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Physician fatigue

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https://www.readbyqxmd.com/read/28530458/-early-symptoms-of-childhood-malignant-diseases
#1
Zsuzsanna Erzsébet Papp, Izabella Kelemen, Adrienne Horváth
INTRODUCTION: Childhood malignant diseases are rare in pediatric pathology. Early symptoms are not specific, fatigue, pallor, compression signs and bone marrow failure are often mentioned. AIM: To summarize the most frequent early symptoms of childhood malignancies in order to help the physicians in the early recognition. METHOD: In our retrospective study, we processed a period of 5 years between 2012-2016, with an accent on the onset manifestations of malignancies...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28528598/the-emergence-of-personal-growth-amongst-healthcare-professionals-who-care-for-dying-children
#2
Laura Beaune, Barbara Muskat, Samantha J Anthony
OBJECTIVE: Compassion fatigue, burnout, and vicarious traumatization are prominent topics in the current literature on the impact of the rewarding but challenging work of healthcare professionals who care for patients with life-limiting illnesses. The positive effects of caregiving constitute a newly emerging outcome that has been relatively unexplored in the pediatric literature, and yet they may play an important role in contributing to the satisfaction and well-being of the healthcare professionals who care for children who have a life-limiting illness...
May 22, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28511451/attitudes-of-mashhad-public-hospital-s-nurses-and-midwives-toward-the-causes-and-rates-of-medical-errors-reporting
#3
Sedigheh Sedigh Mobarakabadi, Hosein Ebrahimipour, Ali Vafaie Najar, Roksana Janghorban, Fatemeh Azarkish
INTRODUCTION: Patient's safety is one of the main objective in healthcare services; however medical errors are a prevalent potential occurrence for the patients in treatment systems. Medical errors lead to an increase in mortality rate of the patients and challenges such as prolonging of the inpatient period in the hospitals and increased cost. Controlling the medical errors is very important, because these errors besides being costly, threaten the patient's safety. AIM: To evaluate the attitudes of nurses and midwives toward the causes and rates of medical errors reporting...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28507187/measuring-disease-exacerbation-and-flares-in-rheumatoid-arthritis-comparison-of-commonly-used-disease-activity-indices-and-individual-measures
#4
Martijn A H Oude Voshaar, Marjan Ghiti Moghadam, Harald E Vonkeman, Peter M Ten Klooster, Dirkjan van Schaardenburg, Janneke Tekstra, Henk Visser, Mart A F J van de Laar, Tim L Jansen
OBJECTIVE: To evaluate and compare the utility of commonly used outcome measures for assessing disease exacerbation or flare in patients with rheumatoid arthritis (RA). METHODS: Data from the Dutch Potential Optimalisation of (Expediency) and Effectiveness of Tumor necrosis factor-α blockers (POET) study, in which 462 patients discontinued their tumor necrosis factor-α inhibitor, were used. The ability of different measures to discriminate between those with and without physician-reported flare or medication escalation at the 3-month visit (T2) was evaluated by calculating effect size (ES) statistics...
May 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28506529/guillain-barr%C3%A3-syndrome-in-a-patient-with-renal-cell-carcinoma-following-the-first-course-of-pazopanib-therapy
#5
Hiroaki Koshikawa, Tomomi Tsukie, Akira Kurita, Mikio Fujikura, Megumi Suzuki, Kazuhiro Araki
Pazopanib, one of the antiangiogenic drugs, has recently become a first-line treatment for metastatic renal cell carcinoma. The most common adverse effects of pazopanib include diarrhea, fatigue, and nausea, but neuropathic complication has not been documented. Here, we report the first case of a patient with metastatic renal cell carcinoma who developed acute neuropathy mimicking Guillain-Barré syndrome following the first course of pazopanib therapy. A 75-year-old man with a metastatic renal cell carcinoma was admitted for rapidly progressive weakness and numbness in the extremities after the first course of pazopanib therapy...
May 12, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28505049/perceived-impairment-in-sports-participation-in-adolescents-with-inflammatory-bowel-diseases-a-preliminary-examination
#6
Jill M Plevinsky, Andrea A Wojtowicz, Natasha Poulopoulos, Kristin L Schneider, Rachel N Greenley
OBJECTIVE: Physical activity is important for adolescents with inflammatory bowel diseases (IBD) given the increased risk of developing osteoporosis and the increased risk of IBD-related complications among those with IBD and obesity. Symptoms like fatigue, abdominal pain, nausea, and frequent bowel movements can interfere with physical activity. Sports participation is an important source of physical activity for adolescents; however, the extent to which IBD interferes with sports participation is unstudied...
