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Sample records for addiction medicine training

  1. Training in Addiction Medicine in Australia

    ERIC Educational Resources Information Center

    Haber, Paul S.; Murnion, Bridin P.

    2011-01-01

    Barriers to entering addiction medicine (AM) have led to a persisting workforce shortage. To address this problem, the Chapter of Addiction Medicine (AChAM) was formed in 2001 as a subdivision of the Royal Australasian College of Physicians (RACP). Through consultation, AChAM has identified the scope of practice and offered fellowship to suitable…

  2. Training the next generation of providers in addiction medicine.

    PubMed

    Rasyidi, Ernest; Wilkins, Jeffery N; Danovitch, Itai

    2012-06-01

    Within the United States there exists a profound discrepancy between the significant public health problem of substance abuse and the access to treatment for addicted individuals. Part of the insufficient access to treatment is a function of relatively low levels or professional experts in addiction medicine. Part of the low levels of professional addiction experts is the result of inadequate addiction medicine training of medical students and residents. This article outlines deficits in addiction medicine training among medical students and residents, yet real change in the addiction medicine training process will always be subject to the complexity of producing alterations across multiple credentialing institutions as well as the keen competition between educators for “more time” for their particular subject. Other hurdles include the broad-based issue of stigma regarding alcoholism and other substance abuse that likely impact all systems that regulate physician addiction medicine training. As noted in the discussion of psychiatry residency, even psychiatry residents manifest stigma regarding substance abusing patients. Five currently active processes may allow for fundamental change to the inertia in physician addiction medicine training while also potentially impacting stigma: 1. We appear to be at the beginning of the integration of addiction into traditional medicine through the formation of a legitimized addiction medicine subspecialty. 2. The training of primary care trainees and practitioners in the use of SBIRT is accelerating, thus creating another process of addiction integration into traditional medicine. 3. The PCMH is being established as a model for primary care 4. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) became effective for group health care plan years beginning on or after July 1, 2010; thereby, substance abuse benefits and cost are to be the same as general medical or surgical

  3. Addiction Medicine: Current Status of Certification, Maintenance of Certification, Training, and Practice.

    PubMed

    Kunz, Kevin; Wiegand, Timothy

    2016-03-01

    Addiction medicine (ADM) is an emerging medical field. It will soon be recognized by the American Board of Medical Specialties as a multispecialty subspecialty, sponsored by the American Board of Preventive Medicine. Certification and maintenance of certification in ADM are available currently through the American Board of Addiction Medicine (ABAM). There is an urgent need for trained and certified ADM physicians to serve the needs of patients and society. Thirty-seven addiction medicine fellowships of 12 months duration are now available, and their number is increasing. Physicians specializing in medical toxicology have educational, training, and practice overlap with addiction medicine. Medical toxicology physicians usually meet ADM examination eligibility requirements, based on clinical practice experience and continuing medical education activities. Those with fellowship training or in a fellowship bring training experience which has commonalities to ADM fellowship training, and therefore are particularly prepared for examination and practice in ADM. There are opportunities for partnerships in training, practice, and leadership between addiction medicine and medical toxicology. PMID:26597980

  4. Developing a Competence-Based Addiction Medicine Curriculum in Indonesia: The Training Needs Assessment

    ERIC Educational Resources Information Center

    Pinxten, W. J. L.; De Jong, C.; Hidayat, T.; Istiqomah, A. N.; Achmad, Y. M.; Raya, R. P.; Norviatin, D.; Siregar, I. M. P.

    2011-01-01

    Indonesia has one of the fastest growing, injecting drugs user-driven, human immunodeficiency virus (HIV) epidemics in Asia. Coverage of needle and syringe programs (NSPs), opioid substitution therapy (OST), and antiretroviral treatment (ART) is increasing, but is still low, whereas professional training in addiction medicine is not yet…

  5. Training program in the field of addiction medicine - an experience of learning while abroad.

    PubMed

    Norsiah, A; Whelan, G; Piterman, L

    2008-01-01

    This paper illustrates the training program in the field of Addiction Medicine designed for primary care doctors by the Department of General Practice, School of Primary Care at Monash University in Melbourne. The nine month program was based around coursework, field visits and clinical observations. There were five modules that were completed and passed, twenty six Continuous Medical Education sessions attended, twenty nine field visits on Drug & Alcohol services, forty seven clinical visits and a total of three hundred and sixty clinical observations made. The comprehensive training program has benefited the first author in several ways to improve the Drugs & Alcohol services in Malaysia. PMID:25606116

  6. Specialized Training on Addictions for Physicians in the United States

    ERIC Educational Resources Information Center

    Tontchev, Gramen V.; Housel, Timothy R.; Callahan, James F.; Kunz, Kevin B.; Miller, Michael M.; Blondell, Richard D.

    2011-01-01

    In the United States accredited residency programs in addiction exist only for psychiatrists specializing in addiction psychiatry (ADP); nonpsychiatrists seeking training in addiction medicine (ADM) can train in nonaccredited "fellowships," or can receive training in some ADP programs, only to not be granted a certificate of completion of…

  7. The Master in Addiction Medicine Program in the Netherlands

    ERIC Educational Resources Information Center

    De Jong, Cornelis; Luycks, Lonneke; Delicat, Jan-Wilm

    2011-01-01

    Since 2007 there is a full-time, 2-year professional training in addiction medicine in the Netherlands. The aim of this article is to describe in detail the development and present status of the Dutch Master in Addiction Medicine (MiAM) program. In this competency-based professional training, theoretical courses are integrated with learning in…

  8. The Integration of Medical Toxicology and Addiction Medicine: a New Era in Patient Care.

    PubMed

    Laes, JoAn R

    2016-03-01

    Medical toxicologists are frequently called upon to treat patients who are addicted to alcohol, tobacco, or other substances across many care settings. Medical toxicologists provide service to their patients through the identification, treatment, and prevention of addiction and its co-morbidities, and practice opportunities are quite varied. Training in addiction medicine can be obtained during or after medical toxicology fellowship through resources offered by the American Society of Addiction Medicine. Additionally, the American Board of Addiction Medicine offers certification in the specialty of addiction medicine to candidates across a wide range of medical specialties. PMID:26576956

  9. Training Psychiatry Addiction Fellows in Acupuncture

    PubMed Central

    Serafini, Kelly; Bryant, Katurah; Ikomi, Jolomi; LaPaglia, Donna

    2015-01-01

    Objective Acupuncture has been studied as an adjunct for addictions treatment. Because many hospitals, outpatient clinics, and facilities are integrating acupuncture treatment, it is important that psychiatrists remain informed about this treatment. This manuscript describes the National Acupuncture Detoxification Association (NADA) protocol and its inclusion as part of the curriculum for psychiatry addictions fellows. Methods Psychiatry and psychology fellows completed the NADA training (N = 20) and reported on their satisfaction with the training. Results Overall, participants stated that they found the training beneficial and many were integrating acupuncture within their current practice. Conclusions Results support the acceptability of acupuncture training among psychiatry fellows in this program. PMID:26048457

  10. Addiction Medicine in Canada: Challenges and Prospects

    ERIC Educational Resources Information Center

    el-Guebaly, Nady; Crockford, David; Cirone, Sharon; Kahan, Meldon

    2011-01-01

    In Canada, the qualification of physicians is the jurisdiction of the College of Family Physicians and the Royal College of Physicians and Surgeons. The Colleges have promoted the training of "generalists" in family medicine and "sophisticated generalists" among the traditional specialties, and the development of subspecialties has not been…

  11. [Addiction].

    PubMed

    Besson, J; Grivel, J; Tomei, A; Gothuey, I; Andronicos, M; Babel, H; Nunweiler, S

    2013-01-01

    What's new in addiction medicine in 2012? The news are presented according three axes: first, in the field of neuroscience, the process of extinction of addiction memories. Then in the clinical field, a reflexion is reported on how to treat addiction in psychiatric hospitals. At last, in the area of teaching, an e-learning development with a virtual patient shows a great interest in addiction psychiatry. PMID:23367696

  12. Addiction medicine: a model osteopathic medical school curriculum.

    PubMed

    Lande, R Gregory; Wyatt, Stephen A; Przekop, Peter R

    2010-03-01

    The World Health Organization has identified nicotine, alcohol, and illicit drugs as among the top 10 contributors of morbidity and mortality in the world. Substance use disorders are preventable conditions that are major contributors to poor health, family dysfunction, and various social problems in the United States-problems that have a profound economic impact. The American Osteopathic Academy of Addiction Medicine seeks to promote teaching of addiction medicine at colleges of osteopathic medicine (COMs), which-honoring the osteopathic concepts of holistic medicine and disease prevention-are well poised to develop a model addiction medicine curriculum. Educators and students at COMs can use guidelines from Project MAINSTREAM, a core addiction medicine curriculum designed to improve education of health professionals in substance abuse, for developing addiction medicine curricula and for gauging their professional growth. These guidelines should be incorporated into the first 2 years of osteopathic medical students' basic science didactics. The authors encourage the development of addiction medicine courses and curricula at all COMs. PMID:20386021

  13. Prescription Pain Medicines - An Addictive Path?

    MedlinePlus

    ... for addiction to these drugs, which include codeine, morphine, oxycodone (OxyContin), hydrocodone (Vicodin), and meperidine (Demerol). The ... the receptors in the brain affected by heroin, morphine, and prescription painkillers. The tablets relieve drug cravings ...

  14. Cognitive interventions for addiction medicine: Understanding the underlying neurobiological mechanisms.

    PubMed

    Zilverstand, Anna; Parvaz, Muhammad A; Moeller, Scott J; Goldstein, Rita Z

    2016-01-01

    Neuroimaging provides a tool for investigating the neurobiological mechanisms of cognitive interventions in addiction. The aim of this review was to describe the brain circuits that are recruited during cognitive interventions, examining differences between various treatment modalities while highlighting core mechanisms, in drug addicted individuals. Based on a systematic Medline search we reviewed neuroimaging studies on cognitive behavioral therapy, cognitive inhibition of craving, motivational interventions, emotion regulation, mindfulness, and neurofeedback training in addiction. Across intervention modalities, common results included the normalization of aberrant activity in the brain's reward circuitry, and the recruitment and strengthening of the brain's inhibitory control network. Results suggest that different cognitive interventions act, at least partly, through recruitment of a common inhibitory control network as a core mechanism. This implies potential transfer effects between training modalities. Overall, results confirm that chronically hypoactive prefrontal regions implicated in cognitive control in addiction can be normalized through cognitive means. PMID:26822363

  15. 2013 Update in addiction medicine for the generalist

    PubMed Central

    2013-01-01

    Increasingly, patients with unhealthy alcohol and other drug use are being seen in primary care and other non-specialty addiction settings. Primary care providers are well positioned to screen, assess, and treat patients with alcohol and other drug use because this use, and substance use disorders, may contribute to a host of medical and mental health harms. We sought to identify and examine important recent advances in addiction medicine in the medical literature that have implications for the care of patients in primary care or other generalist settings. To accomplish this aim, we selected articles in the field of addiction medicine, critically appraised and summarized the manuscripts, and highlighted their implications for generalist practice. During an initial review, we identified articles through an electronic Medline search (limited to human studies and in English) using search terms for alcohol and other drugs of abuse published from January 2010 to January 2012. After this initial review, we searched for other literature in web-based or journal resources for potential articles of interest. From the list of articles identified in these initial reviews, each of the six authors independently selected articles for more intensive review and identified the ones they found to have a potential impact on generalist practice. The identified articles were then ranked by the number of authors who selected each article. Through a consensus process over 4 meetings, the authors reached agreement on the articles with implications for practice for generalist clinicians that warranted inclusion for discussion. The authors then grouped the articles into five categories: 1) screening and brief interventions in outpatient settings, 2) identification and management of substance use among inpatients, 3) medical complications of substance use, 4) use of pharmacotherapy for addiction treatment in primary care and its complications, and 5) integration of addiction treatment and

  16. [Guideline 'Medicinal care for drug addicts in penal institutions'].

    PubMed

    Westra, Michel; de Haan, Hein A; Arends, Marleen T; van Everdingen, Jannes J E; Klazinga, Niek S

    2009-01-01

    In the Netherlands, the policy on care for prisoners who are addicted to opiates is still heterogeneous. The recent guidelines entitled 'Medicinal care for drug addicts in penal institutions' should contribute towards unambiguous and more evidence-based treatment for this group. In addition, it should improve and bring the care pathways within judicial institutions and mainstream healthcare more into line with one another. Each rational course of medicinal treatment will initially be continued in the penal institution. In penal institutions the help on offer is mainly focused on abstinence from illegal drugs while at the same time limiting the damage caused to the health of the individual user. Methadone is regarded at the first choice for maintenance therapy. For patient safety, this is best given in liquid form in sealed cups of 5 mg/ml once daily in the morning. Recently a combination preparation containing buprenorphine and naloxone - a complete opiate antagonist - has become available. On discontinuation of opiate maintenance treatment intensive follow-up care is necessary. During this period there is considerable risk of a potentially lethal overdose. Detoxification should be coupled with psychosocial or medicinal intervention aimed at preventing relapse. Naltrexone is currently the only available opiate antagonist for preventing relapse. In those addicted to opiates, who also take benzodiazepines without any indication, it is strongly recommended that these be reduced and discontinued. This can be achieved by converting the regular dosage into the equivalent in diazepam and then reducing this dosage by a maximum of 25% a week. PMID:20051159

  17. A Survey of Training Needs of Experienced Certified Addictions Counselors.

    ERIC Educational Resources Information Center

    Taleff, Michael J.

    1996-01-01

    Survey of 208 Certified Addiction Counselors (CAC) and Certified Prevention Specialists (CPS) about education and training topics in the field of alcohol and other drug abuse. Results indicate that CAC/CPS professionals prefer training topics that encompass cultural issues, alternative forms of treatment and relapse prevention delivered in…

  18. Training Addiction Counselors: Collaborating through Diversity.

    ERIC Educational Resources Information Center

    Miller, Geri; Elliott, Ellen; Finch, Jennifer; Kirkley, Dale; Litten, DeLillian; Nunn, David; Brown, Jacky; Lassiter, Pam

    At the 2002 American Counseling Association Conference, eight individuals presented their experiences in classroom collaboration among four different settings (university classroom, university counseling wellness center, community college classroom, addiction counseling treatment center). Student activities, that were a part of the graduate…

  19. Rural family medicine training site

    PubMed Central

    Liskowich, Sarah; Walker, Kathryn; Beatty, Nicolas; Kapusta, Peter; McKay, Shari; Ramsden, Vivian R.

    2015-01-01

    Abstract Objective To develop a framework for a successful rural family medicine training program and to assess the potential for a rural family medicine residency training program using the Weyburn and Estevan areas of Saskatchewan as test sites. Design A mixed-method design was used; however, the focus of this article was on the qualitative data collected. Questions formulated for the semistructured interviews evolved from the literature. Setting Rural Saskatchewan. Participants Community physicians and representatives from the Sun Country Regional Health Authority, the Saskatchewan Ministry of Health, and the University of Saskatchewan. Methods The data were documented during the interviews using a laptop computer, and the responses were reviewed with participants at the end of their interviews to ensure accuracy. The qualitative data collected were analyzed using inductive thematic analysis. Main findings Through the analysis of the data several themes emerged related to implementing a rural family medicine residency training program. Key predictors of success were physical resources, physician champions, physician teachers, educational support, administrative support, and other specialist support. Barriers to the development of a rural family medicine training site were differing priorities, lack of human resources, and lack of physical resources. Conclusion A project of this magnitude requires many people at different levels collaborating to be successful. PMID:26380856

  20. Marijuana: A Fifty-Year Personal Addiction Medicine Perspective.

    PubMed

    Smith, David E

    2016-01-01

    As of September 2015, the cultivation, possession, and/or use of marijuana is illegal under U.S. federal law as a Schedule I narcotic; however, it is legal in four states and Washington, D.C. Forty-six states allow some form of medicinal marijuana or decriminalization. Marijuana has been used medicinally for thousands of years; Marijuana's regulation by law enforcement in the U.S., rather than the medical community, led to an almost complete halt to academic and scientific research after the 1930s. The late 1960s saw an upsurge in recreational marijuana use by middle-class youth, the majority of whom experienced minimal adverse effects aside from arrest and attendant legal complications. Since the mid-1990s, the use of medicinal marijuana for certain conditions has gained increasing acceptance. Stronger strains and formulations of marijuana pose a risk to the developing brains of adolescents. Within the addiction medicine community, there is currently no consensus on marijuana. In the East, the feeling is primarily that marijuana continue to be proscribed. In the West, where clinicians must face the realities of medicalization, decriminalization, and/or legalization, as well as widespread recreational use, there is more of a movement to minimize adverse effects, particularly on youth. PMID:26757396

  1. Internal Medicine Residents' Training in Substance Use Disorders: A Survey of the Quality of Instruction and Residents' Self-Perceived Preparedness to Diagnose and Treat Addiction

    ERIC Educational Resources Information Center

    Wakeman, Sarah E.; Baggett, Meridale V.; Pham-Kanter, Genevieve; Campbell, Eric G.

