Doctors Deal Research Articles

Mix of relief and disappointment—striking a balance in the pay deal for resident doctors in England

Mix of relief and disappointment—striking a balance in the pay deal for resident doctors in England

Maria „omnis sancta” i „forma sanctificationis”. Zarys mariologii średniowiecznej według Bonawentury z Bagnoregio

In his numerous sermons, Bonaventure proves how deeply Marian piety was rooted in the liturgy of the Church, but also how deeply it should be rooted in Sacred Scripture and in theology. Two sermons deserve special mention. One is the second sermon, De Purificatione, for the feast of the Purification, and another is the second sermon preached on the feast of the Epiphany. These are the first examples of such an unambiguous and at the same time comprehensive approach to the Marian doctrine. From an analysis of these sermons, it is clear that Bonaventure’s main contribution to Mariology is not so much in the direction of doctrinal novelty, but rather in the approach and the method he used, which he remained faithful to in his teaching, whether from the cathedral or the pulpit. The Seraphic Doctor deals primarily with the defense and re-proposal of the truths of faith affirmed and professed by generations of Christians. For him, Mary is the Mother of Truth, and the doctrine concerning her, to be worthy of attention, must be deeply rooted in the theology dealing with the mysteries of her Son.

Communication strategies used by medical physicians when delivering bad news at the Maputo Central Hospital, Mozambique: a cross-sectional study

BackgroundPhysicians’ communication with patients and their families is important during both the disease diagnosis and prognosis stages and through the follow-up process. Effective physician communication improves patients’ quality of life and satisfaction with care and helps reduce suffering for those newly diagnosed with advanced progressive illnesses. This study aims to identify the communication strategies physicians use in the transition to palliative care and how these professionals perceive their academic and clinical preparation concerning this task.MethodsA cross-sectional and quantitative study. Physicians providing palliative care at the Maputo Central Hospital, Mozambique, were invited to complete a 17-question questionnaire. This questionnaire was based on a Brazilian adaptation of the Setting-Perception-Invitation-Knowledge-Emotions-Strategy (SPIKES) tool, the P-A-C-I-E-N-T-E protocol, with additional questions regarding socio-demographic details and the integration of “communication of bad news” into hospital training.ResultsOf the 121 participants, 62 (51.2%) were male, and 110 (90.9%) were general practitioners, with a median age of 36 years old. They had worked in clinical practice for a median of 8 years and in their current department for three years. The majority of the participants considered that they have an acceptable or good level of bad news communication skills and believed that they do it in a clear and empathic way, paying attention to the patient’s requests and doubts; however, most were not aware of the existing tools to assist them in this task and suggested that delivering bad news ought to be integrated into the undergraduate medical course and included in hospital training.ConclusionsThis study adds to our understanding of physicians’ strategies when communicating bad news in the context of palliative care at one Mozambique hospital. As palliative care is not fully implemented in Mozambique, it is important to use protocols suitable to the country’s healthcare level to improve how doctors deal with patients and their family members.

The problem of medical errors in the context of Burnout syndrome

Purpose. To highlight the significance and trends in solving the problem of medical errors in the context of the burnout syndrome. Materials and methods. With the help of the Google Scholar search engine and the Medline, Web of Science bibliographic databases, according to the key phrases, the literary sources and normative acts related to the studied problem were selected and analyzed. Results. Overstrain and emotional exhaustion of doctors (burnout syndrome) poses a direct risk to patient safety - burned out doctors are much more likely to make mistakes. Identification and analysis of relevant errors can be a step towards their understanding and correction; which, on the one hand, will improve the quality of medical care, and on the other hand, will help doctors deal with the psycho-emotional and legal consequences of medical errors. Conclusions. The burnout syndrome poses a direct risk to patient safety. Prevention of this syndrome improves the quality of medical care, prevents medical errors, their legal and other consequences.

How to differentiate the B.1.1.7 variant from COVID-19 in hospitalized patients?

Objectives: Little is known about COVID-19 and less about the B.1.1.7. There is a need for clinical information and tests to help doctors deal with the pandemic. This study aimed to investigate clinical and laboratory differences between hospitalized non-variant COVID-19 and the B.1.1.7 variant. Methods: Data of 173 hospitalized non-variant COVID-19 and 176 B.1.1.7 variants were retrospectively investigated. D-dimer monocyte ratio (DMR) and ferritin monocyte ratio (FMR) values were calculated by dividing D-dimer and ferritin levels to monocyte count, respectively. Monocyte eosinophil ratio (MER) was obtained by dividing monocyte count by eosinophil levels. Results: Clinical stay, intensive care unit (ICU) stay, and severe disease rates were found to be higher in the non-variant COVID-19. Eosinophil and basophil levels remained lower, whereas ferritin, FMR, and MER were more elevated in the same group. On ROC analysis, areas under the curve (AUC) of ferritin and FMR were found as 0.7 (p = 0.001) and 0.75 (p = 0.001), respectively. Conclusions: The present study revealed that the B.1.1.7 variant had milder clinical manifestations, shorter clinic and ICU stay, and less severe disease rates than the non-variant COVID-19. Higher levels of ferritin, FMR, and MER may indicate the B.1.1.7 variant.

