Role Of Physician Research Articles

Heterogeneity in the role of emergency physicians and treatment of acute atrial fibrillation in emergency departments—results of the International Atrial Fibrillation Background (AFiB) Study

The consept of emergency departments (EDs) with specialized teams of emergency physicians originated in the United Kingdom and the United States during the 1970s and was expanded across most European countries in the twenty-first century. Among the various cardiac arrhythmias encountered in EDs, atrial fibrillation (AF) is the most prevalent, contributing to ED congestion. Existing guidelines offer multiple treatment options for acute-onset AF occurring within 48 hours. The aim of The Atrial Fibrillation Background Study is to evaluate treatment strategies, practices and the role of emergency physicians in managing acute-onset AF in Western medical tradition across Europe, the United States and China (Hong Kong). The data for this nonexperimental survey were collected through a questionnaire administered to the medical director or a senior physician at each of the 12 participating EDs. We obtained information regarding the total number of physicians employed in these EDs, their respective specialties, and the patient caseloads they managed. Additionally, we gathered data on the diagnostic and treatment protocols employed for atrial fibrillation (AF). In the investigated EDs in Hong Kong, the United Kingdom and the United States, patients were treated by emergency physicians. Comparatively, many European EDs primarily relied on physicians with traditional medical specialties. Diagnostic methods employed for acute AF ranged from point-of-care testing to comprehensive laboratory panels and echocardiography. In terms of AF treatment, rate control was the preferred approach in Hong Kong and the USA EDs, while rhythm control was preferred in European settings. Regarding rhythm control, there were considerable variations in preferences between pharmacological and electrical cardioversion methods. Findings from the AFiB Study highlight the growing significance of emergency physicians in the management of acute AF, as well as the divergent treatment approaches for acute AF observed in EDs between Europe and the United States.

The impact of gestational diabetes on infants’ neurodevelopmental status: a cohort study

Objective: The prevalence of gestational diabetes is increasing worldwide. Several studies have indicated that gestational diabetes can cause neurodevelopmental disorders in children. None of them has examined all areas of neurodevelopment. We conducted this pilot study to compare the neurodevelopmental status in infants of mothers with and without gestational diabetes. Materials and Methods: Forty infants of mothers with gestational diabetes and 40 infants of healthy mothers were included and followed up at 6 and 12 months old of age. The primary data of the study were extracted from a cohort study (PERSIAN Birth Cohort) done in Yazd province, Iran. Ages and Stages Questionnaire (ASQ) was used as a standard test to assess all domains of neurodevelopment. Finally, the data obtained from the questionnaire were statistically analyzed using SPSS software. Results: Data analysis showed a significant relationship between gestational diabetes and neurodevelopment in the area of problem solving at one year old, but its relationship with other domains was not significant. In the case group, there was a significant relationship between the type of treatment (insulin therapy) and neurodevelopment in the area of gross motor skills at one year of age. Conclusion: Based on this study, it seems that infants' neurodevelopment in the area of problem solving has been affected by gestational diabetes. Thus, the role of physicians in follow up of the neurodevelopmental progress of infants of diabetic mothers is significant

Roles for Maine ’s Physicians in the Climate Crisis

Physicians have important roles to play in the climate crisis because they deal with the health impacts of climate change. We surveyed physicians in Maine about climate change and health, and of the 108 respondents, 84 (78 percent) believe that climate change poses a threat to the health of their patients, particularly for asthma, vector-borne diseases, heat-related illnesses, chronic obstructive pulmonary disease, and mental health problems. Most reported that these conditions are becoming more prevalent, and they identified children, older adults, and patients with chronic health conditions as those most at risk. Despite this awareness, most respondents did not discuss climate change as a health determinant with their patients, although they identified communicating with patients and the public as a role for physicians.

