Clinical empathy in GP-training: Experiences and needs among Dutch GP-trainees. "Empathy as an element of personal growth".

Objective: Clinical empathy has been described as a key component of effective person-centeredness in patient-physician communication. Yet little is known about general practitioner (GP) trainees' experiences and opinions regarding clinical empathy, empathy-education and the development of empathic skills. This study aimed to explore trainees' experiences with clinical empathy during GP training.

[Meeting, attention and equivalence, the value of the doctor-patient consultation].

The concepts of individualised care and continuity are used in many ways in healthcare. However, these concepts are in conflict with actual choices in healthcare which focus mainly on efficiency, standardization and productivity. In this perspective paper, we analyse the thoughts of three philosophers - Levinas, Baart and Nussbaum - on the important starting points of the doctor-patient consultation.

Empathy in general practice-the gap between wishes and reality: comparing the views of patients and physicians.

Background: Empathy is regarded by patients and general practitioners (GPs) as fundamental in patient-GP communication. Patients do not always experience empathy and GPs encounter circumstances which hamper applying it.

Objective: To explore why receiving and offering empathy during the encounter in general practice does not always meet the wishes of both patients and GPs.

Consequences of the presence and absence of empathy during consultations in primary care: A focus group study with patients.

Objective: There is general consensus that explicit expression of empathy in patient-GP communication is highly valued. Yet, little is known so far about patients' personal experiences with and expectations of empathy. Insight into these experiences and expectations can help to achieve more person-centeredness in GP practice care.

Managing barriers to empathy in the clinical encounter: a qualitative interview study with GPs.

Background: Current daily general practice has become increasingly technical and somatically oriented (where attention to patients' feelings is decreased) due to an increase in protocol-based guidelines. Priorities in GP-patient communication have shifted from a focus on listening and empathy to task-oriented communication.

Aim: To explore what barriers GPs experience when applying empathy in daily practice, and how these barriers are managed.

Regional heterogeneity in the reactivity of equine small pulmonary blood vessels.

Regional differences in large equine pulmonary artery reactivity exist. It is not known if this heterogeneity extends into small vessels. The hypothesis that there is regional heterogeneity in small pulmonary artery and vein reactivity to sympathomimetics (phenylephrine and isoproterenol) and a parasympathomimetic (methacholine) was tested using wire myography on small vessels from caudodorsal (CD) and cranioventral (CV) lung of 12 horses [9 mares, 3 geldings, 8.

Empathy: what does it mean for GPs? A qualitative study.

Background: Research has highlighted empathy as an important and effective factor in patient-physician communication. GPs have extensive practical experience with empathy. However, little is known about the personal views of GPs regarding the meaning and application of empathy in daily practice.

Lung region and racing affect mechanical properties of equine pulmonary microvasculature.

Exercise-induced pulmonary hemorrhage is a performance-limiting condition of racehorses associated with severe pathology, including small pulmonary vein remodeling. Pathology is limited to caudodorsal (CD) lung. Mechanical properties of equine pulmonary microvasculature have not been studied.

Airborne particulates (PM10) and tracheal mucus: A case-control study at an American Thoroughbred racetrack.

Reasons For Performing Study: Particle mapping within stalls has demonstrated a relationship between particulate concentrations and visible accumulations of tracheal mucus. However, measurement of breathing zone particulate concentrations, which is the most accurate way to measure exposure, has not been performed to determine the relationship between exposures and accumulations of tracheal mucus sufficient to affect performance.

Objectives: To compare breathing zone particulate exposures between horses with tracheal mucus scores (MS) previously demonstrated to affect performance (MS≥2) and those without (MS = 0) visible tracheal mucus.

Effects of exercise on markers of venous remodeling in lungs of horses.

Objective: To determine the effects of 2 weeks of intense exercise on expression of markers of pulmonary venous remodeling in the caudodorsal and cranioventral regions of the lungs of horses.

Animals: 6 horses.

Procedures: Tissue samples of the caudodorsal and cranioventral regions of lungs were obtained before and after conditioning and 2 weeks of intense exercise.

Ultrasound-guided biopsy of the cricoarytenoideus lateralis muscle: technique and safety in horses.

