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Physician wellness

Simon A Sarkisian, Daniel Brillhart
In the United States, the rate of primary and secondary syphilis has increased by 18% in 2016, the highest rate since 1993. These patients can often present to the emergency department (ED) in various stages. Although syphilis is well described in the literature, there is a paucity of ED reports of atypical cases. A 22-yr-old male presented to the ED complaining of neck pain. The patient was found to have right-sided tender cervical lymphadenopathy causing neck pain. A thorough physical exam revealed diffuse lymphadenopathy...
March 14, 2018: Military Medicine
Idan Steinberg, Gil Tamir, Israel Gannot
Solid malignant tumors are one of the leading causes of death worldwide. Many times complete removal is not possible and alternative methods such as focused hyperthermia are used. Precise control of the hyperthermia process is imperative for the successful application of such treatment. To that end, this research presents a fast method that enables the estimation of deep tissue heat distribution by capturing and processing the transient temperature at the boundary based on a bio-heat transfer model. The theoretical model is rigorously developed and thoroughly validated by a series of experiments...
March 16, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
K Kuismanen, K Nieminen, K Karjalainen, K Lehto, J Uotila
BACKGROUND: The aim of the present study was to evaluate the subjective outcome of primary repair of obstetric anal sphincter injury (OASIS) at 6 months, the factors associated with the symptoms of anal incontinence (AI), and the role of a simple survey consisting in one question with three answer choices, combined with the Wexner incontinence score for the assessment of this patient population. METHODS: A retrospective cohort study was conducted on patients with third- or fourth-degree OASIS operated on between January 2007 and December 2013 inclusive at Tampere University Hospital, Finland...
March 15, 2018: Techniques in Coloproctology
Barbara J Howard, Raymond Sturner
Purpose of review: To describe benefits and problems with screening and addressing developmental and behavioral problems in primary care and using an online clinical process support system as a solution. Recent findings: Screening has been found to have various implementation barriers including time costs, accuracy, workflow and knowledge of tools. In addition, training of clinicians in dealing with identified issues is lacking. Patients disclose more to and prefer computerized screening...
December 2017: Current Developmental Disorders Reports
Florian Ferreri, Alexis Bourla, Stephane Mouchabac, Laurent Karila
Background: New technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping , a paradigmatic example, refers to the use of computerized measurement tools to capture the characteristics of different psychiatric disorders. Similarly, machine learning-a form of artificial intelligence-can improve the classification of patients based on patterns that clinicians have not always considered in the past...
2018: Frontiers in Psychiatry
Mansour Abdullah Alshehri, Hammad Alhasan, Mohamed Alayat, Moayad Al-Subahi, Khalid Yaseen, Ayah Ismail, Abdullah Tobaigy, Obaid Almalki, Abdulfattah Alqahtani, Basmah Fallata
[Purpose] To investigate physicians' attitudes, opinions and experiences towards physiotherapy services as well as to identify the potential factors that may affect the extent of utilization of physiotherapy services (based on physicians' beliefs) in Saudi Arabia (SA). [Subjects and Methods] A cross-sectional study was conducted. [Results] A total of 108 respondents met the inclusion criteria. The respondents' attitude towards physiotherapy was slightly low (53.5%), while their opinions and experiences of physiotherapy indicated some important issues...
February 2018: Journal of Physical Therapy Science
Edward Snelson, Shammi Ramlakhan
OBJECTIVE: In an attempt to improve the diagnosis of sepsis in children, diagnostic aids have concentrated on clinical features that suggest that sepsis is present. Clinicians need to be able to clinically rule out sepsis as well as rule it in. Little is known about which features are consistent with wellness and/or absence of sepsis. Guidelines are therefore likely to improve sensitivity without preserving specificity. We aimed to gather expert opinion on which (if any) features would make clinicians consider a child to be unlikely to have sepsis...
