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https://www.readbyqxmd.com/read/27919630/knowledge-and-attitudes-towards-influenza-vaccination-of-health-care-workers-in-emergency-services
#1
Sébastien Hulo, Alexandra Nuvoli, Annie Sobaszek, Alexandra Salembier-Trichard
Annual vaccination rates among French health care workers (HCWs) are in decline even in Emergency Services to which patients at highest risk of influenza complications are admitted, and in which HCWs have the greatest risk of exposure to influenza from patients. We aimed here to identify knowledge and attitudes towards influenza vaccination of HCWs in Emergency Services. We collected 344 self-administered questionnaires of 1060 HCWs. Only 18% of HCWs were vaccinated against influenza. Physicians were vaccinated more often (55%) than nurses (16%) or aid nurses (11%)...
December 2, 2016: Vaccine
https://www.readbyqxmd.com/read/27918336/resident-physicians-improve-nontechnical-skills-when-on-operating-room-management-and-leadership-rotation
#2
Devon C Cole, Christopher R Giordano, Terrie Vasilopoulos, Brenda G Fahy
BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27914568/motivations-of-patients-seeking-supportive-care-for-cancer-from-physicians%C3%A2-prescribing-homeopathic-or-conventional-medicines-results-of-an-observational-cross-sectional-study
#3
Karine Danno, Aurélie Colas, Gilles Freyer, Jean-Paul Guastalla, Gérard Duru, Eric Musial, Vincent Libourel, Jean-Philippe Fendler, Jean-Louis Masson, Marie-France Bordet
BACKGROUND & AIMS: The motivations of patients who consult a homeopathic (GP-Ho) or conventional (GP-CM) general practitioner for supportive care during cancer treatment have not been widely studied. We investigated the reasons why cancer patients consult a GP-Ho versus a GP-CM for supportive care and the GPs' motivations for their prescriptions. METHODS: This observational survey was carried out in France between October 2008 and October 2011. GPs across France were randomly selected and asked to recruit four cancer patients each...
November 2016: Homeopathy: the Journal of the Faculty of Homeopathy
https://www.readbyqxmd.com/read/27910035/self-care-as-a-professional-imperative-physician-burnout-depression-and-suicide
#4
Catherine M Kuhn, Ellen M Flanagan
PURPOSE: Burnout has been identified in approximately half of all practicing physicians, including anesthesiologists. In this narrative review, the relationship between burnout, depression, and suicide is explored, with particular attention to the anesthesiologist. Throughout this review, we highlight our professional imperative regarding this epidemic. SOURCE: The authors searched the existing English language literature via PubMed from 1986 until present using the search terms physician burnout, depression, and suicide, with particular attention to studies regarding anesthesiologists and strategies to address these problems...
December 1, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27908840/prescription-opioid-taper-support-for-outpatients-with-chronic-pain-a-randomized-controlled-trial
#5
Mark D Sullivan, Judith A Turner, Cory DiLodovico, Angela D'Appolonio, Kari Stephens, Ya-Fen Chan
Patients receiving long-term opioid therapy for chronic pain and interested in tapering their opioid dose were randomly assigned to a 22-week taper support intervention (psychiatric consultation, opioid dose tapering, and 18 weekly meetings with a physician assistant to explore motivation for tapering and learn pain self-management skills) or usual care (N=35). Assessments were conducted at baseline and 22 and 34 weeks after randomization. Using an intention-to-treat approach, we constructed linear regression models to compare groups at each follow-up...
November 28, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27904985/effectiveness-of-an-intervention-to-enhance-occupational-physicians-guideline-adherence-on-sickness-absence-duration-in-workers-with-common-mental-disorders-a-cluster-randomized-controlled-trial
#6
Karlijn M van Beurden, Evelien P M Brouwers, Margot C W Joosen, Michiel R de Boer, Jaap van Weeghel, Berend Terluin, Jac J L van der Klink
Purpose Evidence-based guidelines in occupational health care improve the quality of care and may reduce sickness absence duration. Notwithstanding that, guideline adherence of occupational physicians (OPs) is limited. Based on the literature on guideline implementation, an intervention was developed that was shown to effectively improve self-reported adherence in OPs. The aim of present study was to evaluate whether this intervention leads to earlier return to work (RTW) in workers with common mental disorders (CMD)...