    2013-01-01

    Background: Resident physicians are the direct care providers for many patients with addiction. This study assesses residents' self-perceived preparedness to diagnose and treat addiction, measures residents' perceptions of the quality of addictions instruction, and evaluates basic knowledge of addictions. Methods: A survey was e-mailed…

  2. A systems medicine research approach for studying alcohol addiction.

    PubMed

    Spanagel, Rainer; Durstewitz, Daniel; Hansson, Anita; Heinz, Andreas; Kiefer, Falk; Köhr, Georg; Matthäus, Franziska; Nöthen, Markus M; Noori, Hamid R; Obermayer, Klaus; Rietschel, Marcella; Schloss, Patrick; Scholz, Henrike; Schumann, Gunter; Smolka, Michael; Sommer, Wolfgang; Vengeliene, Valentina; Walter, Henrik; Wurst, Wolfgang; Zimmermann, Uli S; Stringer, Sven; Smits, Yannick; Derks, Eske M

    2013-11-01

    According to the World Health Organization, about 2 billion people drink alcohol. Excessive alcohol consumption can result in alcohol addiction, which is one of the most prevalent neuropsychiatric diseases afflicting our society today. Prevention and intervention of alcohol binging in adolescents and treatment of alcoholism are major unmet challenges affecting our health-care system and society alike. Our newly formed German SysMedAlcoholism consortium is using a new systems medicine approach and intends (1) to define individual neurobehavioral risk profiles in adolescents that are predictive of alcohol use disorders later in life and (2) to identify new pharmacological targets and molecules for the treatment of alcoholism. To achieve these goals, we will use omics-information from epigenomics, genetics transcriptomics, neurodynamics, global neurochemical connectomes and neuroimaging (IMAGEN; Schumann et al. ) to feed mathematical prediction modules provided by two Bernstein Centers for Computational Neurosciences (Berlin and Heidelberg/Mannheim), the results of which will subsequently be functionally validated in independent clinical samples and appropriate animal models. This approach will lead to new early intervention strategies and identify innovative molecules for relapse prevention that will be tested in experimental human studies. This research program will ultimately help in consolidating addiction research clusters in Germany that can effectively conduct large clinical trials, implement early intervention strategies and impact political and healthcare decision makers. PMID:24283978

  3. Ethics and Accreditation in Addictions Counselor Training: Possible Field Placement Issues for CACREP-Accredited Addictions Counseling Programs

    ERIC Educational Resources Information Center

    Linton, Jeremy M.

    2012-01-01

    Professional counselors have long been practicing in alcohol and drug treatment settings. However, only recently has the counseling field offered formal recognition of addictions counseling as a specialization through the implementation of accreditation standards for addiction counseling training programs. With the passage of the 2009 standards,…

  4. Interdisciplinary research training in substance abuse and addictions.

    PubMed

    Thompson, Elaine Adams

    2013-01-01

    Considerable evidence shows that the management of complex problems of and related to substance abuse and addictions require comprehensive approaches based on solid research. Nonetheless, timely and widespread dissemination of research findings remains uncommon, hindering nursing practice, impeding the health of individuals and families, and imposing untoward costs for society. Shifts in science paradigms underscore the need for efficient and effective interdisciplinary research teams to carry out innovative research within a translational science framework. This means that early career investigators will need the knowledge and skills to conduct research as part of an interdisciplinary team and to contribute systematically to translational research in the area of substance abuse and addictions. This brief report describes a nursing research training program sponsored by the National Institute on Drug Abuse that evolved into an interdisciplinary program administrated within a school of nursing. Factors conducive to program development are described, along with the structure and elements of the program and examples of the scholars' projects and accomplishments. The common benefits of interdisciplinary research training for both predoctoral and postdoctoral research scholars include consistent exposure to new and alternative scientific models and methodological approaches as well as endurance of cross-discipline network connections. Benefits and challenges of this program carry implications for the design of future nursing research training programs in the field of substance abuse and addictions. PMID:24622528

  5. Training the Staff of a Drug Addiction Treatment Facility: A Case Study of Hogar De Encuentro

    ERIC Educational Resources Information Center

    Sorensen, Andrew A.; Leske, M. Cristina

    1977-01-01

    This paper, presented at the American Public Health Association meeting; Chicago, November 1975, discusses a staff training program at a drug addiction treatment facility established for Spanish-speaking (and other) drug addicts. Staff improved counseling skills and knowledge of drug addiction, but changed little in attitudes toward drug use and…

  6. Rural family medicine training in Canada.

    PubMed Central

    Rourke, J. T.; Rourke, L. L.

    1995-01-01

    OBJECTIVE: To examine the status of postgraduate family medicine training that occurs in rural family practice settings in Canada and to identify problems and how they are addressed. DESIGN: A retrospective questionnaire sent to all 18 Canadian family medicine training programs followed by a focus group discussion of results. SETTING: Canadian university family medicine training programs. PARTICIPANTS: Chairs or program directors of all 18 Canadian family medicine training programs and people attending a workshop at the Section of Teachers of Family Medicine annual meeting. MAIN OUTCOME MEASURES: Extent of training offered, educational models used, common problems for residents and teachers. RESULTS: Nine of 18 programs offer some family medicine training in a rural practice setting to some or all of their first-year family medicine residents, and 99 of 684 first-year family medicine residents did some training in a rural practice. All programs offer some training in a rural practice to some or all of the second-year residents, and 567 of 702 second-year residents did some training in a rural setting. In 12 of 18 programs, a rural family medicine block is compulsory. Education models for training for rural family practice vary widely. Isolation, accommodation, and supervision are common problems for rural family medicine residents. Isolation and faculty development are common problems for rural physician-teachers. Programs use various approaches to address these problems. CONCLUSIONS: The variety of postgraduate training models for rural family practice used in the 18 training programs reflects different regional health care needs and resources. There is no common rural family medicine curriculum. Networking through a rural physician-teachers group or a faculty of rural medicine could further the development of education for rural family practice. PMID:7780331

  7. Evaluation of a Cross-Training Curriculum for Mental Health and Addiction Counselors

    ERIC Educational Resources Information Center

    Wendler, Alicia M.; Murdock, Tamera B.

    2005-01-01

    Cross-training professionals from mental health and addiction treatment systems can help further the goal of comprehensive treatment for clients with co-occurring mental health and substance use disorders (co-occurring disorders). Two such trainings brought together 122 professionals from mental health and addiction treatment fields. This…

  8. Genetic imaging consortium for addiction medicine: From neuroimaging to genes.

    PubMed

    Mackey, Scott; Kan, Kees-Jan; Chaarani, Bader; Alia-Klein, Nelly; Batalla, Albert; Brooks, Samantha; Cousijn, Janna; Dagher, Alain; de Ruiter, Michiel; Desrivieres, Sylvane; Feldstein Ewing, Sarah W; Goldstein, Rita Z; Goudriaan, Anna E; Heitzeg, Mary M; Hutchison, Kent; Li, Chiang-Shan R; London, Edythe D; Lorenzetti, Valentina; Luijten, Maartje; Martin-Santos, Rocio; Morales, Angelica M; Paulus, Martin P; Paus, Tomas; Pearlson, Godfrey; Schluter, Renée; Momenan, Reza; Schmaal, Lianne; Schumann, Gunter; Sinha, Rajita; Sjoerds, Zsuzsika; Stein, Dan J; Stein, Elliot A; Solowij, Nadia; Tapert, Susan; Uhlmann, Anne; Veltman, Dick; van Holst, Ruth; Walter, Henrik; Wright, Margaret J; Yucel, Murat; Yurgelun-Todd, Deborah; Hibar, Derrek P; Jahanshad, Neda; Thompson, Paul M; Glahn, David C; Garavan, Hugh; Conrod, Patricia

    2016-01-01

    Since the sample size of a typical neuroimaging study lacks sufficient statistical power to explore unknown genomic associations with brain phenotypes, several international genetic imaging consortia have been organized in recent years to pool data across sites. The challenges and achievements of these consortia are considered here with the goal of leveraging these resources to study addiction. The authors of this review have joined together to form an Addiction working group within the framework of the ENIGMA project, a meta-analytic approach to multisite genetic imaging data. Collectively, the Addiction working group possesses neuroimaging and genomic data obtained from over 10,000 subjects. The deadline for contributing data to the first round of analyses occurred at the beginning of May 2015. The studies performed on this data should significantly impact our understanding of the genetic and neurobiological basis of addiction. PMID:26822360

  9. What does addiction medicine expect from neuroscience? From genes and neurons to treatment responses.

    PubMed

    Le Foll, Bernard

    2016-01-01

    The field of neuroscience is rapidly growing as evidenced by the mapping of the human genome, the progress in brain imaging technologies, and the refinement of sophisticated molecular tools that can be combined with innovative preclinical models. With these advances, it seems that our understanding of processes underlying addiction has never been so great. In comparison, the clinical domain has evolved at a much slower pace. Nonetheless, the addiction medical field has seen some gradual improvements in clinical care with the availability of a larger range of pharmacological options. Notably, several therapeutic alternatives are now offered for the treatment of nicotine, alcohol, and opioid use disorders. Some of these developments in treatment regimens have directly emerged from basic neuroscience research and represent a success story for the bench to beside translational approach. However, the clinical and research needs in addiction medicine are huge. There are still no pharmacological interventions available for psychostimulant and cannabis use disorders. Further, major questions remain unanswered: Would a better understanding of the neurocircuitry of addiction lead to therapeutic intervention? Would a better understanding of the neurochemical signature of addiction lead to the validation of a therapeutic target? Will pharmacogenetics hold its promise as a personalized medicine treatment approach? Using recent research developments, we will illustrate the potential of neuroscience to address some of the pressing questions in Addiction Medicine. PMID:26822369

  10. Opioid neuroscience for addiction medicine: From animal models to FDA approval for alcohol addiction.

    PubMed

    Berrettini, Wade

    2016-01-01

    Alcohol addiction is one of the most common and devastating diseases in the world. Given the tremendous heterogeneity of alcohol-addicted individuals, it is unlikely that one medication will help nearly all patients. Thus, there is a clear need to develop predictors of response to existing medications. Naltrexone is a mu opioid receptor antagonist which has been approved in the United States for treatment of alcohol addiction since 1994. It has limited efficacy, in part due to noncompliance, but many patients do not respond despite high levels of compliance. There are reports that a mis-sense single-nucleotide polymorphism (rs179919 or A118G) in the mu opioid receptor gene predicts a favorable response to naltrexone if an individual carries a "G" allele. This chapter will review the evidence for this hypothesis. The data suggest that the "G" allele has a complex role in alcohol addiction, increasing the rewarding valence of alcohol. Whether the G allele increases risk for alcoholism and whether it predisposes to a beneficial naltrexone response among alcohol-addicted persons must await additional research with large sample sizes of multiple ethnicities in prospective clinical trials. PMID:26806780

  11. Interprofessional Integrative Medicine Training for Preventive Medicine Residents.

    PubMed

    Cowen, Virginia S; Thomas, Pauline A; Gould-Fogerite, Susan E; Passannante, Marian R; Mahon, Gwendolyn M

    2015-11-01

    Integrative medicine training was incorporated into the Rutgers New Jersey Medical School Preventive Medicine residency at the Rutgers Biomedical and Health Sciences Newark Campus as a collaboration between the Rutgers New Jersey Medical School and the School of Health Related Professions. Beginning in 2012, an interdisciplinary faculty team organized an Integrative Medicine program in a Preventive Medicine residency that leveraged existing resources across Rutgers Biomedical and Health Sciences. The overarching aim of the programs was to introduce residents and faculty to the scope and practice of integrative medicine in the surrounding Newark community and explore evidence-based research on integrative medicine. The faculty team tapped into an interprofessional network of healthcare providers to organize rotations for the preventive medicine residents that reflected the unique nature of integrative medicine in the greater Newark area. Residents provided direct care as part of interdisciplinary teams at clinical affiliates and shadowed health professionals from diverse disciplines as they filled different roles in providing patient care. The residents also participated in research projects. A combination of formal and informal programs on integrative medicine topics was offered to residents and faculty. The Integrative Medicine program, which ran from 2013 through 2014, was successful in exposing residents and faculty to the unique nature of integrative medicine across professions in the community served by Rutgers Biomedical and Health Sciences. PMID:26477901

  12. Internal Medicine Training in the Inpatient Setting

    PubMed Central

    Lorenzo, Di Francesco; Pistoria, Michael J; Auerbach, Andrew D; Nardino, Robert J; Holmboe, Eric S

    2005-01-01

    PURPOSE Although the inpatient setting has served as the predominant educational site of internal medicine training programs, many changes and factors are currently affecting education in this setting. As a result, many educational organizations are calling for reforms in inpatient training. This report reviews the available literature on specific internal medicine inpatient educational interventions and proposes recommendations for improving internal medicine training in this setting. METHOD We searched Medline for articles published between 1966 and August 2004 which focused on internal medicine training interventions in the inpatient setting; bibliographies of Medline-identified articles, as well as articles suggested by experts in the field provided additional citations. We then reviewed, classified, and abstracted only articles where an assessment of learner outcomes was included. RESULTS Thirteen studies of inpatient internal medicine educational interventions were found that included an outcome assessment. All were single institution studies. The majority of these studies was of poor methodological quality and focused on specific content areas of internal medicine. None assessed the effectiveness or impact of internal medicine core inpatient experiences or curriculum. CONCLUSION This review identifies significant gaps in our understanding of what constitutes effective inpatient education. The paucity of high quality research in the internal medicine inpatient setting highlights the urgent need to formally define and study what constitutes an effective “core” inpatient curriculum. PMID:16423111

  13. Addiction.

    PubMed

    Naim-Feil, Jodie; Zangen, Abraham

    2013-01-01

    Drug and alcohol addiction is a debilitating disorder characterized by persistent drug-seeking behaviors despite negative physiological, medical, or social consequences. Neurobiological models of addiction propose that the reinforcing effects of addictive drugs are associated with altered neurotransmission within the reward 'mesocorticolimbic' circuitry in the brain. Immense efforts are therefore designed to target the mesocorticolimbic circuitry in attenuating drug dependence and addiction-related behaviors. Yet, to date, most addiction treatments have demonstrated only limited success in reducing addiction-related behaviors. Accumulating and compelling evidence suggests that novel nonsurgical brain stimulation techniques, such as transcranial magnetic stimulation and transcranial direct current stimulation, could serve as promising tools for indexing altered neurotransmission associated with repetitive drug use, and moreover, may hold therapeutic potential for the treatment of drug dependence and addiction-related behaviors. This chapter reviews and discusses the current and potential applications of such techniques in the study and treatment of addiction; we focus on a number of common drugs of abuse, including nicotine, alcohol, cocaine, cannabis, and ecstasy. PMID:24112928

  14. A Training Manual for Nuclear Medicine Technologists.

    ERIC Educational Resources Information Center

    Simmons, Guy H.; Alexander, George W.

    This manual was prepared for a training program in Nuclear Medicine Technology at the University of Cincinnati. Instructional materials for students enrolled in these courses in the training program include: Nuclear Physics and Instrumentation, Radionuclide Measurements, Radiation Protection, and Tracer Methodology and Radiopharmaceuticals. (CS)

  15. Opportunities for emergency medicine training in Australia.

    PubMed Central

    Ryan, J M; Gaudry, P I

    1997-01-01

    Opportunities exist for graduates from the United Kingdom to undertake some of their emergency medicine training in Australia. Guidelines for graduates are presented on when to travel, how to find a position, what information one should obtain about a position, and how to acquire the necessary visa and medical registration. A successful visit takes some time to plan and requires cooperation between the negotiating parties. The graduate who undertakes training abroad can expect to benefit professionally and personally. The development of an international exchange network for trainees would streamline the process and broaden the appeal to graduates of completing some of their emergency medicine training in another country. PMID:9023622

  16. Sleep medicine training across the spectrum.

    PubMed

    Strohl, Kingman P

    2011-05-01

    There is now a new pathway and examination for sleep medicine, sponsored by the American Board of Internal Medicine, and a number of accredited sleep medicine fellowship programs through the Accreditation Council for Graduate Medical Education. This review takes an historical approach to discuss the process of education for sleep physiology and disorders not only in the postgraduate period but also at all levels of instruction. In reality, there is a continuum of knowledge that needs to be reinforced up and down the educational system, of which Sleep Medicine subspecialty training is just one part. Although progress has been made at all educational levels up to this point, the future of training and education will depend on a sustained effort at several levels from undergraduate to postgraduate continuing medical education and will be facilitated by professional societies and other specialties who will collectively promote the value of and outcomes for clinical sleep medicine. PMID:21540220

  17. Assessment of training in psychosexual medicine.

    PubMed Central

    Mathers, N.; Bramley, M.; Draper, K.; Snead, S.; Tobert, A.

    1994-01-01

    The Institute of Psychosexual Medicine offers training in the treatment of psychosexual problems to medically qualified doctors. Training takes place in fortnightly seminars in which trainees present and discuss real cases. Assessment of cases presented at the beginning and end of the six term basic training showed appreciable improvement in doctors' abilities. The proportion of doctors meeting each of the 14 predetermined clinical objectives rose. Factors which affected the amount of improvement were the initial score, the number of cases presented at the seminars, the occupation of the leader, and the duration of training. Accreditation by the Institute of Psychosexual Medicine was shown to be an appropriate outcome measure for the achievement of the required standards for practising psychosexual medicine. PMID:8173408

  18. The International Certification of Addiction Medicine: Validating Clinical Knowledge across Borders

    ERIC Educational Resources Information Center

    el-Guebaly, Nady; Violato, Claudio

    2011-01-01

    The experience of the International Society of Addiction Medicine in setting up the first international certification of clinical knowledge is reported. The steps followed and the results of a psychometric analysis of the tests from the first 65 candidates are reported. Lessons learned in the first 5 years and challenges for the future are…

  19. Meditation Awareness Training for the Treatment of Sex Addiction: A Case Study.

    PubMed

    Van Gordon, William; Shonin, Edo; Griffiths, Mark D

    2016-06-01

    Background Sex addiction is a disorder that can have serious adverse functional consequences. Treatment effectiveness research for sex addiction is currently underdeveloped, and interventions are generally based on the guidelines for treating other behavioral (as well as chemical) addictions. Consequently, there is a need to clinically evaluate tailored treatments that target the specific symptoms of sex addiction. It has been proposed that second-generation mindfulness-based interventions (SG-MBIs) may be an appropriate treatment for sex addiction because in addition to helping individuals increase perceptual distance from craving for desired objects and experiences, some SG-MBIs specifically contain meditations intended to undermine attachment to sex and/or the human body. The current study conducts the first clinical investigation into the utility of mindfulness for treating sex addiction. Case presentation An in-depth clinical case study was conducted involving an adult male suffering from sex addiction that underwent treatment utilizing an SG-MBI known as Meditation Awareness Training (MAT). Following completion of MAT, the participant demonstrated clinically significant improvements in addictive sexual behavior, as well as reductions in depression and psychological distress. The MAT intervention also led to improvements in sleep quality, job satisfaction, and non-attachment to self and experiences. Salutary outcomes were maintained at 6-month follow-up. Discussion and conclusion The current study extends the literature exploring the applications of mindfulness for treating behavioral addiction, and findings indicate that further clinical investigation into the role of mindfulness for treating sex addiction is warranted. PMID:27348560

  20. Training Physician Investigators in Medicine and Public Health Research

    PubMed Central

    Jay, Melanie R.; Goldfrank, Lewis R.; Mendelsohn, Alan L.; Dreyer, Benard P.; Foltin, George L.; Lipkin, Mack; Schwartz, Mark D.

