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Doctor avoidance

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https://www.readbyqxmd.com/read/29333825/6-minutes
#1
Pablo R Justich Zabala
At present, there is a trend towards reducing the duration of office visits. In some regions of Spain, it has been set at 6 minutes per patient. This impacts on several levels: literally, many times it is impossible to complete the medical act; at an emotional level, because there is little possibility to establish an adequate doctor-patient relationship; and symbolically, for considering that the main aspects of humane health care are expendable. This takes place in a society that tends to see health care as a merchandise subject to market rules that gives priority to the immediate over the important...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29328511/stigma-and-unmet-sexual-and-reproductive-health-needs-among-international-migrant-sex-workers-at-the-mexico-guatemala-border
#2
Teresita Rocha-Jiménez, Sonia Morales-Miranda, Carmen Fernández-Casanueva, Kimberly Brouwer, Shira M Goldenberg
OBJECTIVE: To explore international migrant sex workers' experiences and narratives pertaining to the unmet need for and access to sexual and reproductive health (SRH) at the Mexico-Guatemala border. METHODS: An inductive qualitative analysis was conducted based on ethnographic fieldwork (2012-2015) including participant observation and audio-recorded in-depth interviews. The participants were female sex workers aged 18 years or older and international migrants working at the Mexico-Guatemala border...
January 12, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29322713/communication-adaptations-for-a-diverse-international-patient-population
#3
Aditya Ghosh, Shashank Joshi, Amit K Ghosh
We live in an age of hyper connectivity, people from around the world are looking outside their own national borders to receive medical care. As more people are learning about the quality that the elite Indian hospitals provide at a competitive, and often more affordable, price compared to other institutions around the world, they are becoming increasingly interested in receiving their medical care in Indian hospitals. It is for this exact reason that it is very important to learn the importance of communicating effectively with people from a diverse background...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29314463/prevalence-and-patterns-of-anti-epileptic-medication-prescribing-in-the-treatment-of-epilepsy-in-older-adults-with-intellectual-disabilities
#4
M O'Dwyer, J Peklar, N Mulryan, P McCallion, M McCarron, M C Henman
BACKGROUND: The prevalence of epilepsy is higher in people with intellectual disability (ID) and increases with the degree of ID. Although life expectancy for people with ID is increasing, people with ID coexisting with epilepsy have a higher mortality rate, particularly those who had recent seizures. There have been few observational studies of the prevalence and patterns of anti-epileptic prescribing among older people with ID and epilepsy. The aim of this study was to investigate prevalence and patterns of anti-epileptic prescribing in the treatment of epilepsy in a representative population of older people with ID and epilepsy...
January 5, 2018: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29305460/delays-in-the-diagnosis-and-treatment-of-bone-and-joint-tuberculosis-in-the-united-kingdom
#5
C Broderick, S Hopkins, D J F Mack, W Aston, R Pollock, J A Skinner, S Warren
AIMS: Tuberculosis (TB) infection of bones and joints accounts for 6.7% of TB cases in England, and is associated with significant morbidity and disability. Public Health England reports that patients with TB experience delays in diagnosis and treatment. Our aims were to determine the demographics, presentation and investigation of patients with a TB infection of bones and joints, to help doctors assessing potential cases and to identify avoidable delays. PATIENTS AND METHODS: This was a retrospective observational study of all adults with positive TB cultures on specimens taken at a tertiary orthopaedic centre between June 2012 and May 2014...
January 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29302603/what-are-the-ethical-dimensions-in-the-profession-of-intensive-care-specialist
#6
REVIEW
Jean-Pierre Quenot, Fiona Ecarnot, Nicolas Meunier-Beillard, Auguste Dargent, Jean-Pierre Eraldi, François Bougerol, Audrey Large, Pascal Andreu, Jean-Philippe Rigaud
Two essential components of the profession of a medical doctor are the constant review of the patient's therapeutic project, and collaboration between healthcare professionals. The profession of intensive care unit (ICU) physician goes further in terms of responsibility, vis-à-vis the intensive treatments dispensed to the patients, and the physician's responsibilities towards the patient's family and the caregiving team, also bearing in mind that ICU care is costly in terms of human and financial resources...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29302554/sexual-behavior-of-adolescent-students-in-chandigarh-and-their-perceptions-regarding-family-life-education
#7
Dinesh Kumar, Naveen Krishan Goel, Ravleen Kaur Bakshi, Manoj Kumar Sharma, Abhik K Ghosh
Background: With rapidly changing lifestyle and exposure to the Internet and mass media, lifestyle and sexual behavior of adolescent students are also changing rapidly. Objectives: To investigate the sexual behavior of adolescent students and to study misconceptions prevailing among them. Methods: A cross-sectional survey of 1022 adolescent students aged 14-19 years as a part of an Indian Council of Medical Research sponsored survey. Sexual behavior explored by interview method...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29301502/cancer-related-maternal-mortality-and-delay-in-diagnosis-and-treatment-a-case-series-on-26-cases
#8
Jorine de Haan, Christianne A R Lok, Joke S Schutte, Lia van Zuylen, Christianne J M de Groot
BACKGROUND: Cancer during pregnancy is relatively rare but may lead to maternal mortality. We aimed to assess the incidence of cancer related maternal mortality and the neonatal outcome in these patients. Also, doctor- and patient-related delay in cancer diagnosis and therapy among patients with cancer related maternal mortality is assessed. METHODS: Maternal mortality was defined as death during pregnancy or within 1 year after delivery. Data of the Dutch Maternal Mortality Committee was used to calculate the cancer related maternal mortality rate and to assess neonatal outcome in the Netherlands...
