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Physician fatigue

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https://www.readbyqxmd.com/read/28402576/finding-the-right-balance
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28363266/a-qualitative-assessment-of-the-impact-of-handedness-among-left-handed-surgeons-in-saudi-arabia
#7
Mohamed S Zaghloul, Juliann Saquib, AbdulRahman Al-Mazrou, Nazmus Saquib
Among Muslims, the use of the left hand in daily activities is discouraged; many people believe that left-handed physicians lack the competency for surgery. The study aim was to document the experience of left-handed surgeons in Saudi Arabia and the impact of handedness on their training, job performance, collegial relationships, and career progression. This qualitative study included 9 left-handed physicians in various surgical specialties from 4 major hospitals in Al-Qassim, Saudi Arabia. Face-to-face interviews using a semi-structured questionnaire were conducted...
March 31, 2017: Laterality
https://www.readbyqxmd.com/read/28358584/assessing-the-utility-and-validity-of-frailty-markers-in-critically-ill-adults
#8
Aluko A Hope, S J Hsieh, Alex Petti, Mariana Hurtado-Sbordoni, Joe Verghese, Michelle Ng Gong
RATIONALE: Identifying frailty by the presence of a critical number of frailty markers has been difficult to operationalize in the Intensive Care Unit (ICU) where patients often cannot complete performance measures or answer complex questions. OBJECTIVES: To assess the construct and predictive validity of a questionnaire-based approach to identifying frailty in adult ICU patients. METHODS: We conducted an observational cohort study of adults admitted to a medical or surgical ICU at one of two hospitals in New York...
March 30, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28347197/forty-to-fifty-five-year-old-women-and-iron-deficiency-clinical-considerations-and-quality-of-life
#9
Anne Firquet, Wolf Kirschner, Johannes Bitzer
Between the age of 40 and 55 years, women experience important changes in their lives. This period, which corresponds to the perimenopause for most women, is associated with the risk of iron deficiency anemia (IDA). The clinical presentation of anemia can be misleading, and the underlying cause, particularly bleeding, is frequently treated without concomitant iron prescription. Iron deficiency (ID) remains a social and economic burden in European countries. Underdiagnosed and undertreated, this problem has a strong negative impact on women's quality of life...
March 28, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28347144/compassion-fatigue-among-palliative-care-clinicians
#10
Sean O'Mahony, Maisa Ziadni, Michael Hoerger, Stacie Levine, Aliza Baron, James Gerhart
OBJECTIVES: Palliative medicine is a rewarding field, but providers encounter patient trauma on a routine basis. Compassion fatigue, marked by burnout, secondary traumatic stress, and low satisfaction may result. However, professionals differ markedly in how they respond to patient trauma. The objective of the current study was to determine whether personality traits of neuroticism and agreeableness relate to aspects of compassion fatigue, after accounting for time spent working in the field...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28345384/parental-evaluation-of-a-telemonitoring-service-for-children-with-type-1-diabetes
#11
E Losiouk, G Lanzola, S Del Favero, F Boscari, M Messori, I Rabbone, R Bonfanti, A Sabbion, D Iafusco, R Schiaffini, R Visentin, S Galasso, F Di Palma, D Chernavvsky, L Magni, C Cobelli, D Bruttomesso, S Quaglini
Introduction In the past years, we developed a telemonitoring service for young patients affected by Type 1 Diabetes. That service provides data to the clinical staff and offers an important tool to the parents, that are able to oversee in real time their children. The aim of this work was to analyze the parents' perceived usefulness of the service. Methods The service was tested by the parents of 31 children enrolled in a seven-day clinical trial during a summer camp. To study the parents' perception we proposed and analyzed two questionnaires...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28339355/psychometric-properties-of-sleep-and-coping-numeric-rating-scales-in-rheumatoid-arthritis-a-subanalysis-of-an-etanercept-trial
#12
Pedro Avila-Ribeiro, Yves Brault, Maxime Dougados, Laure Gossec
OBJECTIVES: In rheumatoid arthritis, quality of sleep and ability to cope are important for patients; however their usefulness as outcome measures is not well established. METHODS: Post-hoc analysis of an open-label 12-week trial of etanercept in biologic-naïve rheumatoid arthritis patients with visits at screening, baseline and over 12 weeks. Outcomes measured included Disease Activity Score 28 erythrocyte sedimentation rate (DAS28), numeric rating scales for sleep, coping, patient and physician-global assessment, pain and fatigue, and modified-HAQ...
March 23, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28332032/qualitative-assessment-of-the-symptoms-and-impact-of-pancreatic-exocrine-insufficiency-pei-to-inform-the-development-of-a-patient-reported-outcome-pro-instrument
#13
Colin D Johnson, Rob Arbuckle, Nicola Bonner, Gary Connett, Enrique Dominguez-Munoz, Philippe Levy, Doris Staab, Nicola Williamson, Markus M Lerch
BACKGROUND: Pancreatic exocrine insufficiency (PEI) affects patients with chronic pancreatitis (CP) and cystic fibrosis (CF) who produce insufficient digestive pancreatic enzymes. Common symptoms include steatorrhoea, diarrhea, and abdominal pain. OBJECTIVE: The objective of the study was to develop and test the content validity of a patient-reported outcome (PRO) instrument assessing PEI symptoms and their impact on health-related quality of life. METHODS: Instrument development was supported by a literature review, expert physician interviews (n = 10: Germany 4, UK 3, France 3), and exploratory, qualitative, concept-elicitation interviews with patients with CF and CP with PEI (n = 61: UK 29, Germany 18, France 14) and expert physicians (n = 10)...
