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Physician productivity

Kathrine Meyers, Yumeng Wu, Atrina Brill, Theodorus Sandfort, Sarit A Golub
BACKGROUND: Phase III trials of long-acting injectable (LAI) PrEP, currently underway, have great potential for expanding the menu of HIV prevention options. Imagining a future in which multiple PrEP modalities are available to potential users of biomedical HIV prevention, we investigated which factors might help direct a patient-physician shared-decision making process to optimize the choice of biomedical HIV prevention method. METHODS: Participants (n = 105; ages 19-63; 46...
2018: PloS One
İpek Özmen, Elif Yıldırım, Reyhan Yıldız, Hamza Ogun, Emine Aksoy, Tülay Törün, Peri Arbak, Haluk Çalışır
Introduction: Welding produces miscellaneous gases and particles that has various impact on respiratory system and long term exposure may result "welders'lung". The aim of this study is to describe the radiological findings of welders' and make an awereness for welders radilogical findings. Materials and Methods: The clinical and radiological findings of welders' who had hospital applications with respiratory symptoms between January 2010-January 2017 were evaluated retrospectively...
March 2018: Tüberküloz Ve Toraks
E Chiong, D G Murphy, H Akaza, N C Buchan, B H Chung, R Kanesvaran, M Khochikar, J Letran, B Lojanapiwat, C F Ng, T Ong, Y-S Pu, M Saad, K Schubach, L Türkeri, R Umbas, L C Vu, S Williams, D Ye, I D Davis
OBJECTIVE: The Asia Pacific Advanced Prostate Cancer Consensus Conference (APAC APCCC 2018) brought together 20 experts from 15 APAC countries to discuss the real-world application of consensus statements from the 2nd Advanced Prostate Cancer Consensus Conference held in St Gallen in 2017 (APCCC 2017). FINDINGS: Differences in genetics, environment, lifestyle, diet and culture are all likely to influence the management of advanced prostate cancer in the APAC region when compared with the rest of the world...
July 18, 2018: BJU International
George A Karpouzas, Vibeke Strand, Sarah R Ormseth
Objective: Patients and physicians commonly differ in their assessments of rheumatoid arthritis (RA) activity. Clinically meaningful discordance thresholds or validation of their ability to predict functional outcomes are lacking. We explored whether an unbiased, person-centred latent profile analysis (LPA) approach could classify cases based on patient global assessment (PtGA) and physician global assessment (MDGA) assessments of RA activity. We further examined whether the LPA groups displayed greater differences in clinical outcomes compared with traditional threshold-based groups...
2018: RMD Open
Alan G Fraser, Eric G Butchart, Piotr Szymański, Enrico G Caiani, Scott Crosby, Peter Kearney, Frans Van de Werf
To use medical devices rationally, health-care professionals must base their choices of which devices to recommend for individual patients on an objective appraisal of their safety and clinical efficacy. The evidence submitted by manufacturers when seeking approval of their high-risk devices must be publicly available, including technical performance and premarket clinical studies. Giving physicians access to this information supplements the peer-reviewed scientific literature and might be essential for comparing alternative devices within any class...
July 13, 2018: Lancet
Sharda Shah Peshin, Y K Gupta
Extensive use of different chemicals in various fields and their easy availability has led to an increased incidence of accidental and intentional poisoning in developing countries including India. A diverse range of household products commonly used for domestic purposes comprise pesticides, household cleaners, thermometer mercury, antiseptics, kerosene, paint thinners etc. Any of these products, if misused or mishandled can cause poisoning. In India, the National Poisons Centre (NPIC) at the All India Institute of Medical Sciences, New Delhi, provides information on management of poisoning to treating physicians...
July 10, 2018: Journal of Forensic and Legal Medicine
Lillian Hung, Alison Phinney, Habib Chaudhury, Paddy Rodney
In this article, we discuss how video-reflexive ethnography may be useful in engaging staff to improve dementia care in a hospital medical unit. Seven patients with dementia were involved in the production of patient-story videos, and fifty members of staff (nurses, physicians, and allied health practitioners) participated in video-reflexive groups. We identified five substantial themes to describe how video-reflexive groups might contribute to enacting person-centered care for improving dementia care: (a) seeing through patients' eyes, (b) seeing normal strange and surprised, (c) seeing inside and between, (d) seeing with others inspires actions, and (e) seeing with the team builds a culture of learning...