Safeguarding in Swiss Sport

In the fall of 2020, various publications of research into abuse and malpractice in Swiss sport caused consternation. As a result, on January 1, 2022, the Antidoping Switzerland Foundation was transformed into the Swiss Sport Integrity Foundation. The objective of the Foundation is to have an independent and secure point of contact for uncovering and eliminating ethics violations and abuses as quickly as possible. The Statutes on Ethics in Swiss Sport lists 4 cases and acts that are considered violations, which are: Mistreatment (and abuse), abuse of a position or function, unsporting behavior, and incitement, complicity, and attempted violations. To protect the right of athletes to a fair, safe and clean sport, all involved parties have to assume their role. The role of physicians can be summarized in the following actions: create a safe space, listen carefully, and support and inform effectively.

A Primer for Workers' Compensation

Abstract Background Context: A physician's role within a workers' compensation injury extends far beyond just evaluation and treatment with several socioeconomic and psychological factors at play when compared to similar injuries occurring outside of the workplace. Although workers' compensation statutes vary among states, all have several basic features with the overall goal of returning the injured worker to maximal function in the shortest time period, with the least residual disability and shortest time away from work. Purpose: To help physicians unfamiliar with the workers' compensation process accomplish these goals. Study Design: Review. Methods: Educational review. Results: The streamlined review addresses the topics of 1) Why is Workers' Compensation Necessary? 2) What does Workers' Compensation Cover? 3) Progression following Work Injury 4) Impairment and Maximum Medical Improvement (MMI), including how to use the 6th edition of American Medical Association's (AMA) Guides, 5) Completion of Work Injury Claim after Impairment Rating, 6) Independent Medical Evaluation, and 7) Causation. Conclusions: In the ‘no-fault’ workers' compensation system, physicians play a key role is progressing the claim along and, more importantly, getting the injured worker back to work as soon as safely possible. Physicians should remain familiar with the workers' compensation process, along with how to properly utilize the AMA Guides.

Medical Doctors Approaches and Understanding of Health Literacy: A Systematic Literature Review.

A physician's role is critical in fostering patient health literacy (HL) and influencing various aspects, including patient-physician communication and treatment effectiveness. The purpose of this systematic literature review is to analyze physicians' perspectives, comprehension, and management of HL. The focus of this review is on physicians' views, opinions, experiences, and strategies related to HL. We conducted comprehensive searches across seven databases, including PubMed, Scopus, ProQuest, Science Direct, Web of Science, The Cochrane Library, and Google Scholar. Original research articles published between January 1, 2009, and July 31, 2020, were considered for inclusion. This literature review incorporates qualitative studies and mixed-methods studies, with a focus on extracting qualitative data. Among the 22 articles included in our review, we employed the method of inductive thematic analysis for data analysis. A detailed description of the review methodology can be found in a previously published protocol available through PROSPERO (CRD42020212599). The themes that emerged from the thematic analysis include: (a) physicians' perception and management of HL; and (b) barriers. The results of the systematic review reveal that healthcare professionals exhibit varying perceptions of patients' HL levels and ascribe different meanings to it. However, none of them employ a specific measuring tool. While there appears to be no uniform approach to managing patients with low HL, some prioritize certain communication strategies, such as repetition, simplified language, and providing written instructions, among others. Most physicians cited multiple barriers that impede the development of patients' HL, including dysfunctions within the healthcare system, staff shortages, managing a large number of patients, limited time, work-related stress, cultural and socio-economic barriers, medical jargon, and language barriers. Considering the pivotal role of physicians in fostering patient HL, it is crucial to enhance medical education in addressing and managing HL, both within academic curricula and through continuing education seminars. Furthermore, there is a pressing need to improve healthcare professionals' working conditions, ensuring that each physician can allocate the necessary time to each patient based on their individual needs, without being hindered by stress-inducing work environments.

Evidence-based position paper on physical and rehabilitation medicine professional practice for persons with COVID-19, including post COVID-19 condition: the European PRM position (UEMS PRM Section).

