the longitudinal public speaking curriculum at Mayo Clinic Pediatric and Adolescent Residency Program. Methods This 3-part survey of Mayo Clinic pediatric residents was conducted from 2013 to 2017 and utilized yes/no questions, Likert scales, and open-ended questions. Code book content analysis was used to analyze open-ended questions. Results A total of 121 participants (96.8%, n = 121/125) completed the survey. Most respondents (93.3%, n = 111/119) either agreed or strongly agreed that the public speaking requirement enabled them to be more effective in delivering information to large groups. Most respondents (89.2%, n = 107/120) agreed or strongly agreed that they incorporated feedback from previous public speaking feedback sessions into subsequent presentations. The 2 activities that respondents found most useful for preparing later presentations were setting goals for future presentations in a feedback session and discussing performance in a feedback session. Conclusions There was a perceived effectiveness of a longitudinal public speaking curriculum among pediatric residents at our program. Multidimensional feedback seems to be a critical aspect of a public speaking curriculum in graduate medical education.

AbstractMetabolic pathways are known to generate byproducts—some of which have no clear metabolic function and some of which are toxic. Nicotinamide adenine dinucleotide phosphate hydrate (NAD(P)HX) is a toxic metabolite that is produced by stressors such as a fever, infection, or physical stress. Nicotinamide adenine dinucleotide phosphate hydrate dehydratase (NAXD) and nicotinamide adenine dinucleotide phosphate hydrate epimerase (NAXE) are part of the nicotinamide repair system that function to break down this toxic metabolite. Deficiency of NAXD and NAXE interrupts the critical intracellular repair of NAD(P)HX and allows for its accumulation. Clinically, deficiency of NAXE manifests as progressive, early onset encephalopathy with brain edema and/or leukoencephalopathy (PEBEL) 1, while deficiency of NAXD manifests as PEBEL2. In this report, we describe a case of probable PEBEL2 in a patient with a variant of unknown significance (c.362C>T, p.121L) in the NAXD gene who presented after routine immunizations with significant skin findings and in the absence of fevers.

Objective: The purpose of this report is to describe the elements of a Covid-19 Care Clinic (CCC), patient demographics, and outcomes. Methods: Descriptive statistics were used to describe demographics, clinical characteristics, and outcomes. This report is based on 4934 unique patients seen in the CCC who provided research authorization within a 10-month period of time (April 1, 2020-January 31, 2021). The CCC infection control processes consisted of a rooming process that mitigated SARS-COV-2 transmission, preparing examination rooms, using PPE by staff, in room lab drawing, and escorting services to minimize the time in clinic. Results: Of the 4934 unique patients seen (age range newborn-102 years), 76.8% were tested for COVID-19. Of those tested, 11.8% were positive for SARS-CoV-2. Ninety-two percent of the patients with the reason for the visit documented had COVID-19 type symptoms. Cough, shortness of breath, and chest pain were the most common presenting symptom in those with COVID-19. At the time of the visit in the CCC, 5.8% of the patients were actively contagious. Thirty days after being seen in the CCC, 9.1% of the patients were seen in the emergency department (ED) and 0.2% died. During the 10-month period there were no known occupationally related COVID-19 infections. Conclusion: The COVID-19 Care Clinic provided face-to-face access for all ages with COVID-19 type symptoms. A minority of patients had COVID-19 who were seen in the clinic. The clinic provided an additional venue of care outside of the ED. The infectious control measures employed were highly effective in protecting the staff. Lessons learned allow for decentralization of COVID-19 symptom care to the primary care practices employing the infection control measures.

ABSTRACT Background Many female residents choose to start families during training, and they want to breastfeed their infants. Continuing lactation while balancing service and education demands can be challenging. Objective We hypothesized that the presence of a dedicated and fully equipped lactation room with a hospital-grade pump (HGP) would increase ease and efficiency of lactation during residency. Methods A quiet HGP was purchased for resident use, and it was stored in a designated room with a computer, telephone, and dictation system. Lactating residents provided information about pumping time and production using their own portable double electric pump (PP) versus the HGP based on the first pump of the morning (for consistency), averaged over the first month back from maternity leave. Results Among 6 residents, lactation time with PP averaged 24 minutes (range, 15–40 minutes) versus 15.5 minutes with HGP (range, 10–32 minutes). Use of the HGP reduced total pumping time by 8.5 minutes (95% confidence interval 3.8–12.2, P = .045). Production volume increased from 6 ounces (range, 3.5–8.5 ounces) with PP to 8.8 ounces (range, 8–11 ounces) with HGP, for a mean increase of 2.8 ounces (95% confidence interval 1.2–4.3, P = .06) despite decreased lactation time. Conclusions In our pilot, an HGP significantly decreased lactation time, while increasing expressed milk volume. Residents completed clinical and educational tasks while pumping. Providing an HGP and equipped lactation space helped residents continue breastfeeding and decreased the burden of lactation on patient care and educational tasks.