January 2018: Global Qualitative Nursing Research
Peter Hallas, Dan Brun Pedersen
Introduction: The effect of changes in doctors' rosters is rarely subjected to scientific evaluation. We describe how a natural experiment (NE) study design can be used to evaluate if a managerial decision about doctors' rosters has an effect on patient flow in an emergency department (ED). We hypothesized that an extra doctor each morning from 6 a.m. (i.e., a modified "casino shift") might improve the productivity of a hospital's ED. Methods: This was an NE observational study using data on patient flow in the ED of Zealand University Hospital, Denmark, between April 1, 2016, and April 1, 2017...
July 2018: Western Journal of Emergency Medicine
Lili Xu, Xiwen Jiang, Yun Zhu, Yali Duan, Taosheng Huang, Zhiwen Huang, Chunyan Liu, Baoping Xu, Zhengde Xie
The reliable and rapid detection of viral pathogens that cause respiratory infections provide physicians several advantages in treating patients and managing outbreaks. The Luminex respiratory virus panel (RVP) assay has been shown to be comparable to or superior to culture/direct fluorescent-antibody assays (DFAs) and nucleic acid tests that are used to diagnose respiratory viral infections. We developed a multiplex asymmetric reverse transcription (RT)-PCR assay that can simultaneously differentiate all influenza A virus epidemic subtypes...
2018: Frontiers in Microbiology
Conor Fearon, Orna O'Toole
Autoimmune movement disorders are rare but potentially treatable entities. They can present with an excess or paucity of movement and may have other associated neurological symptoms. These disorders were originally recognized by their classic clinical presentations and the cancers associated with them. Recent emphasis has been targeted on associated, and sometimes causative, antibodies. Although some disorders have stereotypical presentations, the spectrum of abnormalities reported in association with antibodies is widening...
June 2018: Seminars in Neurology
F Salamanna, V Borsari, D Contartese, N Nicoli Aldini, M Fini
Different fields of cancer management consider bone health to be of increasing clinical importance for patients: 1) presence of bone metastases in many solid tumors, 2) use of bone-targeted treatments in the reduction of bone metastasis, 3) effects of cancer treatment on reproductive hormones, critical for normal bone remodeling maintenance. Additionally, bone microenvironment is further complicated by the decline of ovarian sex steroid production and by the related increase in inflammatory factors linked to menopause, which result in accelerated bone loss and increased risk of osteoporosis (OP)...
June 22, 2018: Breast: Official Journal of the European Society of Mastology
A Kamenshchikova, P F G Wolffs, C J Hoebe, J Penders, K Horstman
Antimicrobial resistance (AMR) is often presented as a major public health problem globally. Screening for AMR usually takes place in clinical settings. Recent developments in microbiology stimulated a series of studies focusing on AMR in communities, and particularly in travelers (any mobile individual), which was argued to be important for identifying potential public health risks. Against this background, microbiologists have become interested in non-hospitalized refugees as one of the traveler groups. However, this attention to refugees has provoked some professional debates on potential stigmatization of refugees as dangerous "others"...
July 7, 2018: Social Science & Medicine
Jennifer K Giancola, Mary Guillot, Archana Chatterjee, Andrew Bleckman, H Eugene Hoyme
INTRODUCTION: The purpose of this article is to describe how a formal mentoring program in pediatrics can prepare new physicians and scientists for their roles and conflicting responsibilities within a community-based medical school. While research supports the impact of faculty mentoring, quality partnerships are reportedly low in academic medicine and can negatively affect junior faculty who are preparing for certifying examinations, orienting to a new role and balancing career and personal life...
June 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Jerry Y Du, Alexander S Rascoe, Randall E Marcus
BACKGROUND: In an era of increasing healthcare costs, the number and value of nonclinical workers, especially hospital management, has come under increased study. Compensation of hospital executives, especially at major nonprofit medical centers, and the "wage gap" with physicians and clinical staff has been highlighted in the national news. To our knowledge, a systematic analysis of this wage gap and its importance has not been investigated. QUESTIONS/PURPOSES: (1) How do wage trends compare between physicians and executives at major nonprofit medical centers? (2) What are the national trends in the wages and the number of nonclinical workers in the healthcare industry? (3) What do nonclinical workers contribute to the growth in national cost of healthcare wages? (4) How much do wages contribute to the growth of national healthcare costs? (5) What are the trends in healthcare utilization? METHODS: We identified chief executive officer (CEO) compensation and chief financial officer (CFO) compensation at 22 major US nonprofit medical centers, which were selected from the US News & World Report 2016-2017 Hospital Honor Roll list and four health systems with notable orthopaedic departments, using publicly available Internal Revenue Service 990 forms for the years 2005, 2010, and 2015...
