“It's not you, it's us”: Promoting physician wellness requires systematic change

2021 ◽  
Author(s):  
Kandace P. McGuire
Keyword(s):  
Systematic Change ◽  
Physician Wellness

Exploring the characteristics of the nickel oxide nanoparticles via Sol - gel method

2020 ◽  
Vol 3 (3) ◽  
Author(s):  
Jothi M ◽  
Sowmiya K
Keyword(s):  
Nickel Oxide ◽  
Ph Value ◽  
Lattice Structure ◽  
Sol Gel ◽  
Systematic Change ◽  
Average Crystalline Size ◽  
Nio Nanoparticles ◽  
Nickel Oxide Nanoparticles ◽  
X Ray ◽  
Vis Spectroscopy

Nickel Oxide (NiO) is an important transition metal oxide with cubic lattice structure. NiO is thermally stable that is suitable for tremendous applications in the field of optic, ceramic,glass, electro-chromic coatings, plastics, textiles, nanowires, nanofibers, electronics,energy technology, bio-medicine, magnetism and so on. In this present study, NiO nanoparticles were successfully synthesized by sol-gel technique. Nano-sols were prepared by dissolving Nickel-Chloride [NiCl2.6H2O] in NaOH solvent and were converted into nano structured gel on precipitation. A systematic change in preparation parameters like calcination temperature, time, pH value has been noticed in order to predict the influence on crystallite size. Then the prepared samples were characterized by the X-ray Diffraction Spectroscopic (XRD), UV-VIS Spectroscopy, Fourier Transform Infra-Red Spectroscopy (FTIR), Energy Dispersive X-ray Spectroscopy (EDX), Scanning Electron Microscopy (SEM) and Particle Size Analyzer (PSA). From XRD, the average crystalline-size has been calculated by Debye-Scherrer Equation and it was found to be 12.17 nm and the band gap energy of Nickel oxide (NiO) from UV studies reveals around 3.85 eV. Further, EDX and FTIR studies, confirm the presences of NiO nanoparticles. The SEM study exhibits the spherical like morphology of Nickel oxide (NiO). Further from PSA, the mean value of NiO nanoparticles has been determined.

Improving physician wellness through electronic health record education

2021 ◽  
pp. 009121742110346
Author(s):  
Elizabette Johnson ◽  
Elizabeth Roth
Keyword(s):  
Electronic Health Record ◽  
Statistical Significance ◽  
Resident Physician ◽  
Health Record ◽  
Physician Burnout ◽  
Paired Data ◽  
Post Intervention ◽  
Physician Wellness ◽  
Resident Wellness ◽  
Electronic Health

Objective Our goal is to improve the wellness of our Family Medicine residents now and in the future by educating them on more efficient use of our electronic health record (EHR). Resident physician burnout is a significant problem and is correlated with time spent using an EHR after work hours. Family physicians have the highest rate of burnout of all specialties, and the EHR is a significant contributor to this burnout. Studies have shown that increased EHR education can improve job satisfaction. Method Over 5 months, we provided weekly brief (15 minute) educational sessions covering 6 topics twice and a one-hour individualized meeting of each resident physician with an EHR trainer. We evaluated our intervention with wellness surveys and objective measures of EHR efficiency both pre and post intervention. We further evaluated efficiency by comparing pre and post-intervention values of the following: average keystrokes, mouseclicks, accelerator use, minutes per encounter and percent closed encounters at month’s end. Results Resident questionnaires showed lessons increased knowledge and intention to use EHR accelerators, but this was not statistically significant. Analysis of objective data showed most efficiency metrics worsened, though most not to a degree that was statistically significant. Residents reported subjective increases in efficiency, and paired data from wellness surveys showed an overall decrease in burnout post-intervention vs. baseline. Conclusions Much of the data in this pilot study does not reach statistical significance, but is highly suggestive that increased EHR training can improve at least perceived efficiency and thereby resident wellness.

scholarly journals Benzodiazepines: the time for systematic change is now

Addiction ◽  
2021 ◽  
Author(s):  
Roy Robertson ◽  
Andrew McAuley ◽  
Catriona Matheson
Keyword(s):  
Systematic Change

Anatomy of Motor Learning. II. Subcortical Structures and Learning by Trial and Error

1997 ◽  
Vol 77 (3) ◽  
pp. 1325-1337 ◽  
Author(s):  
M. Jueptner ◽  
C. D. Frith ◽  
D. J. Brooks ◽  
R.S.J. Frackowiak ◽  
R. E. Passingham
Keyword(s):  
Motor Learning ◽  
Response Times ◽  
Cerebellar Nuclei ◽  
Selection Task ◽  
Systematic Change ◽  
Trial And Error ◽  
Subcortical Structures ◽  
Learning Condition ◽  
Positron Emission ◽  
New Learning