March 15, 2018: Archives of Disease in Childhood
Kriangsak Piyakunmala, Thananit Sangkomkamhang
BACKGROUND: Aims of this study included providing a comparison of the measurement of limb-length discrepancy after primary total hip arthroplasty between patient's perception and weight-bearing orthoroentgenographic measurement. A comparison between patient's perception and pelvic radiographic measurement was examined as well. METHODS: This prospective study comprised patients who had already undergone total hip arthroplasty and were receiving postoperative outpatient care between April 2017 and July 2017...
February 15, 2018: Journal of Arthroplasty
Claire de Brie, Emmanuelle Piet, Patrick Chariot
BACKGROUND: Violence for educational purpose refers to a modality of education that includes threats, verbal abuse, physical abuse and humiliations. Twenty European countries, not including France, have abolished corporal punishment through explicit laws and regulations. The position of general practitioners in the screening and care of violence for educational purpose in France is unknown. In this study, we aimed to assess the representations of this form of violence among general practitioners...
March 12, 2018: La Presse Médicale
R M Gracia Gozalo, J M Ferrer Tarrés, A Ayora Ayora, M Alonso Herrero, A Amutio Kareaga, R Ferrer Roca
OBJECTIVE: To evaluate the effect of a mindfulness training program on the levels of burnout, mindfulness, empathy and self-compassion among healthcare professionals in an Intensive Care Unit of a tertiary hospital. DESIGN: A longitudinal study with an intrasubject pre-post intervention design was carried out. SETTING: Intensive Care Unit of a tertiary hospital. PARTICIPANTS: A total of 32 subjects (physicians, nurses and nursing assistants) participated in the study...
March 12, 2018: Medicina Intensiva
Thomas Stephan Hiller, Antje Freytag, Jörg Breitbart, Tobias Teismann, Elisabeth Schöne, Wolfgang Blank, Mercedes Schelle, Horst Christian Vollmar, Jürgen Margraf, Jochen Gensichen
BACKGROUND: Behavior therapy-oriented methods are recommended for treating anxiety disorders in primary care. The treatment of patients with long-term conditions can be improved by case management and structured clinical monitoring. The present paper describes the rationale, design and application of the 'Jena Anxiety Monitoring List' (JAMoL), a monitoring tool for the treatment of patients with panic disorder, with or without agoraphobia, in primary care. METHODS: JAMoL's design was based on established clinical measures, the rationale of exposure-based anxiety treatment, and research on family practice-based case management...
March 12, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Sabine Salloch, Ina C Otte, Anke Reinacher-Schick, Jochen Vollmann
The impact of patient preferences in evidence-based medicine is a complex issue which touches on theoretical questions as well as medical practice in the clinical context. The interaction between evidence-based recommendations and value-related patient preferences in clinical practice is, however, highly complex and requires not only medical knowledge but social, psychological and communicative competencies on the side of the physician. The multi-layered process of oncology physicians' clinical decision-making was explored in 14 semi-structured interviews with respect to a first diagnosis of a pancreatic adenocarcinoma...
March 12, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Emily M Ko, Laura J Havrilesky, Ronald D Alvarez, Oliver Zivanovic, Leslie R Boyd, Elizabeth L Jewell, Patrick F Timmins, Randall S Gibb, Anuja Jhingran, David E Cohn, Sean C Dowdy, Matthew A Powell, Eva Chalas, Yongmei Huang, Jill Rathbun, Jason D Wright
Health care in the United States is in the midst of a significant transformation from a "fee for service" to a "fee for value" based model. The Medicare Access and CHIP Reauthorization Act of 2015 has only accelerated this transition. Anticipating these reforms, the Society of Gynecologic Oncology developed the Future of Physician Payment Reform Task Force (PPRTF) in 2015 to develop strategies to ensure fair value based reimbursement policies for gynecologic cancer care. The PPRTF elected as a first task to develop an Alternative Payment Model for thesurgical management of low risk endometrial cancer...