ARTICULATOR APPLICATION IN ORTHODONTIC DIAGNOSTICS.

The aim: The purpose of the study was to determine the indications for the use of articulator in orthodontics based on the results of the analysis of scientific and foreign literature. Materials and methods: 23 scientific sources were selected, from more than 11 countries over the past 39 years (1981 - 2020) devoted to the use of orthodontics articula¬tors. As a result of processing 23 key international scientific papers on the use of articulators in orthodontics, we can talk about three areas of opinion regarding this problem. Conclusions: To sum up 30.34% of authors consider the articulator to be an obligatory orthodontist's tool for correct diagnosis. The idea of 34.78% of specialists is that the articulator cannot simulate the physiology of the TMJ - therefore, it is more a source of additional errors than an assistant in the orthodontic diagnostics. The rest of the scientists (34.78%) agree that it is advisable to use the articulator selectively - namely, if the doctor deals with "complex" orthodontic pathologies.

Caroli's disease (clinical observation)

In their medical practice doctors deal with rare diseases which present difficulties in making a clinical diagnosis, in this case additional diagnostic methods are required. One of these diseases is Caroli's disease (syndrome), characterized by cystic enlargement of the intrahepatic bile ducts with frequent formation of intrahepatic stones. Taking into account the difficulties of early diagnosis, we present our own observation.

Post traumatic growth during COVID-19: unity in diversity

AimsThis poster reflects how the experience of staying with people of diverse nations and cultural background helped the stranded IMGs cope with this agony in a foreign land during an unprecedented tumultuous situation. The aim is to show that despite diversity among people, the hard times made them unite and overcome countless difficulties.BackgroundThe COVID 19 pandemic has been a period of global health crisis and has exponentially affected mental health issues in the world population. In these difficult times, several International Medical Graduates (IMGs), who had come to the UK to attend their PLAB exams, were left stranded as the exams were postponed, flights cancelled and borders sealed. Faced with huge uncertainty their mental health was of great concern.At this time the British Association of Physicians of Indian Origin (BAPIO) came forward to help this cohort of stranded doctors in terms of accommodation, finances, mental health support, preparation for exams to the extent of liaising with General Medical Council (GMC) and Home Office. The virtual support group provided a platform for IMGs from different nations and cultures to get in touch with each other helping overcome mental burden and stress.The stories presented in the poster show how unity in diversity helped these young doctors deal with mental trauma amidst the Pandemic.Method276 doctors from 27 countries were looked after by BAPIO. From those excerpts taken from 26 IMGs, personal narratives was used as a method for qualitative assessment.The percentage of IMGs clearing their exams and getting jobs in the NHS has been used for quantitative assessment.ResultQualitative: The personal narratives of the IMGs show how they were positively impacted by staying together albeit different nationalities and cultural background.Quantitative: A total of 21 IMGs out of the 26 cleared their PLAB 2 exams and got registration under General Medical Council giving a percentage of 81.7%. 20 IMGs have successfully joined the NHS in various posts giving a job success rate of 95.2%.ConclusionThe experience of living and sharing housings with people from different nationalities, has increased appreciation and also prepared them to work in the NHS which has a diverse work force. This learning experience has been integral for all of us in shaping our life in the UK making everyone more compassionate.

A National, Palliative Care Competency Framework for Undergraduate Medical Curricula.

As nearly all doctors deal with patients requiring palliative care, it is imperative that palliative care education starts early. This study aimed to validate a national, palliative care competency framework for undergraduate medical curricula. We conducted a Delphi study with five groups of stakeholders (palliative care experts, physicians, nurses, curriculum coordinators, and junior doctors), inviting them to rate a competency list. The list was organized around six key competencies. For each competency, participants indicated the level to which students should have mastered the skill at the end of undergraduate training. Stability was reached after two rating rounds (N = 82 round 1, N = 54 round 2). The results showed high levels of agreement within and between stakeholder groups. Participants agreed that theoretical knowledge is not enough: Students must practice palliative care competencies, albeit to varying degrees. Overall, communication and personal development and well-being scored the highest: Junior doctors should be able to perform these in the workplace under close supervision. Advance care planning scored the lowest, indicating performance in a simulated setting. A wide range of stakeholders validated a palliative care competency framework for undergraduate medical curricula. This framework can be used to guide teaching about palliative care.