July 10, 2018: Clinical Orthopaedics and related Research
F Schwind, H Münch, A Schröter, R Brandner, U Kutscha, A Brandner, O Heinze, B Bergh, U Engelmann
PURPOSE: Sharing of medical data is crucial for the proper treatment of patients as it could reduce the risk of duplicated medical tests and speed up the care process if all documents are readily available. Despite great technical progress, sharing patient data while maintaining full control over the process in an intersectoral (in Germany, this describes the different actors in the healthcare system consisting of clinic, ambulatory care, etc.) setting remains a particular challenge. This paper focuses on the successful implementation of a privacy compliant, standards-based image-management component of a personal electronic health record...
July 11, 2018: International Journal of Computer Assisted Radiology and Surgery
Megan M Schmidt, Paul A Iaizzo
This review describes the utilization of Visible Heart® methodologies for electrophysiologic studies, specifically in the investigation of monophasic action potential (MAP) recordings, with the aim to facilitate new catheter/device design and development that may lead to earlier diagnosis, treatment, and ultimately a higher quality of life for patients with atrial fibrillation. Areas Covered: We describe the historically proposed mechanisms behind which electrode is responsible for the MAP recording, new catheters for recording these signals, and how Visible Heart methodologies can be utilized to develop and test new technologies for electrophysiologic investigations...
July 10, 2018: Expert Review of Medical Devices
Leah Zallman, Karen Finnegan, David Roll, Martina Todaro, Rawan Oneiz, Assaad Sayah
BACKGROUND: Medical scribes are a clinical innovation increasingly being used in primary care. The impact of scribes in primary care remain unclear. We aimed to examine the impact of medical scribes on productivity, time spent facing the patient during the visit, and patient comfort with scribes in primary care. METHODS: We conducted a prospective observational pre-post study of 5 family and internal medicine-pediatrics physicians and their patients at an urban safety net health clinic...
July 2018: Journal of the American Board of Family Medicine: JABFM
Nicole J Asal, Janelle Poyant
BACKGROUND AND PURPOSE: Colleges of pharmacy will be seeking new opportunities to provide student pharmacists with interprofessional and global experiences. The objectives of this paper are to describe an international experience to expand interprofessional and global pharmacy education and to evaluate the roles and impact of fourth-year pharmacy students and a pharmacist integrated into an interprofessional team on a medical brigade to Guatemala. EDUCATIONAL ACTIVITY AND SETTING: In August 2014, two fourth-year student pharmacists and one pharmacist/professor joined a group of 26 pre-medical students from Boston College (BC), six medical doctors and a nursing assistant as part of a one-week medical brigade to Quetzaltenango, Guatemala...
May 2018: Currents in Pharmacy Teaching & Learning
Z Kosan, E O Calikoglu, A Guraksin
Context: The concept of burnout is a condition seen in occupational groups working face-to-face with people and resulting in emotional exhaustion, depersonalization, and low professional productivity. Aims: The purpose of this study was to determine burnout levels and associated factors in physicians practicing in Erzurum, Northeast Anatolia, Turkey. Settings and Design: This research was designed as a cross-sectional descriptive study. The research sample size was calculated at 663 participants with a 99% confidence interval and a 3% margin of error using Epi Info software...
July 2018: Nigerian Journal of Clinical Practice
Pernille Linde Jellestad, Louise Ninett Carlsen, Maria Lurenda Westergaard, Signe Bruun Munksgaard, Lars Bendtsen, Miguel Lainez, Ricardo Fadic, Zaza Katsarava, Maria Teresa Goicochea, Santiago Spadafora, Rigmor Højland Jensen, Giuseppe Nappi, Cristina Tassorelli
Background Medication-overuse headache is a costly disease for individuals and society. Objective To estimate the impact of medication-overuse headache treatment on direct and indirect headache-related health care costs. Methods This prospective longitudinal study was part of the COMOESTAS project (COntinuous MOnitoring of Medication Overuse Headache in Europe and Latin America: development and STAndardization of an Alert and decision support System). Patients with medication-overuse headache were included from four European and two Latin American headache centers...
January 1, 2018: Cephalalgia: An International Journal of Headache
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