I sometimes like to open my posts with a joke. But not this time. There isn't a joke for this.Mrs. Dalai has cancer.How's that for a kick in the ass? I am neither vain nor arrogant enough to think that I could write the ultimate treatise on dealing with a loved one's cancer. There are any number of engaging stories out there on Caring Bridge and the like. You don't want to read a tear-jerker anyway, nor do you want to endure every last boring and/or gory detail. Mrs. Dalai would be very upset with me if I shared all that. Hell, she's probably going to be upset with me for writing this at all. She is a very private person, and does not like any of her personal details floating out there in cyberspace. Unlike me, of course. What Ican deliver is a sort of gestalt, a seat-of-the-pants level series of vignettes, of observations, of feelings. Perhaps a few do's and don'ts for friends of those going through such things. In other words, I'm going to start typing and we'll see what comes out. As usual. So...Where to start? Mrs. Dalai had upper respiratory symptoms periodically throughout the Fall of last year. Naturally, we worried about COVID-19, but we weren't as petrified over the possibility as her then-internist, who wouldn't let her in the door without a negative COVID test. And another one. And ANOTHER one. And eventhen, he referred her to the ER rather than risk her coming in the office. As you might guess, he is no longer her internist.We did finally get ...
AbstractChronic thromboembolic pulmonary hypertension is an underdiagnosed condition. Patients typically present with the symptoms of right heart failure. Diagnosis is usually done by radionuclide ventilation/perfusion (VQ) scan, high-quality multidetector computed tomography (CT) or pulmonary angiography at expert centers. Pulmonary endarterectomy remains the corner stone in management of chronic thromboembolic pulmonary hypertension. Deep hypothermic circulatory arrest is commonly used for the operation at most centers. In-hospital mortality ranges from 1.7 to 14.2%. Pulmonary hemorrhage, reperfusion lung injury, and rig...
ConclusionsWe established the feasibility of initiating and managing patients in a monthly text-based symptom-monitoring program. The provision of smartphones and patient navigation were unique and vital components of this program.
ConclusionsInformatics solutions can generate timely, tailored office reports including PROs and predictive analytics. Patients successfully complete the pre-visit PRO assessments and clinicians and patients value the report to support shared surgical decisions.
ConclusionMultilevel IS frameworks are necessary for PROM/PREM implementation given the complexity. In cross-study comparisons, barriers to PROM/PREM implementation were consistent across patient populations and care settings, but enablers were context specific, suggesting the need for tailored implementation strategies based on clinic resources. Theoretically guided studies are needed to clarify how, why, and in what circumstances IS principles lead to successful PROM/PREM integration and sustainability.
ConclusionThis study was the preparatory phase for a future trial on a method to stimulate setting specific goals. The future trial would provide a thorough understanding of the quality of person-defined goals.
ConclusionPatients recovering at home following major cancer surgery regarded electronic symptom-monitoring and feedback as acceptable and beneficial. Patients perceived that the system enhanced information provision and provided a direct link to their care team. Patients felt that the system provided reassurance at a time of uncertainty and isolation, enabling them to feel in control of their symptoms and recovery.
ConclusionElectronic patient-reported outcomes are perceived as valuable for variable reasons by Black and White cancer populations, with greater perceived value for communicating with clinicians reported among Blacks. To optimize equitable uptake of ePROs, oncology practices should offer several ePRO options (e.g., web-based, phone-based), as well as paper-based options, and consider the e-health literacy needs of patients during implementation.
COVID-19 deaths per day have begun to creep back up again after a decline that started in late September.Associated Press
The federal government will open the US to international travelers again if they are fully vaccinated and can prove it. For others, exemptions are limited.Medscape Medical News
I don’t do Twitter cause social media is cancer so I will post here instead: 1. Social justice - we need more diversity in the specialty and need to stop the white male micro aggressions and unconscious biases. 2. Burnout - this needs to improve. What better way to do this than academic expansion and consolidation? As we all know physicians in academic satellites are deliriously happy, content and have a major say in what their RN/MBA overlords wish to do. 3. Jobs - Potters tweeted... Read more
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