November 30, 2016: Journal of Occupational Rehabilitation
https://www.readbyqxmd.com/read/27903754/trajectories-to-seeking-demedicalised-assistance-in-suicide-a-qualitative-in-depth-interview-study
#7
Martijn Hagens, Bregje D Onwuteaka-Philipsen, H Roeline W Pasman
BACKGROUND: In the Netherlands, people can receive (limited) demedicalised assistance in suicide (DAS)-an option less well known than physician-assisted dying (PAD). AIM: This study explores which trajectories people take to seek DAS, through open-coding and inductive analysis of in-depth interviews with 17 people who receive(d) DAS from counsellors facilitated by foundation De Einder. RESULTS: People sought DAS as a result of current suffering or as a result of anticipating possible prospective suffering...
November 30, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27901398/discriminating-between-neuropathic-pain-and-sensory-hypersensitivity-using-the-chronic-pain-questions-cpq
#8
Karin S Coyne, Brooke M Currie, Sean Donevan, Joseph C Cappelleri, Rozelle Hegeman-Dingle, Lucy Abraham, Christine Thompson, Alesia Sadosky, Marina Brodsky
OBJECTIVE: The Chronic Pain Questions (CPQ) were developed for clinical use with the aim of supporting primary care physicians in the screening, assessment and monitoring of patients with chronic pain. The purpose of this study was to examine the ability of the CPQ to discriminate between patients with neuropathic pain (NeP) versus those with sensory hypersensitivity (SH). METHODS: Adult men and women with a diagnosis of a NeP or SH condition were recruited from 5 clinical sites across the United States...
November 30, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27898477/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#9
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
November 24, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27895827/malawian-impressions-of-expatriate-physicians-a-qualitative-study
#10
Natasha Parekh, Adam P Sawatsky, Ihunanya Mbata, Adamson S Muula, Thuy Bui
BACKGROUND: In many low-income countries, including Malawi, expatriate physicians serve diverse roles in clinical care, education, mentorship, and research. A significant proportion of physicians from high-income countries have global health experience. Despite the well-known benefits of global health experiences for expatriates, little is known about local physician and trainee impressions of their expatriate counterparts. The objective of this study was to explore University of Malawi College of Medicine (COM) physicians' and trainees' impressions of expatriate physicians...
June 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27893517/ready-for-change-the-role-of-physician-and-staff-engagement-burnout-and-workplace-attributes
#11
Dorothy Hung, Po-Han Chen
We examined factors associated with change readiness among 343 primary care physicians and 590 nonphysician staff undergoing "Lean"-based process improvements. Baseline levels of engagement were associated with greater readiness for change across all measured domains. Job-related burnout correlated with greater need for change, but lower self-efficacy and perceived support, whereas a personal sense of accomplishment was associated with higher efficacy to implement changes. At a department level, teamwork, participation in decision making, and change history were associated with higher engagement and lower burnout among physicians and staff; conversely, a busy or stressful department correlated with lower engagement and higher burnout...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27889367/use-or-abuse-a-qualitative-study-of-emergency-physicians-views-on-use-of-observation-stays-at-three-hospitals-in-the-united-states-and-england
#12
Graham P Martin, Brad Wright, Azeemuddin Ahmed, Jay Banerjee, Suzanne Mason, Damian Roland
STUDY OBJECTIVE: Accumulating evidence has shown increasing use of observation stays for patients presenting to emergency departments and requiring diagnostic evaluation or time-limited treatment plans, but critics suggest that this expansion arises from hospitals' concerns to maximize revenue and shifts costs to patients. Perspectives of physicians making decisions to admit, observe, or discharge have been absent from the debate. We examine the views of emergency physicians in the United States and England on observation stays, and what influences their decisions to use observation services...
November 23, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27887795/clinician-knowledge-clinician-barriers-and-perceived-parental-barriers-regarding-human-papillomavirus-vaccination-association-with-initiation-and-completion-rates
#13
Lila J Finney Rutten, Jennifer L St Sauver, Timothy J Beebe, Patrick M Wilson, Debra J Jacobson, Chun Fan, Carmen Radecki Breitkopf, Susan T Vadaparampil, Robert M Jacobson
PURPOSE: We tested the hypothesis that clinician knowledge, clinician barriers, and perceived parental barriers relevant to the human papillomavirus (HPV) vaccination account for the variation in vaccine delivery at the practice-site level. METHODS: We conducted a survey from October 2015 through January 2016 among primary care clinicians (n=280) in a 27-county geographic region to assess clinician knowledge, clinician barriers, and perceived parental barriers regarding HPV vaccination...
