scholarly journals Telemedicine in pediatric rheumatology: this is the time for the community to embrace a new way of clinical practice

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Susan Shenoi ◽  
Kristen Hayward ◽  
Megan L. Curran ◽  
Elizabeth Kessler ◽  
Jay J. Mehta ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Physical Examination ◽  
Paradigm Shift ◽  
Pediatric Rheumatology ◽  
Multidisciplinary Care ◽  
Rapid Expansion ◽  
Health Record ◽  
Global Pandemic ◽  
Multidisciplinary Care Team ◽  
Virtual Visits

Abstract Background The use of telemedicine in pediatric rheumatology has been historically low. The current COVID 19 global pandemic has forced a paradigm shift with many centers rapidly adopting virtual visits to conduct care resulting in rapid expansion of use of telemedicine amongst practices. Body This commentary discusses practical tips for physicians including guidance around administrative and governance issues, preparation for telemedicine, involving the multidisciplinary care team, and teaching considerations. We also outline a standard proforma and smart phrases for the electronic health record. A proposed variation of the validated pediatric gait arms legs spine examination (pGALS) called the video pGALS (VpGALS) as a means of conducting virtual pediatric rheumatology physical examination is presented. Conclusion This commentary provides a starting framework for telemedicine use in pediatric rheumatology and further work on validation and acceptability is needed.

Webside manner: maskless communication

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ankit Mehta ◽  
Benji K. Mathews
Keyword(s):  
Communication Skills ◽  
Rapid Expansion ◽  
Technical Aspects ◽  
The Core ◽  
Core Elements ◽  
Virtual Visits ◽  
Virtual Platform ◽  
Structured Approach

Abstract Telemedicine has seen a rapid expansion lately, with virtual visits ushering in telediagnosis. Given the shift in the interpersonal and technical aspects of communications in a virtual visit, it is prudent to understand its effect on the patient-provider relationships. A range of interpersonal and communication skills can be utilized during telemedicine consultations in establishing relationships, and reaching a diagnosis. We propose a construct of “webside manner,” a structured approach to ensure the core elements of bedside etiquette are translated into the virtual encounter. This approach entails the totality of any interpersonal exchange on a virtual platform, to ensure a clinician’s presence, empathy and compassion is translated through this medium.

scholarly journals Harnessing COVID-Driven Technical Innovations for Improved Multi-Disciplinary Cancer Care in the Post-COVID Era: The Virtual Patient Room

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482096480 ◽  
Author(s):  
Austin J. Sim ◽  
Gage Redler ◽  
Jeffrey Peacock ◽  
Cristina Naso ◽  
Stuart Wasserman ◽  
...  
Keyword(s):  
New Technology ◽  
Multidisciplinary Care ◽  
Virtual Patient ◽  
Paradigm Shifts ◽  
Patient Room ◽  
Patient Centered ◽  
Team Members ◽  
The Road ◽  
Centered Care ◽  
Virtual Visits

Emergence of the COVID-19 crisis has catalyzed rapid paradigm shifts throughout medicine. Even after the initial wave of the virus subsides, a wholesale return to the prior status quo is not prudent. As a specialty that values the proper application of new technology, radiation oncology should strive to be at the forefront of harnessing telehealth as an important tool to further optimize patient care. We remain cognizant that telehealth cannot and should not be a comprehensive replacement for in-person patient visits because it is not a one for one replacement, dependent on the intention of the visit and patient preference. However, we envision the opportunity for the virtual patient “room” where multidisciplinary care may take place from every specialty. How we adapt is not an inevitability, but instead, an opportunity to shape the ideal image of our new normal through the choices that we make. We have made great strides toward genuine multidisciplinary patient-centered care, but the continued use of telehealth and virtual visits can bring us closer to optimally arranging the spokes of the provider team members around the central hub of the patient as we progress down the road through treatment.

Is This the First Adherence-Focused Multidisciplinary Care Team App?

2016 ◽  
Vol 51 (1) ◽  
pp. 94-95
Author(s):  
Bill G. Felkey ◽  
Brent I. Fox
Keyword(s):  
Multidisciplinary Care ◽  
Care Team ◽  
Multidisciplinary Care Team

scholarly journals Diabetes Drugs and Cardiovascular Event Reduction: A Paradigm Shift

2018 ◽  
Vol 12 (1) ◽  
pp. 46-50
Author(s):  
Erik M Kelly ◽  
Donald E Cutlip
Keyword(s):  
Clinical Practice ◽  
Cost Effectiveness ◽  
Paradigm Shift ◽  
Cardiovascular Events ◽  
Outcome Data ◽  
Review Article ◽  
Sodium Glucose Cotransporter ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Effectiveness Data

This review article summarizes the recent cardiovascular outcome data for sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 analogues, which have been found to reduce cardiovascular events. We also detail the implications these new medications will have on clinical practice through a review of recent diabetes guidelines and cost-effectiveness data.

