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Physician interaction strategies

Cynthia Cheng, Fatima Mithoowani, Thomas Ungar, Monica Lee
Background: Interaction between alcohol and certain medications can lead to adverse consequences. Individuals with mental health disorders are particularly vulnerable because of their psychotropic medications, which are typically taken over extended periods and which are known to have pharmacokinetic and pharmacodynamic interactions with alcohol. It is unknown what education these patients receive from their health care providers and how such interactions are managed. Objectives: To determine whether individuals with mental health disorders are aware of alcohol-drug interactions and if so, how they use such information...
January 2018: Canadian Journal of Hospital Pharmacy
Rebekah Laidsaar-Powell, Phyllis Butow, Frances Boyle, Ilona Juraskova
OBJECTIVE: Family caregivers regularly attend medical consultations and are often involved in decision-making; however, there are few practical strategies to guide effective communication for the clinician-patient-family trio. We aimed to develop and evaluate the first comprehensive guidelines for oncology physicians and nurses, on how to positively and effectively involve family caregivers of adult patients in consultations and patient care (TRIO Guidelines-1) and how to manage challenging interactions with family caregivers (TRIO Guidelines-2)...
January 31, 2018: Patient Education and Counseling
Rebekah Laidsaar-Powell, Phyllis Butow, Frances Boyle, Ilona Juraskova
OBJECTIVE: Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members...
February 2, 2018: Patient Education and Counseling
Judith Tiferes, Ahmed A Hussein, Ann Bisantz, D Jeffery Higginbotham, Mohamed Sharif, Justen Kozlowski, Basel Ahmad, Ryan O'Hara, Nicole Wawrzyniak, Khurshid Guru
Communication breakdowns in the operating room (OR) have been linked to errors during surgery. Robot-assisted surgery (RAS), a new surgical technology, can lead to new challenges in communication owing to the remote location of the surgeon away from the patient and bedside assistants. Nevertheless, few studies have studied communication strategies during RAS. In this study, 11 robot-assisted radical prostatectomies were recorded and the interaction events between the surgeon and two bedside surgical team members were categorized by modality (verbal/nonverbal), topic, and pair (sender and receiver)...
March 7, 2018: Applied Ergonomics
Jeremy P Harris, Michelle M Chen, Ryan K Orosco, Davud Sirjani, Vasu Divi, Wendy Hara
Importance: Shortening the time from surgery to the start of radiation (TS-RT) is a consideration for physicians and patients. Although the National Comprehensive Cancer Network recommends radiation to start within 6 weeks, a survival benefit with this metric remains controversial. Objective: To determine the association of delayed TS-RT with overall survival (OS) using a large cancer registry. Design, Setting, and Participants: In this observational cohort study, 25 216 patients with nonmetastatic stages III to IV head and neck cancer were identified from the National Cancer Database (NCDB)...
March 8, 2018: JAMA Otolaryngology—Head & Neck Surgery
Elizabeth C Lee, Ali Arab, Sandra M Goldlust, Cécile Viboud, Bryan T Grenfell, Shweta Bansal
The surveillance of influenza activity is critical to early detection of epidemics and pandemics and the design of disease control strategies. Case reporting through a voluntary network of sentinel physicians is a commonly used method of passive surveillance for monitoring rates of influenza-like illness (ILI) worldwide. Despite its ubiquity, little attention has been given to the processes underlying the observation, collection, and spatial aggregation of sentinel surveillance data, and its subsequent effects on epidemiological understanding...
March 7, 2018: PLoS Computational Biology
Subir Bhatia, Alan Sugrue, Samuel Asirvatham
Atrial fibrillation is the most common cardiac dysrhythmia encountered in the primary care setting. Although a rate control strategy is pursued by physicians for the initial treatment of atrial fibrillation, the efficacy of a rhythm control approach is often undervalued despite offering effective treatment options. There are many pharmacological therapies available to patients, with drug choice often dictated by safety concerns (toxicities and proarrhythmic adverse effects) as well as patient characteristics and comorbidities...
