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integrity of physicians

Mary Anne Purtzer, Carol J Hermansen-Kobulnicky
PURPOSE/OBJECTIVES: To investigate oncology professionals' perspectives about, experience with, and envisioned feasibility of incorporating patient self-monitoring as a patient-centered practice. 
. RESEARCH APPROACH: An interpretive, descriptive study.
. SETTING: Four health systems and five cancer centers in three states. 
. PARTICIPANTS: 38 nurses, nurse practitioners, oncologists, physician assistants, and radiation therapists...
November 1, 2016: Oncology Nursing Forum
A L Adams, F Xue, J Q Chantra, R M Dell, S M Ott, S Silverman, J C Giaconi, C Critchlow
: Using the American Society for Bone and Mineral Research Task Force case definition for atypical femoral fractures, sensitivity and specificity of radiographic fracture characteristics were calculated. Fracture pattern was the most sensitive and specific characteristic. This suggests that some characteristics should be weighted more heavily when identifying these fractures. INTRODUCTION: To estimate the sensitivity and specificity of each radiographic criterion in the 2013 ASBMR atypical femoral fracture (AFF) case definition for distinguishing AFF from other subtrochanteric/diaphyseal fractures (non-AFF) among women enrolled in a large integrated health care organization...
October 21, 2016: Osteoporosis International
Deven A Karvelas, Sean D Rundell, Janna L Friedly, Alfred C Gellhorn, Laura S Gold, Bryan A Comstock, Patrick J Heagerty, Brian W Bresnahan, David R Nerenz, Jeffrey G Jarvik
BACKGROUND: The association between early physical therapy (PT) and subsequent healthcare utilization following a new visit for low back pain is not clear, particularly in the setting of acute low back pain. PURPOSE: To estimate the association between initiating early physical therapy following a new visit for an episode of low back pain and subsequent back-pain-specific health care utilization in older adults. STUDY DESIGN/SETTING: Prospective cohort study...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Mark Corbett
Conceivably, in an ideal world, all patients with a life-limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician-assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life...
2016: Narrative Inquiry in Bioethics
Sytske Anne Bergstra, Pedro M M C Machado, Rosaline van den Berg, Robert B M Landewé, Tom W J Huizinga
OBJECTIVES: Ten years ago, the METEOR tool was developed to simulate treatment-to-target and create an international research database. The development of the METEOR tool and database, research opportunities and future perspectives are described. METHODS: The METEOR tool is a free, online, internationally available tool in which daily practice visits of all rheumatoid arthritis patients visiting a rheumatologist can be registered. In the tool, disease characteristics, patient- and physician-reported outcomes and prescribed treatment could be entered...
September 2016: Clinical and Experimental Rheumatology
Amy Blake, Bryan T Carroll
OBJECTIVE: This paper analyses how game theory can provide a framework for understanding the strategic decision-making that occurs in everyday scenarios in medical training and practice, and ultimately serves as a tool for improving the work environment and patient care. Game theory has been applied to a variety of fields outside of its native economics, but has not been thoroughly studied in the context of health care provision. METHODS: The paper discusses four of the most common 'games' and applies each to a scenario in medicine to provide new insight on the incentives and drivers for certain types of behaviour and a deeper understanding of why certain results are valued more strongly than others...
November 2016: Medical Education
Tamara Seitz, Bela R Turk, Henriette Löffler-Stastka
The increasing emigration of graduates of the Medical University of Vienna presents a serious problem. This study examined students' evaluation of clinical rotations, their self-rated performance, and where they felt the most deficits exist. Medical students answered an online questionnaire surveying the following aspects: an evaluation of their internship; supervision; integration in the team and improvement of field-specific knowledge; the qualities of taking a patient's medical history by empathy; patient-centeredness; structure; target orientation; and the ability to integrate field-specific knowledge into anamnesis...
