The Role of Patient and Physician in Establishing Patient-Physician Communication in the In-Patient Environment

Communication in the in-patient environment is crucial, and the relationship between a patient and physician can enhance patient health and improve overall wellness. Patients need to feel confident with their abilities in order to feel comfortable conversing with physicians, which would thus improve health and treat symptoms more effectively. This communication has decreased over time, hence patients are often are unable to obtain medical information from their healthcare providers. Are there psychological factors involved in a patient’s inability to communicate with a physician? What is the relationship between self-esteem and quality of patient-physician communication? In addition, what can physicians do to ensure increased patient comfort in the medical environment? Various factors can affect the patient’s comfort with the physician, and when addressed, these factors can help improve patient-physician communication. For this paper, articles were analyzed that explored the effects of language barriers on patient-physician communication, and these articles showed that the patient can feel intimidated and later inadequate when forced to be dependent on others to voice his concerns. Articles that showed the role of social support in the medical environment were also analyzed and these showed that a sense of belonging in one’s family or community help a patient find the encouragement needed to help cope with his medical concerns. Lastly, articles were analyzed that connect the role of increased time online to communication. While the patient can be increasingly independent because of the Internet, a large use of such technology decreases patient-physician communication. This also puts the patient at risk of misinformation as he may expose himself to false information and incorrectly treat symptoms. All of these aspects lead to a disparity in self-esteem that decreases the patient’s comfort with the physician. As the patient feels unable to voice his concerns properly to the healthcare provider, the physician needs to take more responsibility in this situation as he has the ability to create a comforting environment for the patient. Physicians need to take a more active role in patients’ lives and provide more resources to communicate their concerns effectively. This will help patients feel a sense of security and comfort in the medical environment, and this change will thus enable patients to work alongside their physicians in managing their health to allow improvement of communication as well as overall patient health

Interview with Pilar Quintana: Colombian writer and screenwriter

Interview with Pilar Quintana: Colombian writer and screenwrite

Physician Role in Enhancing Patient Communication

Communication in the in-patient environment is crucial, and the relationship between a patient and physician enhances patient health and wellness. Patients should feel confident with their abilities to feel comfortable conversing with physicians, which would thus treat symptoms more effectively. This communication has decreased over time, hence patients are often are unable to obtain medical information from their healthcare providers. What is the relationship between psychological factors, such as self-esteem, and quality of patient-physician communication? And can physicians ensure increased patient comfort in the medical environment? Various factors can affect the patients’ comfort with their physicians, and when addressed, these factors can help improve patient-physician communication. I explored articles that analyzed the effect of language barriers, the role of familial support in the mental strength of the patient, and the effect of increased time spent online on communication. All of these aspects lead to a disparity between the patient and the physician as the patient cannot adequately communicate himself as a result of a lack of confidence and support, thus putting the responsibility on the part of the healthcare provider. Physicians have the ability to create a comforting environment for the patient and need to take a more active role in patients’ lives and provide more resources to communicate their concerns effectively to help the patient feel secure and comfortable in the medical environment. This change will thus enable patients to work alongside their physicians in managing their health to allow improvement of communication as well as overall patient health.https://scholarscompass.vcu.edu/uresposters/1124/thumbnail.jp

Development of Microfluidic Devices for Studying Protein Conformational Dynamics via HDX/TRESI-MS

Studies of protein conformational dynamics can lead to a deeper understanding of biological functions of proteins, protein/protein interactions, catalysis and allostery. Most of the conformers involved in biological pathways are short-lived. These conformers represent challenging analytical targets since they are weakly populated at equilibrium and demand ultra-rapid online analytical techniques. To address this demand, the development of new tools that will offer enhanced time and spatial resolution in measurements is essential. Towards that end, we took advantage of microfluidics to fabricate custom polymeric devices that would allow direct mass spectrometric measurements of protein dynamics. This dissertation presents successful development of new tools and demonstrates their practical applications in studying dynamics of weakly structured regions of proteins on the millisecond time scale, which is unattainable by conventional biophysical techniques. This thesis introduces a simple, rapid, inexpensive and easily modifiable fabrication protocol which enables the integration of multiple functionalities on a single platform that accommodates complete ‘bottom up’ continuous/pulse labelling Hydrogen-deuterium exchange (HDX) work flow. These integrated devices can be directly interfaced with mass spectrometry as custom electrospray ionization (ESI) sources to conduct site specific mass spectrometric protein conformational analysis. The continuous HDX labelling device enables structural analysis of ubiquitin and distinguishes loop dynamics in cytochrome c. The effect of ligand binding in conformational dynamics in a molten globule protein DAHP synthase was also monitored via continuous HDX labelling. Another analogous device, capable of performing millisecond HDX pulse labelling, reveals allosteric hot spots in TEM-1 which is an antibiotic resistant β-lactamase. Complementary experiments with multiple antibiotics compare the allosteric responses of TEM-1 upon inhibitor or substrate binding. The results exhibit an exciting correlation between allosteric dynamic responses and functionally relevant mutations at the periphery of the protein. This strong correlation demonstrates that this device can be applied in predicting sites of probable mutations. This dissertation successfully introduces integrated microfluidic devices that represent a promising tool for studying dynamics of weakly structured proteins, intrinsically disordered proteins and allostery

Primary fatty acid amides in mammalian tissues: Isolation and analysis by HPTLC and SPE in conjunction with GC/MS

Primary fatty acid amides (PFAM\u27s) are a novel class of bio-active lipids present in mammals in trace level. Selective isolation of PFAM\u27s from lipid extracts is crucial for obtaining them in pure and concentrated form for interference-free instrumental detection and analysis. Synthesis of these commercially unavailable lipids is also important for method development and quantitative analysis by instrumental means. In this study a wide variety of long chain saturated and unsaturated primary fatty acid amides were synthesized and characterized. This list includes the positional and geometrical isomers of naturally abundant PFAM\u27s. Two isotopically enriched PFAM\u27s were also synthesized which are important for establishing the fragmentation patterns of the amides by mass-spectral analysis as well as for use as internal standards in quantitative analyses. The separation of saturated and some unsaturated amides was obtained using a non polar HP-5MS column. A more polar column, BPX70, was employed for the separation of the geometric and positional isomers of the unsaturated amides. Two methods for the isolation of PFAM\u27s from lipid extracts were developed and validated. First method is a high performance thin layer chromatography (HPTLC), which was found to be efficient in quick profiling of different lipid classes present in a total lipid extract. Any lipid class of choice can also be further analyzed by scraping it off the HPTLC plates. The second method is a solid-phase extraction (SPE) for selectively extracting the amides in a single fraction by a specific elution solvent from a normal phase column. This fraction can be dried and brought to the desired concentration for further instrumental analysis. Lowest mass of amides to be loaded and recovered by SPE was also optimized. Both HPTLC and SPE amide isolation methods were validated using the total lipids extracted from N18TG2 mouse neuroblastoma cell line. The detection limits of the amides by gas chromatography/mass spectrometry (GC/MS) were found to be in the order of 5-30 pg. PFAM\u27s isolated from rabbit brain and heart tissues by these methods were identified as palmitamide, stearamide and oleamide. Trace amounts of linoleamide and eicosenoamide were also observed in brain tissues