Jueptner, M., C. D. Frith, D. J. Brooks, R.S.J. Frackowiak, and R. E. Passingham. Anatomy of motor learning. II. Subcortical structures and learning by trial and error. J. Neurophysiol. 77: 1325–1337, 1997. We used positron emission tomography to study motor learning by trial and error. Subjects learned sequences of eight finger movements. Tones generated by a computer told the subjects whether any particular move was correct or incorrect. A control condition was used in which the subjects generated moves, but there was no feeback to indicate success or failure, and so no learning occured. In this condition (free selection) the subjects were required to make a finger movement on each trial and to vary the movements randomly over trials. The subjects had a free choice of which finger to move on any one trial. On this task there was no systematic change in responses over trials and no change in the response times. Two other conditions were included. In one the subjects repetitively moved the same finger on all trials and in a baseline condition the subjects heard the pacing tones and auditory feedback but made no movements. Comparing new learning with the free selection task, there was a small activation in the right prefrontal cortex. This may reflect the fact that in new learning, but not free selection, the subjects rehearse past moves and adapt their responses accordingly. The caudate nucleus was strongly activated during new learning. It is suggested that this activity may be related either to mental rehearsal or to reinforcement of the movements as a consequence of the outcomes. The putamen was activated anteriorly on the free selection task and more posteriorly when the subjects repetitively made the same movement. It is suggested that the differences in the location of the peak activation in the striatum may represent the operation of different corticostriatal loops. The cerebellar nuclei (bilaterally) and vermis were more active in the new learning condition than during the performance of the free selection task. There was no difference in the activation of the cerebellum when the free selection task was compared with repetitive performance of the same movement. We tentatively suggest that the basal ganglia may be involved in the specification of movement on the basis of memory of either the movements or the outcomes, but that the cerebellum may be more directly involved in changes in the parameters of movement execution.

scholarly journals Sensorimotor priors in nonstationary environments

2013 ◽  
Vol 109 (5) ◽  
pp. 1259-1267 ◽  
Author(s):  
Devika Narain ◽  
Robert J. van Beers ◽  
Jeroen B. J. Smeets ◽  
Eli Brenner
Keyword(s):  
Environmental Variables ◽  
A Priori ◽  
Past Research ◽  
Systematic Change ◽  
Recent Experience ◽  
Environmental Variance ◽  
Adaptive Models ◽  
Priori Information ◽  
Human Nervous System ◽  
Better Than

In the course of its interaction with the world, the human nervous system must constantly estimate various variables in the surrounding environment. Past research indicates that environmental variables may be represented as probabilistic distributions of a priori information (priors). Priors for environmental variables that do not change much over time have been widely studied. Little is known, however, about how priors develop in environments with nonstationary statistics. We examine whether humans change their reliance on the prior based on recent changes in environmental variance. Through experimentation, we obtain an online estimate of the human sensorimotor prior (prediction) and then compare it to similar online predictions made by various nonadaptive and adaptive models. Simulations show that models that rapidly adapt to nonstationary components in the environments predict the stimuli better than models that do not take the changing statistics of the environment into consideration. We found that adaptive models best predict participants' responses in most cases. However, we find no support for the idea that this is a consequence of increased reliance on recent experience just after the occurrence of a systematic change in the environment.

Physician moral injury in the context of moral, ethical and legal codes

2021 ◽  
pp. medethics-2021-107225
Author(s):  
Philip Day ◽  
Jennifer Lawson ◽  
Sneha Mantri ◽  
Abhi Jain ◽  
David Rabago ◽  
...  
Keyword(s):  
Medical Practice ◽  
Moral Distress ◽  
Codes Of Ethics ◽  
Professional Associations ◽  
Moral Injury ◽  
Systematic Change ◽  
Ethical Codes ◽  
Validity Tests

After 40 years of attributing high rates of physician career dissatisfaction, attrition, alcoholism, divorce and suicide to ‘burnout’, there is growing recognition that these outcomes may instead be caused by moral injury. This has led to a debate about the relative diagnostic merits of these two terms, a recognition that interventions designed to treat burnout may be ineffective, and much perplexity about how—if at all—this changes anything.The current research seeks to develop the construct of moral injury outside military contexts, generate more robust validity tests and more fully describe and measure the experiences of persons exposed to moral harms. Absent from the literature is a mechanism through which to move from the collective moral injury experience of physicians to a systematic change in the structure of medical practice. To address this, after providing a brief history, definitions and contrasts between burnout, moral distress and moral injury, we review the interplay of moral and ethical codes in the context of moral injury. We conclude by suggesting that professional associations can potentially prevent moral injury by providing protections for physicians within their codes of ethics.

Building community during the COVID-19 pandemic: a system level approach to physician well-being

2021 ◽  
Vol 7 (4) ◽  
pp. 166-170
Author(s):  
Serena Siow ◽  
Carmen Gittens
Keyword(s):  
Emotional Health ◽  
Well Being ◽  
Shared Responsibility ◽  
System Level ◽  
Group Discussions ◽  
Physician Wellness ◽  
Physician Leaders ◽  
Building Community ◽  
Support Team ◽  
Emotional Strain

Before the COVID-19 pandemic, physician burnout was identified as reaching crisis proportions, and the pandemic is expected to worsen the already perilous state of physician wellness. It has affected physicians’ emotional health, not only by increasing workload demands, but also by eroding resilience under increasing pressures. The mental health consequences are expected to persist long after the pandemic subsides. With physician wellness increasingly recognized as a shared responsibility between individual physicians and the health care system, system-level approaches have been identified as important interventions for addressing physician well-being. In this article, we describe two evidence-guided initiatives implemented in our hospitalist network during the current pandemic: a trained peer-support team and facilitated physician online group discussions. These initiatives acknowledge the emotional strain of physicians’ work and challenge the “iron doc” culture of medicine. Our efforts build community and shift culture toward improved physician wellness. We suggest that the pandemic might be an opportunity for our profession to strengthen our support networks and for physician leaders to advance physician wellness in their work environments.

Improvement in Outcomes of Major Obstetric Hemorrhage Through Systematic Change

2017 ◽  
Vol 130 (4) ◽  
pp. 770-777 ◽  
Author(s):  
Daniel W. Skupski ◽  
David Brady ◽  
Isaac P. Lowenwirt ◽  
Jason Sample ◽  
Stephanie N. Lin ◽  
...  
Keyword(s):  
Systematic Change ◽  
Obstetric Hemorrhage
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