October 19, 2016: Wiener Klinische Wochenschrift
Nirav Patel, Justine Pierson, Timothy Lee, Bruce Mast, Bernard T Lee, Irene Estores, Dhruv Singhal
BACKGROUND: Integrative medicine (IM) is currently used by 40% of Americans. Our objective is to examine the prevalence and perception of IM utilization in patients being evaluated for elective plastic surgery. METHODS: In July 2014, 402 consecutive patients presenting to plastic surgery clinics at the University of Florida, Veterans Affairs (VA), and Private Practices in Gainesville, Florida were requested to complete a survey regarding utilization of and attitudes towards IM...
October 17, 2016: Annals of Plastic Surgery
Aline Kunz, Sabrina Pohlmann, Oliver Heinze, Antje Brandner, Christina Reiß, Martina Kamradt, Joachim Szecsenyi, Dominik Ose
BACKGROUND: The importance of information and communication technology for healthcare is steadily growing. Newly developed tools are addressing different user groups: physicians, other health care professionals, social workers, patients, and family members. Since often many different actors with different expertise and perspectives are involved in the development process it can be a challenge to integrate the user-reported requirements of those heterogeneous user groups. Nevertheless, the understanding and consideration of user requirements is the prerequisite of building a feasible technical solution...
October 18, 2016: JMIR Human Factors
Sheng-Yu Fan, I-Mei Lin, Jyh-Gang Hsieh, Chih-Jung Chang
CONTEXT: Psychosocial care is an important component of palliative care, which is also provided by physicians and nurses. OBJECTIVE: The aim of this study was to explore the experiences of physicians and nurses in palliative care regarding the process of psychosocial care, the difficulties, and the support needs from psychosocial care professionals. METHODS: A two-phase mixed methods study was conducted. In the first phase, 16 physicians and nurses with palliative care experience were recruited...
October 15, 2016: Journal of Pain and Symptom Management
O Razum, J Wenner, K Bozorgmehr
Health and access to health care are considered a human right. "Regular" immigrants such as work migrants in Germany have the same entitlement to health care coverage through the statutory health insurance as the majority population. This, however, is not the case for refugees and asylum seekers. According to paragraphs 4 and 6 of the Asylum Seekers' Benefit Act, their entitlement is restricted to care for acute pain, pregnancy and childbirth, as well as immunizations in the first 15 months. Additional care can be financed on a case-by-case basis...
October 18, 2016: Das Gesundheitswesen
Disa Dahlman, Åsa Palm, Christina Sunesdotter, Katja Troberg, Camilla Wallin
Low-threshold primary care for patients in opiate maintenance therapy. A pilot project in Malmö, Sweden, integrates primary care and OMT  This report illustrates how integration of primary care and opiate maintenance therapy (OMT) may improve OMT patients health and minimize obstacles for care seeking. OMT patients have poor health. Around 80 % have hepatitis C, a majority smoke tobacco, and socio-economic status is generally low. However, somatic health is often under-prioritized in this group. To improve OMT patients physical health', two OMT clinics and one primary care center in Malmö, Sweden, started a pilot project in 2014...
October 14, 2016: Läkartidningen
Svetlana Villevalde, Zhanna Kobalava
OBJECTIVE: Antihypertensive medication nonadherence is significant contributor to poor BP control. Patient-related factors (lack of motivation or risk understanding) are important. The aim of PRISMA study was to determine the impact of integrated approach with therapy based on perindopril arginine in the improvement of motivation, adherence to antihypertensive treatment and BP control. DESIGN AND METHOD: 906 (315 male, 56.0 ± 10.6 years) non-adherent (score < 4 in Morisky and Green Test for Measure of Adherence to Therapy) hypertensive patients with planning or action stages of behavior changes (Prochaska and DiClemente model) with uncontrolled hypertension (BP > 140/90 mmHg) were randomly assigned to 2 strategies: integrated approach with therapy based on perindopril arginine with added-on therapy if necessary (G1, n = 755) or routine practice (G2, n = 151)...
