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Physician fatigue

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https://www.readbyqxmd.com/read/27902537/effect-of-time-of-operation-on-hip-fracture-outcomes-a-retrospective-analysis
#1
Gonzalo Barinaga, Erik Wright, Paul J Cagle, Afshin A Anoushiravani, Zain Sayeed, Monique C Chambers, Mouhanad M El-Othmani, Khaled J Saleh
INTRODUCTION: Hip fractures are a common source of morbidity, mortality, and cost burden for elderly patients. We conducted a retrospective analysis of patients with hip fracture treated during the day or night at a rural level I academic trauma center and compared the postoperative outcomes and resource utilization for both groups. METHODS: Patients aged ≥55 years with hip fractures treated with definitive surgical fixation from April 2011 to April 2013 were included in this study...
November 29, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27895218/a-new-approach-to-identify-high-burnout-medical-staffs-by-kernel-k-means-cluster-analysis-in-a-regional-teaching-hospital-in-taiwan
#2
Yii-Ching Lee, Shian-Chang Huang, Chih-Hsuan Huang, Hsin-Hung Wu
This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27878349/operation-start-times-and-postoperative-morbidity-from-liver-resection-a-propensity-score-matching-analysis
#3
Qiang Lu, Yuan Shen, Jing Zhang, Yi-Fan Ren, Jian Dong, Zhao-Qing Du, Xue-Min Liu, Zheng Wu, Yi Lv, Xu-Feng Zhang
BACKGROUND: Surgeons are likely to get progressively fatigued and work less effectively during the course of a normal workday. We sought to examine the effects of surgery start times (morning vs. afternoon) and workload of the surgeons on morbidity of patients after partial liver resection (LR). METHODS: A total of 155 pairs of the patients from 383 patients undergoing LR were generated by propensity score analysis (PSM) according to the start times of surgery: group M (morning surgery, 8 a...
November 22, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27874495/evolution-of-multiple-sclerosis-spasticity-associated-symptoms-latest-data
#4
Peter Flachenecker
In addition to muscle stiffness and increasing mobility restrictions, symptoms commonly associated with multiple sclerosis (MS) spasticity are spasms, sleep disturbances, pain, fatigue and bladder dysfunction. Treatment options include trigger factor avoidance, physiotherapy and antispasticity medication. Oral antispasticity agents commonly used in Germany are baclofen, tizanidine and gabapentin, but physician and patient satisfaction with their effectiveness is low. Over the past few years, randomized controlled trials, observational studies and registry data have demonstrated the positive risk:benefit profile of add-on 9-delta-tetra-hydrocannabinol:cannabidiol oromucosal spray for moderate-to-severe resistant MS spasticity...
December 2016: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/27858461/how-could-patient-reported-outcomes-improve-patient-management-in-chronic-myeloid-leukemia
#5
Federico De Marchi, Marta Medeot, Renato Fanin, Mario Tiribelli
Patients reported outcome (PRO) are still under-used in patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs), though data on the correlation between quality of life (QoL) and therapeutic efficacy are increasingly known. Chronic low-grade toxicities can reduce patient's QoL and negatively impact on adherence. Areas covered: This review will focus on the role of QoL questionnaires in patients with CML, receiving imatinib or newer TKIs (dasatinib, nilotinib, bosutinib, ponatinib)...
November 30, 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27830952/return-to-work-following-acquired-brain-injury-the-views-of-patients-and-employers
#6
Birgit H P M Donker-Cools, Maria J E Schouten, Haije Wind, Monique H W Frings-Dresen
PURPOSE: To investigate which factors are experienced as facilitators of or barriers to return to work (RTW), or as solutions to RTW-problems, by patients with acquired brain injury (ABI) and by employers. DESIGN: Qualitative study. METHOD: Ten patients with ABI and seven employers participated in semi-structured interviews. Patients and employers were unrelated. Transcripts were open coded. Factors perceived to be facilitators, barriers, or solutions to RTW-problems were grouped on a thematic basis...