Impact of an educational workshop on psychiatrists\u2019 attitude towards psychosomatic medicine

BackgroundAlthough psychosomatic medicine is not recognised as a medical specialisation globally, it has proven useful for treating many disorders in Germany. This paper reports on the impact of an educational workshop as a tool for raising awareness about psychosomatic medicine among international psychiatrists.MethodsPsychiatrists from eight different countries were educated on psychosomatic medicine and psychotherapy during a 90-min workshop using a video, a slide presentation and an innovative teaching format called ‘speed coaching’. Learning outcomes were assessed by analysing questionnaires completed by the participants before and after the workshop.ResultsHalf of the participants who initially rejected the notion that psychosomatic medicine should be a specialisation on its own changed their minds in favour for it to be a separate discipline (p = 0.125). Awareness about which diseases and patients psychosomatic doctors deal with was increased. The intent for treatment of patients with eating disorders by a psychosomatic physician quadrupled among the participants (p = 0.004).ConclusionsA brief educational intervention can influence psychiatrists’ decisions to opt for approaches by doctors specialized in psychosomatics for certain disorders. Further studies may explore why psychiatrists agree or disagree that psychosomatic medicine should be a separate specialisation on its own.

A literature review of interventions to reduce stress in doctors.

Stress is prevalent among doctors, and interventions are offered, often as part of their continuing professional development, to help doctors learn in the workplace about the recognition, prevention and management of the harmful effects of stress. The aim of this review was to examine existing research to ascertain the features of successful educational interventions with practising doctors and any factors that may affect outcomes. We searched key databases for papers published between 1990 and 2017 on the themes of stress that included an education-based intervention and practising doctors. Using an inclusive approach to the review, a broad evaluation was made of the primary research using both quantitative and/or qualitative evidence where the study reported a positive outcome in terms of stress management. Review criteria were met in 31 studies of 1,356 originally retrieved. Three broad categories of interventions emerged from the coding process: mindfulness-type (n = 12), coping and solutions focused (CSF) (n = 12) and reflective groups (n = 7). There is evidence that these interventions can be successful to help doctors deal with stress. Based on the results from this review, an original guide is advanced to help educators choose an educational intervention. Although evidence for some interventions may be 'hierarchically stronger', it is misleading to assume that interventions can be imported as successfully into any context. Factors such as medical specialty and health care systems may affect which intervention can be used. The guide offers an evidence base on which further research can be built.

THE LANGUAGE OF THE DOCTOR AND THE PATIENT

The language of medicine is the language of medical science, practical medicine, and the language of the patient.When assessing medical terminology through the prism of its historical origin and time influences, we may see clearly that even today it relies heavily on two classical languages: Greek and Latin. This is because these languages are characterized by clarity of terms and lack of polysemantic shades, which is not true for all other languages. The main distinctive feature of the language of medicine from other natural sciences is primarily related to the fact that doctors use it not just to communicate with each other, but with patients too. Any dialog between the doctor and the patient goes far beyond the scientific and technical communication aspect. The very conversation often serves as a treatment factor as it influences the spiritual condition of the patient. The principle of the dialog is one of the main concepts of medicine. Such notions as a “person – environment, psyche – soma, health – illness” complement each other and should always be taken into account and viewed as a whole in the process of studying etiology, symptomatology, and the choice of therapy. When talking to the patient, the doctor deals with his or her feelings and thoughts, fears and hopes. It is important for the patient to explain his or her complaints and for the doctor to show understanding, attentively accept the patient and explain the reasons, consequences, and subsequent therapeutic steps in detail. There is a close relationship between the close doctor-patient contact and successful treatment. However, the medical progress dedicates very little attention to communication between the doctor and the patient. In many countries, medical university students study forms of communication with patients. The question arises: whether students can explain their own knowledge using professional language to someone who is not related to medicine? Are they able to convey the meaning of the medical terminology using a common language? Unfortunately, these questions are often left without answers. However, the reality shows the need to improve the communicative component of tthe doctor’s work. It is worth specifically emphasizing that, first and foremost, there is a need of appropriate training of students at universities, which would let future doctors to better interpret medical terminology using a common language depending on the specific situation.

