scholarly journals Value of a Detailed Clinical Examination

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Adverse Effects ◽  
Physical Examination ◽  
Giant Cell Arteritis ◽  
Modern Medicine ◽  
Time Constraints ◽  
Easy Access ◽  
Post Herpetic Neuralgia ◽  
Face To Face ◽  
Diagnostic Investigations

The role of a physician in modern medicine has changed in recent times. The advances in technology, easy access to modern diagnostic investigations, workload and time constraints seems to a deterrent to the physical examination skills of modern doctors [1]. There are many recent studies suggesting the failure of modern doctors to correctly identifying physical signs [2]. The restrictions on face-to-face consultations imposed by the COVID-19 pandemic adds to the challenge in examining patients. This at times induces a huge threat to patients’ safety, leading to missing vital diagnoses, unnecessary investigations, and prolonged treatments with drugs causing harmful adverse effects [4]. Here, we present a case of post-herpetic neuralgia which was misdiagnosed initially as Giant Cell Arteritis due to insufficient history and physical examination.

What is the patient's and multidisciplinary team's perspective on telephone clinics?

2021 ◽  
Vol 27 (1) ◽  
pp. 26-31
Author(s):  
Sonia Bouri ◽  
Jean-Frédéric LeBlanc ◽  
Ravi Misra ◽  
Nikolaos Kamperidis ◽  
Gabriela Poufou ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Patient Satisfaction ◽  
Physical Examination ◽  
Bowel Disease ◽  
High Patient Satisfaction ◽  
Face To Face ◽  
Inflammatory Bowel ◽  
Remote Services ◽  
Remote Care

Background/Aims During the COVID-19 pandemic, inflammatory bowel disease clinics were converted to telephone clinics at St. Mark's Hospital in Harrow. This study assessed the response of patients and clinicians to remote telemedicine services, with the view of establishing whether there was scope for increasing the role of remote services in the inflammatory bowel disease clinics. Methods Clinicians administered a questionnaire to patients at the end of their appointments regarding their opinions on the telephone clinic format. Eleven questions used a 5-point Likert scale while a further three questions asked the patient for their comments on future clinics. Clinicians provided information about the patients' condition and management, as well as their own comments. Results Overall satisfaction with telephone clinics was found to be high among patients and clinicans, with many feeling that telephone clinics were more convenient. In total, 94.3% of patients said they would prefer either all telephone or a mix of phone and face-to-face clinics in the future. However, some patients felt that it was more complicated to have blood or stool tests done and roughly a quarter of patients were concerned that something could be missed without a physical examination. Conclusions High patient satisfaction can be achieved by delivering a mix of telephone, video and face-to-face clinics. In certain clinical situations, face-to-face clinics would be appropriate, such as patients with active diseases and first appointments. The pandemic is an opportunity respond to patients' preferences by increasing the range of remote care options.

Collection of Ego-Centered Network Data with Computer-Assisted Interviews

Methodology ◽  
2006 ◽  
Vol 2 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Joachim Gerich ◽  
Roland Lehner
Keyword(s):  
Survey Methods ◽  
A Priori ◽  
Dynamic Structure ◽  
Computer Assisted ◽  
Network Data ◽  
Great Effort ◽  
Self Administration ◽  
Face To Face ◽  
Full Network

Although ego-centered network data provide information that is limited in various ways as compared with full network data, an ego-centered design can be used without the need for a priori and researcher-defined network borders. Moreover, ego-centered network data can be obtained with traditional survey methods. However, due to the dynamic structure of the questionnaires involved, a great effort is required on the part of either respondents (with self-administration) or interviewers (with face-to-face interviews). As an alternative, we will show the advantages of using CASI (computer-assisted self-administered interview) methods for the collection of ego-centered network data as applied in a study on the role of social networks in substance use among college students.

