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Physician health

Tsai-Ling Liu, A Sidney Barritt Iv, Morris Weinberger, John E Paul, Bruce Fried, Justin G Trogdon
BACKGROUND: Increasingly, patients with multiple chronic conditions are being managed in patient-centered medical homes (PCMH) that coordinate primary and specialty care. However, little is known about the types of providers treating complex patients with diabetes and compensated cirrhosis. OBJECTIVE: We examined the mix of physician specialties who see patients dually-diagnosed with diabetes and compensated cirrhosis. DESIGN: Retrospective cross-sectional study using 2000-2013 MarketScan® Commercial Claims and Encounters and Medicare Supplemental Databases...
2016: PloS One
Glenda Tettamanti, Alessia Varetta, Marcello Macchi, Cristina Gallotti, Maria Stella Laddomada
The aim of this study was to investigate attitudes and awareness about conventional and electronic cigarettes in a sample of students attending the Faculty of Medicine of Pavia University (Italy). An anonymous and self-reported questionnaire was administered to 226 students attending either the first or third years of medical school during the 2013 to 2014 school year. Participation was voluntary and required signing an informed consent form. The prevalence of smokers was 12%. Sixty-seven percent of smokers reported smoking less than 5 cigarettes/day, and 15% more than 10 cigarettes/day...
July 2016: Igiene e Sanità Pubblica
Janice L Pringle, Arnie Aldridge, Shannon M Kearney, Kim Grasso, John Radack, Susan Hogue, Chronis Manolis
BACKGROUND: Medication nonadherence is problematic throughout health care practice. Patient nonadherence is a result of several factors, such as financial issues, confusion about the medication, or concerns about possible side effects. Efforts to improve adherence have been implemented, but new strategies are needed to ensure that patients fill their medication prescriptions and adhere to their prescribed use. OBJECTIVE: To investigate whether providing patients with a free 30-day supply of medication at the point of care via a dispensing kiosk-a secure, computerized cabinet placed in the prescriber's office-that provides sample medication and educational materials had a measurable impact on adherence and health care cost...
November 2016: Journal of Managed Care & Specialty Pharmacy
Scott Monteith, Tasha Glenn
Automated decision-making by computer algorithms based on data from our behaviors is fundamental to the digital economy. Automated decisions impact everyone, occurring routinely in education, employment, health care, credit, and government services. Technologies that generate tracking data, including smartphones, credit cards, websites, social media, and sensors, offer unprecedented benefits. However, people are vulnerable to errors and biases in the underlying data and algorithms, especially those with mental illness...
December 2016: Current Psychiatry Reports
Caroline A Yao, Jordan Swanson, Dayana Chanson, Trisa B Taro, Barrie Gura, Jane C Figueiredo, Heather Wipfli, Kristin Hatcher, Richard Vanderburg, William P Magee
BACKGROUND: Despite health system advances, residents of low- and middle-income countries continue to experience substantial barriers in accessing health care, particularly for specialized care such as plastic and reconstructive surgery. METHODS: A cross-sectional household survey of patients seeking surgical care for cleft lip and/or cleft palate was completed at five Operation Smile International mission sites throughout Vietnam (Hanoi, Nghe An, Hue, Ho Chi Minh City, An Giang, and Bac Lieu) in November of 2014...
November 2016: Plastic and Reconstructive Surgery
Valentina Iacopino, Daniele Mascia, Americo Cicchetti
BACKGROUND: In recent decades, the role of technology in health care organizations has become increasingly relevant because it enhances health care outcomes and the achievement of clinical goals. Extant research demonstrates that the effectiveness of a medical innovation depends largely on health care professionals' perceptions of its usefulness and impact on their activities and practices. We also know that interaction among social actors contributes to the shaping of their judgments and opinions regarding innovation...