Although multiple factors still pose challenges to inpatient/outpatient rehabilitation for survivors of COVID-19, rehabilitation plays a key role for this patient population. This study aimed to improve Physical and Rehabilitation Medicine (PRM) physician's professional practice for persons with COVID-19-related functioning limitations, to promote functional recovery and reduce activity limitations and/or participation restrictions. A systematic review of the scientific literature was performed from December 2019 to August 2022, followed by production of recommendations through 5 Delphi rounds, by consensus among the delegates of all European countries represented in the Union of European Medical Specialists PRM Section. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The PRM physician's role for persons with COVID-19-related limitations of functioning is to develop, foster, and monitor the implementation of an individual rehabilitation project tailored to the patient's age, previous medical and functional status, current comorbidities and complications, activity limitations and participation restrictions and personal and environmental factors. This is done by applying the concept of a multi-specialty integrated service model with multi-professional/interdisciplinary teams, providing care at all stages of COVID-19 illness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section.

The role of the family physician in increasing the chances of survival in lung cancer

The role of the family physician in increasing the chances of survival in lung cancer

The Role of Female Physicians in Psychosomatic Medicine: Opportunities and Challenges.

Female physicians are in some cases preferred by patients due to their sex-related characteristics such as softness and empathy. Psychosomatic medicine presents a compelling working environment due to its holistic approach. This brief review synthesizes the challenges encountered by female physicians in psychosomatic medicine and outlines potential strategies for overcoming these barriers. The presence of female role models may constitute a crucial advancement in this process. There exists a pressing demand for specialized clinical and scientific programs in psychosomatic medicine at both national and international levels. Such programs, offered by universities and ministries, as well as comprehensive training initiatives, are indispensable in fostering the next generation of females in psychosomatics. Leading journals can lend their support by publishing special issues dedicated to female physicians. Strengthening female physicians throughout all positions in psychosomatic medicine can contribute ultimately to the improvement of patient care.

Tobacco use : guidelines for primary care physicians

Tobacco use affects about 25% of the population and is the most important modifiable risk factor for many diseases, namely cancers, cardiovascular and pulmonary diseases. The role of the primary care physician is essential in providing screening and brief intervention to all patients, particularly to those at higher risk. This will help them to quit smoking, or adopt risk reduction strategies, according to their own wish. The main interventions include motivational support, nicotine replacement therapy and other medications. Vaping has been proved to be efficient for tobacco withdrawal and is still studied as a risk reduction tool. At the moment, it is considered by some as twenty times less harmful than smoked tobacco.

Knowledge, attitudes, beliefs and practices of pregnant women towards the influenza vaccine in Trinidad.

Pregnant women and their babies are at increased risk of influenza-related complications. The World Health Organisation recommends influenza vaccination to this high-risk population as the highest priority. A knowledge, attitudes,beliefs, and practices (KAP) of pregnant women towards the influenza vaccine in Trinidad. It was disseminated to 480 pregnant women attending the clinic and completed by 146 yielding a response rate of 30%. Women who received the vaccine in a past pregnancy were nine times more likely to consider taking the vaccine in the current pregnancy. There was a statistically significant difference in vaccine uptake based on the source of information received by participants about the influenza vaccine (χ2 (3) = 9.864, P = 0.020), with the highest mean score for uptake shown in women who received information from a health care provider. A moderate, positive correlation was found between knowledge and vaccine uptake (rs (143) =0.430, P < 0.01), a weak, positive correlation between perceived susceptibility and vaccine uptake (rs (143) = 0.264, P < 0.01), and a weak, positive correlation between knowledge and perceived susceptibility (rs (143) = 0.229, P < 0.01). The study findings highlight that the source of information significantly influences vaccine uptake, with health care providers being the most influential source. This underscores the role of primary care physicians in providing accurate and up-to-date information about influenza vaccination to pregnant women. There is a need for accurate information and recommendations to be given to pregnant women by all health care workers including primary care physicians in order to increase vaccine uptake and reduce maternal and neonatal morbidity and mortality.

Longitudinal Trends in Insurer Participation in Multisector Population Health Activities.

