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    A Randomized Trial Comparing Direct Challenges to Penicillin Skin Testing for Outpatient Low-Risk Penicillin Allergy Evaluations in Pregnancy

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    BACKGROUND: The importance of penicillin allergy de-labeling in the general population is well known. Its significance is further highlighted in pregnancy because penicillin-based antibiotics are first-line therapy for most infections at the time of delivery, particularly group B Streptococcus. OBJECTIVE: To evaluate the safety of a two-step direct challenge (DC) to amoxicillin without preceding skin testing in pregnant patients with a low-risk penicillin allergy label, regardless of trimester. METHODS: We performed a prospective, randomized controlled trial comparing penicillin skin testing (PST) followed by an oral amoxicillin challenge versus a two-step DC to amoxicillin without preceding skin testing in pregnant patients regardless of trimester with a low-risk penicillin allergy label. RESULTS: A total of 144 women were included in this study, 73 of whom underwent PST and 70 of whom underwent DC. Of those women, 68 (93.2%) undergoing PST had a negative evaluation for penicillin allergy compared with 70 (100%) who underwent DC. No reactions in either PST or DC groups required medical treatment or, notably, administration of epinephrine. Direct challenge took significantly less time compared with PST. Median time for PST was 75 minutes (interquartile range, 75-80 minutes) compared with 65 minutes (interquartile range, 65-70 minutes) for DCs. CONCLUSION: For evaluation of penicillin allergy in pregnancy, we demonstrate that a DC is as safe as PST in low-risk pregnant patients

    A retrospective self-report analysis of health anxiety among medical students across a global health crisis

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    Background: This retrospective within-subjects observational study aims to examine how the global health crisis has influenced perceived health anxiety levels among medical students by comparing their current self-reported anxiety to their retrospective recall of anxiety levels before the crisis. Method: A total of 239 medical students participated in this study. Health anxiety was measured using the Short Health Anxiety Inventory (SHAI). The study was designed as a retrospective within-subject research with a pre-post self-report comparison using retrospective recall. Results: Mean SHAI scores increased significantly from 12.08 ± 7.07 pre-pandemic to 16.33 ± 9.07 post-pandemic (p \u3c 0.001). The Illness Likelihood sub-section of SHAI showed a greater mean difference (2.91) than the Negative Consequences sub-section (1.82). No significant subgroup differences were noted based on gender, academic phase, or COVID-19 infection status (p \u3e 0.05). Correlation analysis indicated a strong relationship between pre- and post-pandemic SHAI scores (r = 0.570, p \u3c 0.001). Conclusion: The study findings help understand medical students\u27 psychological vulnerabilities due to the pandemic and highlight the dire need to integrate mental health support strategies in medical education

    RRH Wellbeing Framework Initiative

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    RRH Wellbeing Framework Initiative. Dr. Charlene Wilson, EVP, Chief People Officer; Sarah Beales, VP, Culture and Development Wellness planning in a healthcare setting is essential because it supports both staff well-being and patient outcomes. By promoting physical, emotional, and mental health among healthcare workers, organizations can: Reduce stress and burnout; improve job satisfaction and retention; enhance teamwork and resilience; lower absenteeism and health-related costs; create a healthier, more positive care environment for patients. Ultimately, a structured wellness plan ensures that caregivers are cared for—allowing them to deliver safer, higher-quality, and more compassionate care. Objectives: Describe methods to reduce burnout scores (measured via Maslach Burnout Inventory or staff surveys) Describe methods to increase employee participation in wellness programs (fitness, mindfulness, counseling, etc.) Describe methods to decrease absenteeism due to stress or illness Describe methods to improve job satisfaction scores on staff engagement survey

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