    2012-01-01

    Objectives. We have described and evaluated the impact of a unique fellowship program designed to train postdoctoral, physician fellows in research at the interface of medicine and public health. Methods. We developed a rigorous curriculum in public health content and research methods and fostered linkages with research mentors and local public health agencies. Didactic training provided the foundation for fellows’ mentored research initiatives, which addressed real-world challenges in advancing the health status of vulnerable urban populations. Results. Two multidisciplinary cohorts (6 per cohort) completed this 2-year degree-granting program and engaged in diverse public health research initiatives on topics such as improving pediatric care outcomes through health literacy interventions, reducing hospital readmission rates among urban poor with multiple comorbidities, increasing cancer screening uptake, and broadening the reach of addiction screening and intervention. The majority of fellows (10/12) published their fellowship work and currently have a career focused in public health–related research or practice (9/12). Conclusions. A fellowship training program can prepare physician investigators for research careers that bridge the divide between medicine and public health. PMID:22594745

  1. Training the Future Leaders in Personalized Medicine

    PubMed Central

    Mason-Suares, Heather; Sweetser, David A.; Lindeman, Neal I.; Morton, Cynthia C.

    2016-01-01

    The era of personalized medicine has arrived, and with it a need for leaders in this discipline. This generation of trainees requires a cadre of new skill sets to lead the implementation of personalized medicine into mainstream healthcare. Traditional training programs no longer provide trainees with all the skills they will need to optimize implementation of this revolution now underway in medicine. Today’s trainees must manage clinical teams, act as clinical and molecular diagnostic consultants, train other healthcare professionals, teach future generations, and be knowledgeable about clinical trials to facilitate genomic-based therapies. To prepare trainees for the transition to junior faculty positions, contemporary genomic training programs must emphasize the development of these management, teaching, and clinical skills. PMID:26751479

  2. Pedagogical training of medicine professors.

    PubMed

    da Silva Campos Costa, Nilce Maria

    2010-01-01

    This study examines the pedagogical training process of medical professors at a Brazilian university, the meanings attributed to it, and the positive and negative aspects identified in it. This is a descriptive-exploratory study, using a qualitative approach with a questionnaire utilizing open-ended and closed questions and a semi-structured interview. The majority of queried individuals had no formal teacher training and learned to be teachers through a process of socialization that was in part intuitive or by modeling those considered to be good teachers; they received pedagogical training mainly in post-graduate courses. Positives aspects of this training were the possibility of refresher courses in pedagogical methods and increased knowledge in their educational area. Negative factors were a lack of practical activities and a dichotomy between theoretical content and practical teaching. The skills acquired through professional experience formed the basis for teaching competence and pointed to the need for continuing education projects at the institutional level, including these skills themselves as a source of professional knowledge. PMID:20428704

  3. Learning by contract in family medicine training.

    PubMed

    Ogborne, W L; Killer, D V

    1984-06-01

    The Family Medicine Programme (FMP) of the Royal Australian College of General Practitioners is a national programme of vocational training for general/family practice. In 1981 the decision was made to adopt 'learning by contract' as an educational method leading to the certification of training. This paper describes the educational philosophy of the FMP and its importance in this decision. The experience of the authors in the implementation of learning by contract is also described. PMID:6530068

  4. Using Experiential Activities to Prepare Counselors-in-Training to Understand the Power of Cravings when Addressing Clients with Addiction

    ERIC Educational Resources Information Center

    Harrawood, Laura K.; McClure, Cristen C.; Nelson, Jennifer

    2011-01-01

    Providing skilled treatment options for clients experiencing addiction is imperative to positive client treatment outcomes. As a prerequisite to providing efficacious addiction treatment, counselors-in-training are charged with the responsibility of understanding the affect of cravings on addiction relapse. This article presents 3 experiential,…

  5. Neurocognitive rehabilitation for addiction medicine: From neurophysiological markers to cognitive rehabilitation and relapse prevention.

    PubMed

    Campanella, Salvatore

    2016-01-01

    Currently, relapse prevention remains the main challenge in addiction medicine, indicating that the established treatment methods combining psychotherapy with neuropharmacological interventions are not entirely effective. Therefore, there is a push to develop alternatives to psychotherapy- and medication-based approaches to addiction treatment. Two major cognitive factors have been identified that trigger relapse in addicted patients: attentional biases directed toward drug-related cues, which increase the urge to consume, and impaired response inhibition toward these cues, which makes it more difficult for addicted people to resist temptation. Recent studies on newly detoxified alcoholic patients have shown that by using the appropriate tasks to index these cognitive functions with event-related potentials (ERPs), it is possible to discriminate between future relapsers and nonrelapsers. These preliminary data suggest that the ERP technique has great clinical potential for preventing relapse in alcohol-dependent patients, as well as for addictive states in general. Indeed, ERPs may help to identify patients highly vulnerable to relapse and allow the development of individually adapted cognitive rehabilitation programs. The implementation of this combined approach requires an intense collaboration between psychiatry departments, clinical neurophysiology laboratories, and neuropsychological rehabilitation centers. The potential pitfalls and limitations of this approach are also discussed. PMID:26822355

  6. Educational contracts in family medicine residency training.

    PubMed Central

    Mahood, S.; Rojas, R.; Andres, D.; Zagozeski, C.; White, G.; Bradel, T.

    1994-01-01

    An educational contract for family medicine residency training and evaluation addresses many of the difficulties and challenges of current postgraduate medical education. This article identifies important principles for developing a contractual approach; describes the contract used in one program and its implementation; and discusses its theory, advantages, and limitations. Images p550-a PMID:8199512

  7. A Behavior Modification Training Program for Staff Working with Drug Addicts.

    ERIC Educational Resources Information Center

    Cheek, Frances E.; And Others

    This paper describes a Behavior Modification Training Program, emphasizing self-control, for staff working with drug addicts. The program, which is primarily geared toward training paraprofessionals, takes place in 10 one-and-a-half hour sessions and includes an overview of behavior modification as well as instruction in behavior control,…

  8. Response inhibition and addiction medicine: from use to abstinence.

    PubMed

    Spechler, Philip A; Chaarani, Bader; Hudson, Kelsey E; Potter, Alexandra; Foxe, John J; Garavan, Hugh

    2016-01-01

    Historically, neuroscientific research into addiction has emphasized affective and reinforcement mechanisms as the essential elements underlying the pursuit of drugs, their abuse, and difficulties associated with abstinence. However, research over the last decade or so has shown that cognitive control systems, associated largely but not exclusively with the frontal lobes, are also important contributors to drug use behaviors. Here, we focus on inhibitory control and its contribution to both current use and abstinence. A body of evidence points to impaired inhibitory abilities across a range of drugs of abuse. Typically, studies suggest that substance-abusing individuals are characterized by relative hypoactivity in brain systems underlying inhibitory control. In contrast, abstinent users tend to show either normal or supernormal levels of activity in the same systems attesting to the importance of inhibitory control in suppressing the drug use urges that plague attempts at abstinence. In this chapter, the brain and behavioral basis of response inhibition will be reviewed, with a focus on neuroimaging studies of response inhibition in current and abstinent drug abusers. PMID:26806775

  9. The Rehabilitation Medicine Scientist Training Program

    PubMed Central

    Whyte, John; Boninger, Michael; Helkowski, Wendy; Braddom-Ritzler, Carolyn

    2016-01-01

    Physician scientists are seen as important in healthcare research. However, the number of physician scientists and their success in obtaining NIH funding have been declining for many years. The shortage of physician scientists in Physical Medicine and Rehabilitation is particularly severe, and can be attributed to many of the same factors that affect physician scientists in general, as well as to the lack of well developed models for research training. In 1995, the Rehabilitation Medicine Scientist Training Program (RMSTP) was funded by a K12 grant from the National Center of Medical Rehabilitation Research (NCMRR), as one strategy for increasing the number of research-productive physiatrists. The RMSTP's structure was revised in 2001 to improve the level of preparation of incoming trainees, and to provide a stronger central mentorship support network. Here we describe the original and revised structure of the RMSTP and review subjective and objective data on the productivity of the trainees who have completed the program. These data suggest that RMSTP trainees are, in general, successful in obtaining and maintaining academic faculty positions and that the productivity of the cohort trained after the revision, in particular, shows impressive growth after about 3 years of training. PMID:19847126

  10. Neuroscience of attentional processes for addiction medicine: from brain mechanisms to practical considerations.

    PubMed

    Fadardi, Javad Salehi; Cox, W Miles; Rahmani, Arash

    2016-01-01

    The present chapter first argues how having a goal for procuring alcohol or other substances leads to the development of a time-binding, dynamic, and goal oriented motivational state termed current concern, as the origin of substance-related attentional bias. Next, it discusses the importance of attentional bias in the development, continuation of, and relapsing to substance abuse. It further proceeds with a review of selective evidence from cognitive psychology that helps account for making decisions about using an addictive substance or refraining from using it. A discussion on the various brain loci that are involved in attentional bias and other kinds of cue reactivity is followed by presenting findings from neurocognitive research. Finally, from an interdisciplinary perspective, the chapter presents new trends and ideas that can be applied to addiction-related cognitive measurement and training. PMID:26806772

  11. Addiction and the pharmacology of cannabis: implications for medicine and the law.

    PubMed

    Lader, Malcolm

    2009-01-01

    The topic of drug addiction or misuse of drugs has numerous far-reaching ramifications into areas such as neuroscience, medicine and therapeutics, toxicology, epidemiology, national and international economics and politics, and the law. The general principles of drug addiction are first summarised. A recurring and intrinsic problem is lack of adequate characterisation of the independent variable, namely the drug taken. Secondly, it is not feasible to allocate subjects randomly to treatments. Thirdly, the heterogeneity of different forms of addiction precludes facile generalisations. "A problem drug user is anyone who experiences social, psychological, physical, or legal problems related to intoxication, and/or regular excessive consumption, and/or dependence as a consequence of their use of drugs" (UK Advisory Council on Misuse of Drugs, 1982). Cannabis is a genus of flowering plants whose products are used as recreational drugs. Claims have been made for a range of therapeutic properties. Its two main active principles are delta9 - tetrahydrocannabinol (THC) and cannabidiol (CBD). These compounds have contrasting pharmacological properties. THC is suspected of causing psychotic phenomena, but CBD seems more sedative and may even be antipsychotic. The past use of cannabis, particularly the concentrations of THC and CBD, can be monitored with hair analysis. Recent studies involving the administration of THC and CBD to human subjects are reviewed. Suggestions are made for further research into the pharmacology and toxicology of CBD. Such data may also point to a more rational evidence-based approach to the legal control of cannabis preparations. PMID:19306615

  12. Mexico, maquiladoras, and occupational medicine training.

    PubMed

    Cordes, D H; Rea, D F; Schwartz, I; Rea, J

    1989-01-01

    Industrialization and its concomitant social and environmental effects in developing countries are considered in this paper. Mexico offers one example of economic progress achieved through the promotion of industrial growth. Recognising the need for trained experts with global experience in occupational health, the University of Arizona (UA) has begun a programme to train occupational and preventive medicine residents in international aspects of occupational health in the nearby industrialized border regions of Mexico. By using the maquiladora (assembly plant) industries and the resources of the Instituto Mexicano del Seguro Social with the State of Sonora, residents observe existing problems in occupational safety and health in addition to adding to their understanding of the need for worldwide cooperation for research and reform in this field. PMID:2719874

  13. Family medicine training--the international experience.

    PubMed

    Roberts, Richard G; Hunt, Vincent R; Kulie, Teresa I; Schmidt, Wesley; Schirmer, Julie M; Villanueva, Tiago; Wilson, C Ruth

    2011-06-01

    Family medicine is undergoing dramatic transformation around the world. Its organisation, delivery, and funding are changing in profound ways. While the specifics of primary care reform vary, a common emerging strategy involves establishment of primary health care teams that provide improved access, use electronic records, are networked with other teams, and are paid using blended payment schemes. More family doctors are needed in all countries. New approaches beyond the traditional apprenticeships or residency programs will be required to meet global demand. Training of family doctors must change to prepare tomorrow's family physician for a different practice reality. Curricula are more competency-oriented, rather than time-focused. Today's trainees can anticipate a career that includes periodic reassessment of their knowledge base and competency. This article explores these trends and offers some strategies that have proved effective in various parts of the world for training increased numbers of qualified family doctors. PMID:21644860

  14. Cognitive neuroscience of cognitive retraining for addiction medicine: From mediating mechanisms to questions of efficacy.

    PubMed

    Gladwin, Thomas E; Wiers, Corinde E; Wiers, Reinout W

    2016-01-01

    Cognitive retraining or cognitive bias modification (CBM) involves having subjects repeatedly perform a computerized task designed to reduce the impact of automatic processes that lead to harmful behavior. We first discuss the theory underlying CBM and provide a brief overview of important research progress in its application to addiction. We then focus on cognitive- and neural-mediating mechanisms. We consider recent criticism of both CBM and its theoretical foundations. Evaluations of CBM could benefit from considering theory-driven factors that may determine variations in efficacy, such as motivation. Concerning theory, while there is certainly room for fundamental advances in current models, we argue that the basic view of impulsive behavior and its control remains a useful and productive heuristic. Finally, we briefly discuss some interesting new directions for CBM research: enhancement of training via transcranial direct current stimulation, online training, and gamification, i.e., the use of gameplay elements to increase motivation. PMID:26822365

  15. A transatlantic comparison of training in emergency medicine.

    PubMed Central

    Wyatt, J P; Weber, J E

    1998-01-01

    The system of training in accident and emergency (A&E) medicine in the United Kingdom is at a critical and much earlier stage of development than in the United States. Transatlantic comparison offers the opportunity to explore possible ways of improving training in the United Kingdom. Comparison revealed deficiencies in the UK training system in the following: prehospital care training, formal theoretical teaching, close supervision in a clinical setting, and in-service training examinations. Implementation of measures designed to address these deficiencies would enhance UK training in A&E medicine. PMID:9639180

  16. Evolution of nuclear medicine training: past, present, and future.

    PubMed

    Graham, Michael M; Metter, Darlene F

    2007-02-01

    Since the official inception of nuclear medicine in 1971, the practice of nuclear medicine and its training programs have undergone major revisions. Numerous procedures that were common in the 1970s are no longer available, and many new radiotracers and procedures have since been developed. Training programs have evolved from an unstructured experience before 1971 to 2 y of nuclear medicine training after 2 clinical years, to 2 y of nuclear medicine training after 1 clinical year and, most recently, to 3 y of nuclear medicine training after 1 clinical year. The most substantial content changes in the new 2007 training program requirements are an increased emphasis on 6 clinical competencies, an increased emphasis on Nuclear Regulatory Commission requirements, and a new CT training requirement that was spawned by the advent of PET/CT. In addition to the new training program requirements, residents will need to become familiar with the concept of maintenance of certification, which will continue to be an important component of their professional careers. Nuclear medicine is gradually evolving into molecular imaging. Hence, it is inevitable that in the near future, training programs will be required to place greater emphasis on molecular imaging in both clinical and research applications. The incorporation of molecular imaging will represent a significant paradigm shift for the specialty but will ensure that nuclear medicine will be a major part of medical practice for the foreseeable future. PMID:17268024

  17. Length of training debate in family medicine: idealism versus realism?

    PubMed

    Orientale, Eugene

    2013-06-01

    How long a resident must train to achieve competency is an ongoing debate in medicine. For family medicine, there is an Accreditation Council for Graduate Medical Education (ACGME)-approved proposal to examine the benefits of lengthening family medicine training from 3 to 4 years. The rationale for adding another year of residency in family medicine has included the following: (1) overcoming the effect of the duty hour limits in further reducing educational opportunities, (2) reversing the growing number of first-time takers of the American Board of Family Medicine primary board who fail to pass the exam, (3) enhancing the family medicine training experience by "decompressing" the ever-growing number of Residency Review Committee requirements to maintain accreditation, and (4) improving the overall quality of family medicine graduates. PMID:24404258

  18. Length of Training Debate in Family Medicine: Idealism Versus Realism?

    PubMed Central

    Orientale, Eugene

    2013-01-01

    How long a resident must train to achieve competency is an ongoing debate in medicine. For family medicine, there is an Accreditation Council for Graduate Medical Education (ACGME)–approved proposal to examine the benefits of lengthening family medicine training from 3 to 4 years. The rationale for adding another year of residency in family medicine has included the following: (1) overcoming the effect of the duty hour limits in further reducing educational opportunities, (2) reversing the growing number of first-time takers of the American Board of Family Medicine primary board who fail to pass the exam, (3) enhancing the family medicine training experience by “decompressing” the ever-growing number of Residency Review Committee requirements to maintain accreditation, and (4) improving the overall quality of family medicine graduates. PMID:24404258

  19. Drug-induced neurotoxicity in addiction medicine: From prevention to harm reduction.

    PubMed

    Mohammad Ahmadi Soleimani, S; Ekhtiari, Hamed; Cadet, Jean Lud

    2016-01-01

    Neurotoxicity is considered as a major cause of neurodegenerative disorders. Most drugs of abuse have nonnegligible neurotoxic effects many of which are primarily mediated by several dopaminergic and glutamatergic neurotransmitter systems. Although many researchers have investigated the medical and cognitive consequences of drug abuse, the neurotoxicity induced by these drugs still requires comprehensive attention. The science of neurotoxicity promises to improve preventive and therapeutic strategies for brain disorders such as Alzheimer disease and Parkinson's disease. However, its clinical applications for addiction medicine remain to be defined adequately. This chapter reviews the most commonly discussed mechanisms underlying neurotoxicity induced by common drugs of abuse including amphetamines, cocaine, opiates, and alcohol. In addition, the known factors that trigger and/or predispose to drug-induced neurotoxicity are discussed. These factors include drug-related, individual-related, and environmental insults. Moreover, we introduce some of the potential pharmacological antineurotoxic interventions deduced from experimental animal studies. These interventions involve various targets such as dopaminergic system, mitochondria, cell death signaling, and NMDA receptors, among others. We conclude the chapter with a discussion of addicted patients who might benefit from such interventions. PMID:26806769

  20. Neuroscience of alcohol for addiction medicine: Neurobiological targets for prevention and intervention in adolescents.

