In the Limelight: July 2021

This month’s feature highlights three articles that appear in the current issue of Mayo Clinic Proceedings. These are also featured on Proceedings’ YouTube Channel (https://youtu.be/MT3ZFDAOKYU). Trust is cornerstone any mutually fulfilling, meaningful human relationship into which one willingly and knowingly enters. As wonderfully discussed by Berry et al Proceedings, importance need for trust especially applicable to health care services, founded as they a particular relationship, this case, patient-provider/health professional relationship. begin their discussion underscoring concept trust, its totality context, includes not just patient’s confidence competence expertise professionals, but hope partnership will be achieved with providers, characterized provision relational medical (as distinct from transactional care), personalized care, shared decision-making, patient-centric focus. identify four interlinked concepts underpin promote trust-based partnerships patients care. The first empathetic creativity reflects commitment seek ability adopt innovative approaches caring patients, when conventional ones prove wanting. second discretionary effort voluntary giving service beyond what usually expected or minimally required, so patient well-being. third seamless represents ready integration marshalling resources attentive address at hand, both immediate far-ranging ramifications. And fourth fear mitigation alleviate disquietude, emotional distress, fear, all may accompaniments illness. delineate number pursued systems partnership-based these include: instilling requisite culture dedicated including informed trust; emphasizing values virtues well skills individuals who recruited hired; promoting continuous learning; attentiveness effective communication; providing readily accessible assist patients; pursuing evidence-based design facilities trust. For each partnerships, provide telling anecdotes vignettes illustrate significance impact. Special Article concludes broadly outlining: 1) key issues impair vitality realization mission adverse profound repercussions clinician burnout; 2) how true can reclaimed strengthened such issues. physicians, we privileged opportunity responsibility serving our patients. privilege granted us, individual leadership levels systems, inspires obligates us best healing In regard, underscore foundational systems. LL, Awdish RLA, Letchuman S, Dahl Steffensen K. Trust-based essential – achievable service. Clin Proc. 2021;96(7):1896-1906. doi.10.1016/j.mayocp.2021.03.035 Cardiovascular diseases (CVD) represent leading cause mortality United States, causing death every 36 seconds; heart disease accounts 1 4 deaths imposes over $200 billion annual costs (www.cdc.gov). Temporal changes CV risk factors CVD thus immense timeliness. addressed present Proceedings study Parcha analyzed data derived 2011 2017 Behavioral Risk Factor Surveillance System (BRFSS), nationally specific regions (Northeast, Midwest, South, West). BRFSS telephone-conducted, validated, health-related survey >400,000 adults regarding chronic factors; it supported Centers Disease Control Prevention (CDC) involves 50 states States. assessed cardiovascular Health Index (CVHI), latter reflecting seven indices: blood pressure, serum cholesterol, glucose, body-mass index, smoking, physical activity, diet. was determined variable (based score 7 indices) categorical (categorized ideal, intermediate, poor, reflected >5, 3-5, <3 indices, respectively). Age-adjusted using CDC Wide-Ranging Online Data Epidemiologic Research. analysis demonstrates that, time frame examined, there quite modest, clinically insignificant improvement CVHI, less than 6 geographic had ideal health. While prevalence dyslipidemia, coronary disease, smoking declined, obesity inactivity increased. Geographic differences CVHI were apparent, southern States exhibiting lowest highest mortality. region exhibited (hypertension, diabetes, hypercholesterolemia, obesity, inactivity), stroke. Discussion, outline contribute observed trends mortality, increasing inactivity; uneven reduction disease; access affordability care; public interventions; socioeconomic effect race ethnicity race/ethnicity-associated inequities important timely because underscores relatively low generally exists States; renewed emphasis national initiatives targeting known CVD; policies regional disparities V, Kalra R, Suri SS, al. variation among American adults. 2021;96(7):1770-1781. doi.org/10.1016/j.mayocp.2020.12.034 Vanichkachorn report clinical features 100 evaluated managed June 1, 2020, December 31, COVID-19 Activity Rehabilitation Program Clinic. multidisciplinary program evaluation management symptoms arising after prior episode COVID-19. major presenting population included fatigue, respiratory neurologic symptoms, disruption sleep, impairment mental acuity presented approximately 3 months COVID-19, majority being women (approximately two-thirds population), mean age 45 years. population, 75% did experience severe enough require hospitalization, conditions recognized uncommon, one-quarter conditions. Functional common more 80% experiencing difficulties household chores, work-related tasks, driving, other activities; one-third unable resume usual work routine responsibility; challenged performing activities daily living. discussing findings emphasize following considerations. First, post-COVID-19 syndrome differ those develop moderate younger relative absence pre-existing Second, predisposing conditions, difficult predict likelihood developing syndrome. Third, results testing normal non-diagnostic, argue discerning prudent use diagnostic testing. caveat, perhaps, autonomic 12 tests abnormal; where indicated, referral neurology considered. Fourth, occupational therapy, brain rehabilitation select aid light frequency functional acuity, respectively. Fifth, psychosocial support play significant role recovery view depression, anxiety, pertaining affirms existence elucidates post (Long Haul) made clear al, physically, emotionally, functionally debilitating, interplay ailments chronicity intractability. Recognizing understanding integrated programs effectively treat critically important. colleagues meeting objectives. G, Newcomb Cowl CT, Post (long haul syndrome): description clinic characteristics initial cohort. 2021;96(7):1782-1791. doi.org/10.1016/j.mayocp.2021.04.024 Trust-Based Partnerships Are Essential — Achievable Care ServiceMayo ProceedingsVol. 96Issue 7PreviewWhen people think about context typically focus whether doctors professionals. But reach full potential service, must include notion partnership, whereby see clinicians reliable, caring, decision-makers ongoing “healing” broadest sense. Four interrelated service-quality central fostering care: creativity, effort, mitigation. Full-Text PDF Variation Among AdultsMayo 7PreviewTo evaluate contemporary distribution Post–COVID-19 Syndrome Haul Syndrome): Description Multidisciplinary Characteristics Initial Patient CohortMayo describe series reporting prolonged an infection coronavirus 2019 (COVID-19).