March 22, 2017: Patient
https://www.readbyqxmd.com/read/28329517/purple-patches-in-an-immunocompromised-patient-a-report-of-secondary-disseminated-cutaneous-mucormycosis-in-a-man-with-chronic-lymphocytic-leukemia
#14
Sanjana Iyengar, Cindy J Chambers, Jillian W Millsop, Maxwell A Fung, Victoria R Sharon
A 60-year-old man with chronic lymphocytic leukemiadeveloped a deeply violaceous annular patchwith a halo of erythema on the right thigh duringhospitalization for neutropenic fever. Associatedsymptoms included chronic cough and fatigue.Bilateral lung opacities with hilar lymphadenopathywere noted on chest computed tomographyscan. Punch biopsy and tissue culture confirmeda diagnosis of secondary disseminated cutaneousmucormycosis. Although rare, physicians shouldinclude mucormycosis in the differential diagnosisof purpuric patches in immunosuppressed patients...
March 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329124/sleep-and-alertness-in-medical-interns-and-residents-an-observational-study-on-the-role-of-extended-shifts
#15
Mathias Basner, David F Dinges, Judy A Shea, Dylan S Small, Jingsan Zhu, Laurie Norton, Adrian J Ecker, Cristina Novak, Lisa M Bellini, Kevin G Volpp
Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy...
February 24, 2017: Sleep
https://www.readbyqxmd.com/read/28306169/economic-burden-of-relapsed-or-refractory-multiple-myeloma-results-from-an-international-trial
#16
Don Robinson, Robert Z Orlowski, Michael Stokes, Jianming He, Samuel Huse, Abhishek Chitnis, Britte Kranenburg, Annette Lam
OBJECTIVE: The direct cost of relapsed or refractory multiple myeloma (RRMM) is documented; indirect costs are being explored. Healthcare payers seek cost offsets from therapies that improve clinical outcomes but challenge budgets; employers seek lower absenteeism and better productivity. Study goals were to: 1) Identify direct and indirect economic factors of RRMM and, 2) Explore longitudinal relationships between clinical, economic, and health-related quality of life (HRQoL) assessments...
March 17, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28302595/behavioral-indicators-on-a-mobile-sensing-platform-predict-clinically-validated-psychiatric-symptoms-of-mood-and-anxiety-disorders
#17
Skyler Place, Danielle Blanch-Hartigan, Channah Rubin, Cristina Gorrostieta, Caroline Mead, John Kane, Brian P Marx, Joshua Feast, Thilo Deckersbach, Alex Sandy Pentland, Andrew Nierenberg, Ali Azarbayejani
BACKGROUND: There is a critical need for real-time tracking of behavioral indicators of mental disorders. Mobile sensing platforms that objectively and noninvasively collect, store, and analyze behavioral indicators have not yet been clinically validated or scalable. OBJECTIVE: The aim of our study was to report on models of clinical symptoms for post-traumatic stress disorder (PTSD) and depression derived from a scalable mobile sensing platform. METHODS: A total of 73 participants (67% [49/73] male, 48% [35/73] non-Hispanic white, 33% [24/73] veteran status) who reported at least one symptom of PTSD or depression completed a 12-week field trial...
March 16, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28293972/a-comparison-of-patients-and-physicians-assessments-of-disease-activity-using-the-swedish-version-of-the-systemic-lupus-activity-questionnaire
#18
S Pettersson, E Svenungsson, J Gustafsson, S Möller, I Gunnarsson, E Welin Henriksson
OBJECTIVES: We compared patients' assessments of systemic lupus erythematosus (SLE) disease activity by a Swedish version of the Systemic Lupus Activity Questionnaire (SLAQ) with physicians' assessments by the Systemic Lupus Activity Measure (SLAM) and Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). We also explored the performance of the SLAQ in patients with short (< 1 year) versus long (≥ 1 year) disease duration. METHOD: Patients filled out the SLAQ before physicians' assessments...
March 15, 2017: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/28286963/rehabilitation-and-education-are-underutilized-for-mild-stroke-and-tia-sufferers
#19
Steven G Faux, Pooja Arora, Christine T Shiner, Angelica G Thompson-Butel, Linda A Klein
PURPOSE: Transient ischemic attack (TIA) and mild stroke represent a large proportion of cerebrovascular events, at high risk of being followed by recurrent, serious events. The importance of early education addressing risk management, secondary prevention and lifestyle modifications is the centerpiece of further stroke prevention. However, delivering education and rehabilitation to this population can be complex and challenging. METHODS: Via synthesis of a narrative review and clinical experience, we explore the unique and inherent complexities of rehabilitation management and education provision for patients following mild stroke and TIA...
March 12, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28280081/myxoedema-in-a-patient-with-achondroplasia-in-rural-area-of-guatemala
#20
Michel Juarez, Peter Rohloff
A 43-year-old indigenous Guatemalan woman with achondroplasia presented to our clinic with chronic fatigue and generalised oedema. She had limited contact with the formal healthcare system. However, 1 year prior, she had sought medical evaluation from a private physician. Her symptoms had been attributed to a combination of heart failure and physical disability due to the musculoskeletal complications of her achondroplasia. She was lost to follow-up due to inability to pay for further testing or treatment...
March 9, 2017: BMJ Case Reports
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