    PubMed

    Cservenka, Anita; Nagel, Bonnie J

    2016-01-01

    Structural and functional neuroimaging studies indicate that heavy alcohol use during adolescence may be neurotoxic to the brain. This chapter reviews the neuroimaging findings in cross-sectional and longitudinal studies of adolescent heavy alcohol users. These youth exhibit reductions in prefrontal, hippocampal, and cerebellar brain volume, decreased frontoparietal, and increased frontolimbic white matter integrity, as well as alterations in blood oxygen level-dependent response during working memory, inhibitory control, verbal encoding, decision making, and reward processing-some of which appear to differ between males and females. Although some exist, additional longitudinal studies will significantly advance addiction medicine by aiding prevention scientists and treatment providers to develop neurobiologically informed ways of strengthening neural networks prior to and after the onset of heavy alcohol use, thereby promoting healthy cognitive functioning across the adolescent period. PMID:26806778

  1. Satisfaction and Difficulties of Korean Family Medicine Resident Training Faculty

    PubMed Central

    Kim, Jung-Ha; Kim, Ju Young; Kwon, Kil Young; Lee, Chul-Min; Hyun, Seung Soo

    2013-01-01

    Background Practitioners of family medicine are essential to primary care practices in Korea. Resident training staffs in Korean family medicine departments have a crucial role in producing well-trained family physicians. This study assesses the aspects of satisfaction and difficulties of Korean family medicine resident training staffs. Methods We surveyed the resident training staffs of various Korean family medicine departments using an online survey tool. The survey used in this study was modified from previously used questionnaires. Respondents rated items using a five-point Likert scale and a 0-10 visual analogue scale. Results The response rate was 43.9% (122/278). The mean satisfaction score with regard to current family medicine residency programs was 7.59 out of 10. Resident training staffs found the administrative aspects of their role to be the most difficult. There were considerable differences in the reported difficulties of resident training according to the differing characteristics of each staff member, including age, sex, type of hospital, number of staff members, role as chief, and duration of staff. Most respondents (91.9%) cited a need for faculty development programs. Conclusion Korean family medicine resident training staffs need faculty development programs for the improvement of resident training. For the strengthening of core competencies among resident training staffs, faculty development programs or courses should be designed and implemented in Korea. PMID:24106588

  2. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training.

    PubMed

    Nawaz, Haq; Via, Christina M; Ali, Ather; Rosenberger, Lisa D

    2015-11-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents' attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907

  3. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training

    PubMed Central

    Nawaz, Haq; Via, Christina M.; Ali, Ather; Rosenberger, Lisa D.

    2016-01-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents’ attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907

  4. Access to palliative medicine training for Canadian family medicine residents.

    PubMed

    Oneschuk, D; Bruera, E

    1998-01-01

    The authors conducted a nine-item mail questionnaire of the 16 Canadian family medicine teaching programme directors to determine the accessibility and operation of palliative care education for their respective family medicine residents. All 16 faculties of medicine responded (100%). The survey revealed that while all universities offer elective time in palliative care only five out of 16 (31%) have a mandatory rotation. The median durations of the mandatory and elective rotations are limited to two and three-and-a-half weeks, respectively. The majority of the universities offer formal lectures in palliative care (12/16, 75%) and educational reading material (13/16, 81%), with the main format in 14/16 (87%) of the sites being case-based learning. The two most common sites for teaching to occur for the residents are the community/outpatient environment and an acute palliative care unit. Fifty-six per cent (9/16) of the universities have designated faculty positions for palliative medicine with a median number of two positions per site. Only one centre offers a specific palliative medicine examination during the rotation. Feedback from the residents regarding their respective palliative medicine programmes were positive overall. Findings from our survey indicate an ongoing need for improved education in palliative medicine at the postgraduate level. PMID:9616456

  5. Nuclear medicine training and practice in the Czech Republic.

    PubMed

    Kamínek, Milan; Koranda, Pavel

    2014-08-01

    Nuclear medicine in the Czech Republic is a full specialty with an exclusive practice. Since the training program was organized and structured in recent years, residents have had access to the specialty of nuclear medicine, starting with a two-year general internship (in internal medicine or radiology). At present, nuclear medicine services are provided in 45 departments. In total, 119 nuclear medicine specialists are currently registered. In order to obtain the title of Nuclear Medicine Specialist, five years of training are necessary; the first two years consist of a general internship in internal medicine or radiology. The remaining three years consist of training in the nuclear medicine specialty itself, but includes three months of practice in radiology. Twenty-one physicians are currently in nuclear medicine training and a mean of three specialists pass the final exam per year. The syllabus is very similar to that of the European Union of Medical Specialists (UEMS), namely concerning the minimum recommended numbers for diagnostic and therapeutic procedures. In principle, the Czech law requires continuous medical education for all practicing doctors. The Czech Medical Chamber has provided a continuing medical education (CME) system. Other national CMEs are not accepted in Czech Republic. PMID:24867257

  6. Graduate Training in Toxicology in Colleges of Veterinary Medicine.

    ERIC Educational Resources Information Center

    Robens, J. F.; Buck, W. B.

    1979-01-01

    Presented are an American Board of Veterinary Toxicology survey and evaluation of the training resources available in graduate programs in toxicology located in colleges of veterinary medicine. Regulatory toxicology, number of toxicologists needed, and curriculum are also discussed. (JMD)

  7. Training Addiction Counselors to Implement an Evidence-Based Intervention: Strategies for Increasing Organizational and Provider Acceptance

    ERIC Educational Resources Information Center

    Woo, Stephanie M.; Hepner, Kimberly A.; Gilbert, Elizabeth A.; Osilla, Karen Chan; Hunter, Sarah B.; Munoz, Ricardo F.; Watkins, Katherine E.

    2013-01-01

    One barrier to widespread public access to empirically supported treatments (ESTs) is the limited availability and high cost of professionals trained to deliver them. Our earlier work from 2 clinical trials demonstrated that front-line addiction counselors could be trained to deliver a manualized, group-based cognitive behavioral therapy (GCBT)…

  8. Hands-On Sports Medicine Training for Residents.

    ERIC Educational Resources Information Center

    Tanji, Jeffrey L.

    1989-01-01

    Describes the development of a hands-on sports medicine training program for residents at the University of California, Davis, Medical Center. Education strategies include clinical teaching, on-the-field education, experiential learning, and didactic instruction. Programs focusing exclusively on sports medicine are needed because the number of…

  9. The Society for Acute Medicine (UK) Acute Medicine Training Survey 2007.

    PubMed

    Skene, Hannah; Ward, David K

    2008-01-01

    An online survey of training in Acute Medicine was conducted to assemble a true picture of the current situation in the UK. The specialty is flourishing, with over 60 trainees having predicted CCT dates in Acute Medicine in 2010 and 2011 alone. 128 respondents highlighted a multitude of issues, including the need for improvements in management and special skills training and part time opportunities. We have used the results of this survey to suggest action points for Deaneries, Training Programme Directors, the Society for Acute Medicine (UK) and those involved in workforce planning. PMID:21607233

  10. Embedded crisis workers help to decompress ED, connect mental health and addiction medicine patients with needed resources.

    PubMed

    2014-02-01

    To manage a big spike in demand from patients seeking emergency care for mental health (MH) and addiction medicine concerns, staff from the University of Pittsburgh Medical Center-Mercy and Western Psychiatric Institute and Clinic of UPMC have devised a series of interventions aimed at quickly linking these patients with the care and resources they need. The most visible intervention is the addition of embedded crisis workers in the ED who help patients with MH or social needs navigate to more appropriate community resources. In just one year, the time it takes for a detox patient to be seen in the ED has decreased from one hour to less than 15 minutes, and the time it takes for a patient to be admitted to a detox unit has gone from about 20 hours to six hours. The percentage of patients admitted for MH or addiction medicine concerns has declined as staff have been able to apply inpatient resources more appropriately. Administrators say the hospital's clinical decision unit, which had been serving as a holding tank for the crush of MH and addiction medicine patients awaiting inpatient beds, can now be used for its intended purpose, for medical issues related to patients evaluated and treatment in the ED. PMID:24505862

  11. Culture Competence in the Training of Geriatric Medicine Fellows

    ERIC Educational Resources Information Center

    Tanabe, Marianne K. G.

    2007-01-01

    With the aging and diversifying of the elder population in the United States, there is a pressing need for an organized and effective curriculum in cultural competence. The Accreditation Council for Graduate Medical Education (ACGME) requires that the curriculum for Geriatric Medicine Fellowship training include cultural competency training.…

  12. Evaluation of a Medicine Information Training Program for Older People.

    ERIC Educational Resources Information Center

    Quine, Susan

    1998-01-01

    Australian older adults were trained to act as advocates and role models to inform peers on effective use of medicines. Trainees reported difficulties experienced by older learners when training is too concentrated. Many noted increased self-esteem and personal growth as a result of their involvement. (SK)

  13. Firearm injury prevention training in Preventive Medicine Residency programs.

    PubMed

    Khubchandani, Jagdish; Price, James H; Dake, Joseph A

    2009-08-01

    Preventive medicine plays a central role in the reducing the number of deaths due to preventable causes of premature deaths. General Preventive Medicine Residency programs have not been studied in relation to training in this area. A three-wave mail survey was conducted with email and telephone follow-ups. The outcome measures were the portion of program directors involved in training residents on firearm injury prevention issues and their perceived benefits and barriers of training residents on firearm injury prevention issues. Only 25% of the programs provided formal training on firearm injury prevention. Program directors who provided formal training perceived significantly higher number of benefits to offering such training than did directors who did not provide such training but no significant difference was found between the two for number of perceived barriers. If preventive medicine residency graduates are to play a role in reducing premature morbidity and mortality from firearms it will require more residencies to offer formal training in this area. The Association for Prevention Teaching and Research needs to develop guidelines on specific curriculum topics regarding firearm injury prevention. PMID:19326195

  14. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use.

    PubMed

    Kampman, Kyle; Jarvis, Margaret

    2015-01-01

    The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed to expansion of the epidemic and concerns for unethical practices. At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it. This "Practice Guideline" was developed to assist in the evaluation and treatment of opioid use disorder, and in the hope that, using this tool, more physicians will be able to provide effective treatment. Although there are existing guidelines for the treatment of opioid use disorder, none have included all of the medications used at present for its treatment. Moreover, few of the existing guidelines address the needs of special populations such as pregnant women, individuals with co-occurring psychiatric disorders, individuals with pain, adolescents, or individuals involved in the criminal justice system. This Practice Guideline was developed using the RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) - a process that combines scientific evidence and clinical knowledge to determine the appropriateness of a set of clinical procedures. The RAM is a deliberate approach encompassing review of existing guidelines, literature reviews, appropriateness ratings, necessity reviews, and document development. For this project, American Society of Addiction Medicine selected an independent committee to oversee guideline development and to assist in writing. American Society of Addiction Medicine's Quality Improvement Council oversaw the selection process for the independent development committee. Recommendations included in the guideline encompass a broad range of topics, starting with the initial evaluation of the

  15. Training requirements for chemists in radiotracer development for nuclear medicine

    SciTech Connect

    Finn, R.; Fowler, J.

    1988-01-01

    This panel was organized to address the current and anticipated future shortage of chemists with advanced training to fill positions in the nuclear medicine field. Although hard data and statistics are difficult to acquire, we will attempt to highlight the impact of chemistry on nuclear medicine and to describe the growth of the field which has led to an increasing need for chemists resulting in the current manpower shortage. We also will make recommendations for attracting Ph.D. chemists to careers in nuclear medicine research and possible mechanisms for postgraduate training. Solving this problem and establishing a long term committment and mechanism for advanced training is critically important to meet the current needs of the profession and to assure future growth and innovation. 3 tabs.

  16. Neuroscience of resilience and vulnerability for addiction medicine: From genes to behavior.

    PubMed

    Morrow, Jonathan D; Flagel, Shelly B

    2016-01-01

    Addiction is a complex behavioral disorder arising from roughly equal contributions of genetic and environmental factors. Behavioral traits such as novelty-seeking, impulsivity, and cue-reactivity have been associated with vulnerability to addiction. These traits, at least in part, arise from individual variation in functional neural systems, such as increased striatal dopaminergic activity and decreased prefrontal cortical control over subcortical emotional and motivational responses. With a few exceptions, genetic studies have largely failed to consistently identify specific alleles that affect addiction liability. This may be due to the multifactorial nature of addiction, with different genes becoming more significant in certain environments or in certain subsets of the population. Epigenetic mechanisms may also be an important source of risk. Adolescence is a particularly critical time period in the development of addiction, and environmental factors at this stage of life can have a large influence on whether inherited risk factors are actually translated into addictive behaviors. Knowledge of how individual differences affect addiction liability at the level of genes, neural systems, behavioral traits, and sociodevelopmental trajectories can help to inform and improve clinical practice. PMID:26806768

  17. Training experts in family medicine teaching.

    PubMed

    Švab, Igor; Allen, Justin; Žebiene, Egle; Petek Šter, Marija; Windak, Adam

    2016-01-01

    Family medicine teachers require specific educational skills. A framework for their professional development is essential for future development of the discipline in Europe. EURACT developed a framework on educational expertise, and subsequently applied it in a curriculum of teaching-skills courses of various levels. The aim of this article is to describe the development of the teaching framework, and of an international three-level course programme for 'teaching-the-teachers'. Furthermore, we describe our experiences and lessons learned, in particular with regard to the level-three programme for proficient teachers, which was new. We conclude that it is possible to develop a theoretical framework of family medicine teaching expertise and to apply it in an international high-level educational programme for future experts in family medicine education. Research evidence of the usefulness of this approach is needed, and the threats for its further development into a sustainable activity are its high teacher/student ratio associated with relatively high costs and difficulties in recruiting suitable participants. PMID:26800044

  18. Resistance training is medicine: effects of strength training on health.

    PubMed

    Westcott, Wayne L

    2012-01-01

    Inactive adults experience a 3% to 8% loss of muscle mass per decade, accompanied by resting metabolic rate reduction and fat accumulation. Ten weeks of resistance training may increase lean weight by 1.4 kg, increase resting metabolic rate by 7%, and reduce fat weight by 1.8 kg. Benefits of resistance training include improved physical performance, movement control, walking speed, functional independence, cognitive abilities, and self-esteem. Resistance training may assist prevention and management of type 2 diabetes by decreasing visceral fat, reducing HbA1c, increasing the density of glucose transporter type 4, and improving insulin sensitivity. Resistance training may enhance cardiovascular health, by reducing resting blood pressure, decreasing low-density lipoprotein cholesterol and triglycerides, and increasing high-density lipoprotein cholesterol. Resistance training may promote bone development, with studies showing 1% to 3% increase in bone mineral density. Resistance training may be effective for reducing low back pain and easing discomfort associated with arthritis and fibromyalgia and has been shown to reverse specific aging factors in skeletal muscle. PMID:22777332

  19. Neuroscience of opiates for addiction medicine: From stress-responsive systems to behavior.

    PubMed

    Zhou, Yan; Leri, Francesco

    2016-01-01

    Opiate addiction, similarly to addiction to other psychoactive drugs, is chronic relapsing brain disease caused by drug-induced short-term and long-term neuroadaptations at the molecular, cellular, and behavioral levels. Preclinical research in laboratory animals has found important interactions between opiate exposure and stress-responsive systems. In this review, we will discuss the dysregulation of several stress-responsive systems in opiate addiction: vasopressin and its receptor system, endogenous opioid systems (including proopiomelanocortin/mu opioid receptor and dynorphin/kappa opioid receptor), orexin and its receptor system, and the hypothalamic-pituitary-adrenal axis. A more complete understanding of how opiates alter these stress systems, through further laboratory-based studies, is required to identify novel and effective pharmacological targets for the long-term treatment of heroin addiction. PMID:26806779

  20. Bench to Bedside: From the Science to the Practice of Addiction Medicine.

    PubMed

    Levounis, Petros

    2016-03-01

    The current understanding of addiction is based on a biopsychosocial model of illness. From a neurobiological perspective, addiction can be seen as the hijacking of the pleasure-reward pathways of the brain with a concomitant weakening of its executive function. The fundamental model has been expanded to include newer concepts such as multiple levels of severity of illness, motivational circuitry, and anti-reward pathways. These neurobiological concepts can explain some of the successes and failures of addiction treatment in the second half of the 20th century and the beginning of the 21st century. Psychosocial interventions (primarily cognitive behavior therapy, mutual help groups, and motivational interviewing) and pharmacological treatments (such as agonists, antagonists, and partial agonists) form the basis of addiction treatment today. PMID:26553278

  1. [Strengthening the medical aspect of addiction care].