November 10, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27826348/complete-heart-block-in-association-with-dengue-hemorrhagic-fever
#7
Hafeez Ul Hassan Virk, Faisal Inayat, Zia Ur Rahman
Dengue virus infection affects the heart structurally and functionally. Clinical manifestations of cardiac complications secondary to dengue virus infection vary from self-limiting arrhythmias to severe myocardial infarction, leading to hypotension, pulmonary edema, and cardiogenic shock. However, we report a case of dengue hemorrhagic fever (DHF) complicated by a complete heart block. A female with DHF due to dengue virus serotype 2, presented to the emergency department with fever, headache, rash, and fatigue followed by an episode of syncope...
November 2016: Korean Circulation Journal
https://www.readbyqxmd.com/read/27822928/factors-contributing-to-discordance-between-the-2011-acr-eular-criteria-and-physician-clinical-judgment-for-the-identification-of-remission-in-patients-with-rheumatoid-arthritis
#8
Yoon Kyoung Sung, Soo Kyung Cho, Dam Kim, Bo Young Yoon, Chan Bum Choi, Hoon Suk Cha, Jung Yoon Choe, Won Tae Chung, Seung Jae Hong, Jae Bum Jun, Young Mo Kang, Jinseok Kim, Tae Hwan Kim, Tae Jong Kim, Eunmi Koh, Choong Ki Lee, Jisoo Lee, Shin Seok Lee, Sung Won Lee, Hye Soon Lee, Yeon Ah Lee, Sung Hoon Park, Dae Hyun Yoo, Wan Hee Yoo, Sang Cheol Bae
Remission is a primary end point of in clinical practice and trials of treatments for rheumatoid arthritis (RA). The 2011 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria were developed to provide a consensus definition of remission. This study aimed to assess the concordance between the new remission criteria and the physician's clinical judgment of remission and also to identify factors that affect the discordance between these two approaches. A total of 3,209 patients with RA were included from the KORean Observational Study Network for Arthritis (KORONA) database...
December 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27822925/national-rules-for-drug-drug-interactions-are-they-appropriate-for-tertiary-hospitals
#9
Insook Cho, Jae Ho Lee, Jinwook Choi, Hee Hwang, David W Bates
The application of appropriate rules for drug-drug interactions (DDIs) could substantially reduce the number of adverse drug events. However, current implementations of such rules in tertiary hospitals are problematic as physicians are receiving too many alerts, causing high override rates and alert fatigue. We investigated the potential impact of Korean national DDI rules in a drug utilization review program in terms of their severity coverage and the clinical efficiency of how physicians respond to them. Using lists of high-priority DDIs developed with the support of the U...
December 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27822121/the-danish-nationwide-clinical-register-for-patients-with-rheumatoid-arthritis-danbio
#10
REVIEW
Else Helene Ibfelt, Dorte Vendelbo Jensen, Merete Lund Hetland
INTRODUCTION: DANBIO is a research register and a data source for rheumatologic diseases (rheumatoid arthritis [RA], axial spondyloarthritis, and psoriatic arthritis) for monitoring clinical quality at the national, regional, and hospital levels. STUDY POPULATION: The register includes patients with rheumatologic diseases who are treated at a hospital or a private rheumatologic clinic. Registration is mandatory for all patients with RA regardless of treatment and also for patients with other diagnoses if treated with biological disease-modifying antirheumatic drugs...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27814714/patient-preferences-for-treatment-of-castration-resistant-prostate-cancer-in-japan-a-discrete-choice-experiment
#11
Hiroji Uemura, Nobuaki Matsubara, Go Kimura, Akito Yamaguchi, Dianne Athene Ledesma, Marco DiBonaventura, Ateesha F Mohamed, Enrique Basurto, Ian McKinnon, Ed Wang, Kristen Concialdi, Aya Narimatsu, Yasuko Aitoku
BACKGROUND: Up to a fifth of patients diagnosed with prostate cancer (PC) will develop castration-resistant prostate cancer (CRPC), which has been associated with a poor prognosis. The aim of this study was to consider the patient perspective as part of the overall treatment decision-making process for CRPC, given that an alignment between patient preference and prescribing has been shown to benefit patient outcomes. This study examines preferences of patients with CRPC in Japan for treatment features associated with treatments like RA-223, abiraterone, and docetaxel and to examine the extent to which treatment preferences may vary between symptomatic and asymptomatic patients...