How Intern Doctors Deal with Hepatitis B in Riyadh and Eastern Saudi Arabia

Background: Hepatitis B is one of popular health problem and is considered as major global infectious hazard. It represents an occupational risk for all people who are working in healthcare, including doctors, nurses, laboratory staff, and training interns as well as the student who is trained in hospitals. This can be correlated with their contact with body fluids during clinical rotations and activities. However, protection from getting any infection logically is mandatory for healthcare worker. Aim: Our problem in this study was to assess how our new doctors in Saudi Arabia, specifically those in Riyadh Region and Eastern Region are safe and are protected from hepatitis B infection by evaluating their knowledge, attitude and practice towards Hepatitis B. Method: That was a cross-sectional study which was conducted to intern doctors in Riyadh and Eastern Regions. Random sampling technique was used to select 350 intern doctors. Study tool was a self-administrated questionnaire that is made online by using Google drive forms and sent as an internet link to all interns via WhatsApp mobile application. Data analysis was done using computer application SPSS 24. Comparison between results and many variables was done using Chi-Square test and statistical significance is considered when P-Value < 0.05. Result: In this study, 131 intern doctors participated out of 350 who received the questionnaires (response rate 94.6%). Regarding the level of knowledge, attitude, and practice, around 86% of participants have good knowledge, 63% of them have a positive attitude and 85% have a good practice. Chi-Square test was applied to compare our results of KAP with gender and region. No difference between males and females was found in the level of knowledge and attitude (P-value > 0.05). Males were better than females in practice (P 0.05). Conclusion: It was obvious that our new doctors in Eastern and Riyadh regions have good knowledge, attitude and practice for Hepatitis B. People in Eastern region have less knowledge and attitude compared to those in Riyadh with a significant difference between them. Also, males interns have a better practice than females interns in general.

How Intern Doctors Deal with Hepatitis B in Riyadh and Eastern Saudi Arabia

How Intern Doctors Deal with Hepatitis B in Riyadh and Eastern Saudi Arabia

Mastectomy—A Critical Review

History of breast cancer dates back to at least 1600 B.C. and treatment methods have undergone significant progress over the last hundred years. We are moving away from frighteningly radical, and towards increasingly more conservational breast cancer surgery. And while mastectomy is no longer a first-line choice for all breast cancers, it is still an important and, really, an essential procedure to discuss and research about. Different types and techniques exist and evidence regarding each is vast-with novel techniques appearing even nowadays. For example, robotic surgery is increasingly more common in many surgical specialties and procedures, and mastectomy is no exception. With several high-profile celebrities recently discussing their experiences of breast cancer and mastectomies, this article covers a multitude of essential aspects relevant to this topic, in turn, hopefully, helping patients and doctors deal with the diagnosis and plan the treatment accordingly. Current breast cancer care and mastectomy trends are also discussed here, giving the readers an up-to-date overview of how breast cancer can and should be managed.

Arab doctors, evolving society and corruption: a medical student’s perspective

Doctors, especially junior doctors, face immense pressure in their day-to-day work. As a result, the rates of depression and anxiety are particularly high in this demanding profession. The pressure, which is compounded by constantly being under societal scrutiny, can unfortunately drive the doctor to breaking point. However, we can help doctors deal with these pressures in a more meaningful way if we make them aware of their wider environment (within a social paradigm) and the implications of their actions.

RCOG launches online tool to help doctors deal with bullying

The Royal College of Obstetricians and Gynaecologists has launched an online tool to help doctors deal with undermining and bullying in the workplace. In the General Medical Council’s 2013 national training survey 13% of doctors in training reported that they had experienced bullying or undermining in the workplace. …

Medical humanities: developing into a mainstream discipline.

Medical humanities: developing into a mainstream discipline.

Silences and Moral Narratives: Infanticide as Reproductive Disruption

Infanticide is a widespread practice, yet few ethnographic and theoretical works examine this. Drawing on ethnographic research conducted in the Indian Himalayas, I argue that infanticide is a form of reproductive disruption that elicits both public moral judgments and private silences. In this Himalayan context, the stigmas of abortion and premarital sex prevent community acknowledgement of infanticide and baby abandonment. Unmarried women hide their pregnancies, deliver and abandon their babies, and later are rushed to the hospital with postdelivery complications. While biomedical doctors deal with the debris of infanticide (postpartum hemorrhage), there is no formal accounting of the practice. I argue that by regarding infanticide as a form of reproductive disruption, we can open up women’s narratives of pain and suffering that are silenced because of moral repugnance.

The Wakley Prize, 2013: true stories

What does today's doctor have in common with his or her forebears? The tools of the trade have changed. The expectations of the patient have changed. Even the social position of the doctor has changed. There is perhaps only one constant thread over the centuries of medical practice, and it is this: doctors deal in stories. The doctor puts together a patient's version of events, the objective signs of disease, and his or her own knowledge to construct a narrative. From this first story, others soon follow—the choice of treatment, the relationship between physician and patient, the advances, and the setbacks. The science with which the doctor started her journey might have been superseded or forgotten at the end of her career. The stories, however, remain. As Oliver Sacks said in a recent interview with The Lancet, “Certainly when I look back on my own medical student days in the 1950s, I can hardly remember any of the lectures that were given, but I do remember all of the patients.”