    PubMed

    van Brussel, G H

    2003-08-23

    The Dutch Association for Addiction Medicine and the umbrella organisation GGZ Nederland (sector organisation for mental health and addiction care) have compiled a report entitled 'Strengthening medical care in the addiction care sector'. The report argues why medical care needs to be strengthened and provides guidance as to how the present shortcomings in quality and quantity can be dealt with. Addiction is now considered to be a medical condition with patients instead of clients. This means that the care, including the financial aspects, needs to be organised in the same way as all other forms of regular health care. Furthermore, the training in addiction medicine needs to be given a clearer status in the form of departments, professorships, training institutes and certification. Within the context of this report the responsibility of addiction centres needs to be emphasised. Vacancies in the many forms of social work could be exchanged for well-trained nurses and physicians, without the need for extra financial assistance. PMID:12966626

  2. Family medicine residency training and burnout: a qualitative study

    PubMed Central

    Rutherford, Kimberly; Oda, Joanna

    2014-01-01

    Background Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Method Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Results Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one’s work is valued and rotations in family medicine. Conclusions The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors. PMID:26451218

  3. The impact of managed care on substance abuse treatment: a report of the American Society of Addiction Medicine.

    PubMed

    Galanter, M; Keller, D S; Dermatis, H; Egelko, S

    2000-01-01

    This report examines the impact of managed care (MC) and related developments on substance abuse treatment, and evaluates how it has been associated with a decline in the availability of proper treatment for many addicted patients. A trend toward carve-out and for-profit MC organizations is associated with lower financial incentives for intensive treatment than in earlier staff-model and not-for-profit MC organizations. The value of substance abuse insurance coverage has declined by 75% between 1988 and 1998 for employees of mid-to large-size companies, compared with only an 11.5% decline for general health insurance. The shift towards MC has also been associated with a drastic reduction in frequency and duration of inpatient hospitalization, and there is no clear evidence that this reduction has been offset by a corresponding increase in outpatient support. In a survey of physicians treating addiction, the majority felt that MC had a negative impact on detoxification and rehabilitation, and on their ethical practice of addiction medicine. PMID:11076117

  4. A Novel Approach to Medicine Training for Psychiatry Residents

    ERIC Educational Resources Information Center

    Onate, John; Hales, Robert; McCarron, Robert; Han, Jaesu; Pitman, Dorothy

    2008-01-01

    Objective: A unique rotation was developed to address limited outpatient internal medicine training in psychiatric residency by the University of California, Davis, Department of Psychiatry and Behavioral Sciences, which provides medical care to patients with mental illness. Methods: The number of patients seen by the service and the number of…

  5. Human Factors in Training - Space Medicine Proficiency Training

    NASA Technical Reports Server (NTRS)

    Connell, Erin; Arsintescu, Lucia

    2009-01-01

    The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1

  6. Herbal medicines for the management of opioid addiction: safe and effective alternatives to conventional pharmacotherapy?

    PubMed

    Ward, Jeanine; Rosenbaum, Christopher; Hernon, Christina; McCurdy, Christopher R; Boyer, Edward W

    2011-12-01

    Striking increases in the abuse of opioids have expanded the need for pharmacotherapeutic interventions. The obstacles that confront effective treatment of opioid addiction - shortage of treatment professionals, stigma associated with treatment and the ability to maintain abstinence - have led to increased interest in alternative treatment strategies among both treatment providers and patients alike. Herbal products for opioid addiction and withdrawal, such as kratom and specific Chinese herbal medications such as WeiniCom, can complement existing treatments. Unfortunately, herbal treatments, while offering some advantages over existing evidence-based pharmacotherapies, have poorly described pharmacokinetics, a lack of supportive data derived from well controlled clinical trials, and severe toxicity, the cause for which remains poorly defined. Herbal products, therefore, require greater additional testing in rigorous clinical trials before they can expect widespread acceptance in the management of opioid addiction. PMID:22133323

  7. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use

    PubMed Central

    Kampman, Kyle; Jarvis, Margaret

    2015-01-01

    The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed to expansion of the epidemic and concerns for unethical practices. At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it. This “Practice Guideline” was developed to assist in the evaluation and treatment of opioid use disorder, and in the hope that, using this tool, more physicians will be able to provide effective treatment. Although there are existing guidelines for the treatment of opioid use disorder, none have included all of the medications used at present for its treatment. Moreover, few of the existing guidelines address the needs of special populations such as pregnant women, individuals with co-occurring psychiatric disorders, individuals with pain, adolescents, or individuals involved in the criminal justice system. This Practice Guideline was developed using the RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) – a process that combines scientific evidence and clinical knowledge to determine the appropriateness of a set of clinical procedures. The RAM is a deliberate approach encompassing review of existing guidelines, literature reviews, appropriateness ratings, necessity reviews, and document development. For this project, American Society of Addiction Medicine selected an independent committee to oversee guideline development and to assist in writing. American Society of Addiction Medicine's Quality Improvement Council oversaw the selection process for the independent development committee. Recommendations included in the guideline encompass a broad range of topics, starting with the initial evaluation of

  8. Personalized Cancer Genetics Training for Personalized Medicine

    PubMed Central

    Blazer, Kathleen R.; MacDonald, Deborah J.; Culver, Julie O.; Huizenga, Carin R.; Morgan, Robert J.; Uman, Gwen C.; Weitzel, Jeffrey N.

    2012-01-01

    Purpose To assess the impact of a multi-modal interdisciplinary course in genetic cancer risk assessment (GCRA) and research collaboration for community-based clinicians. Clinicians are increasingly requested to conduct GCRA, but many are inadequately prepared to provide these services. Methods A prospective analysis of 131 participants (48 physicians, 41 advanced-practice nurses and 42 genetic counselors) from community settings across the U.S. The course was delivered in three phases: distance didactic learning, face-to-face training and 12 months of Web-based professional development activities to support integration of skills into practice. Cancer genetics knowledge, skills, professional self-efficacy and practice changes were measured at baseline, immediate- and 14-months-post course. Results Knowledge, skills and self-efficacy scores were significantly different between practice disciplines; however, post scores increased significantly overall and for each discipline (p<.001). Fourteen-month practice outcomes reflect significant increases in provision of GCRA services (p=.018), dissemination of cancer prevention information (p=.005) and high-risk screening recommendations (p=.004) to patients, patient enrollment in research (p=.013), and educational outreach about GCRA (p=.003). Conclusions Results support the efficacy of the multi-modal course as a tool to develop a genetically literate workforce. Sustained alumni participation in Web-based professional development activities has evolved into a distance-mediated Community of Practice in clinical cancer genetics, modeling the lifelong learning goals envisioned by leading CME stakeholders. PMID:21629123

  9. Training of Generalists in Medicine and Pediatrics: Experience at Harvard, and Adding a General Medicine Track

    ERIC Educational Resources Information Center

    Dorsey, Joseph; Relman, Arnold S.

    1975-01-01

    Joseph Dorsey describes the development of the Harvard Medical School service program now serving 40,000 members in two health centers. Planning considerations for developing the primary care residency are included. Arnold Relman discusses the role of internal medicine and pediatrics in training primary care physicians noting subspecialization…

  10. Adolescent psychotherapy for addiction medicine: From brain development to neurocognitive treatment mechanisms.

    PubMed

    Thayer, Rachel E; Feldstein Ewing, Sarah W

    2016-01-01

    Effectively treating addiction is a challenge among any population, and treatment for adolescents may be particularly challenging in the context of ongoing neurodevelopment, which may alter the brain's initial response to substances as well as its response to treatment. One way to improve treatment outcomes for youth is to use a translational perspective that explicitly connects cognitive and neurodevelopmental fields with the field of behavioral therapies. This integrative approach is a potential first step to inform the correspondence between the neurocognitive and behavioral fields in youth addiction. This chapter seeks to provide context for neurocognitive treatment studies by first discussing recent structural and functional neuroimaging studies showing associations with substance use or behavioral addictions. Several regions of interest are then proposed that appear to also be associated with addiction treatment across multiple studies, namely, the accumbens/striatum, precuneus, insula, anterior cingulate cortex, and dorsolateral prefrontal cortex. This research suggests that reward, self-reflective, and executive control areas might be especially relevant in youth behavioral treatment response, and preliminary evidence suggests that existing treatments may encourage neurocognitive changes in these areas. PMID:26822364

  11. Training in intensive care medicine. A challenge within reach.

    PubMed

    Castellanos-Ortega, A; Rothen, H U; Franco, N; Rayo, L A; Martín-Loeches, I; Ramírez, P; Cuñat de la Hoz, J

    2014-01-01

    The medical training model is currently immersed in a process of change. The new paradigm is intended to be more effective, more integrated within the healthcare system, and strongly oriented towards the direct application of knowledge to clinical practice. Compared with the established training system based on certification of the completion of a series or rotations and stays in certain healthcare units, the new model proposes a more structured training process based on the gradual acquisition of specific competences, in which residents must play an active role in designing their own training program. Training based on competences guarantees more transparent, updated and homogeneous learning of objective quality, and which can be homologated internationally. The tutors play a key role as the main directors of the process, and institutional commitment to their work is crucial. In this context, tutors should receive time and specific formation to allow the evaluation of training as the cornerstone of the new model. New forms of objective summative and training evaluation should be introduced to guarantee that the predefined competences and skills are effectively acquired. The free movement of specialists within Europe is very desirable and implies that training quality must be high and amenable to homologation among the different countries. The Competency Based training in Intensive Care Medicine in Europe program is our main reference for achieving this goal. Scientific societies in turn must impulse and facilitate all those initiatives destined to improve healthcare quality and therefore specialist training. They have the mission of designing strategies and processes that favor training, accreditation and advisory activities with the government authorities. PMID:24589154

  12. Core content for training in venous and lymphatic medicine

    PubMed Central

    Min, Robert J; Comerota, Anthony J; Meissner, Mark H; Carman, Teresa L; Rathbun, Suman W; Jaff, Michael R; Wakefield, Thomas W; Feied, Craig F

    2014-01-01

    The major venous societies in the United States share a common mission to improve the standards of medical practitioners, the educational goals for teaching and training programs in venous disease, and the quality of patient care related to the treatment of venous disorders. With these important goals in mind, a task force made up of experts from the specialties of dermatology, interventional radiology, phlebology, vascular medicine, and vascular surgery was formed to develop a consensus document describing the Core Content for venous and lymphatic medicine and to develop a core educational content outline for training. This outline describes the areas of knowledge considered essential for practice in the field, which encompasses the study, diagnosis, and treatment of patients with acute and chronic venous and lymphatic disorders. The American Venous Forum and the American College of Phlebology have endorsed the Core Content. PMID:25059735

  13. [Residency training of European respiratory medicine specialists: The HERMES project].

    PubMed

    Tirado-Conde, Gema; Miravitlles, Marc; Alvarez-Sala, José Luis; de Castro, Felipe Rodríguez; Ancochea, Julio

    2009-02-01

    Given the movement of medical specialists across borders in recent years, and the changes in legislation affecting the structure and operation of boards responsible for the various medical specialties, the task of harmonizing the training of respiratory medicine residents across the European Union has become crucial. The project for Harmonized Education in Respiratory Medicine for European Specialists (HERMES) is a collective response to this need. After 3 years of work toward building consensus, HERMES is entering its second phase. The Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has the aim of informing our resident trainees, their instructors, and others concerned with postgraduate education in respiratory medicine in Spain about this undeniably difficult task of harmonization. PMID:19232271

  14. A dual-systems perspective on addiction: contributions from neuroimaging and cognitive training.

    PubMed

    McClure, Samuel M; Bickel, Warren K

    2014-10-01

    Dual-systems theories explain lapses in self-control in terms of a conflict between automatic and deliberative modes of behavioral control. Numerous studies have now tested whether the brain areas that control behavior are organized in a manner consistent with dual-systems models. Brain regions directly associated with the mesolimbic dopamine system, the nucleus accumbens and ventromedial prefrontal cortex in particular, capture some of the features assumed by automatic processing. Regions in the lateral prefrontal cortex are more closely linked to deliberative processing and the exertion of self-control in the suppression of impulses. While identifying these regions crudely supports dual-systems theories, important modifications to what constitutes automatic and deliberative behavioral control are also suggested. Experiments have identified various means by which automatic processes may be sculpted. Additional work decomposes deliberative processes into component functions such as generalized working memory, reappraisal of emotional stimuli, and prospection. The importance of deconstructing dual-systems models into specific cognitive processes is clear for understanding and treating addiction. We discuss intervention possibilities suggested by recent research, and focus in particular on cognitive training approaches to bolster deliberative control processes that may aid quit attempts. PMID:25336389

  15. A dual-systems perspective on addiction: contributions from neuroimaging and cognitive training

    PubMed Central

    McClure, Samuel M.; Bickel, Warren K.

    2014-01-01

    Dual-systems theories explain lapses in self-control in terms of a conflict between automatic and deliberative modes of behavioral control. Numerous studies have now tested whether the brain areas that control behavior are organized in a manner consistent with dual-systems models. Brain regions directly associated with the mesolimbic dopamine system, the nucleus accumbens (NAcc) and ventromedial prefrontal cortex (vmPFC) in particular, capture some of the features assumed by automatic processing. Regions in the lateral prefrontal cortex (lPFC) are more closely linked to deliberative processing and the exertion of self-control in the suppression of impulses. While identifying these regions crudely supports dual-system theories, important modifications to what constitutes automatic and deliberative behavioral control are also suggested. Experiments have identified various means by which automatic processes may be sculpted. Additional work decomposes deliberative processes into component functions such as generalized working memory, reappraisal of emotional stimuli, and prospection. The importance of deconstructing dual-systems models into specific cognitive processes is clear for understanding and treating addiction. We discuss intervention possibilities suggested by recent research, and focus in particular on cognitive training approaches to bolster deliberative control processes that may aid quit attempts. PMID:25336389

  16. "Attitude Is a Little Thing that Makes a Big Difference": Reflection Techniques for Addiction Psychiatry Training

    ERIC Educational Resources Information Center

    Ballon, Bruce C.; Skinner, Wayne

    2008-01-01

    Objective: The authors aim to incorporate educational reflection techniques in an addiction psychiatry postgraduate core rotation in order to increase critical self-awareness of attitudes, values, and beliefs related to working with people with substance use and other addictive disorders. Methods: Reflection discussion times, reflection…

  17. Internal Medicine Residents' Perceptions of Cross-Cultural Training

    PubMed Central

    Park, Elyse R; Betancourt, Joseph R; Miller, Elizabeth; Nathan, Michael; MacDonald, Ellie; Ananeh-Firempong, Owusu; Stone, Valerie E

    2006-01-01

    BACKGROUND Physicians increasingly face the challenge of managing clinical encounters with patients from a range of cultural backgrounds. Despite widespread interest in cross-cultural care, little is known about resident physicians' perceptions of what will best enable them to provide quality care to diverse patient populations. OBJECTIVES To assess medicine residents' (1) perceptions of cross-cultural care, (2) barriers to care, and (3) training experiences and recommendations. DESIGN, SETTING, AND PATIENTS Qualitative individual interviews were conducted with 26 third-year medicine residents at Massachusetts General Hospital in Boston (response rate = 87%). Interviews were recorded, transcribed, and analyzed. RESULTS Despite significant interest in cross-cultural care, almost all of the residents reported very little training during residency. Most had gained cross-cultural skills through informal learning. A few were skeptical about formal training, and some expressed concern that it is impossible to understand every culture. Challenges to the delivery of cross-cultural care included managing patients with limited English proficiency, who involve family in critical decision making, and who have beliefs about disease that vary from the biomedical model. Residents cited many implications to these barriers, ranging from negatively impacting the patient-physician relationship to compromised care. Training recommendations included making changes to the educational climate and informal and formal training mechanisms. CONCLUSIONS If cross-cultural education is to be successful, it must take into account residents' perspectives and be focused on overcoming residents' cited barriers. It is important to convey that cross-cultural education is a set of skills that can be taught and applied, in a time-efficient manner, rather than requiring an insurmountable knowledge base. PMID:16704391

  18. Training Standards Statements of Family Medicine Postgraduate Training – A Review of Existing Documents Worldwide

    PubMed Central

    Berger, Sarah; Szecsenyi, Joachim; Marquard, Sabine

    2016-01-01

    Introduction For the effective and safe management of complex care needs for patients in community settings, high quality family medicine (FM) training programmes are needed. In less primary care oriented countries, training standards statements for FM postgraduate training are less commonly found. The aim of this study was to review international training standards statements in FM postgraduate training and to catalogue these statements to be used as a best practice standard guide for FM training programs in Germany. Materials and Methods A structured three-tiered search was performed: a systematic literature search in MEDLINE®; a search of international indicator databases; and a search in grey literature, consisting of a survey of international experts and a search in “Google (Scholar)”. From all identified documents, training standards statements were extracted, translated and summarized into categories referring to the same quality aspect. Results The search strategy revealed 25 relevant documents (MEDLINE® n = 15, databases n = 2, experts n = 7, “Google” n = 1), containing 337 training standards statements. These were summarized into 80 statements. They covered structure quality (n = 35); process quality (n = 43); and two training standards statements referred to outcome quality (n = 2). Conclusion A broad range of internationally sourced training standards statements for FM postgraduate training could be identified from countries with well-established primary care systems. Only few statements internationally referred to outcome quality, expressing the difficulty in assessing outcome. The resulting inventory of training standards statements for FM postgraduate training can serve as a resource for institutions seeking to formalise and systematise FM training at regional or national levels. PMID:27459714

  19. Family Medicine Training in the Care of Older Adults--Has the Retreat Been Sounded?

    ERIC Educational Resources Information Center

    Mouton, Charles P.; Parker, Robert W.