Healthcare organizations increasingly engage in activities to identify and address social determinants of health (SDOH) among their patients to improve health outcomes and reduce costs. While several studies to date have focused on the evolving role of hospitals and physicians in these types of population health activities, much less is known about the role health insurers may play. We used data from the National Longitudinal Survey of Public Health Systems for the period 2006 to 2018 to examine trends in health insurer participation in population health activities and in the multi-sector collaborative networks that support these activities. We also used a difference-in-differences approach to examine the impact of Medicaid expansion on insurer participation in population health networks. Insurer participation increased in our study period both in the delivery of population health activities and in the integration into collaborative networks that support these activities. Insurers were most likely to participate in activities focusing on community health assessment and policy development. Results from our adjusted difference-in-differences models showed variation in association between insurer participation in population health networks and Medicaid expansion (Table 2). Population health networks in expansion states experienced significant increases insurer participation in assessment (4.48 percentage points, P < .05) and policy and planning (7.66 percentage points, P < .05) activities. Encouraging insurance coverage gains through policy mechanisms like Medicaid expansion may not only improve access to healthcare services but can also act as a driver of insurer integration into population health networks.

The Role of Primary Care Physicians in the Co-Management of Patients with Genetic Conditions

The Role of Primary Care Physicians in the Co-Management of Patients with Genetic Conditions

Telemedicine Could Reduce the Role of Family Physicians to Case Managers.

The COVID-19 pandemic led to the widespread and continuing use of telemedicine in primary care. Despite telemedicine's benefits, it threatens to reduce the role of family physician to that of gatekeeper and case manager, nullifying decades of experience and medical intuition that is more difficult to develop and apply virtually. Additionally, many values of family medicine have eroded during this global process. The narrative presents 3 vignettes that illustrate different ways in which we contend with this complex issue. The challenges presented by telemedicine require us to re-examine our professional and personal values such as maintaining the centrality of the therapeutic relationship with patients. The greatest concern, however, relates to the future of the profession and the ability of new family doctors to overcome the challenges of telemedicine in an increasingly digital world.

The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases

Gastrointestinal diseases encompass conditions affecting the gastrointestinal tract, including the esophagus, stomach, and small and large intestines. These conditions are prevalent in general practice, with common diseases such as irritable bowel syndrome, inflammatory bowel disease, and celiac disease. Primary care physicians encounter a broad spectrum of clinical problems, necessitating a wide range of knowledge for accurate diagnosis and prescription of medications.It is crucial to recognize the role of primary care physicians in the diagnosis and management of gastrointestinal diseases, given their frequent presentation in primary care settings. This review aims to provide an overview of the role of primary care physicians in the diagnosis and management of various chronic gastrointestinal diseases.Scientific websites and databases were utilized to search for relevant articles. Various keywords were employed in different combinations to retrieve all possible articles related to the current subject. The findings incorporated in this review consist of original articles, review articles, and systematic reviews written in the English language that address our objectives.The selected articles underwent a thorough review based on inclusion criteria. The articles included in this review were published between 2010 and 2022. Despite the availability of original research and reviews, there is insufficient information on the role of primary care physicians in the diagnosis and treatment of chronic gastrointestinal diseases. Physicians may lack knowledge regarding the proper management and diagnosis of these conditions; however, their roles can be enhanced through increased education and awareness

Role of Endovascular Physicians in the Treatment of Various Spinal Arteriovenous Shunts

Role of Endovascular Physicians in the Treatment of Various Spinal Arteriovenous Shunts

Radiographic Diagnostic Dilemma – A Rare Case Report of Secondary Hyperparathyroidism

Abstract This case report highlights the role of oral physicians in taking a detailed systemic history along with relevant laboratory investigations to rule out some rarer cases of secondary hyperparathyroidism manifesting in the jaw/mandibular bone. Although radographicaly the tumour site was resembling like Central giant cell granuloma but on detiled laboratory investigations alkaline phospahatase levels (401IU/L)were raised and serum calcium levels were (8.5mg/dl) hence final diagnosis of secondary hyperparathyroidisum was made and pateint was managed by giving vitamin d3 and calcium support rather then surgery. Hence, cases like this draw the attention of oral as well as general physicians to not treat the patient based only on histopathological or radiological findings without proper correlation of clinical and other laboratory investigations.

