Week of Sept. 27, 2020

Missed a post this last week? Here is your chance to catch up!




Let’s read an article a month – October 2020

A cropped screenshot of the first page of the article.

Every month I try to read an open-access article. After reading the article, I share the tittle and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

Link to the article: https://erj.ersjournals.com/content/erj/56/2/1900495.full.pdf

Link to the blog post: https://respiratory.blog/lets-read-an-article-a-month-october-2020/

This month I found a great piece to share with you.  This one falls under original research and Tuberculosis. The objective of this paper is to “ to evaluate the EUROHIS-QOL tool for quantifying QOL in TB-affected people (patients and their contacts) versus healthy community controls, and to assess whether QOL at the time of diagnosis predicts treatment outcome, including survival. ” (p 2).  

Quality of life, tuberculosis and treatment outcome; a case-control and nested cohort study

By: Sumona Datta, Robert H. Gilman, Rosario Montoya, Luz Quevedo Cruz, Teresa Valencia, Doug Huff, Matthew J. Saunders, and Carlton A. Evans.

European Respiratory Journal 2020 56: 1900495;
DOI: 10.1183/13993003.00495-2019

Common abbreviations used in this post and article include Tuberculosis (TB), Quality of Life (QOL), and Activities of daily living (ADL).

Top 3 reasons why I enjoyed reading this article

  • It is a reminder of the impact of this disease.  Infects 10 million people annually with 1.5 million of them passing away because of it (p.2).
  • The authors express that the treatment of a condition is not just the identification and its treatment.  There are psychological and socioeconomic elements that also need to be considered. “It highlights the need to improve TB-related QOL, including the profound dissatisfaction with one’s self, relationships, global QOL, potentially worsened by TB-related distress, stigma and isolation” (p.10). 
    This article also supports the WHO recommendation “such as education and counseling to improve adherence and treatment completion” (p.11)
  • The authors were clear about the strengths and weaknesses of their article.
    (-) It was shared that QOL questionnaires are subjective (p12). 
    (+) The authors recognized the diversity in their study: “15 peri-urban shantytowns and 17 urban communities” (p.12).  

Personal thoughts and reflections

In this article, the World Health Organization’s The End TB Strategy was brought up. I located the page on the WHO’s website: https://www.who.int/tb/strategy/en/.
There is a vast amount of information available, including tabs for Strategy Pillars, Strategy Principles, Adapting the Strategy, Measuring Progress, and TB Elimination.  TB is not unique to other countries.  A 2017 Canadian government statistics showed that “4.9 per 100, 000 of the population” has active TB (https://www.canada.ca/en/public-health/services/diseases/tuberculosis/surveillance.html). I encourage you to take a moment and learn more about TB and its impact on people.

What are your thoughts on this article?  Do you have any experience treating patients with TB? 

Happy learning and reading!

Farzad Refahi

October 1st, 2020


Happy at work?

Woman giving the thumbs up.
Image by Robin Higgins from Pixabay 

Wondering what kind of employer you need to work for? Or wondering how to keep your team happy?   

Prior to the pandemic I occasionally attended networking events.  I heard an interesting mindset from a hard-working, loyal and driven presenter. He asks himself these three questions before applying for any job:

  • Would the opportunity lead to new knowledge or skillset?
  • Would the position give you access to quality mentorship and coaching?
  • Does the role and workplace rate highly on: compensation, work culture and work flexibility.   

Have you ever asked yourself what you are looking for in a workplace?  What makes you choose one offer over the other? What’s your career development look like?

Several factors play into this, including but not limited to one’s personality (intro-/extro-vert), stages in life, career goals, financial needs, work-life balance, available opportunities and many more. 

If you are a manager and/or employer, there are things that you can do to keep your employees happy.  These may include but are not limited to: offering compatible compensation, growth and learning opportunities, providing constructive feedback, flexible scheduling if applicable, and encouraging a respectful work environment among many others. 

Yesterday I attended an anniversary celebration at work to support those who are receiving recognition for their service.  At such challenging times, a small token of appreciation through recognizing people for their loyalty goes a long way.

What are some ways working for your employer keeps you happy, motivated and feeling valued?

Farzad Refahi
September 23, 2020

Look after yourself

Mask, carrot, celery, pistachios and almonds.
Snack Time. Mask, carrot, celery, pistachios and almonds.

Recently I have begun eating healthier. By better looking after myself, I can better look after others (which includes my patients). All of this with by taking baby steps of course!

Drinking more water is the hard step as I didn’t hydrate myself frequently throughout the day. Now here comes the best part! Healthy snacks! Veggies and healthy fats are now part of my snacks. To make the process easier, which in turn can improve the chance of success, food preparation is strongly recommended. The night before, my wife and I make bags with celery and carrot sticks and containers of almonds. Along with a previously cooked and frozen lunch, I just need to grab my meal and snacks in the mornings!

Without this preparation, a slight temptation or laziness may lead to a Tim Horton’s coffee and a Timbit… or two… let’s be honest, I can easily have four to half a dozen of those to myself. While a cup of coffee and a few Timbits can be an occasional treat, it is not recommended as a frequent snack. To my followers outside of North America, check out Tim Horton’s website to have a better look at Timbits (small and round doughnuts/donuts): http://company.timhortons.com/ca/en/menu/timbits.php

While drinking more water and having small healthy snacks may be a small step, it is a noticeable improvement for me.

What are some of the things you have recently done to improve your self-care? What are some things you would like to do?

Farzad Refahi
September 11th, 2020


Pen, spacer, mouth piece and filter, nose clips, Salbutamol on the desk.

Equipment is ready to go before calling in the next person! 
I don’t have many extra or other items on the countertops and desks. This is so things don’t get contaminated with droplet and airborne particles. Also, with  limited items on surfaces, it makes the clinical setting more organized and less distracting for patients.
What are some of your practices?

Farzad Refahi

September 9th, 2020