One Year of Family Physicians' Observations on Working with Medical Scribes

Objective: To examine whether links between psychiatric services and family physicians can be strengthened and additional support provided for family physicians if a psychiatrist is available by phone to respond to clinical calls from family physicians. Method: A psychiatrist, who visited 18 family physicians in 5 practices on a regular basis to provide clinical consultations, was available to provide telephone backup concerning mental health problems the family physicians encountered. All calls received by the psychiatrist were documented and analysed at the end of a 12-month period. Results: Over the course of one year, 128 calls were received from the 5 practices. Fifty were considered urgent, while 78 involved more routine management or medication issues. Telephone advice enabled the family physicians to handle these cases more effectively, often reducing utilization of other mental health services and providing support that was not otherwise available. The average time spent per call was 8 minutes, which meant the psychiatrist was only spending 20 minutes per week on the phone responding to family physicians' requests. Conclusion: Providing telephone backup to family physicians is a time-efficient and effective method of supporting family physicians and reducing utilization of mental health services. It is applicable to psychiatrists working in any clinical setting.

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Changes in Opioid Prescribing Behaviors among Family Physicians Who Participated in a Weekly Tele-Mentoring Program

Journal of Clinical Medicine ◽

10.3390/jcm9010014 ◽

2019 ◽

Vol 9 (1) ◽

pp. 14 ◽

Cited By ~ 1

Author(s):

Santana Díaz ◽

Jane Zhao ◽

Shawna Cronin ◽

Susan Jaglal ◽

Claire Bombardier ◽

...

Keyword(s):

Index Date ◽

Family Physicians ◽

High Dose ◽

Mentoring Program ◽

Matched Cohort ◽

Healthcare Outcomes ◽

Control Groups ◽

Opioid Prescribing ◽

Number Of Patients ◽

One Year

A weekly tele-mentoring program was implemented in Ontario to help address the growing opioid crisis through teaching and mentoring family physicians on the management of chronic pain and opioid prescribing. This study assessed opioid prescribing behaviours among family physicians who attended the tele-mentoring program compared to two groups of Ontario family physicians who did not attend the program. We conducted a retrospective cohort study with two control groups: a matched cohort, and a random sample of 3000 family physicians in Ontario. Each physician was followed from one year before the program, which is the index date, and one year after. We examined the number and proportion of patients on any opioid, on high dose opioids, and the average daily morphine equivalent doses prescribed to each patient. We included 24 physicians who participated in the program (2760 patients), 96 matched physicians (11,117 patients) and 3000 random family doctors (374,174 patients). We found that, at baseline, the tele-mentoring group had similar number of patients on any opioid, but more patients on high dose opioids than both control groups. There was no change in the number of patients on any opioid before and after the index date, but there was a significant reduction in high-dose opioid prescriptions in the extension for community healthcare outcomes (ECHO) group, compared to a non-significant increase in the matched cohort, and a non-significant reduction in the Ontario group during the same comparable periods. Participation in the program was associated with a greater reduction in high-dose opioid prescribing.

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Prevalence and Characteristics of Insomnia Problems Among Adults in Central Istria

Archives of Psychiatry Research ◽

10.20471/dec.2021.57.02.03 ◽

2021 ◽

Vol 57 (2) ◽

pp. 147-158

Author(s):

Tina Zavidić ◽

Valerija Bralić Lang

Keyword(s):

Sleep Disturbances ◽

Family Physicians ◽

Sleep Apnoea ◽

Daytime Functioning ◽

Ideal Position ◽

Sociodemographic Data ◽

High Prevalence ◽

Care Family ◽

One Year ◽

Insomnia Symptoms

Aim: We sought to examine the frequency and characteristics of insomnia among adults in central Istria, as well as to analyse sociodemographic characteristics and explore whether there is an association between symptoms of insomnia and sociodemographic parameters. Methods: This research included 685 participants that visited family medicine offices (FMOs) in Central Istria from September till December 2016. Mean age of the sample was 52.73 ± 17.93 years. Participants were randomly selected and interviewed and all gave their informed consent. Participants with sleep disturbances and insomnia lasting one year prior to study enrolment were assessed using the questionnaire designed for the study; along with gathering of sociodemographic data. Results: More than half of the participants had insomnia, 30% of them each night or several times a week, mostly older participants and women. Regardless of the frequency of insomnia symptoms, all participants reported great impairment in all areas of daytime functioning. The most frequent incidence of insomnia was associated with more frequent sleep apnoea and less frequent bruxism. Frequent night awakenings and restless legs syndrome were not related to a greater incidence of insomnia. Conclusion: Insomnia is a common problem among patients treated in primary care. Family physicians are therefore in an ideal position to identify, evaluate and treat insomnia. The high prevalence of insomnia highlights the need for a more adequate recognition and treatment of this psychiatric illness.