The Impact of Racism on Health: A Health Equity Training on Structural Racism for Military Residents and Fellows.

Recognizing the need for more opportunities to learn about health equity within military graduate medical education (GME), we developed a resident-led curriculum to introduce these concepts from a military cultural competency lens. The Impact of Racism on Health module focuses on structural racism and health disparities. This 60-minute module was presented to ear, nose, and throat (ENT) and pediatrics residents and fellows. It includes a case presentation of an adolescent with an asthma exacerbation, a large-group discussion about social determinants of health and structural racism, and a small-group discussion/debrief conceptualizing the case. Thirty pediatrics residents and 15 ENT residents participated in this activity with a 46% and 60% pretest response rate, respectively. A two-sample Mann-Whitney U test showed statistically significant improvement (p = .005) in knowledge related to structural racism between the pretest (M = 0.5, SD = 0.3) and posttest (M = 0.7, SD = 0.1) knowledge assessments with a small effect size (r = 0.4; Z = 2.8). We demonstrated that interactive teaching methods can be used to educate military GME trainees on the impact of structural racism on health outcomes for military health care beneficiaries. Understanding the role of structural racism in the context of military health care using curricula that highlight military-specific health disparities is essential to understanding the role of the military physician in systemically addressing health disparities.

Exploring the role of physician associates in Aotearoa New Zealand primary health care

Introduction New Zealand’s health care system faces significant shortages in health care workers. To address workforce challenges and meet the population’s health needs, health care systems around the world have introduced new clinical roles, such as physician associates/assistants (PAs) into existing health care teams. Aim This article aims to examine the benefits, challenges, and broader implications of regulating PAs in the context of New Zealand’s primary care sector, with a specific emphasis on how it may impact general practice. Methods A range of literature surrounding the role, impact, and perception of PAs were selected and included in this article. Results The PA profession can significantly strengthen New Zealand’s primary care workforce, improving patient access and continuity of care. However, the global deployment of PAs has faced scrutiny due to concerns about its potential risks to patient safety and the overall viability of such a role. Discussion If regulated, the PA profession can reshape New Zealand’s primary care, offering a partial solution to current medical staff shortages. Trained under a generalised medical model similar to doctors, PAs possess the necessary skills to perform both routine and non-routine medical tasks. This dual capability can significantly improve primary care service provision, reduce existing workloads, and allow for a more efficient deployment of doctor expertise. However, medico-legal issues and the supervisory burden can impede widespread integration into general practice. Despite challenges, the success of the PA role relies on mutual trust, respect, and support from other clinical team members within primary health care.

Cooking for Health: a comprehensive narrative review of Culinary Medicine as an educational tool in medical training in Brazil and Globally.

The poor diet quality in line with the rising prevalence of noncommunicable chronic diseases, coupled with the substantial deficit in nutritional education within medical training programs, has precipitated the emergence of Culinary Medicine as an evolving discipline. Culinary Medicine fuses the art of home cooking with the sciences of human nutrition, psychology, gastronomy, and medicine to promote health and well-being. This comprehensive narrative review explores the diverse facets of Culinary Medicine, elucidating its historical evolution, theoretical foundations, educational initiatives in Brazil and worldwide, and its practical implementation in clinical contexts. By integrating evidence-based nutrition knowledge with culinary skills, behavior change tools, and well-established principles of healthy dietary practices, Culinary Medicine arrives to empower individuals - physicians and patients - to make informed dietary choices and enhance their overall health outcomes. Moreover, this review contemplates the roles of physicians in providing dietary guidance within the Culinary Medicine paradigm and the challenges associated with incorporating Culinary Medicine as a complementary facet of conventional medical care and medical education.