November 4, 2016: BMC Urology
https://www.readbyqxmd.com/read/27807794/low-testosterone-in-men-with-cardiovascular-disease-or-risk-factors-to-treat-or-not-to-treat
#12
REVIEW
Dimitri C Cassimatis, Matthew T Crim, Nanette K Wenger
Current evidence supports the use of testosterone replacement in men with the clinical-biochemical syndrome of hypogonadism, defined as low testosterone serum levels and symptoms such as fatigue, exercise intolerance, erectile dysfunction, low libido, or depression. Although the evidence consistently shows that hypogonadism is associated with elevated cardiovascular risk, evidence is mixed regarding whether testosterone (T) replacement provides cardiovascular (CV) benefit or harm. For a man with symptomatic hypogonadism in the setting of CV disease, clinical heart failure, and/or traditional CV risk factors (hypertension, diabetes, and hyperlipidemia), a balanced approach would be to counsel him that overall, the evidence should not dissuade him from utilizing T replacement for non-cardiac symptom relief but that more data are needed before a definitive recommendation can be made about T replacement for CV benefit...
December 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27804088/first-real-world-insights-into-belimumab-use-and-outcomes-in-routine-clinical-care-of-systemic-lupus-erythematosus-in-germany-results-from-the-observe-germany-study
#13
Andreas Schwarting, Johann O Schroeder, Tobias Alexander, Marc Schmalzing, Christoph Fiehn, Christof Specker, Alessandra Perna, Constanze Cholmakow-Bodechtel, Volker B Koscielny, Heike Carnarius
OBSErve Germany was the first observational study of belimumab as add-on treatment for systemic lupus erythematosus (SLE) in routine clinical care in Germany, retrospectively collecting data from 102 SLE patients, 6 months before and after belimumab initiation. Most patients had moderate or severe SLE and several SLE manifestations. After 6 months of belimumab treatment, 78% of patients showed an improvement in overall disease activity of at least 20% in their physician's judgment and for 42% of patients the improvement was at least 50%...
December 2016: Rheumatology and Therapy
https://www.readbyqxmd.com/read/27797570/moral-distress-in-physicians-and-nurses-impact-on-professional-quality-of-life-and-turnover
#14
Cindy L Austin, Robert Saylor, Phillip J Finley
Objective: The purpose of this study was to investigate moral distress (MD) and turnover intent as related to professional quality of life in physicians and nurses at a tertiary care hospital. Method: Health care providers from a variety of hospital departments anonymously completed 2 validated questionnaires (Moral Distress Scale-Revised and Professional Quality of Life Scale). Compassion fatigue (as measured by secondary traumatic stress [STS] and burnout [BRN]) and compassion satisfaction are subscales which make up one's professional quality of life...
October 31, 2016: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/27790350/adherence-to-treatment-in-patients-with-open-angle-glaucoma-and-its-related-factors
#15
Tayebeh Movahedinejad, Mohsen Adib-Hajbaghery
INTRODUCTION: Lack of adherence to medical treatments typically lead to burdensome consequences such as progressive visual impairment, blindness, and disabilities. This study aimed to determine the adherence to medication in patients with open-angle glaucoma and related factors in patients referred to the Matini Ophthalmology Hospital in Kashan, Iran. METHODS: A cross-sectional study was conducted from 23 July 2015 to 20 January 2016 on all patients with open-angle glaucoma referred to the Matini Ophthalmology Hospital in Kashan, Iran...
September 2016: Electronic Physician
https://www.readbyqxmd.com/read/27786335/how-physician-perspectives-on-e-prescribing-evolve-over-time-a-case-study-following-the-transition-between-ehrs-in-an-outpatient-clinic
#16
Erika L Abramson, Vaishali Patel, Elizabeth R Pfoh, Rainu Kaushal
BACKGROUND: Physicians are expending tremendous resources transitioning to new electronic health records (EHRs), with electronic prescribing as a key functionality of most systems. Physician dissatisfaction post-transition can be quite marked, especially initially. However, little is known about how physicians' experiences using new EHRs for e-prescribing evolve over time. We previously published a qualitative case study about the early physician experience transitioning from an older to a newer, more robust EHR, in the outpatient setting, focusing on their perceptions of the electronic prescribing functionality...