May 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28478701/exercise-habits-and-factors-associated-with-exercise-in-systemic-sclerosis-a-scleroderma-patient-centered-intervention-network-spin-cohort-study
#7
Marleine Azar, Danielle B Rice, Linda Kwakkenbos, Marie-Eve Carrier, Ian Shrier, Susan J Bartlett, Marie Hudson, Luc Mouthon, Serge Poiraudeau, Cornelia H M van den Ende, Sindhu R Johnson, Tatiana Sofia Rodriguez Reyna, Anne A Schouffoer, Joep Welling, Brett D Thombs
OBJECTIVE: Exercise is associated with improved health in many medical conditions. Little is known about the exercise habits of people with systemic sclerosis (SSc, or scleroderma). This study assessed the proportion of individuals with SSc who exercise and associations of demographic and disease variables with exercise. Additionally, the weekly amount of time spent exercising and the types of exercise performed were assessed among patients exercising. METHODS: The sample consisted of adult participants with SSc enrolled in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort who completed baseline questionnaires from March 2014 through August 2015...
May 8, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28464179/physician-order-entry-clerical-support-improves-physician-satisfaction-and-productivity
#8
Erin Contratto, Katherine Romp, Carlos A Estrada, April Agne, Lisa L Willett
OBJECTIVES: To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. METHODS: All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28463031/amount-and-quality-of-sleep-exploring-the-role-of-stress-and-work-experience-in-a-sample-of-obstetrician-gynecologists
#9
Laura Taouk, Victoria A Farrow, Jay Schulkin
INTRODUCTION: Sufficient sleep is necessary for optimal performance and the delivery of safe and effective health care. To establish an empirical understanding of physician fatigue, the present study investigated the factors that contributed to the amount and the quality of sleep among obstetricians and gynecologists (ob-gyns). METHODS: A survey of personal and work experiences was sent to 495 eligible physicians belonging to the American College of Obstetricians and Gynecologists (ACOG)...
May 2, 2017: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28462482/what-do-people-search-online-concerning-the-elusive-fibromyalgia-insights-from-a-qualitative-and-quantitative-analysis-of-google-trends
#10
Nicola Luigi Bragazzi, Howard Amital, Mohammad Adawi, Francesco Brigo, Samaa Watad, Gali Aljadeff, Daniela Amital, Abdulla Watad
Fibromyalgia is a chronic disease, characterized by pain, fatigue, and poor sleep quality. Patients and mainly those with chronic diseases tend to search for health-related material online. Google Trends (GT), an online tracking system of Internet hit-search volumes that recently merged with its sister project Google Insights for Search (Google Inc.), was used to explore Internet activity related to fibromyalgia. Digital interest in fibromyalgia and related topics searched worldwide has been reported in the last 13 years...
May 1, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28460772/profiling-cardiac-arrhythmia-and-heart-failure-patients-in-india-the-pan-arrhythmia-and-heart-failure-observational-study
#11
Amit Vora, Ajay Naik, Yash Lokhandwala, Arun Chopra, Jagmohan Varma, G S Wander, Aparna Jaswal, V Srikanthan, Balbir Singh, Dhiman Kahali, Anoop Gupta, R R Mantri, Anil Mishra, Ulhas Pandurangi, Debashis Ghosh, Jitendra Singh Makkar, Sujaayaa Sahu, Rajesh Radhakrishnan
BACKGROUND: The PANARrhythMia and Heart Failure Registry (PANARM HF) characterized demographic, clinical and interventional therapy indication profiles of cardiac arrhythmia (CA) and heart failure (HF) patients in India. METHODS: Consulting Physicians (CP) who medically manage CA and HF patients enrolled patients with one or more of the following: syncope, pre-syncope, dyspnea, palpitation, fatigue and LV dysfunction. The CPs were trained by interventional cardiologists (IC) to identify CA/HF patients indicated for implantable device/radiofrequency ablation (RFA)...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28449612/residents-responsibilities-adopting-a-wider-view
#12
Ami Schattner
Current ACGME regulations have limited residents' weekly hours and continuous working hours, a marked change, despite its uncertain effects on physician well-being and quality of care. Although residency programs in internal medicine and family medicine have adapted schedules to conform to these regulations, increasing evidence is accumulating to suggest that these training experiences are not adequately preparing the next generation of practicing primary care and hospital-based physicians. Data from an array of sources continue to demonstrate significant deficiencies in six areas of residents' responsibilities towards their patients: diminished patient "face time" and direct patient care; focus on patients' "reason for hospitalization" or "reason for visit" at the expense of possible neglect of patients' "secondary" medical problems; limited attention to patients' emotional or contextual problems and limited empathy; deficient implementation of the essential constituents of patient-centered care; neglect of habitual "reflective practice"; and excessive distinction between inpatient and outpatient responsibilities, leading to missed opportunities for inpatient residents to be aware of and attend to patients' post-discharge course although new information and readmissions related to the index hospitalization are prevalent...
April 27, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28447135/-environmental-medical-syndromes
#13
REVIEW
Gerhard A Wiesmüller, Claudia Hornberg
Environmental medical syndromes comprise sick building syndrome (SBS), multiple chemical sensitivity (MCS)/idiopathic environmental intolerances (IEI), electromagnetic hypersensitivity, chronic fatigue syndrome (CFS), burnout, fibromyalgia, and the candida syndrome. There is also some overlap described in the literature. There is still no established knowledge of etiology, pathology, pathophysiology, diagnostics, therapy, prevention and prognosis. These syndromes are thought to result from a complex interaction of physical, chemical and/or (micro)biological environmental stresses, individual dispositions, psychological influencing factors, perceptual and processing processes, variants of somatization disorders, culturally or socially caused distress, or simply iatrogenic causation...