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Between ‘Savage Man’ and ‘Most Faithful Englishman’ Manteo and the Early Anglo-Indian Exchange, 1584–1590

Itinerario ◽

10.1017/s0165115300044545 ◽

2000 ◽

Vol 24 (2) ◽

pp. 146-169 ◽

Cited By ~ 1

Author(s):

Michael Leroy Oberg

Keyword(s):

North Carolina ◽

Chesapeake Bay ◽

One Year ◽

Anglo Indian

In August of 1587 Manteo, an Indian from Croatoan Island, joined a group of English settlers in an attack on the native village of Dasemunkepeuc, located on the coast of present-day North Carolina. These colonists, amongst whom Manteo lived, had landed on Roanoke Island less than a month before, dumped there by a pilot more interested in hunting Spanish prize ships than in carrying colonists to their intended place of settlement along the Chesapeake Bay. The colonists had hoped to re-establish peaceful relations with area natives, and for that reason they relied upon Manteo to act as an interpreter, broker, and intercultural diplomat. The legacy of Anglo-Indian bitterness remaining from Ralph Lane's military settlement, however, which had hastily abandoned the island one year before, was too great for Manteo to overcome. The settlers found themselves that summer in the midst of hostile Indians.

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Some Biological Applications of High Voltage Electron Microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100051505 ◽

1974 ◽

Vol 32 ◽

pp. 298-299

Author(s):

Hans Ris

Keyword(s):

High Voltage ◽

Chromosome Structure ◽

Nerve Fibers ◽

Good Resolution ◽

High Voltage Electron Microscopy ◽

Voltage Electron ◽

University Of Wisconsin ◽

High Voltage Electron ◽

One Year ◽

The University

The High Voltage Electron Microscope Laboratory at the University of Wisconsin has been in operation a little over one year. I would like to give a progress report about our experience with this new technique. The achievement of good resolution with thick specimens has been mainly exploited so far. A cold stage which will allow us to look at frozen specimens and a hydration stage are now being installed in our microscope. This will soon make it possible to study undehydrated specimens, a particularly exciting application of the high voltage microscope.Some of the problems studied at the Madison facility are: Structure of kinetoplast and flagella in trypanosomes (J. Paulin, U. of Georgia); growth cones of nerve fibers (R. Hannah, U. of Georgia Medical School); spiny dendrites in cerebellum of mouse (Scott and Guillery, Anatomy, U. of Wis.); spindle of baker's yeast (Joan Peterson, Madison) spindle of Haemanthus (A. Bajer, U. of Oregon, Eugene) chromosome structure (Hans Ris, U. of Wisconsin, Madison). Dr. Paulin and Dr. Hanna are reporting their work separately at this meeting and I shall therefore not discuss it here.

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Osseointegration interface of calcified bone and endosseous implants

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100130110 ◽

1992 ◽

Vol 50 (2) ◽

pp. 1096-1097

Author(s):

K.E. Krizan ◽

J.E. Laffoon ◽

M.J. Buckley

Keyword(s):

Structure And Function ◽

Titanium Implants ◽

En Bloc ◽

Endosseous Implants ◽

Ultrastructural Studies ◽

The Past ◽

Cacodylate Buffer ◽

One Year ◽

And Function

With increase use of tissue-integrated prostheses in recent years it is a goal to understand what is happening at the interface between haversion bone and bulk metal. This study uses electron microscopy (EM) techniques to establish parameters for osseointegration (structure and function between bone and nonload-carrying implants) in an animal model. In the past the interface has been evaluated extensively with light microscopy methods. Today researchers are using the EM for ultrastructural studies of the bone tissue and implant responses to an in vivo environment. Under general anesthesia nine adult mongrel dogs received three Brånemark (Nobelpharma) 3.75 × 7 mm titanium implants surgical placed in their left zygomatic arch. After a one year healing period the animals were injected with a routine bone marker (oxytetracycline), euthanized and perfused via aortic cannulation with 3% glutaraldehyde in 0.1M cacodylate buffer pH 7.2. Implants were retrieved en bloc, harvest radiographs made (Fig. 1), and routinely embedded in plastic. Tissue and implants were cut into 300 micron thick wafers, longitudinally to the implant with an Isomet saw and diamond wafering blade [Beuhler] until the center of the implant was reached.

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Effectiveness of a 24-hour nicotine patch in conjunction with a cognitive behavioural programme: one year outcome transdermal

Addiction ◽

10.1046/j.1360-0443.1997.921274.x ◽

1997 ◽

Vol 92 (1) ◽

pp. 27-31

Author(s):

Robyn L. Richmond ◽

Linda Kehoe ◽

Abilio Cesar De Almeida Neto

Keyword(s):

Nicotine Patch ◽

Cognitive Behavioural ◽

One Year

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Resources: Internet Resources for the Independent Medical Evaluator – 2007

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2007.julaug02 ◽

2007 ◽

Vol 12 (4) ◽

pp. 4-7

Author(s):

Christopher R. Brigham ◽

Jenny Walker

Keyword(s):

Head Trauma ◽

Clonic Seizure ◽

Acute Subdural Hematoma ◽

Orbital Fracture ◽

Orbital Wall ◽

First Occurrence ◽

One Year ◽

The One ◽

Neurological Injuries ◽

Medial Orbital Wall

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.

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