October 26, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27784995/satisfaction-with-control-of-systemic-lupus-erythematosus-and-lupus-nephritis-physician-and-patient-perspectives
#17
Neelufar Mozaffarian, Steve Lobosco, Peng Lu, Adam Roughley, Gabriela Alperovich
PURPOSE: Patient satisfaction with disease control of systemic lupus erythematosus (SLE) is an important component of medical management. This analysis evaluated patient and physician satisfaction with disease control of SLE, factors associated with satisfaction/dissatisfaction, and the degree of physician-patient concordance of these parameters. PATIENTS AND METHODS: Data were extracted from the US Adelphi Real World Lupus Disease Specific Programme(®), a cross-sectional survey of 50 rheumatologists, 25 nephrologists, and their patients with non-nephritis SLE (NNSLE) or lupus nephritis (LN)...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27782288/development-of-a-standardized-rating-tool-for-drug-alerts-to-reduce-information-overload
#18
Barbara Pfistermeister, Brita Sedlmayr, Andrius Patapovas, Gerald Suttner, Ozan Tektas, Aleksey Tarkhov, Johannes Kornhuber, Martin F Fromm, Thomas Bürkle, Hans-Ulrich Prokosch, Renke Maas
BACKGROUND: A well-known problem in current clinical decision support systems (CDSS) is the high number of alerts, which are often medically incorrect or irrelevant. This may lead to the so-called alert fatigue, an overriding of alerts, including those that are clinically relevant, and underuse of CDSS in general. OBJECTIVES: The aim of our study was to develop and to apply a standardized tool that allows its users to evaluate the quality of system-generated drug alerts...
October 26, 2016: Methods of Information in Medicine
https://www.readbyqxmd.com/read/27780748/prophylactic-use-of-oral-dexamethasone-to-alleviate-fatigue-during-regorafenib-treatment-for-patients-with-metastatic-colorectal-cancer
#19
Shota Fukuoka, Kohei Shitara, Masaaki Noguchi, Akihito Kawazoe, Yasutoshi Kuboki, Hedeaki Bando, Wataru Okamoto, Takashi Kojima, Toshihiko Doi, Atsushi Ohtsu, Takayuki Yoshino
BACKGROUND: Fatigue is the most common toxicity of all grade toxicities with regorafenib, was the second most common toxicity in the CORRECT (regorafenib monotherapy for previously treated metastatic colorectal cancer) study, and is a major reason for early dose modification. The results from a recent randomized study suggested that dexamethasone (DEX) can improve cancer-related fatigue. PATIENTS AND METHODS: We retrospectively analyzed the effect of prophylactic use of an oral DEX on fatigue during regorafenib treatment in patients with metastatic colorectal cancer (mCRC)...
August 18, 2016: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/27773802/effects-of-the-traditional-chinese-herb-astragalus-membranaceus-in-patients-with-poststroke-fatigue-a-double-blind-randomized-controlled-preliminary-study
#20
Chung-Hsiang Liu, Chang-Hai Tsai, Tsai-Chung Li, Yu-Wan Yang, Wei-Shih Huang, Ming-Kui Lu, Chun-Hung Tseng, Hui-Chun Huang, Kuan-Fei Chen, Thih-Shan Hsu, Yi-Ting Hsu, Chon-Haw Tsai, Ching-Liang Hsieh
BACKGROUND AND PURPOSE: Astragalus membranaceus (AM) is the first-choice herb for fatigue treatment in traditional Chinese medicine and the main herb used for stroke treatment in China and Taiwan. The purpose of this study was to evaluate the effect of AM on poststroke fatigue (PSF). MATERIALS AND METHODS: This study was designed as a double-blind, randomized, controlled preliminary study. Sixty-four patients with PSF were assigned to treatment group (TG; 31 patients), which received oral administration of AM (2...
October 20, 2016: Journal of Ethnopharmacology
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