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The Nutrition-Focused History and Physical Examination (NFPE) in Malnutrition
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Diminished functional status as by handgrip strength. Malnutrition affects energy metabolism and depletes muscles of fuel. The handgrip is an easy and reliable measure of this. Simply asking the patient to give you a firm handshake is a good bedside tool. But handgrip can also be quantified with a dynamometer. Handgrip should be measured in the dominant hand with the patient sitting upright or standing and the forearm at a right angle to the upper arm. A number of tables exist for normal dynamometer measurements by age and gender (Werle et al. 2009).
What Promotes Joy
Published in Eve Shapiro, Joy in Medicine?, 2020
Here’s another story I had with a student. We saw a patient; I don’t remember what his problem was. The student took a very thorough history and when he got to his educational history, he asked, “How far did you get in school?” The patient said, “11th grade.” I waited until we were all done and were ready to walk out of the room and I told the patient, “Listen to me. You’re obviously a smart guy. There’s no question in my mind. Would you mind telling me why you left school in 11th grade? You had one more year till you graduated.” He said, “Because I was a dumb kid.” I said, “Well you’re not a dumb kid now. What are you going to do about it?” He said, “I have a number. I know where to call.” And I said, “Okay. I want you to shake my hand and promise me you’re going to do it.’” In medicine the handshake is a very important thing. Sometimes people won’t shake your hand; that tells you something. And he shook my hand and said, “I’m going to do it!”
An American Art Therapist in France
Published in Audrey Di Maria, Exploring Ethical Dilemmas in Art Therapy, 2019
While a handshake is considered the appropriate greeting in any clinical situation in France, members of my cancer patient group kissed each other and me on both cheeks upon entering and leaving sessions. Although kissing patients is regarded as a boundary violation by US standards, may we view this parameter from a cultural and therapeutic, as well as an ethical, vantage point?
COVID-19: a wreak havoc across the globe
Published in Archives of Physiology and Biochemistry, 2023
Heena Rehman, Md Iftekhar Ahmad
The first case of coronavirus reported in Wuhan was the person who visited Chinese ‘wet’ food market. As a preventive measure, the Chinese authorities closed seafood market. However, strict control over those markets is recommended by scientist instead of just forbidding it. Another urgent need of the hour is providing protection to the healthcare professionals against nosocomical infections. Surgical masks are not sufficient for healthcare professional; rather they need personal protective equipment (PPE) including N95 masks, protective gowns and goggles (Chang et al. 2020b). For general public, avoiding handshakes, maintaining social distancing (at least 2 m), washing hands frequently, sneezing and coughing etiquette, avoiding touching of mouth, eyes and nose, and wearing masks are recommended (Wang C et al. 2020a). Cleaning and disinfecting the touched objects and surfaces frequently is also recommended. Other preventive measures such as limiting the movement of people to and fro from red zones of infections, isolation of patients, and avoiding consumption of meat play significant role in controlling the disease.
Family medicine in times of ‘COVID-19’: A generalists' voice
Published in European Journal of General Practice, 2020
An de Sutter, Carl Llor, Manfred Maier, Christian Mallen, Athina Tatsioni, Henk van Weert, Adam Windak, Jelle Stoffers
Family doctors also are dealing with new forms of stress. Many of us feel ill at ease with the new ways of working. As generalists, we are used to assessing health complaints based on our knowledge of the patient as well as our observations: what we see and hear is vital. Non-verbal communication, as well as physical examination, are essential tools to our practice. Now, however, we need to make decisions without seeing the patient and sometimes even without knowing him or her. The answer to a question like ‘Are these chest complaints due to COVID-19 or could it be heart failure?’, now needs to be answered by means of a mere phone call. The care of patients suffering the burden of chronic disease is transformed from a holistic, multi-professional service into merely providing prescriptions and making the occasional phone call. Even if we – and our patients – have the capacity to make video calls, it is difficult to assess whether a COPD patient’s condition is exacerbating, whether the diabetes still is under control, or if the medication we started a few days ago is effective and is well tolerated. Home visits are avoided as much as possible. When family doctors do see a patient, we need to protect ourselves with masks, goggles and a protective coverall, and we can only touch patients while wearing gloves. Greeting a patient with a warm handshake seems to belong to an era long past. This detached way of seeing patients seems vastly unsuited to a profession in which the doctor’s relationship of trust with the patient is crucial.
Smartphone addiction across the lifetime during Italian lockdown for COVID-19
Published in Journal of Addictive Diseases, 2021
Pasquale Caponnetto, Lucio Inguscio, Sara Valeri, Marilena Maglia, Riccardo Polosa, Carlo Lai, Giuliana Mazzoni
The COVID-19 pandemic has shocked the majority of the world's population both in everyday life and in relationships. Suddenly the possibility of hugging and kissing was forbidden, even a handshake was an indication of danger and a vector of contagion. In order to contain the spread of the virus as much as possible, a series of "drastic" measures were set up, first of all the now famous "Lockdown"21. This imposition has led to social/physical distancing, the restrictions of personal freedom, the self-imposed choice and/or imposed social isolation to avoid contagion, the measures of social distancing, all measures that had a powerful impact on interpersonal relationships.