March 12, 2018: Gynecologic Oncology
Winnie Wing Yan Yuen, Albert Lee, Paul K S Chan, Lynn Tran, Erica Sayko
The present study is aimed at assessing the feasibility of delivering the HPV (human papillomavirus) vaccine to girls through a school-based program in Hong Kong, as well as to examine the facilitators and barriers associated with their participation. We approached 1,229 eligible girls aged 9 to 14 at eight schools in Hong Kong to join the program and then delivered the bivalent HPV vaccine at 0 and 6 months over the course of one school year. The students and their parents completed separate questionnaires to indicate their decision on whether or not to participate, and to assess their knowledge of cervical cancer and the HPV vaccine...
2018: PloS One
Amy E Vinson, Gail Randel
PURPOSE OF REVIEW: Peer support, a method of providing for the well being of healthcare providers following adverse or stressful events, is garnering increased attention in light of the increased prevalence and awareness of burnout, depression and suicidality in physicians. In this review, we will summarize the evolution of the 'second victim,' explore methods of support and examine how new regulatory requirements are changing the peer support landscape. RECENT FINDINGS: As peer support and the second victim are investigated more, themes are emerging regarding the natural history of recovery...
March 14, 2018: Current Opinion in Anaesthesiology
Jacqueline H Wolf
In the late 19th-century United States and Europe, infants died at high rates from diarrhea. Physicians and social justice advocates responded to the public health crisis with attempts to clean up the water and cows' milk supplies, as well as social welfare legislation and assorted educational efforts to help mothers better care for their children. Most visible among the educational efforts were breastfeeding campaigns. A century later in developing countries, physicians and activists were confronted with a similar problem-infants dying from diarrhea due to the unethical advertising and marketing practices of formula companies...
March 1, 2018: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
Y Dargaud, X Delavenne, D P Hart, S Meunier, P Mismetti
Over the past decades, haemophilia management has continually evolved, with prophylaxis now considered the treatment of choice. Prophylaxis primarily seeks to prevent bleeding and haemarthrosis episodes from occurring and avert the otherwise inevitable haemophilic arthropathy. Yet, numerous unanswered issues remain. These concern dose levels, dosing intervals, ways of integrating variability in bleeding phenotype, patient age, joint status, lifestyle, physical activity, treatment adherence and individual responses to FVIII or FIX concentrates...
March 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Shatha A Al Shanqeeti, Yasser N Alkhudairy, Alwaleed A Alabdulwahed, Anwar E Ahmed, Maysoon S Al-Adham, Naveed M Mahmood
To estimate the prevalence of subclinical hypothyroidism (SCH) in Saudi Arabia and assess the need for an SCH screening program. Methods: This cross-sectional study was conducted at King Abdulaziz Medical City and the Khashmulaan Clinic at the National Guard Health Affairs, Riyadh, Saudi Arabia in August 2016. All women attending the antenatal clinics were  invited to participate in the study. In addition, data were retrieved from the files of pregnant women who had been screened for hypothyroidism from January 2016 to August 2016...
March 2018: Saudi Medical Journal
Peter A Nigrovic, Timothy Beukelman, George Tomlinson, Brian M Feldman, Laura E Schanberg, Yukiko Kimura
BACKGROUND: Systemic juvenile idiopathic arthritis is a rare febrile arthritis of childhood characterized by a potentially severe course, including prolonged glucocorticoid exposure, growth failure, destructive arthritis, and life-threatening macrophage activation syndrome. Early cytokine-blocking biologic therapy may improve long-term outcomes, although some systemic juvenile idiopathic arthritis patients respond well to non-biologic treatment, leaving optimal management undefined. Consequently, treatment of new-onset systemic juvenile idiopathic arthritis by expert clinicians varies widely...
March 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
Samin Nobakht, Arash Shirdel, Yasamin Molavi-Taleghani, Mohammad M Doustmohammadi, Hojjat Sheikhbardsiri
INTRODUCTION: Human resource supply is considered as one of the most vital factors in achieving organizational goals, and human resources are the most valuable factor in the production and delivery of services. Labor shortages and surpluses could downgrade the quality of services offered to patients. Considering the seriousness of this issue, this study aimed to investigate the status of human resources in Iran hospitals. METHODS: The narrative review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines...
March 15, 2018: International Journal of Health Planning and Management
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