    2003-01-01

    Discusses the trend away from geriatrics training in family medicine residency despite the growing need in society. Asserts that family medicine is failing to seize an opportunity to advance the care of older adults and discusses what would constitute acceptable training in geriatrics and how it should fit into the family medicine curriculum. (EV)

  20. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

    ERIC Educational Resources Information Center

    Perez, Jose A., Jr.; Greer, Sharon

    2009-01-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

  1. 76 FR 64952 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-19

    ... Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a)(2) of the Federal... Committee on Training in Primary Care, Medicine and Dentistry . Dates and Times: November 7, 2011, 8:30 a.m.... Purpose: The Advisory Committee on Training in Primary Care Medicine and Dentistry (``Advisory...

  2. ‘I can't be an addict. I am.’ Over-the-counter medicine abuse: a qualitative study

    PubMed Central

    Cooper, Richard J

    2013-01-01

    Objectives Over-the-counter (OTC) pharmacy medicines are considered relatively safe in contrast to prescribed and illicit substances, but their abuse and addiction potential is increasingly recognised. Those affected represent a hard to reach group, with little known about their experiences. Study objectives were to describe the experiences and views of those self-reporting OTC medicine abuse, and why medicines were taken, how they were obtained and associated treatment and support sought. Design Qualitative study using in-depth mainly telephone interviews. Participants A purposive sample of 25 adults, aged 20–60s, 13 women. Setting UK, via two internet support groups. Results Individuals considered themselves ‘addicted’, but socially and economically active and different from illicit substance misusers. They blamed themselves for losing control over their medicine use, which usually began for genuine medical reasons and not experimentation and was often linked to the cessation of, or ongoing, medical prescribing. Codeine, in compound analgesics, was the main medicine implicated with three distinct dose ranges emerging with decongestant and sedative antihistamine abuse also being reported. Subsequent use was for the ‘buzz’ or similar effects of the opiate, which was obtained unproblematically by having lists of pharmacies to visit and occasionally using internet suppliers. Perceived withdrawal symptoms were described for all three dose ranges, and work and health problems were reported with higher doses. Mixed views about different treatment and support options emerged with standard drug treatment services being considered inappropriate for OTC medicines and concerns that this ‘hidden addiction’ was recorded in medical notes. Most supported the continued availability of OTC medicines with appropriate addiction warnings. Conclusions Greater awareness of the addiction potential of OTC medicines is needed for the public, pharmacists and medical

  3. Mindfulness Training Targets Neurocognitive Mechanisms of Addiction at the Attention-Appraisal-Emotion Interface

    PubMed Central

    Garland, Eric L.; Froeliger, Brett; Howard, Matthew O.

    2014-01-01

    Prominent neuroscience models suggest that addictive behavior occurs when environmental stressors and drug-relevant cues activate a cycle of cognitive, affective, and psychophysiological mechanisms, including dysregulated interactions between bottom-up and top-down neural processes, that compel the user to seek out and use drugs. Mindfulness-based interventions (MBIs) target pathogenic mechanisms of the risk chain linking stress and addiction. This review describes how MBIs may target neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface. Empirical evidence is presented suggesting that MBIs ameliorate addiction by enhancing cognitive regulation of a number of key processes, including: clarifying cognitive appraisal and modulating negative emotions to reduce perseverative cognition and emotional arousal; enhancing metacognitive awareness to regulate drug-use action schema and decrease addiction attentional bias; promoting extinction learning to uncouple drug-use triggers from conditioned appetitive responses; reducing cue-reactivity and increasing cognitive control over craving; attenuating physiological stress reactivity through parasympathetic activation; and increasing savoring to restore natural reward processing. Treatment and research implications of our neurocognitive framework are presented. We conclude by offering a temporally sequenced description of neurocognitive processes targeted by MBIs through a hypothetical case study. Our neurocognitive framework has implications for the optimization of addiction treatment with MBIs. PMID:24454293

  4. Electrophysiology for addiction medicine: From methodology to conceptualization of reward deficits.

    PubMed

    Stewart, Jennifer L; May, April C

    2016-01-01

    In the past decade, electroencephalographic research on addiction has employed passive viewing, oddball, inhibition, prediction, gambling, and reversal learning tasks to study how substance users neurally prioritize drug-related rewards at the expense of nondrug rewards. On the whole, findings across substances (alcohol, cannabis, cocaine, nicotine, opiates, gambling, and gaming) demonstrate impairments in the differentiation of monetary incentives and the inhibition of prepotent responses. Furthermore, exaggerated resources devoted to drug cues and attenuated processing of other types of pleasant emotional stimuli predict greater probability of future drug use. However, drug use recency, frequency, sensitivity, and insight all appear to be moderators of these effects. We argue that more longitudinal studies are warranted to determine the time course of reward processing as a function of development and chronicity. PMID:26822354

  5. Ambulatory care training during core internal medicine residency training: the Canadian experience.

    PubMed Central

    McLeod, P J; Meagher, T W

    1993-01-01

    OBJECTIVE: To determine the status of ambulatory care training of core internal medicine residents in Canada. DESIGN: Mail survey. PARTICIPANTS: All 16 program directors of internal medicine residency training programs in Canada. OUTCOME MEASURES: The nature and amount of ambulatory care training experienced by residents, information about the faculty tutors, and the sources and types of patients seen by the residents. As well, the program directors were asked for their opinions on the ideal ambulatory care program and the kinds of teaching skills required of tutors. RESULTS: All of the directors responded. Fifteen stated that the ambulatory care program is mandatory, and the other stated that it is an elective. Block rotations are more common than continuity-of-care assignments. In 12 of the programs 10% or less of the overall training time is spent in ambulatory care. In 11 the faculty tutors comprise a mixture of generalists and subspecialists. The tutors simultaneously care for patients and teach residents in the ambulatory care setting in 14 of the schools. Most are paid through fee-for-service billing. The respondents felt that the ideal program should contain a mix of general and subspecialty ambulatory care training. There was no consensus on whether it should be a block or continuity-of-care experience, but the directors felt that consultation and communication skills should be emphasized regardless of which type of experience prevails. CONCLUSIONS: Although there is a widespread commitment to provide core internal medicine residents with experience in ambulatory care, there is little uniformity in how this is achieved in Canadian training programs. PMID:8324688

  6. Re-Training the Addicted Brain: A Review of Hypothesized Neurobiological Mechanisms of Mindfulness-Based Relapse Prevention

    PubMed Central

    Witkiewitz, Katie; Lustyk, M. Kathleen B.; Bowen, Sarah

    2013-01-01

    Addiction has generally been characterized as a chronic relapsing condition. Several laboratory, preclinical, and clinical studies have provided evidence that craving and negative affect are strong predictors of the relapse process. These states, as well as the desire to avoid them, have been described as primary motives for substance use. A recently developed behavioral treatment, Mindfulness-Based Relapse Prevention (MBRP), was designed to target experiences of craving and negative affect and their roles in the relapse process. MBRP offers skills in cognitive behavioral relapse prevention integrated with mindfulness meditation. The mindfulness practices in MBRP are intended to increase discriminative awareness, with a specific focus on acceptance of uncomfortable states or challenging situations without reacting “automatically.” A recent efficacy trial found that those randomized to MBRP, as compared to those in a control group, demonstrated significantly lower rates of substance use and greater decreases in craving following treatment. Furthermore, individuals in MBRP did not report increased craving or substance use in response to negative affect. Importantly, areas of the brain that have been associated with craving, negative affect, and relapse have also been shown to be affected by mindfulness training. Drawing from the neuroimaging literature, we review several plausible mechanisms by which MBRP might be changing neural responses to the experiences of craving and negative affect, which subsequently may reduce risk for relapse. We hypothesize that MBRP may affect numerous brain systems and may reverse, repair, or compensate for the neuroadaptive changes associated with addiction and addictive behavior relapse. PMID:22775773

  7. From Ancient Chinese Medicine to a Novel Approach to Treat Cocaine Addiction.

    PubMed

    Diamond, Ivan; Yao, Lina

    2015-01-01

    Pharmacologic agents for CNS disorders are often inhibitors that occupy receptors, with frequent unavoidable side effects likely due to continuous binding. This review summarizes development of a novel aldehyde dehydrogenase 2 (ALDH2) inhibitor that specifically targets unique drug related episodic surges in dopamine (DA), a pathophysiologic mechanism that appears to underlie much of drug-seeking behavior. We have synthesized highly selective novel ALDH2 inhibitors (ALDH2i) that block alcohol- and cocaine cue-induced surges in nucleus accumbens (NAc) DA and prevent reinstatement of alcohol heavy drinking, cocaine self-administration and reinstatement of cocaine relapse-like behavior. The mechanism of action of ALDH2i depends on inhibiting dopamine aldehyde (DOPAL) clearance by ALDH2, enabling unmetabolized DOPAL to condense with DA to generate tetrahydropapaveroline (THP). THP selectively inhibits the activated (phosphorylated) tyrosine hydroxylase (TH) to suppress DA synthesis. Selective inhibition of ALDH2 appears to have therapeutic potential for treating cue-induced drug relapse, a major unmet need for treating addicted subjects. PMID:26022266

  8. Neuroscience of nicotine for addiction medicine: novel targets for smoking cessation medications.

    PubMed

    D'Souza, Manoranjan S

    2016-01-01

    Morbidity and mortality associated with tobacco smoking constitutes a significant burden on healthcare budgets all over the world. Therefore, promoting smoking cessation is an important goal of health professionals and policy makers throughout the world. Nicotine is a major psychoactive component in tobacco that is largely responsible for the widespread addiction to tobacco. A majority of the currently available FDA-approved smoking cessation medications act via neuronal nicotinic receptors. These medications are effective in approximately half of all the smokers, who want to quit and relapse among abstinent smokers continues to be high. In addition to relapse among abstinent smokers, unpleasant effects associated with nicotine withdrawal are a major motivational factor in continued tobacco smoking. Over the last two decades, animal studies have helped in identifying several neural substrates that are involved in nicotine-dependent behaviors including those associated with nicotine withdrawal and relapse to tobacco smoking. In this review, first the role of specific brain regions/circuits that are involved in nicotine dependence will be discussed. Next, the review will describe the role of specific nicotinic receptor subunits in nicotine dependence. Finally, the review will discuss the role of classical neurotransmitters (dopamine, serotonin, noradrenaline, glutamate, and γ-aminobutyric acid) as well as endogenous opioid and endocannabinoid signaling in nicotine dependence. The nicotinic and nonnicotinic neural substrates involved in nicotine-dependent behaviors can serve as possible targets for future smoking cessation medications. PMID:26806777

  9. Training and education to increase the effectiveness of technology introduction in medicine

    NASA Astrophysics Data System (ADS)

    Gagne, Albert H.

    1994-12-01

    Training and education can increase the effectiveness with which new technology can be introduced in medicine. However, the use of technology in the education and training itself can be the vehicle for that increased effectiveness. The most effective way that education and training can be improved by technology is through the use of simulation. Examples are given from, first, the historical perspective in aircrew and spacecrew flight training; an anesthesiology training simulator; and a laparoscopic surgery training simulator.

  10. Training on Exercise is Medicine® Within an Integrative Medicine Curriculum.

    PubMed

    Hill, Linda L; Nichols, Jeanne; Wing, David; Waalen, Jill; Friedman, Elizabeth

    2015-11-01

    Physicians are increasingly approached by individuals seeking integrative approaches to health care and well-being. Many integrative modalities include a physical activity component. Patients seek guidance from primary and specialty care providers on the safe and effective incorporation of these modalities into their lifestyle. Physicians and other health professionals receive very limited training in the clinical applications of exercise science. This paper reports on a curriculum designed to teach health professionals key exercise constructs for application to clinical practice for prevention and management of lifestyle-related disease, and incorporating the curriculum into a preventive medicine residency training program. The course was developed in 2012-2013, data collected in 2013-2015, and analysis was done in 2015. Six modules were developed as part of a 24-hour course. Each module included didactic, laboratory, and case examples. The modules included energetics, exercise and cardiorespiratory health, bone health, obesity and sarcopenia, balance and fall prevention, and behavior change and the use of technologies. The delivery was found feasible for all three components, delivered in 2-4-hour segments. The incorporation into the residency curriculum was feasible, efficacious, well received, and easily incorporated into the existing curriculum. This comprehensive curriculum has the potential to close the gap in medical school, residency, graduate, nursing, and integrative curricula on this important topic. Current practitioners would benefit in primary care and geriatric settings. This curriculum would also be useful for cross-disciplinary researchers, including public health, health behaviors, and integrative medicine practitioners. PMID:26477904

  11. Integrating complementary and alternative medicine into pediatric training.

    PubMed

    Barnes, Linda; Risko, Wanessa; Nethersole, Sharl; Maypole, Jack

    2004-04-01

    The Center for Pediatric Integrative Medical Education and Boston Healing Landscape Project represent diverse approaches to integrative medicine and its practice. The relationship and collegial collaboration between the two programs illustrates the extent to which they complement one another. Both recognize the importance of curriculum geared to different levels of learners and of interventions introduced across the full curriculum. Both use case-based learning, although each focuses on different kinds of CAM and different case models. The Center for Pediatric Integrative Medical Education promotes interactive didactics with hands-on, direct experiential learning. The BHLP applies active-learning pedagogy, through experiential learning and its teaching case model. Both programs understand that, given the ongoing interaction among medical students, residents, fellows, and faculty, each group's training in CAM must reinforce the others for a larger system to change. PMID:15101232

  12. A Model for Training Master's Level Addiction Counselors in Group Process

    ERIC Educational Resources Information Center

    O'Mara, Eileen McCabe; Demask, Michael P.

    2003-01-01

    The authors present a model for teaching group at the master's level that integrates classroom with experiential group practice. The basis for this adult learning model is an understanding of addiction, a model of how people change, and an appreciation of the stages of group development. The components of the model are didactic presentation, class…

  13. Effects of Medicine Ball Training on Fitness Performance of High-School Physical Education Students

    ERIC Educational Resources Information Center

    Faigenbaum, Avery D.; Mediate, Patrick

    2006-01-01

    The purpose of this study was to examine the effects of medicine ball training on the fitness performance of high-school physical education students. Sixty-nine high-school students participated in a 6-week medicine training program during the first 10 to 15 minutes of each physical education class. A group of 49 students who participated in…

  14. The foundations of interdisciplinary fellowship training in adolescent medicine in the United States.

    PubMed

    Bravender, Terrill

    2016-08-01

    The field of adolescent medicine, having developed from the specialty of Pediatrics, encompasses a holistic and developmental approach from its very origin. While its foundations were in medicine, early leaders in the field emphasized the importance of mental health care as well as nutrition, public health, and social justice. As the specialty became further established in the US with the creation of an academic society, board certification and training program accreditation, the interdisciplinary nature of adolescent medicine practice and training became formalized. This formal recognition brought with it strict guidelines with regards training and board certification. Despite the often Byzantinian training requirements, an interdisciplinary approach forms the core of adolescent medicine practice, and the incorporation of interdisciplinary training is a necessity for graduate medical education programs in the field of adolescent medicine. PMID:26115494

  15. Obstetric training in Emergency Medicine: a needs assessment

    PubMed Central

    Janicki, Adam James; MacKuen, Courteney; Hauspurg, Alisse; Cohn, Jamieson

    2016-01-01

    Background Identification and management of obstetric emergencies is essential in emergency medicine (EM), but exposure to pregnant patients during EM residency training is frequently limited. To date, there is little data describing effective ways to teach residents this material. Current guidelines require completion of 2 weeks of obstetrics or 10 vaginal deliveries, but it is unclear whether this instills competency. Methods We created a 15-item survey evaluating resident confidence and knowledge related to obstetric emergencies. To assess confidence, we asked residents about their exposure and comfort level regarding obstetric emergencies and eight common presentations and procedures. We assessed knowledge via multiple-choice questions addressing common obstetric presentations, pelvic ultrasound image, and cardiotocography interpretation. The survey was distributed to residency programs utilizing the Council of Emergency Medicine Residency Directors (CORD) listserv. Results The survey was completed by 212 residents, representing 55 of 204 (27%) programs belonging to CORD and 11.2% of 1,896 eligible residents. Fifty-six percent felt they had adequate exposure to obstetric emergencies. The overall comfort level was 2.99 (1–5 scale) and comfort levels of specific presentations and procedures ranged from 2.58 to 3.97; all increased moderately with postgraduate year (PGY) level. Mean overall percentage of items answered correctly on the multiple-choice questions was 58% with no statistical difference by PGY level. Performance on individual questions did not differ by PGY level. Conclusions The identification and management of obstetric emergencies is the cornerstone of EM. We found preliminary evidence of a concerning lack of resident comfort regarding obstetric conditions and knowledge deficits on core obstetrics topics. EM residents may benefit from educational interventions to increase exposure to these topics. PMID:27357908

  16. Education and training in family medicine: progress and a proposed national vision for 2030

    PubMed Central

    Goh, Lee Gan; Ong, Chooi Peng

    2014-01-01

    This review provides an update of education and training in family medicine in Singapore and worldwide. Family medicine has progressed much since 1969 when it was recognised as the 20th medical discipline in the United States. Three salient changes in the local healthcare landscape have been noted over time, which are of defining relevance to family medicine in Singapore, namely the rise of noncommunicable chronic diseases, the care needs of an expanding elderly population, and the care of a larger projected population in 2030. The change in the vision of family medicine into the future refers to a new paradigm of one discipline in many settings, and not limited to the community. Family medicine needs to provide a patient-centred medical home, and the discipline’s education and training need to be realigned. The near-term training objectives are to address the service, training and research needs of a changing and challenging healthcare landscape. PMID:24664375

  17. Are family medicine residents adequately trained to deliver palliative care?

    PubMed Central

    Mahtani, Ramona; Kurahashi, Allison M.; Buchman, Sandy; Webster, Fiona; Husain, Amna; Goldman, Russell

    2015-01-01

    Objective To explore educational factors that influence family medicine residents’ (FMRs’) intentions to offer palliative care and palliative care home visits to patients. Design Qualitative descriptive study. Setting A Canadian, urban, specialized palliative care centre. Participants First-year (n = 9) and second-year (n = 6) FMRs. Methods Semistructured interviews were conducted with FMRs following a 4-week palliative care rotation. Questions focused on participant experiences during the rotation and perceptions about their roles as family physicians in the delivery of palliative care and home visits. Participant responses were analyzed to summarize and interpret patterns related to their educational experience during their rotation. Main findings Four interrelated themes were identified that described this experience: foundational skill development owing to training in a specialized setting; additional need for education and support; unaddressed gaps in pragmatic skills; and uncertainty about family physicians’ role in palliative care. Conclusion Residents described experiences that both supported and inadvertently discouraged them from considering future engagement in palliative care. Reassuringly, residents were also able to underscore opportunities for improvement in palliative care education. PMID:27035008

  18. The East African Training Initiative. A Model Training Program in Pulmonary and Critical Care Medicine for Low-Income Countries.