March 2018: Mayo Clinic Proceedings
E Parimbelli, B Bottalico, E Losiouk, M Tomasi, A Santosuosso, G Lanzola, S Quaglini, R Bellazzi
OBJECTIVES: The main purpose of the article is to raise awareness among all the involved stakeholders about the risks and legal implications connected to the development and use of modern telemedicine systems. Particular focus is given to the class of "active" telemedicine systems, that imply a real-world, non-mediated, interaction with the final user. A secondary objective is to give an overview of the European legal framework that applies to these systems, in the effort to avoid defensive medicine practices and fears, which might be a barrier to their broader adoption...
April 2018: International Journal of Medical Informatics
Thomas Schultz, Anna Vilanova
Modern diffusion magnetic resonance imaging (dMRI) acquires intricate volume datasets and biological meaning can only be found in the relationship between its different measurements. Suitable strategies for visualizing these complicated data have been key to interpretation by physicians and neuroscientists, for drawing conclusions on brain connectivity and for quality control. This article provides an overview of visualization solutions that have been proposed to date, ranging from basic grayscale and color encodings to glyph representations and renderings of fiber tractography...
February 27, 2018: NMR in Biomedicine
Patricia Thille
In many wealthy countries, fatness is stigmatized as a sign of personal failure. Health care interactions can enact fat-related stigmatization, which can worsen health outcomes. The present analysis highlights how stigmatizing discourses about fat bodies emerge in primary care appointments, and examines immediate conversational effects. METHODS: Observational study in three primary care clinics in Canada, using conversation and discourse analytic methods on transcripts of 29 audio-recorded appointments with adults...
February 21, 2018: Health Communication
Carmen Alvarez, Katrina Debnam, Amber Clough, Kamila Alexander, Nancy E Glass
Supportive care for survivors of intimate partner violence (IPV) remains limited in primary care settings. Low-income and Spanish-speaking survivors of IPV are even more disadvantaged, given the dearth of linguistically and culturally appropriate interventions for IPV. We conducted semi-structured individual interviews with 17 healthcare workers, including physicians, nurses, and social workers, to describe how healthcare workers serving primarily low-income, Latina populations are currently screening and responding to IPV disclosure, and to explore the acceptability of integrating an interactive, personalized safety decision aid application-myPlan app-into the clinic setting...
February 14, 2018: Research in Nursing & Health
Fariba Taleghani, Mohsen Shahriari, Nasrollah Alimohammadi
Background: Chronic diseases such as cancer would lead to various health needs in patients and their families. To meet needs, developing new educational nursing courses is necessary. Therefore this study was conducted to empower nurses through designing and conducting short-term educational courses for training palliative care nurses. Materials and Methods: This study was a community-based action research which was conducted at Isfahan hospitals that provide services for cancer patients during 2015 at four stages (planning, acting, reflection, and evaluation)...
January 2018: Indian Journal of Palliative Care
Sushma Bhatnagar, Anuradha Patel, Srinivasa N Raja
Background: Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. Objectives: The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers...
January 2018: Indian Journal of Palliative Care
Ellen Reynolds, Line Guénette, Joel Lexchin, Alan Cassels, Michael S Wilkes, Geneviève Durrieu, Marie-Dominique Beaulieu, Barbara Mintzes
OBJECTIVES: To examine and compare the experiences and attitudes of primary care physicians in three different regulatory environments (United States, Canada, and France) towards interactions with pharmaceutical sales representatives, particularly their perspectives on safety information provision and self-reported influences on prescribing. METHODS: We recruited primary care physicians for 12 focus groups in Montreal, Sacramento, Toulouse and Vancouver. A thematic analysis of the interview data followed a five-stage framework analysis approach...