January 5, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29301226/impact-of-pharmacist-conducted-comprehensive-medication-reviews-for-older-adult-patients-to-reduce-medication-related-problems
#9
Whitney J Kiel, Shaun W Phillips
Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization...
December 31, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29298965/stigmatization-of-psychiatrists-by-pedagogues
#10
Andrzej Witusik
Psychiatrists, as well as their patients, are the objects of the stigmatization process. The question arises as to whether stigmatization of psychiatrists is a phenomenon that occurs among the pedagogues. Answering this question has an important social dimension because it is the teacher and the pedagogue who shapes the attitudes of young people. AIM: Aim of the study was preliminary, pilot assessment of the severity of stigmatization of psychiatrists by teachers and educators who do not have everyday contact with mentally ill patients...
December 22, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29296223/development-and-validation-of-a-prognostic-index-to-predict-pulmonary-metastasis-of-giant-cell-tumor-of-bone
#11
Bo Wang, Wei Chen, Xianbiao Xie, Jian Tu, Gang Huang, Changye Zou, Junqiang Yin, Lili Wen, Jingnan Shen
Purpose: Giant cell tumor of bone (GCTB) is an intermittent tumor with a low probability of pulmonary metastasis. Our aim was to investigate the risk factors and establish a nomogram predictive model for GCTB pulmonary metastasis. Methods: We retrospectively evaluated GCTB patients at our center from 1991 to 2014. The cohort was randomized into training and validation sets. Univariate and multivariate analyses were used to evaluate the risk factors of pulmonary metastasis...
December 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/29290330/affective-science-and-avoidant-end-of-life-communication-can-the-science-of-emotion-help-physicians-talk-with-their-patients-about-the-end-of-life
#12
Jesse A Soodalter, Greg J Siegle, Michele Klein-Fedyshin, Robert Arnold, Yael Schenker
Despite believing end-of-life (EOL) discussions with patients are important, doctors often do not have them. Multiple factors contribute to this shortfall, which interventions including reimbursement changes and communication skills training have not significantly improved to date. One commonly cited but under-researched reason for physician avoidance of EOL discussion is emotional difficulty. High occupational demand for frequent difficult discussions may overload physicians' normal emotional functioning, leading to avoidance or failure...
December 11, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29285410/the-clinical-examination-in-the-patient-with-subarachnoid-hemorrhage-is-still-the-most-reliable-parameter-for-predicting-pathophysiological-changes
#13
Athanasios K Petridis, Kerim Beseoglu, Hans J Steiger
Background: Macrovasospasms and delayed cerebral injury are factors which correlate with high morbidity in patients suffering a subarachnoid hemorrhage. Transcranial Doppler (TCD) ultrasonography and perfusion computed tomography (PCT) are diagnostic tools used to diagnose such pathologies. However, TCD is not very reliable and PCT exposes patients to radiation and cannot be performed daily. Case Description: We present the case of a 47-year-old female with subarachnoid hemorrhage caused by rupture of an intracranial aneurysm...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29284248/streptococcus-suis-a-re-emerging-pathogen-associated-with-occupational-exposure-to-pigs-or-pork-products-part-i-epidemiology
#14
Jacek Dutkiewicz, Jacek Sroka, Violetta Zając, Bernard Wasiński, Ewa Cisak, Anna Sawczyn, Anna Kloc, Angelina Wójcik-Fatla
<i>Streptococcus suis</i> (ex Elliot 1966, Kilpper-Bälz & Schleifer 1987) is a facultatively anaerobic Gram-positive ovoid or coccal bacterium surrounded by a polysaccharide capsule. Based on the antigenic diversity of the capsule, <i>S. suis</i> strains are classified serologically into 35 serotypes. <i>Streptococcus suis</i> is a commensal of pigs, commonly colonizing their tonsils and nasal cavities, mostly in weaning piglets between 4-10 weeks of age. This species occurs also in cattle and other mammals, in birds and in humans...
