A new study demonstrates that young doctors often fail to heed the Biblical injunction, "physician, heal thyself." In a research letter published in the September 15, 2010, issue of JAMA, researchers report that three out of five residents surveyed came to work in the previous year while sick, possibly exposing their patients and colleagues to suboptimal performance and, in many cases, communicable disease. The survey, which involved multiple hospitals, found that 60 percent of residents—physicians who have completed medical school and are getting on-the-job advanced ...

Scientists have overturned the conventional wisdom that cooperation is essential for the well-being of the whole population, finding evidence that slackers can sometimes help the common good. Researchers, from Imperial College London, the Universities of Bath and Oxford, University College London and the Max Planck Institute for Evolutionary Biology studied populations of yeast and found that a mixture of 'co-operators' and 'cheats' grew faster than a more utopian one of only "co-operators." The study, publishing next week in the online, open access journal PLoS Biology, ...

In research published this week in PLoS Medicine, results from the Shanghai Women's Health Study reveal the impact of lifestyle-related factors on mortality in a cohort of Chinese women – confirming the results from other Western research studies. The large prospective cohort study by Wei Zheng and colleagues (from Vanderbilt University & Shanghai Cancer Institute) showed that lifestyle factors other than active smoking and alcohol consumption, have a major combined impact on total mortality on a scale comparable to the effect of smoking. For example healthier lifestyle-related ...

David Henry from the University of Toronto and colleagues analysed Australian news stories over a five-year period, and examined whether experienced specialist health reporters write better stories than other categories of journalists. They found that it does matter who writes news stories that cover the benefits and harms of health care interventions: stories written by specialist health journalists working for a single media outlet were of higher quality than those written by less experienced writers. The authors say their findings are important because "this source of ...

Amos Channon from the University of Southampton, United Kingdom and colleagues outline the complexities of urban advantage in maternal health where the urban poor often have worse access to health care than women in rural areas. They used improved methods to measure urban poverty in 30 countries, and found substantial inequalities in maternal and newborn health, and in access to health care. The authors outline two main patterns of urban inequality in developing countries, and offer recommendations for improving access to care. INFORMATION: Funding: No funding was received ...

Medical students with higher levels of distress (burnout) were more likely to self-report unprofessional conduct related to patient care and less altruistic professional values, according to a study in the September 15 issue of JAMA, a theme issue on medical education. "Professionalism is a core competency for all physicians. Professionalism includes being honest, acting with integrity, advocating for the needs of patients, reducing barriers to equitable health care, and adhering to an ethical code of conduct," the authors write. "Despite the widely acknowledged importance ...

Medical students with moderate to severe depression more frequently endorsed several depression stigma attitudes than nondepressed students and had a higher rate of suicidal thoughts, according to a study in the September 15 issue of JAMA, a theme issue on medical education. "Medical students experience depression, burnout, and mental illness at a higher rate than the general population, with mental health deteriorating over the course of medical training. Medical students have a higher risk of suicidal ideation and suicide, higher rates of burnout, and a lower quality ...

Fourth-year medical students who participated in an educational intervention were more likely to seek, identify and incorporate into care patient circumstances that may require variation from standard care, compared to students in a control group, according to a study in the September 15 issue of JAMA, a theme issue on medical education. "Clinical decision making requires 2 distinct skills: classifying patients' conditions into diagnostic and management categories that permit the application of best-evidence guidelines, and individualizing or contextualizing care for ...

Sunita Sah, M.B.Ch.B., B.Sc., M.B.A., M.S., and George Loewenstein, Ph.D., of Carnegie Mellon University, Pittsburgh, conducted a study to determine whether reminding resident physicians of the sacrifices made to obtain training, as well as suggesting this as a potential rationalization, increases self-stated willingness to accept gifts from industry. In a study that included a survey of 301 U.S. resident physicians, the researchers found that "reminding physicians of sacrifices made in obtaining their education resulted in gifts being evaluated as more acceptable: 21.7 ...

Silvia Mamede, M.D., Ph.D., of Erasmus University Rotterdam, the Netherlands and colleagues investigated whether recent experience with clinical problems provokes availability bias (overestimation of the likelihood of a diagnosis based on the ease with which it comes to mind) resulting in diagnostic errors and whether reflection (structured reanalysis of the case findings) counteracts this bias. The researchers conducted a study in 2009 with 18 first-year and 18 second-year internal medicine residents and found that "the availability bias may occur in medical diagnosis ...

Dorothy A. Andriole, M.D., and Donna B. Jeffe, Ph.D., of Washington University, St. Louis, conducted a study to identify demographic variables prior to medical school acceptance associated with outcomes for medical school students. The study used data from a 1994-1999 national cohort of 97,445 students accepted to medical school who were followed up through March 2009 and had graduated, withdrawn, or were dismissed. The authors found that "lower scores on the Medical College Admission Test, nonwhite race/ethnicity, and premedical debt of at least $50,000 were independently ...

Susan M. Kies, Ed.D., of the University of Illinois College of Medicine, Urbana, and colleagues conducted a study to assess whether the order in which third-year core clerkships are completed affects student performance. Anecdotal experience has suggested that third-year medical students whose first clerkship is internal medicine may have superior performance throughout the academic year. The researchers reviewed the clerkship performance records of medical students at all four campuses of the University of Illinois College of Medicine who completed their third-year core ...

Heart patients with the "distressed" (Type D) personality profile may face a higher risk of future cardiovascular problems, according to a summary article published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes. An analysis of previous reports involving more than 6,000 patients found an association between the Type D personality and future cardiovascular issues among heart patients. The personality classification system that identified "Type A" decades ago more recently defined Type D as a personality marked by chronic negative ...