    PubMed

    Sherman, Charles B; Carter, E Jane; Braendli, Otto; Getaneh, Asqual; Schluger, Neil W

    2016-04-01

    Despite an extensive burden of lung disease in East Africa, there are remarkably few pulmonary physicians in the region and no pulmonary subspecialty training programs. We developed a unique training program for pulmonary medicine in Ethiopia. The East African Training Initiative (EATI) is a 2-year fellowship program at Tikur Anbessa (Black Lion) Specialized Teaching Hospital, the largest public hospital in Ethiopia and the teaching hospital for the Addis Ababa University School of Medicine. The first year is devoted to clinical care and procedural skills. Lectures, conferences, daily inpatient and outpatient rounds, and procedure supervision by visiting faculty provide the clinical knowledge foundation. In the second year, training in clinical research is added to ongoing clinical training. Before graduation, fellows must pass rigorous written and oral examinations and achieve high marks on faculty evaluations. Funding derives from several sources. Ethiopian trainees are paid by the Ethiopian Ministry of Health and the Addis Ababa University School of Medicine. The World Lung Foundation and the Swiss Lung Foundation supply travel and housing costs for visiting faculty, who receive no other stipend. The first two trainees graduated in January 2015, and a second class of three fellows completed training in January 2016. All five presented research abstracts at the annual meetings of the International Union Against Tuberculosis and Lung Disease in 2014 and 2015. The EATI has successfully provided pulmonary medicine training in Ethiopia and has capacity for local leadership. We believe that EATI could be a model for other resource-limited countries. PMID:26991950

  19. 78 FR 26053 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a) (2) of the Federal... Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD). Dates and Times: May 20, 2013 (8:30... only and will be on a first come, first served basis. Space is limited. FOR FURTHER INFORMATION...

  20. Undergraduate Training in Companion Animal Preventive Medicine at Louisiana State University.

    ERIC Educational Resources Information Center

    Bech-Nielsen, Steen

    1979-01-01

    The veterinary curriculum at the LSU School of Veterinary Medicine has developed an undergraduate professional training program in companion animal preventive medicine--a new area of specialization--as a field of clinical practice. Curricula for years three and four are described. (Author/MLW)

  1. Epidemiology and Herd Health Training in the School of Veterinary Medicine, Louisiana State University.

    ERIC Educational Resources Information Center

    Archbald, L. F.; Hagstad, H. V.

    1978-01-01

    At Louisiana State University School of Veterinary Medicine, training in preventive medicine is incorporated into all four years of the curriculum. The curriculum is described with focus on the fourth year practical course that involves problem solving, using various herds in the area. (JMD)

  2. The Teaching of Liberal Arts in Internal Medicine Residency Training.

    ERIC Educational Resources Information Center

    Povar, Gail J.; Keith, Karla J.

    1984-01-01

    A survey on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine is discussed. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. (Author/MLW)

  3. Understanding British addiction statistics.

    PubMed

    Johnson, B D

    1975-01-01

    The statistical data issued by the Home Office and Department of Health and Social Security are quite detailed and generally valid measures of hard core addiction in Great Britain (Judson, 1973). Since 1968, the main basis of these high quality British statistics is the routine reports filed by Drug Treatment Centres. The well-trained, experienced staff of these clinics make knowledgeable dicsions about a cleint's addiction, efficiently regulate dosage, and otherwise exert some degree of control over addicts (Judson, 1973; Johnson, 1974). The co-operation of police, courts, prison physicians, and general practitioners is also valuable in collecting data on drug addiction and convictions. Information presented in the tables above indicates that a rising problem of herion addiction between 1962 and 1967 were arrested by the introduction of the treatment clinics in 1968. Further, legally maintained heroin addiction has been reduced by almost one-third since 1968, since many herion addicts have been transferred to injectable methadone. The decline in herion prescribing and the relatively steady number of narcotics addicts has apparently occurred in the face of a continuing, and perhaps increasing, demand for heroin and other opiates. With few exceptions of a minor nature analysis of various tables suggests that the official statistics are internally consistent. There are apparently few "hidden" addicts, since few unknown addicts die of overdoses or are arrested by police (Lewis, 1973), although Blumberg (1974) indicates that some unknown users may exist. In addition, may opitate usersnot officially notified are known by clinic doctors as friends of addicts receiving prescriptions (Judson, 1973; Home Office, 1974). In brief, offical British drug statistics seem to be generally valid and demonstrate that heroin and perhaps methadone addiction has been well contained by the treatment clinics. PMID:1039283

  4. 75 FR 64318 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-19

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Training in Primary... Congress and to the Secretary of the Department of Health and Human Services. Agenda: The meeting on Monday... Committee on Training in Primary Care, Medicine and Dentistry (ACTPCMD). Date and Time: November 15, 2010,...

  5. 77 FR 36550 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Training in Primary.... The ACTPCMD's reports are submitted to the Secretary of the Department of Health and Human Services... Committee on Training in Primary Care, Medicine and Dentistry (ACTPCMD). Dates and Times: July 19, 2012,...

  6. 77 FR 64116 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-18

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Training in Primary... to the Secretary of the Department of Health and Human Services; the Committee on Health, Education... Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD). Date and Time: November 1, 2012,...

  7. 76 FR 30951 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Training in Primary... policy and program development to the Secretary of the U.S. Department of Health and Human Services (HHS... Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD). Date and Time: June 13, 2011, 1...

  8. 75 FR 14446 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-25

    ... HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Training in Primary... Secretary of the Department of Health and Human Services and to Congress. Agenda: The meeting on Thursday... Committee on Training in Primary CareMedicine and Dentistry (ACTPCMD). Date and Time: April 22, 2010, 8...

  9. Addiction Training Scale: Pilot Study of a Self-Report Evaluation Tool for Psychiatry Residents

    ERIC Educational Resources Information Center

    Sattar, S. Pirzada; Madison, James; Markert, Ronald J.; Bhatia, Subhash C.; Petty, Frederick

    2004-01-01

    Objective: Alcohol and drug dependence disorders have become common public health hazards. Psychiatrists encounter these problems in a major portion of their patients. However, recent data suggest that their training does not provide them the confidence to treat these disorders. Current methods of evaluating residents fail to adequately ascertain…

  10. Conceptualizing Nonsuicidal Self-Injury as a Process Addiction: Review of Research and Implications for Counselor Training and Practice

    ERIC Educational Resources Information Center

    Buser, Trevor J.; Buser, Juleen K.

    2013-01-01

    Nonsuicidal self-injury (NSSI) may be characterized as a process addiction for some individuals who self-injure. The authors review findings on the addictive features of NSSI, including compulsivity, loss of control, continued use despite negative consequences, and tolerance.

  11. Development of Family Medicine training in Botswana: Views of key stakeholders in Ngamiland

    PubMed Central

    Mash, Robert

    2015-01-01

    Background Family Medicine training commenced in Botswana in 2011, and Maun was one of the two sites chosen as a training complex. If it is to be successful there has to be investment in the training programme by all stakeholders in healthcare delivery in the district. Aim The aim of the study was to explore the attitudes of stakeholders to initiation of Family Medicine training and their perspectives on the future roles of family physicians in Ngami district, Botswana. Setting Maun and the surrounding Ngami subdistrict of Botswana. Methods Thirteen in-depth interviews were conducted with purposively selected key stakeholders in the district health services. Data were recorded, transcribed and analysed using the framework method. Results Participants welcomed the development of Family Medicine training in Maun and expect that this will result in improved quality of primary care. Participants expect the registrars and family physicians to provide holistic health care that is of higher quality and expertise than currently experienced, relevant research into the health needs of the community, and reduced need for referrals. Inadequate personal welfare facilities, erratic ancillary support services and an inadequate complement of mentors and supervisors for the programme were some of the gaps and challenges highlighted by participants. Conclusion Family Medicine training is welcomed by stakeholders in Ngamiland. With proper planning introduction of the family physician in the district is expected to result in improvement of primary care.

  12. Value of subspecialty experience in internal medicine undergraduate training.

    PubMed

    Al Kadri, Hanan M F; Al-Moamary, Mohamed S; Tamim, Hani M; Al-Kadi, Mohammed T

    2012-05-01

    We aimed from our study to assess how students and clinical supervisors perceive students' achievement in the internal medicine subspecialty clinical attachments in comparison with the general attachments. We conducted a cross-sectional study comparing students' self-assessment ratings during the Medicine Block general and subspecialties clinical attachments at our college of medicine during the period between February 2007 and June 2009. We assessed the level of agreement between students' self-assessment in the different subspecialties with their self-assessment in the general attachments. We repeated the same calculation for the supervisors' assessment. Eighty-three students were included; these students attended eight different clinical attachments. A total of 517 self-assessment forms were completed (120 general internal medicine clinical attachments and 397 forms in different specialty attachments). The clinical supervisors completed parallel assessment forms. The undergraduate medical students' perceived their achievement in the subspecialty attachments well. This was similar to their perception of their achievement in the general clinical attachments. The clinical supervisors perceived students achievement in the subspecialties to be similar to their achievement in the general clinical attachments. In conclusion, we do encourage the implementation of specialty and subspecialty undergraduate clinical attachments for all students as part of their curriculum requirements. Furthermore, we encourage the strategic utilization of specialties/subspecialties attachment distribution aiming to enhance students' future interest to achieve balance in the different health specialties/subspecialties manpower. Further research to support this recommendation is needed. PMID:22569442

  13. Interpersonal Skills Training: Evaluation in an Internal Medicine Residency.

    ERIC Educational Resources Information Center

    Robbins, Alan S.; And Others

    1979-01-01

    To determine the effectiveness of teaching interpersonal skills in a general internal medicine residency, a program was developed utilizing videotape feedback of hospital house-staff/patient interactions. Fifty-one randomly selected house officers were included in a controlled pre- and post-test study design. The results suggest that such a…

  14. Case Presentations from the Addiction Academy.

    PubMed

    Laes, JoAn R; Wiegand, Timothy

    2016-03-01

    In this article, a case-based format is used to address complex clinical issues in addiction medicine. The cases were developed from the authors' practice experience, and were presented at the American College of Medical Toxicology Addiction Academy in 2015. Section I: Drug and Alcohol Dependence and Pain explores cases of patients with co-occurring pain and substance use disorders. Section II: Legal and Policy Issues in Substance Use Disorders highlights difficult legal and policy questions in addiction medicine. Section III: Special Populations and Addictive Disorders delves into the complexity of addiction in special populations (pregnant, pediatric, and geriatric patients). PMID:26586253

  15. New family medicine residency training programme: Residents’ perspectives from the University of Botswana

    PubMed Central

    Tshitenge, Stephane; Setlhare, Vincent; Tsima, Billy; Adewale, Ganiyu; Parsons, Luise

    2016-01-01

    Background Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported. Aims This study explored and assessed residents’ experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents. Methods A descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB. Results Eight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents’ potential solutions included an increase in staff, the acquisition of equipment at teaching sites and emphasis on FM core topics teachings. They had different views regarding how certain future career paths will be. Conclusions Despite the general dissatisfaction among residents because of challenges faced by the training programme, we have learnt that residents are capable of valuable inputs for improvement of their programme when engaged. There is need for the Department of Family Medicine to work with the Ministry of Health to set a clear career pathway for future graduates and to reflect on residents’ input for possible implementation.

  16. Key informants’ perspectives on development of family medicine training programs in Ethiopia

    PubMed Central

    Gossa, Weyinshet; Wondimagegn, Dawit; Mekonnen, Demeke; Eshetu, Wondwossen; Abebe, Zerihun; Fetters, Michael D

    2016-01-01

    As a very low-income country, Ethiopia faces significant development challenges, though there is great aspiration to dramatically improve health care in the country. Family medicine has recently been recognized through national policy as one potential contributor in addressing Ethiopia’s health care challenges. Family medicine is a new specialty in Ethiopia emerging in the context of family medicine development in Sub-Saharan Africa. The Addis Ababa University family medicine residency program started in 2013 and is the first and the only family medicine program in the country as of March 2016. Stakeholders on the ground feel that family medicine is off to a good start and have great enthusiasm and optimism for its success. While the Ministry of Health has a vision for the development of family medicine and a plan for rapid upscaling of family medicine across the country, significant challenges remain. Continuing discussion about the potential roles of family medicine specialists in Ethiopia and policy-level strategic planning to place family medicine at the core of primary health care delivery in the country is needed. In addition, the health care-tier system needs to be restructured to include the family medicine specialists along with appropriately equipped health care facilities for training and practice. Key stakeholders are optimistic that family medicine expansion can be successful in Ethiopia through a coordinated effort by the Ministry of Health and collaboration between institutions within the country, other Sub-Saharan African countries, and international partners supportive of establishing family medicine in Ethiopia. PMID:27175100

  17. National Library of Medicine Training Grant Program 1965-1971.

    ERIC Educational Resources Information Center

    National Library of Medicine (DHEW), Bethesda, MD.

    In general, the program has made a significant impact on the field of biomedical librarianship and information sciences. The majority of employees now entering the field are products of these programs and are attaining high levels of professionalism. Their specialized training has provided new and improved skills. Presently there does not appear…

  18. Drug Abuse Training as Part of a Family Medicine Clerkship.

    ERIC Educational Resources Information Center

    Confusione, Michael; And Others

    1982-01-01

    A program incorporating experiential and didactic experience in identification and treatment of drug abuse into third-year clerkship curriculum is described. Experiential training is in a methadone maintenance clinic. Students are evaluated on their knowledge, attitudes, and level of participation in the drug abuse treatment. (MSE)

  19. Screening for addiction in patients with chronic pain and "problematic" substance use: evaluation of a pilot assessment tool.

    PubMed

    Compton, P; Darakjian, J; Miotto, K

    1998-12-01

    Assessing for the presence of addiction in the chronic pain patient receiving chronic opioid analgesia is a challenging clinical task. This paper presents a recently developed screening tool for addictive disease in chronic pain patients, and pilot efficacy data describing its ability to do so. In a small sample of patients (n = 52) referred from a multidisciplinary pain center for "problematic" medication use, responses to the screening questionnaire were compared between patients who met combined diagnostic criteria for a substance use disorder and those who did not, as assessed by a trained addiction medicine specialist. Responses of addicted patients significantly differed from those of nonaddicted patients on multiple screening items, with the two groups easily differentiated by total questionnaire score. Further, three key screening indicators were identified as excellent predictors for the presence of addictive disease in this sample of chronic pain patients. PMID:9879160

  20. Gambling Addiction

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Gambling Addiction KidsHealth > For Teens > Gambling Addiction Print A ... So what's the story with gambling? What Is Gambling? Gambling means taking part in any activity or ...

  1. [Work addiction].

    PubMed

    Mentzel, G

    1979-01-01

    The symptomatology of workaholism (work addiction) was presented in the form of a questionnaire and compared with other forms of addiction, especially alcoholism. Then a case was used as example to illustrate the development of the illness and its psychodynamics. The therapy procedure was also briefly explained. Moreover the psychodynamics of workaholism (work addiction) are described, once again in comparison to other addictions. Finally the author gives general guidelines for therapy. PMID:452731

  2. Research Training Fellowship Program (Formerly Military Medicine and Allied Sciences Course).

    ERIC Educational Resources Information Center

    Walter Reed Army Hospital, Washington, DC.

    This document provides an outline of the Research Training Fellowship Program at the Walter Reed Army Institute of Research. Emphasizing the scientific foundations of military medicine, the course aims at preparing medical corps officers for careers in laboratory research or clinical investigation and teaching. The intent is to give officers who…

  3. 78 FR 48440 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Service Administration Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub. L. 92-463), notice...

  4. Graduate primary care training: a collaborative alternative for family practice, internal medicine, and pediatrics.

    PubMed

    Strelnick, A H; Bateman, W B; Jones, C; Shepherd, S D; Massad, R J; Townsend, J M; Grossman, R; Korin, E; Schorow, M

    1988-08-15

    The Residency Program in Social Medicine at Montefiore Medical Center is a collaborative, integrated training program for primary care pediatricians, internists, and family physicians within one interdisciplinary organization. Since 1970 we have trained more than 200 physicians, prepared them for board certification in their specialty, emphasized the psychosocial aspects and social determinants of health and illness, and shared a faculty, curriculum, and commitment to provide medical care for inner-city, underserved populations. We discuss the program's history and curriculum, administrative and academic structure, shared "cross-track" faculty units (psychosocial; social medicine; and research, education, and evaluation), and graduates' practice outcomes. The interdisciplinary character of the Residency Program in Social Medicine helps physicians successfully serve the underserved and exemplifies that interdisciplinary medical education succeeds when interdisciplinary health care teams are organized for optimal patient care. Only the federal government has the perspective and power to foster more interdisciplinary collaboration and strengthen primary care education in a period of shrinking resources. PMID:3395040

  5. [Further training for medical specialists in respiratory medicine: how can we improve it?].