November 23, 2016: Vaccine
https://www.readbyqxmd.com/read/27878690/willingness-to-pay-and-the-sensitivity-of-willingness-to-pay-for-interdisciplinary-musculoskeletal-clinics-a-contingent-valuation-study-in-quebec-canada
#14
Thomas G Poder, Jie He
Orthopedics is a discipline that requires a continuum of care in close collaboration with physicians, nurses, and healthcare professionals to ensure effective rehabilitation. In some cases, the wait time for a consultation may be very long, which can jeopardize the patient's rehabilitation and sometimes even cause complications that lead to a loss of autonomy. In Quebec, there is a severe shortage of healthcare professionals-and of orthopedic surgeons, in particular-specializing in musculoskeletal problems...
December 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27875605/sustaining-family-physicians-in-urban-underserved-settings
#15
Anne Getzin, Bonnie L Bobot, Deborah Simpson
OBJECTIVE: Our objective was to identify factors that sustain family physicians practicing in Milwaukee's underserved urban areas. METHODS: Family physicians with clinical careers in Milwaukee's urban, underserved communities were identified and invited to participate in a 45-60 minute interview using a literature-based semi-structured protocol. Each interview was transcribed and de-identified prior to independent analysis using a grounded theory qualitative approach by two authors to yield sustaining themes...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27871287/perspectives-on-death-and-dying-a-study-of-resident-comfort-with-end-of-life-care
#16
Jessica M Schmit, Lynne E Meyer, Jennifer M Duff, Yunfeng Dai, Fei Zou, Julia L Close
BACKGROUND: Despite the benefits to early palliative care in the treatment of terminal illness, barriers to timely hospice referrals exist. Physicians who are more comfortable having end-of-life (EOL) conversations are more likely to refer to hospice. However, very little is known about what factors influence comfort with EOL care. METHODS: An anonymous survey was sent to all the residents and fellows at a single institution. Self-reported education, experience and comfort with EOL care was assessed...
November 21, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27870675/comanagement-and-gainsharing-opportunities-for-independent-physicians
#17
Chris McBride, Peter L Althausen
Gainsharing and comanagament programs are both successful means of achieving physician buy-in for all cost containment programs in Orthopaedic Trauma. Under comanagement agreements, physicians are reimbursed for their time and intellectual efforts in program and algorithm creation. The cost is minimal for the hospital in return for the millions of dollars in savings they achieve. Gainsharing models can incentivize physicians to quickly adopt cost-effective implant choices, care plans, and program development...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870547/prescribers-perceptions-of-medication-discontinuation-survey-instrument-development-and-validation
#18
Amy Linsky, Steven R Simon, Kelly Stolzmann, Barbara G Bokhour, Mark Meterko
OBJECTIVES: Primary care providers (PCPs) and clinical pharmacists have concerns about the adverse consequences of using medications inappropriately and generally support the notion of reducing unnecessary drugs. Despite this attitude, many factors impede clinicians' ability to discontinue medication in clinical settings. We sought to develop a survey instrument that assesses PCPs' and pharmacists' experiences, attitudes, and beliefs toward medication discontinuation. STUDY DESIGN: Survey development and psychometric assessment...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27870086/health-care-for-nfl-players-upholding-physician-standards-and-enhancing-the-doctor-patient-relationship
#19
Laurent Duvernay-Tardif
Beginning my third year with the Kansas City Chiefs and being also a medical student at McGill University, I was at first a little reluctant to comment on Glenn Cohen et al.'s critique of the National Football League's structure involving player health and team doctors, but the opportunity to provide a perspective as both a football player and a medical student was too much to forgo. Because of my athletic and academic background, I am often asked what I think about injuries in professional sports and about the role of sports medicine physicians, and Cohen et al...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27864628/provider-perspectives-on-patient-provider-communication-for-adjuvant-endocrine-therapy-symptom-management
#20
Kea Turner, Cleo A Samuel, Heidi As Donovan, Ellen Beckjord, Alexandra Cardy, Mary Amanda Dew, G J van Londen
PURPOSE: Providers' communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care. METHODS: We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13)...
November 18, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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