April 26, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28444532/the-utrecht-cohort-for-multiple-breast-cancer-intervention-studies-and-long-term-evaluation-umbrella-objectives-design-and-baseline-results
#14
D A Young-Afat, C H van Gils, H J G D van den Bongard, H M Verkooijen
PURPOSE: In oncology, RCTs are often beset by slow recruitment, limited generalizability, and strong preferences for interventions by patients and physicians. The cohort multiple randomized controlled trial (cmRCT) is an innovative design with the potential to overcome those challenges. In cmRCT, a prospective cohort serves as an infrastructure for multiple RCTs. We implemented cmRCT in a clinical breast cancer setting by creating UMBRELLA-a large prospective cohort of breast cancer and DCIS patients/survivors...
April 25, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28402576/finding-the-right-balance
#15
Sean Price
Since the 1980s, concerns about resident fatigue have caused lawmakers and medical policymakers to pull back on resident duty hours. In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) shortened resident hours. In March, ACGME modified those hours again. The latest rule change has reignited a long-running debate among physicians.
April 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28397575/physical-and-psychological-morbidities-among-selected-antenatal-females-in-kegalle-district-of-sri-lanka-a-cross-sectional-study
#16
I N S Herath, A Balasuriya, S Sivayogan
While motherhood is often a positive and satisfying experience, for some women, it is linked with suffering and ill-health. A woman should be able to feel physically and mentally content during pregnancy. Discomforts in pregnancy may be considered as insignificant by the physician. Therefore, the objective of this study was to determine physical and psychological morbidities among primigravid antenatal females in the Kegalle District, Sri Lanka. A sample of 1017 second and third trimester primigravid antenatal females selected by a two-stage probability proportional to size cluster sampling method, were assessed for physical and psychological problems...
April 11, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28395667/effects-of-workload-work-complexity-and-repeated-alerts-on-alert-fatigue-in-a-clinical-decision-support-system
#17
Jessica S Ancker, Alison Edwards, Sarah Nosal, Diane Hauser, Elizabeth Mauer, Rainu Kaushal
BACKGROUND: Although alert fatigue is blamed for high override rates in contemporary clinical decision support systems, the concept of alert fatigue is poorly defined. We tested hypotheses arising from two possible alert fatigue mechanisms: (A) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B) desensitization from repeated exposure to the same alert over time. METHODS: Retrospective cohort study using electronic health record data (both drug alerts and clinical practice reminders) from January 2010 through June 2013 from 112 ambulatory primary care clinicians...
April 10, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28394892/acute-q-fever-in-febrile-patients-in-northwestern-of-iran
#18
Saber Esmaeili, Farhad Golzar, Erfan Ayubi, Behrooz Naghili, Ehsan Mostafavi
BACKGROUND: Q fever is an endemic disease in different parts of Iran. This study aimed to investigate the prevalence of acute Q fever disease among at-risk individuals in northwestern Iran. METHODOLOGY: An etiological study was carried out in 2013 in Tabriz County. A total of 116 individuals who were in contact with livestock and had a nonspecific febrile illness were enrolled in the study. IgG phase II antibodies against Coxiella burnetii were detected using ELISA...
April 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28372710/outpatient-emergencies-acute-heart-failure
#19
REVIEW
Malgorzata Mysliwiec, Raphael E Bonita
Heart failure is an epidemic in the United States and a major health problem worldwide. The syndrome of acute heart failure is marked by a recent onset of symptoms usually in terms of days to a few weeks of worsening fatigue, shortness of breath, orthopnea, swelling, and sudden onset of weight gain. Physicians caring for patients with heart failure must know the risk factors for this disease, pathophysiology, symptomatology, important examination findings, key diagnostic tests, and management approach so as to improve symptoms and reduce mortality...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28366592/patients-preferences-for-the-treatment-of-metastatic-castrate-resistant-prostate-cancer-a-discrete-choice-experiment
#20
Lina Eliasson, Hayley M de Freitas, Lindsay Dearden, Brian Calimlim, Andrew J Lloyd
PURPOSE: Patient treatment preferences are increasingly being used to inform health care decision making. This discrete choice experiment assessed how men perceive the risks and benefits of hypothetical treatment options for metastatic castrate-resistant prostate cancer (mCRPC). METHODS: Treatment attributes for inclusion were identified through a review of the literature and product labels. Expert interviews confirmed clinical appropriateness and patient relevance of the attributes, which included effectiveness (delay in months before chemotherapy), steroid use, possible drug interactions (additional hospital visits for monitoring), fogginess (effects on cognition and memory), fatigue (extreme tiredness), food restrictions, and bone pain...
March 30, 2017: Clinical Therapeutics
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