October 25, 2016: Health Care Management Review
Judith Born, Jürgen Albert, Elizabeth M Borycki, Norbert Butz, Kendall Ho, Josh Koczerginski, Andre W Kushniruk, Johannes Schenkel, Christian Juhra
BACKGROUND: In order to improve access to critical patient data in case of emergency, many countries have begun or intend to implement emergency datasets. In Germany, the German Medical Association developed a medical emergency dataset (MED), which provides the possibility to store information on prior diagnoses, medications, allergies and other emergency-relevant information on the German Electronic Health Card. OBJECTIVES: The aim of the study is to evaluate how the MED can be used internationally...
2016: Studies in Health Technology and Informatics
Benjamin A Steinberg
Atrial fibrillation (AF) is the most common cardiac arrhythmia, and conveys a significant risk of morbidity and mortality due to related stroke and systemic embolism. Oral anticoagulation (OAC) is the mainstay of thromboembolism prevention and management of anticoagulation can be challenging. For patients without significant valvular disease, decisions around anticoagulation therapy are first based on the presence of additional stroke risk factors, as measured by the CHA2DS2-VASc score. Patients with increased CHA2DS2-VASc scores (by regional guidelines) should next be evaluated to determine if they are candidates for non-vitamin K antagonist oral anticoagulant (NOAC) therapy...
October 25, 2016: Blood
Faina Linkov, Benita Valappil, Jacob McAfee, Sharon L Goughnour, Douglas M Hildrew, Andrew A McCall, Igor Linkov, Barry Hirsch, Carl Snyderman
OBJECTIVE: To integrate multiple sources of clinical information with patient feedback to build evidence-based decision support model to facilitate treatment selection for patients suffering from vestibular schwannomas (VS). METHODS: This was a mixed methods study utilizing focus group and survey methodology to solicit feedback on factors important for making treatment decisions among patients. Two 90-minute focus groups were conducted by an experienced facilitator...
September 30, 2016: American Journal of Otolaryngology
Lisa I Iezzoni
Erroneous assumptions among health care professionals about the daily lives, preferences, values, and expectations of persons with disability can contribute to documented health care disparities, faulty communication, and substandard quality of care affecting this heterogeneous population. Efforts to reduce racial and ethnic disparities have focused on expanding diversity in the physician workforce. Would expanding the numbers of physicians with disability benefit patients with disability? Increasing the number of physicians who identify as "disabled" is one strategy for proactively confronting disability-related barriers affecting patients, but such efforts will likely face substantial challenges...
October 1, 2016: AMA Journal of Ethics
Ewa Staszewska-Jakubik, Mirosław P Czarkowski, Barbara Kondej
OBJECTIVE: Assessment of the epidemiological situation of scarlet fever in Poland in 2014. MATERIALS AND METHODS: The evaluation was performed by reviewing surveillance data published in the bulletin “Infectious diseases and poisonings in Poland in 2014” as well as in previous bulletins, and unpublished data collected under Statistical survey program of official statistics. These data relate to cases of scarlet fever registered by health sanitary inspection on the basis of statutory notification of scarlet fever reported by physicians...
2016: Przegla̧d Epidemiologiczny
Inger Hagqvist, Stig Rödjer, Anna Aggeryd, Ebba Holmberg, Göran Bondjers
Experiences from PLUS - program for learning and development in Swedish health care In Sweden, more than half of newly registered physicians have been trained outside of the country. Thus, they are not familiar with Swedish culture and the Swedish healthcare system. To support their introduction to a professional carrier in Sweden, in line with the WHO ethical code for recruitment of health personnel, the health care region of Western Sweden established PLUS - program for learning and development in Swedish Health care...
October 24, 2016: Läkartidningen
Margaret J Livingstone, Cornelius B Groenewald, Jennifer A Rabbitts, Tonya M Palermo
BACKGROUND: Concerns regarding the safety of codeine have been raised. Cases of life-threatening respiratory depression and death in children have been attributed to codeine's polymorphic metabolic pathway. International health agencies recommend restricted use of codeine in children. Despite these recommendations, the epidemiology of codeine use among children remains unknown. AIMS: Our objective was to examine patterns of codeine use in the US among children. METHODS: A cross-sectional analysis of children of age 0-17 years from 1996 to 2013 in the US was performed...