Reasons For Performing Study: Current diagnosis of recurrent laryngeal neuropathy (RLN) depends upon disease recognition in the clinically affected horse. Biopsy of the intrinsic laryngeal muscles may provide a method to identify the changes in fibre-type composition that occur in RLN before clinical signs become apparent.

Objective: To develop an ultrasound-guided biopsy technique of the left cricoarytenoideus lateralis muscle (CALM) and evaluate its efficacy and safety in vivo.

Distribution of venous remodeling in exercise-induced pulmonary hemorrhage of horses follows reported blood flow distribution in the equine lung.

Exercise-induced pulmonary hemorrhage (EIPH), which has been reported in humans and a variety of domestic animals following strenuous exercise, is most often documented in racehorses. Remodeling of pulmonary veins (VR) in equine EIPH was recently described, suggesting that it contributes to the pathogenesis of the disease. The cause of VR is unknown.

Effectiveness of empathy in general practice: a systematic review.

Background: Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice. This literature review explores the effectiveness of empathy in general practice.

Local airborne particulate concentration is associated with visible tracheal mucus in Thoroughbred racehorses.

Reason For Performing Study: Accumulations of tracheal mucus assessed by endoscopic examination are associated with poor performance in racehorses. The air quality in horses' stalls may contribute to this visible tracheal mucus.

Objectives: To determine whether the concentration and number of airborne particulates in stalls are associated with visible accumulations of tracheal mucus and with the number of inflammatory cells in tracheal aspirates.

Exercise-induced pulmonary hemorrhage in horses: the role of pulmonary veins.

While airway endoscopy and bronchoalveolar lavage are the methodsof choice for diagnosing exercise-induced pulmonary hemorrhage (EIPH), these techniques do not allow accurate evaluation of the severity of bleeding. EIPH pathology is characterized by occlusive remodeling of pulmonary veins. Affected veins have large collagen deposits in their walls, which reduces their lumens.

Cervical vertebral canal endoscopy in a horse with cervical vertebral stenotic myelopathy.

A 3-year-old Thoroughbred gelding presented with a history of neurological signs, including incoordination in his hindlimbs, of about 7 months' duration. On initial examination, the horse exhibited ataxia and paresis in all limbs with more severe deficits in the hindlimbs. Cervical radiographs displayed severe osteoarthritis of the articular processes between C5 and C6.

Particle mapping in stables at an American Thoroughbred racetrack.

Reasons For Performing Study: Airway inflammation and mucus in the trachea are common in racehorses. Fine airborne particles can initiate and coarse particles can worsen airway inflammation in man and in animal models of airway disease. The regional and seasonal distribution of particles of different sizes has never been investigated in American racing stables.

Cervical vertebral canal endoscopy in the horse: intra- and post operative observations.

Reasons For Performing Study: Despite modern medical diagnostic imaging, it is not possible to identify reliably the exact location of spinal cord compression in horses with cervical vertebral stenotic myelopathy (CVSM). Vertebral canal endoscopy has been successfully used in man and a technique for cervical vertebral canal endoscopy (CVCE) has been described in equine cadavers.

Objective: To determine the feasibility and safety of CVCE in healthy mature horses.

Repeated blood instillation into the airway of the horse does not cause pulmonary fibrosis.

Reasons For Performing The Study: Exercise-induced pulmonary haemorrhage (EIPH) occurs in nearly all strenuously exercising horses. Recent studies have attempted to identify the role of free blood within the airspaces, in the lung fibrosis that develops within the lungs of EIPH horses.

Hypothesis: Repeated exposure of the equine lung to autologous blood results in lung fibrosis similar to that observed in spontaneous EIPH.

Endoscopic anatomy of the cervical vertebral canal in the horse: a cadaver study.

Reason For Performing Study: Localisation of spinal cord compression in horses with cervical vertebral stenotic myelopathy is inexact. Vertebral canal endoscopy has been used in man to localise spinal cord lesions and has the potential to become a useful diagnostic technique in horses.

Objective: To establish a surgical approach via the atlanto-occipital space to the cervical vertebral canal in equine cadavers and describe the endoscopic anatomy of the cervical epidural and subarachnoid spaces.