September 2016: Journal of Hypertension
J Trotman, J Trinh, Y L Kwan, J A Estell, J Fletcher, K Archer, K Lee, K Foo, J Curnow, A Bianchi, L Wignall, E Verner, R Gasiorowski, E Siedlecka, I Cunningham
BACKGROUND: Multidisciplinary Team (MDT) meetings aimed at facilitating peer review have become standard practice in oncology. However, there is scant literature on the optimal structure and conduct of such meetings. AIMS: We aimed to develop a process for formal peer review of patients with haematologic malignancies, and to audit any resulting changes made to the management recommendations of the treating physician. METHODS: A standard operating procedure (SOP) for MDT meetings was developed essentially to integrate clinical peer review with weekly pathology and radiology meetings...
October 18, 2016: Internal Medicine Journal
William R Fox, Deborah B Diercks
Troponins are proteins commonly found in cardiac tissue that are released during myocardial ischemia or necrosis. These troponins can be detected by assays that can then be used to guide clinical decision-making and disposition, especially if the suspected insult is related to acute coronary syndrome. Timing of troponin measurement can be important as elevations may not be detectible immediately after an insult. New assays have been designed to detect troponin con-centrations previously too low to be detected by conventional assays...
March 2016: Clin Exp Emerg Med
S Seidu, D H Bodicoat, M J Davies, H Daly, B Stribling, A Farooqi, E M Brady, K Khunti
: Diabetes is an ambulatory care-sensitive condition and a high quality primary care or risk factor control can lead to a decrease in the risk of non-elective hospitalisations while ensuring continuity of care with usual primary care teams. AIMS AND METHODS: In this before and after study, eight primary care practices providing a newer enhanced diabetes model of care in Leicester UK, were compared with matched neighbouring practices with comparable demographic features providing a more expensive integrated specialist-community care diabetes service...
October 10, 2016: Primary Care Diabetes
Joseph Arthur, Sriram Yennu, Kresnier Perez Zapata, Hilda Cantu, Jimin Wu, Diane Liu, Eduardo Bruera
BACKGROUND: Data on the use of question prompt sheets (QPS) in palliative care is limited. Our team previously developed a single page QPS using a Delphi process. The main objective of this study was to determine the perception of helpfulness of a QPS in patient-physician communication among advanced cancer outpatients. METHODS: 100/104(96%) eligible patients and 68/68(100%) caregivers received the QPS during their first palliative care clinic. 12 palliative medicine specialists also participated in the study...
October 12, 2016: Journal of Pain and Symptom Management
Marshall B Kapp
Medical education, including education intended to prepare future physicians to care to older individuals, should include development and implementation of competencies relating to a physician's ability to understand and interact with the legal environment and legal actors who will impact the practice of medicine. The wisdom of integrating legal knowledge into the medical curriculum has been documented and literature discusses the content and methods of teaching medical students and residents about law and the legal system...
October 14, 2016: Gerontology & Geriatrics Education
William Ventres, Paul Gross
In this article we introduce family medicine educators to storytelling as an important teaching tool. We describe how stories are a critical part of the work of family physicians. We review the rationales for family medicine educators to become skilled storytellers. We present the components of effective stories, proposing two different perspectives on how to imagine, construct, and present them. We provide a list of resources for getting started in storytelling and offer two personal vignettes that articulate the importance of storytelling in the authors' respective professional developments...
October 2016: Family Medicine
Lori A Stolz, Uwe Stolz, J Matthew Fields, Turandot Saul, Michael Secko, Matthew J Flannigan, Johnathan M Sheele, Robert P Rifenburg, Anthony J Weekes, Elaine B Josephson, John Bedolla, Dana M Resop, Jonathan Dela Cruz, Megan Boysen-Osborn, Terrell Caffery, Charlotte Derr, Rimon Bengiamin, Gerardo Chiricolo, Brandon Backlund, Jagdipak Heer, Robert J Hyde, Srikar Adhikari
OBJECTIVES: Emergency ultrasound (EUS) has been recognized as integral to the training and practice of emergency medicine (EM). The Council of Emergency Medicine Residency-Academy of Emergency Ultrasound (CORD-AEUS) consensus document provides guidelines for resident assessment and progression. The Accredited Council for Graduate Medical Education (ACGME) has adopted the EM Milestones for assessment of residents' progress during their residency training which includes demonstration of procedural competency in bedside ultrasound...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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