Weaning Analgosedation in Patients Requiring Prolonged Mechanical Ventilation

2021 ◽  
pp. 088506662110487
Author(s):  
Stephanie Parks Taylor ◽  
John M. Hammer ◽  
Brice T. Taylor
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Multidisciplinary Care ◽  
Potential Harm ◽  
Mechanically Ventilated ◽  
Multidisciplinary Care Team ◽  
Clinical Trial Evidence ◽  
Adults And Children ◽  
Trial Evidence

Although research supports the minimization of sedation in mechanically ventilated patients, many patients with severe acute respiratory distress syndrome (ARDS) receive prolonged opioid and sedative infusions. ICU teams face the challenge of weaning these medications, balancing the risks of sedation with the potential to precipitate withdrawal symptoms. In this article, we use a clinical case to discuss our approach to weaning analgosedation in patients recovering from long-term mechanical ventilation. We believe that a protocolized, multimodal weaning strategy implemented by a multidisciplinary care team is required to reduce potential harm from both under- and over-sedation. At present, there is no strong randomized clinical trial evidence to support a particular weaning strategy in adult ICU patients, but appraisal of the existing literature in adults and children can guide decision-making to enhance the recovery of these patients.

A paradigm shift in corporate social responsibility: India’s transition from mandatory regime to the COVID-19 era

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Aparna Bhatia ◽  
Amandeep Dhawan
Keyword(s):  
Corporate Social Responsibility ◽  
Social Responsibility ◽  
Paradigm Shift ◽  
Design Methodology ◽  
Gradual Increase ◽  
Stock Exchange ◽  
Content Type ◽  
Global Pandemic ◽  
Corporate Social ◽  
Practical Implications

Purpose This study aims to examine the pattern of corporate social responsibility expenditure (CSRE) incurred by Indian companies after the inception of Companies Act 2013. It also highlights the resultant change brought in the corporate social responsibility (CSR) spends of the companies because of COVID-19 pandemic. Design/methodology/approach The CSR index provided by the Ministry of Corporate Affairs under Companies (CSR Policy) Rules 2014, is adopted to measure the extent of CSRE made by top 30 Indian companies listed on Bombay Stock Exchange. To study the pattern of CSRE in various domains mentioned in the CSR index, the study is conducted over four points of time. Three alternative years since the commencement of the Companies Act 2013 i.e. 2014–2015, 2016–2017 and 2018–2019 have been taken up. Additionally, the financial year 2019–2020 is included as it marks the inception of the COVID-19 pandemic. Findings The findings show that the CSRE made by companies is increasing every year over all points of time taken in the study. In addition to this, Indian companies have voluntarily contributed a substantial amount towards COVID-19 relief over and above the required mandatory limits. Practical implications The gradual increase in CSR contributions even above the mandated amount and voluntary contribution towards COVID-19 relief by Indian companies implies that the nature of CSR in India is still philanthropic. Originality/value The study contributes to the CSR literature after the implementation of the mandatory CSR provisions in India and in the wake of the global pandemic caused by COVID-19 as so far there is no such study available in the extant literature.

Nursing assessment

2021 ◽  
pp. 201-210
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Clinical Practice ◽  
Physical Examination ◽  
General Health ◽  
Nutritional Assessment ◽  
Health Assessment ◽  
Digital Rectal Examination ◽  
Assessment Methods ◽  
Patient History ◽  
Nursing Assessment ◽  
Rectal Examination

The nursing assessment chapter explores the essential processes required to enable nurses to effectively assess patients and subsequently plan care. Undertaking a general patient history is important to determine a general health assessment. Additionally, there are a number of additional assessments that can be undertaken to gain greater understanding of specific gastrointestinal systems, such as a gastrointestinal assessment, a liver assessment, or a nutritional assessment. After performing an assessment through the use of questions, to gain more details about the patient and any condition they might be presenting with, a physical examination is necessary of the abdomen and rectum; a digital rectal examination may be undertaken. Succinct explorations on the various assessment methods that nurses use to evaluate the needs of patients can be reviewed when necessary within clinical practice by the nurse.

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