Natriuretic Peptides – Addressing the Dilemma of Heart Failure Management

2011 ◽  
Vol 7 (2) ◽  
pp. 104
Author(s):  
Kenneth McDonald ◽  
Ulf Dahlström ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Physical Examination ◽  
Natriuretic Peptides ◽  
Normal Values ◽  
Outpatient Setting ◽  
Heart Failure Management ◽  
Effective Screening ◽  
Specific Symptoms ◽  
Objective Marker

Heart failure (HF) is characterised by non-specific symptoms and unremarkable physical examination; therefore, the need exists for an available objective marker of HF status. Natriuretic peptides (NPs) are a marker that can aid the dilemmas in present-day HF management. More effective screening for clinical deterioration would include changes in brain natriuretic peptide (BNP) levels. Normal values for BNP, <50–100 pg/ml, have excellent negative predictive value (NPV) in excluding HF as a diagnosis. BNP values that are significantly elevated, e.g. >500 pg/ml, make the diagnosis of HF more likely. There are now established and emerging uses for NPs in managing HF in the community. These include the role of NPs at the time of possible new presentation of HF, its role in prognostication and, finally, the increasing interest in using NPs to guide therapy in the outpatient setting.

Participation of ABCA1 transporter in development of chronic obstructive pulmonary disease

2020 ◽  
Vol 28 (3) ◽  
pp. 360-370
Author(s):  
Stanislav N. Kotlyarov ◽  
Anna A. Kotlyarova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Significant Contribution ◽  
Modern Medicine ◽  
Lipid Homeostasis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reverse Transport ◽  
Current Paradigm

Despite all achievements of the modern medicine, the problem of chronic obstructive pulmonary disease (COPD) does not lose its relevance. The current paradigm suggests a key role of macrophages in inflammation in COPD. Macrophages are known to be heterogeneous in their functions. This heterogeneity is determined by their immunometabolic profile and also by peculiarities of lipid homeostasis of cells. Aim. To analyze the role of the ABCA1 transporter, a member of the ABC A subfamily, in the pathogenesis of COPD. The expression of ABCA1 in lung tissues is on the second place after the liver, which shows the important role of the carrier and of lipid homeostasis in the function of lungs. Analysis of the literature shows that participation of the transporter in inflammation consists in regulation of the content of cholesterol in the lipid rafts of the membranes, in phagocytosis and apoptosis. Conclusion. Through regulation of the process of reverse transport of cholesterol in macrophages of lungs, ABCA1 can change their inflammatory response, which makes a significant contribution to the pathogenesis of COPD.

Dietary Modifications in Fissure-in-ano: A Qualitative Study Based on Persian Medicine

2020 ◽  
Vol 16 (6) ◽  
pp. 860-865
Author(s):  
Sedigheh Tavakoli-Dastjerdi ◽  
Mandana Tavakkoli-Kakhki ◽  
Ali R. Derakhshan ◽  
Azam Teimouri ◽  
Malihe Motavasselian
Keyword(s):  
Modern Medicine ◽  
Integrative Approach ◽  
Future Research ◽  
Common Disease ◽  
Fissure In Ano ◽  
High Fiber ◽  
Baked Goods ◽  
Persian Medicine

Background: Anal fissure (AF) is a common disease associated with severe pain and reduced quality of life. Factors related to lifestyle, including diet and bowel habits, play a pivotal role in its pathogenesis. Most of the chronic fissures are not responsive to drugs and more likely to recur. Given the significance of diet in Persian medicine (PM), investigation on physiopathology and appropriate foods can be useful for decreases in AF symptoms and consequences. Objective: This study was intended to evaluate the role of diet in the formation and progression of AF from the perspective of PM. Methods: In this study, the most important resources of PM dating back to thousands of years were reviewed. All these textbooks contained a section on AF, its causes, and treatment. Further analysis was performed on these resources in comparison with databank and resources of modern medicine to develop a food-based strategy for AF management. Results: From the view of PM, the warmth and dryness of anus temperament accounted for AF. Both Persian and modern medicine identified constipation as another cause for AF. Therefore, avoidance from some foods and commercial baked goods was recommended. Both Persian and modern medicine forbad the following foods: potato, cabbage, cauliflower, pasta, beef, fish, and so forth. High fiber and oligo-antigen diets with some limitations have garnered more attention. Conclusion: An integrative approach is recommended employing both Persian and modern medicine for AF. There have been some evidence in this regard, however standardized clinical trials are required for future research.