October 25, 2016: Paediatric Anaesthesia
Teresa Rincón-Del Toro, Adela Villanueva-Guerra, Ricardo Rodríguez-Barrientos, Elena Polentinos-Castro, Mª José Torijano-Castillo, Emilia de Castro-Monteiro, Blanca Escrivá de Romaní de Gregorio, Margarita Barba Calderón, María Soledad de Frías Redondo, Nury Alejo Brú, Concepción Blanco Morales, Margarita Vázquez Pinilla, Cristina Besora Altés, Julio Heras-Mosteiro, Juan Ángel Infantes Rodríguez, Pilar Bustamante Fernández, Victorina de Blas Salvador
OBJECTIVE: The number of aggressions towards health care professionals has risen over the past few years. There are no previous studies in primary care covering an entire region and to all professional categories. The aim of this study was to characterize aggressions in Primary Care in the Community of Madrid. METHODS: Multicenter cross-sectional study. Analysis of a Registration System that reports any type of aggression suffered by Primary Care workers, in the Community of Madrid...
October 25, 2016: Revista Española de Salud Pública
Jason M Etchegaray, Madelene J Ottosen, Aitebureme Aigbe, Emily Sedlock, William M Sage, Sigall K Bell, Thomas H Gallagher, Eric J Thomas
IMPORTANCE: Patient safety experts believe that patients/family members should be involved in adverse event review. However, it is unclear how aware patients/family members are about the causes of adverse events they experienced. OBJECTIVE: To determine whether patients/family members interviewed could identify at least one contributing factor for the event they experienced. Secondary objectives included understanding the way patients/family members became aware of adverse events, the types of contributing factors patients/family members identified for different types of adverse events, and recommendations provided by patients/family members to address the contributing factors...
October 24, 2016: Health Services Research
Oni J Blackstock, Brent A Moore, Gail V Berkenblit, Sarah K Calabrese, Chinazo O Cunningham, David A Fiellin, Viraj V Patel, Karran A Phillips, Jeanette M Tetrault, Minesh Shah, E Jennifer Edelman
BACKGROUND: Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. OBJECTIVE: To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. DESIGN: Cross-sectional online survey conducted in April and May 2015...
October 24, 2016: Journal of General Internal Medicine
Sharon E Card, Heather D Clark, Michelle Elizov, Narmin Kassam
General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition...
October 24, 2016: Journal of General Internal Medicine
Miriam Friedemann
In November 2012, 23 cases of ciguatera with typical combinations of gastrointestinal and neurological symptoms occurred in Germany after consumption of imported tropical fish (Lutjanus spp.). A questionnaire was used to gather information on the disease course and fish consumption. All patients suffered from pathognomonic cold allodynia. Aside from two severe courses of illness, all other cases showed symptoms of moderate intensity. During a three-year follow-up, seven patients reported prolonged paresthesia for more than one year...
October 24, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Ethan B Fram, Matthew D Sorensen, Vincent G Bird, Joshua M Stern
Some regions are known to have an increased burden of urolithiasis. Urolithiasis is known to be affected by weather patterns, particularly high ambient temperatures. To identify geographic differences in risk factors, we compared metabolic information for 1254 patients in two geographically distinct regions, New York and Florida, with per sample adjustment for ambient weather. We observed that patients in New York were more likely to have low urine volume, but also lower total urinary calcium (168 vs 216 mg, p = 0...
October 24, 2016: Urolithiasis
Meredith A Heberer, Ian K Komenaka, Jesse N Nodora, Chiu-Hsieh Hsu, Sonal G Gandhi, Lauren E Welch, Marcia E Bouton, Paula Aristizabal, Barry D Weiss, Maria Elena Martinez
AIM: To identify factors associated with Papanicolaou-smear (Pap-smear) cervical cancer screening rates in a safety net population. METHODS: From January 2012 to May 2013, the use of Pap-smear was determined for all patients seen at the breast clinic in a safety net hospital. Health literacy assessment was performed using the validated Newest Vital Sign. The records of patients were reviewed to determine if they had undergone Pap-smears for cervical cancer screening...
October 10, 2016: World Journal of Clinical Oncology
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