ROCHESTER, Minn. -- A Mayo Clinic study involving seven major medical schools shows a majority of medical students surveyed suffer from burnout and that those students were more likely to cheat or be dishonest in relation to patient care. The findings appear in this week's issue of JAMA. The study was based on anonymous responses from 4,400 students. Just over half (53 percent) the students responding were found to have burnout. Academic cheating was relatively rare, but roughly 40 percent of third- and fourth-year students admitted to some form of unprofessional conduct ...

Doctors can be taught to listen better to individual circumstances that may affect patient care, according to researchers at the University of Illinois at Chicago College of Medicine. The findings are reported in the Sept. 15 issue of JAMA. In a previous study the investigators had shown that doctors are not good at picking up clues to details in their patients' personal lives that may affect their treatment -- what the researchers call "context." The current study was designed to see if doctors could be taught to think about context when examining patients. Fourth-year ...

Researchers from Mount Sinai School of Medicine have found a new mechanism that explains why a certain gene mutation causes craniofrontonasal syndrome (CFNS), a disorder that causes cleft palate and other malformations in the face, brain, and skeleton. Cleft palate affects one of every 1,000 newborns. The research is published in the September 15 issue of Genes & Development. Previous research has shown that a mutation in a gene called ephrin-B1 caused abnormalities in facial development, but researchers were uncertain of how. Philipe M. Soriano, PhD, Professor, Developmental ...

Washington, DC — Honey bees removed from their usual roles in the hive quickly and drastically changed their biological rhythms, according to a study in the Sept. 15 issue of The Journal of Neuroscience. The changes were evident in both the bees' behavior and in their internal clocks. These findings indicate that social environment has a significant effect on the physiology and behavior of animals. In people, disturbances to the biological clock are known to cause problems for shift workers and new parents and for contributing to mood disorders. Circadian rhythm, the ...

PITTSBURGH— Despite heightened awareness about the undue influence that gifts from pharmaceutical companies can have on doctors' prescribing practices, and despite expanding institutional conflict-of-interest policies and state laws targeted at preventing such practices, companies continue to reward doctors for prescribing their drugs with gifts ranging from pens and paper, to free dinners and trips. A new study by two researchers at Carnegie Mellon University, published in the Journal of the American Medical Association, helps to explain how doctors rationalize acceptance ...

Ann Arbor, Mich. --- Medical students experience depression at a higher rate than the general population and attach high levels of stigma to the mental illness, according to U-M research to be published Sept. 15 in the Journal of the American Medical Association. The study showed that 53.3 percent of medical students who reported high levels of depressive symptoms were worried that revealing their illness would be risky. Almost 62 percent of the same students said asking for help would mean the student's coping skills were inadequate. Those with moderate to severe ...

"People's views of their neighbourhood can influence major decisions such as moving house and choice of school. A neighbourhood can also acquire a reputation as a 'good' or 'bad' area. It is therefore important to understand what these views are based on," says Dr Liz Twigg, University of Portsmouth, who led the research. "Previous research has suggested that diverse communities are less cohesive and suffer from problems associated with anti-social behaviour, crime and lack of trust," she explains. "Our research suggests that this is not true. In general, what people ...

REM sleep disturbances constitute an early marker of neurodegenerative diseases. This was demonstrated by the Multidisciplinary Sleep Disturbances Unit of the Hospital Clínic, in an article published in 2006. A new study published by the same team in Lancet Neurology applies neuroimaging techniques to identify patients with REM sleep disturbances who will develop neurodegenerative disorders over the short term. The first signing author of both papers is Dr. Àlex Iranzo, a physician belonging to the Neurology Department of the Hospital Clínic in Barcelona, who is also an ...

BOSTON, Mass.—With the potential to save tens of thousands of lives each year, a new cost-effective rabies therapy developed by MassBiologics at the University of Massachusetts and the Serum Institute of India took an important step forward with positive results from a Phase 1 study. The recently completed study showed that a new monoclonal antibody (RAB-1) resulted in protective antibody levels in the serum of treated subjects equal to the current standard of treatment, which is often not available in the areas of the world hit hardest by rabies. Details of the study ...

Medical students and residents should receive much more thorough and realistic instruction about the economic forces affecting health care and their own clinical decisions so that they can better serve patients' well-being and the nation's economic welfare, says a commentary published today in a theme issue of the Journal of the American Medical Association (JAMA), which focuses on improving medical education. The commentary is written by Samuel Y. Sessions, MD, JD, a Los Angeles Biomedical Research Institute (LA BioMed) investigator, and Allan S. Detsky, MD, PhD, Departments ...

Existing evidence from randomised controlled trials does not support routine population screening for prostate cancer, concludes a study published on bmj.com today. However, a second study also published today suggests that a single test at age 60 could identify men who are most likely to develop and die from prostate cancer. These men could then be monitored more closely, while others could be exempt from further screening. Prostate cancer is one of the most common cancers among men worldwide. Screening is widely used in many countries, but it remains controversial ...

It is widely known that a healthy lifestyle that includes not smoking, limiting alcohol intake, and maintaining a proper weight reduces disease risk. In the journal PLoS Medicine, Wei Zheng, M.D., Ph.D., M.P.H., and colleagues at Vanderbilt University Medical Center now report results from a large study quantifying the impact of combining healthy lifestyle factors. They found that a healthy lifestyle pattern – being normal weight, having low belly fat, participating in regular physical activity, limiting exposure to secondhand cigarette smoke, and consuming higher ...