December 23, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/29275001/recommendations-of-the-spanish-working-group-on-crohn-s-disease-and-ulcerative-colitis-geteccu-and-the-association-of-crohn-s-disease-and-ulcerative-colitis-patients-accu-in-the-management-of-psychological-problems-in-inflammatory-bowel-disease-patients
#15
Manuel Barreiro-de Acosta, Ignacio Marín-Jiménez, Abel Panadero, Jordi Guardiola, Mercedes Cañas, Milena Gobbo Montoya, Yolanda Modino, Guillermo Alcaín, Marta Maia Bosca-Watts, Xavier Calvet, Francesc Casellas, María Chaparro, Luis Fernández Salazar, Rocío Ferreiro-Iglesias, Daniel Ginard, Marisa Iborra, Noemí Manceñido, Miriam Mañosa, Olga Merino, Montserrat Rivero, Oscar Roncero, Laura Sempere, Pablo Vega, Yamile Zabana, Miguel Mínguez, Pilar Nos, Javier P Gisbert
AIMS: To establish recommendations for the management of psychological problems affecting patients with inflammatory bowel disease (IBD). METHODS: A meeting of a group of IBD experts made up of doctors, psychologists, nurses and patient representatives was held. The following were presented: 1) Results of a previous focal group, 2) Results of doctor and patient surveys, 3) Results of a systematic review of tools for detecting anxiety and depression. A guided discussion was then held about the most important psychological and emotional problems associated with IBD, appropriate referral criteria and situations to be avoided...
December 20, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/29260408/practical-treatment-of-lewy-body-disease-in-the-clinic-patient-and-physician-perspectives
#16
Elisabet Londos
This article describes the practical considerations in the clinical medical treatment in dementia with Lewy body (DLB) patients. It is illustrated with the voice of a DLB sufferer and his wife. According to our experience, emanating from a 15 year collaboration between a doctor and a nurse at a memory clinic, there are several possible therapeutical entrances. However, the order in which the medication is introduced is of great importance to avoid aggravation of other DLB symptoms. We start the treatment with cholinesterase inhibitor and memantine, and; thereafter, we treat the most disturbing symptom...
December 19, 2017: Neurology and Therapy
https://www.readbyqxmd.com/read/29249776/-diseases-requiring-severe-level-care-certification-for-long-term-care-insurance
#17
Kyoko Takahashi, Eri Tsukishima
Objectives Extending health expectancy is important; however, health and welfare programs in local areas and communities present their own issues. This study aimed to identify main diseases requiring severe-level care certification for long-term care insurance based on information gathered from opinion papers prepared by primary doctors.Methods Data were obtained for 4,089 patients aged ≧65 years who were certified for long-term care insurance for the first time between April 1, 2013, and March 31, 2015...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/29249189/medical-care-avoidance-among-older-adults
#18
Bryan Leyva, Jennifer M Taber, Amal N Trivedi
OBJECTIVE: To examine factors and reasons associated with medical care avoidance among older adults in the United States. METHOD: Analysis of data on 2,155 adults aged 65 and older, who completed the 2008 Health Information National Trends Survey. RESULTS: Nearly one fourth of older adults reported medical care avoidance ( n = 449; weighted % = 22.5%). Of these, more than one third reported doing so because of feeling uncomfortable when their body is examined (34...
December 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29245272/epithelial-myoepithelial-carcinoma-with-high-grade-transformation-of-parotid-gland-a-case-report-and-literature-review
#19
Bowen Li, Hongyu Yang, Xia Hong, Yufan Wang, Feng Wang
RATIONALE: Epithelial-myoepithelial carcinoma (EMC) is regarded as a rare low-grade malignant tumor of the salivary gland, accounting for 0.4% to 1% of all salivary gland tumors. However, epithelial-myoepithelial carcinoma with high-grade transformation (EMC with HGT) is extremely rare, therefore it is easily to be inappropriately diagnosed and treated. Herein, we report an unusual case of EMC with HGT involving the parotid gland and discuss the clinical features and histological characteristic of EMC with HGT, in order to remind the doctors to take appropriate diagnosis and treatment...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29244988/chemotherapy-use-at-the-end-of-life-in-uganda
#20
Daniel Low, Emily C Merkel, Manoj Menon, Gary H Lyman, Henry Ddungu, Elizabeth Namukwaya, Mhoira Leng, Corey Casper
Purpose Avoiding chemotherapy during the last 30 days of life has become a goal of cancer care in the United States and Europe, yet end-of-life chemotherapy administration remains a common practice worldwide. The purpose of this study was to determine the frequency of and factors predicting end-of-life chemotherapy administration in Uganda. Methods Retrospective chart review and surveys and interviews of providers were performed at the Uganda Cancer Institute (UCI), the only comprehensive cancer center in the area, which serves a catchment area of greater than 100 million people...
December 2017: Journal of Global Oncology
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