Mr. and Mrs. Smith: A Student Introduction to Federal Tax Compliance and Documentation

2015 ◽  
Vol 31 (1) ◽  
pp. 119-132 ◽  
Author(s):  
Michaele L. Morrow ◽  
Shane R. Stinson
Keyword(s):  
Communication Skills ◽  
Professional Practice ◽  
Income Tax ◽  
Tax Compliance ◽  
Personal Income Tax ◽  
Initial Information ◽  
Face To Face ◽  
Client Advocacy ◽  
Tax Practice

ABSTRACT In this case, students assume the role of new accounting staff tasked with the preparation of a personal income tax return and supporting documentation for a client of their firm. Students are provided prior year work papers and client communications, a copy of the prior year's tax return, as well as a letter and supporting documents from the client for the current year. To complete the case, students generate questions based on the initial information provided, meet face-to-face with the client, and roll forward a set of electronic work papers before submitting a complete current year engagement file for senior review. This case adds work papers and client interaction to the traditional tax compliance case to reinforce both the technical and communication skills valued in professional practice. The formulation of questions for the client also allows students to practice discussing technical topics in a non-technical manner and underscores the required balance between attitudes of client advocacy stressed in professional tax practice and legal requirements for “good-faith” tax return reporting. This case is appropriate for an individual income tax course at either the undergraduate or graduate level, and can be easily adapted to increase or decrease difficulty.

Talking, Reading, and Writing on Smartphones

2020 ◽  
pp. 407-422
Author(s):  
Naomi S. Baron
Keyword(s):  
Mobile Phones ◽  
Easy Access ◽  
Reading Habits ◽  
Internet Protocols ◽  
Reading And Writing ◽  
Reading Material ◽  
Voice Calls ◽  
News Headlines ◽  
Communication Preference

Mobile phones have increasingly been transformed from speaking technologies to devices for reading and writing. Cost helped drive this shift since written short messages were historically less expensive than voice calls. A second factor was communication preference for texting over talking, especially among younger users. With ready Internet access on smartphones, reading habits began shifting as well. Social networking messages, along with other short texts such as weather reports or news headlines, made for obvious reading material, as did the plethora of longer written documents available online. The e-book revolution enabled readers to retrieve entire books on their phones. Mobile phones are also writing platforms. Developments in hardware and software dramatically simplified the input process. Instead of multi-taps, users now rely on virtual keyboards for easy access not only to alphanumeric characters and punctuation marks but also to sophisticated predictive texting and autocorrection. Interestingly, while technically we are writing when inputting text on smartphones, many users do not perceive such input as real “writing”—a term they reserve for writing by hand or with a computer. Additional writing issues include norms regarding so-called textisms, along with the role of culture in shaping attitudes regarding linguistic correctness. Many organizations are discontinuing voicemail systems in favor of written messaging. At the same time, voice over Internet protocols continue to grow, and small voice-activated social robots designed for home use are proliferating. The chapter closes by asking what the spoken–written balance on smartphones might look like in the future.

scholarly journals Eye contact effect: The role of vagal regulation and reactivity, and self-regulation of attention

2021 ◽  
Author(s):  
Alicja Niedźwiecka
Keyword(s):  
Executive Functions ◽  
Cognitive Performance ◽  
Self Regulation ◽  
Eye Contact ◽  
Autonomic Regulation ◽  
Face To Face ◽  
Effective Strategies ◽  
Contact Effect ◽  
The Individual

AbstractEye contact is a crucial aspect of social interactions that may enhance an individual’s cognitive performance (i.e. the eye contact effect) or hinder it (i.e. face-to-face interference effect). In this paper, I focus on the influence of eye contact on cognitive performance in tasks engaging executive functions. I present a hypothesis as to why some individuals benefit from eye contact while others do not. I propose that the relations between eye contact and executive functioning are modulated by an individual’s autonomic regulation and reactivity and self-regulation of attention. In particular, I propose that individuals with more optimal autonomic regulation and reactivity, and more effective self-regulation of attention benefit from eye contact. Individuals who are less well regulated and over- or under-reactive and who do not employ effective strategies of self-regulation of attention may not benefit from eye contact and may perform better when eye contact is absent. I present some studies that justify the proposed hypothesis and point to a method that could be employed to test them. This approach could help to better understand the complex mechanisms underlying the individual differences in participant’s cognitive performance during tasks engaging executive functions.

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