January 30, 2018: Health Policy
Nermine S Choumane, Diana N Malaeb, Bassem Malaeb, Souheil Hallit
BACKGROUND: Health care professionals (HCP) are known key elements of effective patient's counselling and education. For patients taking warfarin, education about the dose, side effects, and toxicity is clearly identified as a cornerstone of achieving improved health and quality of life. The study objective was to evaluate the patients' knowledge about warfarin and assess the impact of the health care professionals' counselling in enhancing patients' knowledge in achieving warfarin therapeutic outcomes...
February 1, 2018: BMC Health Services Research
Judith L Bowen, Bridget C O'Brien, Jonathan S Ilgen, David M Irby, Olle Ten Cate
CONTEXT: Transitions of patient care responsibility occur frequently between physicians. Resultant discontinuities make it difficult for physicians to observe clinical outcomes. Little is known about what physicians do to overcome the practical challenges to learning these discontinuities create. This study explored physicians' activities in practice as they sought follow-up information about patients. METHODS: Using a constructivist grounded theory approach, semi-structured interviews with 18 internal medicine hospitalist and resident physicians at a single tertiary care academic medical center explored participants' strategies when deliberately conducting follow-up after they transitioned responsibility for patients to other physicians...
January 30, 2018: Medical Education
Audrey Duval, Thomas Obadia, Lucie Martinet, Pierre-Yves Boëlle, Eric Fleury, Didier Guillemot, Lulla Opatowski, Laura Temime
Understanding transmission routes of hospital-acquired infections (HAI) is key to improve their control. In this context, describing and analyzing dynamic inter-individual contact patterns in hospitals is essential. In this study, we used wearable sensors to detect Close Proximity Interactions (CPIs) among patients and hospital staff in a 200-bed long-term care facility over 4 months. First, the dynamic CPI data was described in terms of contact frequency and duration per individual status or activity and per ward...
January 26, 2018: Scientific Reports
Gerry Larsson, Sofia Nilsson, Peder Hyllengren, Alicia Ohlsson, Gudmund Waaler, Kjell Kallenberg
Many health care professionals have to make morally difficult decisions during acute, stressful situations. The aim was to explore the applicability of an existing qualitatively developed model of individual reactions among professional first responders following such situations using a quantitative approach. According to the model, the interaction of antecedent individual and contextual characteristics affect the immediate emotional reactions to acute, stressful events involving a moral dilemma. Continuous coping efforts and the quality of social support will also affect the long-term positive and negative reactions to the event...
January 23, 2018: Scandinavian Journal of Psychology
Roopinder K Sandhu, Lisa M Guirguis, Tammy J Bungard, Erik Youngson, Lisa Dolovich, Jamie C Brehaut, Jeff S Healey, Finlay A McAlister
Background: Oral anticoagulant therapy (OAC) to prevent atrial fibrillation (AF)-related strokes remains poorly used. Alternate strategies, such as community pharmacist prescribing of OAC, should be explored. Methods: Approximately 400 pharmacists, half with additional prescribing authority (APA), randomly selected from the Alberta College of Pharmacists, were invited to participate in an online survey over a 6-week period. The survey consisted of demographics, case scenarios assessing appropriateness of OAC (based on the 2014 Canadian Cardiovascular Society AF guidelines) and perceived barriers to prescribing...
January 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Roger Lee Mendoza
Purpose: While the individual and social costs of alcoholism or alcohol use disorder are well established, few are aware that medical problems can arise during detoxification, some of which can be life-threatening. This study determines if sustained treatment for Alcohol Withdrawal Syndrome (AWS) might be based on the strategic choices and expectations of patients and health care providers alike, as well as the risk mitigation options available to them. Design/approach: AWS was modeled as a Stag Hunt to explain both risk and decision-making in medical treatments for detoxification, since it can deduce a set of equilibrium strategies available to both patient and provider...
2018: Risk Management and Healthcare Policy
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