    PubMed

    Karg, O

    2015-09-01

    Young physicians in Germany often criticize the advanced training programme, especially the lack of structure and the insufficient rotations. The Medical Association in each Bundesland/federal state require to include a proposal for advanced training and rotation in a trainer's aplication for an educational license. However, there is no systematic scrutiny of these concepts and therefore the criteria stated outcomes are often only incompletely met. Trainers engage too little in training methods and medical didactics. They rarely evaluate learning outcomes, and structured assessments based on workplace are exceptions. The reasons are deeply rooted in Germany's education system: Resources for specialist training are not provided, and there is no funding for a commitment in continued medical education. In addition, teaching is not assigned a quantifiable value. However, during the last decade awareness has arisen that good training programmes are an important part of quality assurance and the validation of a hospital. Better planning, structuring and evaluation of training programmes is necessary. New learning methods should be incorporated in training programmes. The German Respiratory Society (DGP) wishes to contribute to the improvement of advanced training: for example with "train the trainer" seminars for teachers, with a structured educational course programme for the trainees, with assessments such as the HERMES (Harmonized Education in Respiratory Medicine for European Specialists) exam and with support for the accreditation as a Respiratory Training Centre of the ERS (European Respiratory Society) and EBAP (European Board for Accreditation in Pneumology). PMID:26335895

  6. Prescription Drugs and Cold Medicines

    MedlinePlus

    ... Abuse » Prescription Drugs & Cold Medicines Prescription Drugs & Cold Medicines Email Facebook Twitter What is Prescription Drug Abuse: ... treatment of addiction. Read more Safe Disposal of Medicines Disposal of Unused Medicines: What You Should Know ( ...

  7. Training in clinical forensic medicine in the UK--perceptions of current regulatory standards.

    PubMed

    Stark, Margaret M; Norfolk, Guy A

    2011-08-01

    As clinical forensic medicine (CFM) is not currently recognised as a speciality in the UK there are no nationally agreed mandatory standards for training forensic physicians in either general forensic (GFM) or sexual offence medicine (SOM). The General Medical Council (GMC), the medical regulator in the UK, has issued clear standards for training in all specialities recommending that "trainees must be supported to acquire the necessary skills and experience through induction, effective educational supervision, an appropriate workload and time to learn". In order to evaluate the current situation in the field of clinical forensic medicine, doctors who have recently (within the last two years) started working in the field "trainees" (n = 38), and trainers (n = 61) with responsibility for clinical and educational supervision of new trainees, were surveyed by questionnaire to gather their perceptions of how the relevant GMC standards are being met in initial on-the-job training. Telephone interviews were performed with eleven doctors working as clinical or medical directors to determine their views. It is clear that currently the quality of training in CFM is sub-standard and inconsistent and that the published standards, as to the minimum requirement for training that must be met by post-graduate medical and training providers at all levels, are not being met. The Faculty of Forensic and Legal Medicine (FFLM) needs to set explicit minimum standards which will comply with the regulator and work to pilot credentialing for forensic physicians. A number of recommendations are made for urgent FFLM development. PMID:21771557

  8. Establishment of a General Medicine Residency Training Program in Rural West Africa

    PubMed Central

    Drislane, Frank W.; Akpalu, Albert; Wegdam, Harry H.J.

    2014-01-01

    Ghana, a developing country in West Africa, has major medical burdens in taking care of a large population with limited resources. Its three medical schools produce more than 200 graduates per year, but most emigrate to developed lands after training. Ghana is working to educate and retain locally trained physicians, but it is difficult to get them to work in rural settings where the need is greatest. This article details the establishment of a General Medicine residency at a 150-bed hospital in rural Ghana. Early training comprises 6 months each in Medicine, Surgery, OB/GYN, and Pediatrics; the hospital in Techiman also has a Surgery residency. House officers choose the program for more hands-on experience than they can get in larger centers. They perform many tasks, including surgery, sooner and more independently than do residents in developed countries. The training program includes a morning report, clinical teaching rounds, and rotations on in-patient wards and in the Emergency Department and clinics. Teaching focuses on history, physical examination, good communication, and proper follow-up, with rigorous training in the OR and some clinical research projects pertinent to Ghana. Trainees work hard and learn from one another, from a dedicated faculty, and by evaluating and treating very sick patients. Ghana’s rural residencies offer rigorous and attractive training, but it is too soon to tell whether this will help stem the “brain drain” of young physicians out of West Africa. PMID:25191148

  9. Postgraduate family medicine training in Singapore--a new way forward.

    PubMed

    Wong, Teck Yee; Chong, Phui Nah; Chng, Shih Kiat; Tay, Ee Guan

    2012-05-01

    Postgraduate Family Medicine (FM) training is important to train future primary care doctors to provide accessible and cost effective healthcare. In Singapore, a structured postgraduate FM training programme has been available for 20 years. This programme is characterised by involvement of both FM and non-FM doctors, well written modules and a rigorous assessment process. However, challenges faced by both the current healthcare system and training structure underlie the need to review the training structure to ensure its relevancy for future Family Physicians (FPs) to manage the needs of their patients. A workgroup was formed to review the current FM postgraduate programme and to explore the possibility of using the Accreditation Council for Graduate Medical Education (ACGME) framework to enhance our current system. The workgroup felt that broad-based training and comprehensive coverage of topics are areas that are important to retain in any new FM residency programme. Weaknesses identified included a lack of early FM exposure and the need to strengthen formative assessments. New organisational structures such as Family Medicine Centres (FMC) need to be established and the involvement of the private sector in any FM residency progammes could be enhanced. The implementation of the FM Residency Programme in 2011 presented a unique opportunity to realign FM postgraduate education in line with the national objectives and to equip FPs with the necessary knowledge and skills for managing the future healthcare needs of Singaporeans. PMID:22760720

  10. Establishment of a general medicine residency training program in rural West Africa.

    PubMed

    Drislane, Frank W; Akpalu, Albert; Wegdam, Harry H J

    2014-09-01

    Ghana, a developing country in West Africa, has major medical burdens in taking care of a large population with limited resources. Its three medical schools produce more than 200 graduates per year, but most emigrate to developed lands after training. Ghana is working to educate and retain locally trained physicians, but it is difficult to get them to work in rural settings where the need is greatest. This article details the establishment of a General Medicine residency at a 150-bed hospital in rural Ghana. Early training comprises 6 months each in Medicine, Surgery, OB/GYN, and Pediatrics; the hospital in Techiman also has a Surgery residency. House officers choose the program for more hands-on experience than they can get in larger centers. They perform many tasks, including surgery, sooner and more independently than do residents in developed countries. The training program includes a morning report, clinical teaching rounds, and rotations on in-patient wards and in the Emergency Department and clinics. Teaching focuses on history, physical examination, good communication, and proper follow-up, with rigorous training in the OR and some clinical research projects pertinent to Ghana. Trainees work hard and learn from one another, from a dedicated faculty, and by evaluating and treating very sick patients. Ghana's rural residencies offer rigorous and attractive training, but it is too soon to tell whether this will help stem the "brain drain" of young physicians out of West Africa. PMID:25191148

  11. Teaching transfusion medicine: current situation and proposals for proper medical training

    PubMed Central

    Flausino, Gustavo de Freitas; Nunes, Flávio Ferreira; Cioffi, Júnia Guimarães Mourão; Proietti, Anna Bárbara de Freitas Carneiro

    2014-01-01

    The current curricula in medical schools and hospital residence worldwide lack exposure to blood transfusion medicine, and require the reformulation of academic programs. In many countries, training in blood transfusion is not currently offered to medical students or during residency. Clinical evidence indicates that blood transfusions occur more frequently than recommended, contributing to increased risk due to this procedure. Therefore, the rational use of blood and its components is essential, due to the frequent undesirable reactions, to the increasing demand of blood products and the cost of the process. Significant improvements in knowledge of and skills in transfusion medicine are needed by both students and residents. Improvements are needed in both background knowledge and the practical application of this knowledge to improve safety. Studies prove that hemovigilance has an impact on transfusion safety and helps to prevent the occurrence of transfusion-related adverse effects. To ensure that all these aspects of blood transfusion are being properly addressed, many countries have instituted hospital transfusion committees. From this perspective, the interventions performed during the formation of medical students and residents, even the simplest, have proven effective in the acquisition of knowledge and medical training, thereby leading to a reduction in inappropriate use of blood. Therefore, we would like to emphasize the importance of the exposure of medical students and residents to blood services and transfusion medicine in order for them to acquire adequate medical training, as well as to discuss some changes in the current medical curricula regarding transfusion medicine that we judge critical. PMID:25638770

  12. Underwater medicine: a neglected area in Accident and Emergency specialist training.

    PubMed Central

    Braatvedt, G D; Mathew, B G; Corrall, R J

    1991-01-01

    We have evaluated the available medical care to sports divers by a postal questionnaire sent to consultants and senior registrars in Accident and Emergency medicine in the UK, assessing their training in underwater medicine. Replies were received from 60 of 96 consultants (63%) and 32 of 58 (55%) senior registrars. Thirty-two per cent of consultants and 50% of senior registrars had previous personal experience in managing an underwater diving accident. Thirty per cent of consultants and only 19% of senior registrars had prior formal postgraduate training in underwater medicine. Twenty-seven per cent of consultants and 13% of senior registrars replying did not know the pattern of referral for specialist advice nor where the nearest recompression chamber was to be found. We believe that more formal postgraduate training in underwater medicine is needed by A and E medical staff. Furthermore, clear guidelines about emergency management and patterns of referral for diving accidents should be displayed prominently in all A and E departments. PMID:1751890

  13. Staffing and training issues in critical care hyperbaric medicine.

    PubMed

    Kot, Jacek

    2015-03-01

    The integrated chain of treatment of the most severe clinical cases that require hyperbaric oxygen therapy (HBOT) assumes that intensive care is continued while inside the hyperbaric chamber. Such an approach needs to take into account all the risks associated with transportation of the critically ill patient from the ICU to the chamber and back, changing of ventilator circuits and intravascular lines, using different medical devices in a hyperbaric environment, advanced invasive physiological monitoring as well as medical procedures (infusions, drainage, etc) during long or frequently repeated HBOT sessions. Any medical staff who take care of critically ill patients during HBOT should be certified and trained according to both emergency/intensive care and hyperbaric requirements. For any HBOT session, the number of staff needed for any HBOT session depends on both the type of chamber and the patient's status--stable, demanding or critically ill. For a critically ill patient, the standard procedure is a one-to-one patient-staff ratio inside the chamber; however, the final decision whether this is enough is taken after careful risk assessment based on the patient's condition, clinical indication for HBOT, experience of the personnel involved in that treatment and the available equipment. PMID:25964039

  14. NIR tracking assists sports medicine in junior basketball training

    NASA Astrophysics Data System (ADS)

    Paeglis, Roberts; Bluss, Kristaps; Rudzitis, Andris; Spunde, Andris; Brice, Tamara; Nitiss, Edgars

    2011-07-01

    We recorded eye movements of eight elite junior basketball players. We hypothesized that a more stable gaze is correlated to a better shot rate. Upon preliminary testing we invited male juniors whose eyes could be reliably tracked in a game situation. To these ends, we used a head-mounted video-based eye tracker. The participants had no record of ocular or other health issues. No significant differences were found between shots made with and without the tracker cap, Paired samples t-test yielded p= .130 for the far and p=..900 > .050 for the middle range shots. The players made 40 shots from common far and middle range locations, 5 and 4 meters respectively for aged 14 years As expected, a statistical correlation was found between gaze fixation (in milliseconds) for the far and middle range shot rates, r=.782, p=.03. Notably, juniors who fixated longer before a shot had a more stable fixation or a lower gaze dispersion (in tracker's screen pixels), r=-.786, p=.02. This finding was augmented by the observation that the gaze dispersion while aiming at the basket was less (i.e., gaze more stable) in those who were more likely to score. We derived a regression equation linking fixation duration to shot success. We advocate infra-red eye tracking as a means to monitor player selection and training success.

  15. Narrative medicine as a means of training medical students toward residency competencies

    PubMed Central

    Arntfield, Shannon L.; Slesar, Kristen; Dickson, Jennifer; Charon, Rita

    2014-01-01

    Objective This study sought to explore the perceived influence of narrative medicine training on clinical skill development of fourth-year medical students, focusing on competencies mandated by ACGME and the RCPSC in areas of communication, collaboration, and professionalism. Methods Using grounded-theory, three methods of data collection were used to query twelve medical students participating in a one-month narrative medicine elective regarding the process of training and the influence on clinical skills. Iterative thematic analysis and data triangulation occurred. Results Response rate was 91% (survey), 50% (focus group) and 25% (follow-up). Five major findings emerged. Students perceive that they: develop and improve specific communication skills; enhance their capacity to collaborate, empathize, and be patient-centered; develop personally and professionally through reflection. They report that the pedagogical approach used in narrative training is critical to its dividends but misunderstood and perceived as counter-culture. Conclusion/Practice implications Participating medical students reported that they perceived narrative medicine to be an important, effective, but counter-culture means of enhancing communication, collaboration, and professional development. The authors contend that these skills are integral to medical practice, consistent with core competencies mandated by the ACGME/RCPSC, and difficult to teach. Future research must explore sequelae of training on actual clinical performance. PMID:23462070

  16. Pilot Program Using Medical Simulation in Clinical Decision-Making Training for Internal Medicine Interns

    PubMed Central

    Miloslavsky, Eli M.; Hayden, Emily M.; Currier, Paul F.; Mathai, Susan K.; Contreras-Valdes, Fernando; Gordon, James A.

    2012-01-01

    Background The use of high-fidelity medical simulation in cognitive skills training within internal medicine residency programs remains largely unexplored. Objective To design a pilot study to introduce clinical decision-making training using simulation into a large internal medicine residency program, explore the practicability of using junior and senior residents as facilitators, and examine the feasibility of using the program to improve interns' clinical skills. Methods Interns on outpatient rotations participated in a simulation curriculum on a voluntary basis. The curriculum consisted of 8 cases focusing on acute clinical scenarios encountered on the wards. One-hour sessions were offered twice monthly from August 2010 to February 2011. Internal medicine residents and simulation faculty served as facilitators. Results A total of 36 of 75 total interns volunteered to participate in the program, with 42% attending multiple sessions. Of all participants, 88% rated the sessions as “excellent,” 97% felt that the program improved their ability to function as an intern and generate a plan, and 81% reported improvement in differential diagnosis skills. Conclusions Simulation training was well received by the learners and improved self-reported clinical skills. Using residents as facilitators, supervised by faculty, was well received by the learners and enabled the implementation of the curriculum in a large training program. Simulation can provide opportunities for deliberate practice, and learners perceive this modality to be effective. PMID:24294427

  17. Addiction Competencies in the 2009 CACREP Clinical Mental Health Counseling Program Standards

    ERIC Educational Resources Information Center

    Lee, Tiffany K.; Craig, Stephen E.; Fetherson, Bianca T. L.; Simpson, C. Dennis

    2013-01-01

    The Council for Accreditation of Counseling and Related Educational Programs developed addiction competencies for clinical mental health counseling students. This article highlights these competencies, provides an overview of current addiction training, and describes methods to integrate addiction education into curricula.

  18. The globalization of training in adolescent health and medicine: one size does not fit all.

    PubMed

    Leslie, Karen

    2016-08-01

    Adolescent medicine across the globe is practiced within a variety of healthcare models, with the shared vision of the promotion of optimal health outcomes for adolescents. In the past decade, there has been a call for transformation in how health professionals are trained, with recommendations that there be adoption of a global outlook, a multiprofessional perspective and a systems approach that considers the connections between education and health systems. Many individuals and groups are now examining how best to accomplish this educational reform. There are tensions between the call for globally accepted standards of education models and practice (a one-size fits all approach) and the need to promote the ability for education practices to be interpreted and transformed to best suit local contexts. This paper discusses some of the key considerations for 'importing' training program models for adolescent health and medicine, including the importance of cultural alignment and the utilization of best evidence and practice in health professions education. PMID:26115497

  19. The Imperial College Cambridge Manchester (ICCAM) platform study: An experimental medicine platform for evaluating new drugs for relapse prevention in addiction. Part A: Study description.

    PubMed

    Paterson, Louise M; Flechais, Remy S A; Murphy, Anna; Reed, Laurence J; Abbott, Sanja; Boyapati, Venkataramana; Elliott, Rebecca; Erritzoe, David; Ersche, Karen D; Faluyi, Yetunde; Faravelli, Luca; Fernandez-Egea, Emilio; Kalk, Nicola J; Kuchibatla, Shankar S; McGonigle, John; Metastasio, Antonio; Mick, Inge; Nestor, Liam; Orban, Csaba; Passetti, Filippo; Rabiner, Eugenii A; Smith, Dana G; Suckling, John; Tait, Roger; Taylor, Eleanor M; Waldman, Adam D; Robbins, Trevor W; Deakin, J F William; Nutt, David J; Lingford-Hughes, Anne R

    2015-09-01

    Drug and alcohol dependence are global problems with substantial societal costs. There are few treatments for relapse prevention and therefore a pressing need for further study of brain mechanisms underpinning relapse circuitry. The Imperial College Cambridge Manchester (ICCAM) platform study is an experimental medicine approach to this problem: using functional magnetic resonance imaging (fMRI) techniques and selective pharmacological tools, it aims to explore the neuropharmacology of putative relapse pathways in cocaine, alcohol, opiate dependent, and healthy individuals to inform future drug development. Addiction studies typically involve small samples because of recruitment difficulties and attrition. We established the platform in three centres to assess the feasibility of a multisite approach to address these issues. Pharmacological modulation of reward, impulsivity and emotional reactivity were investigated in a monetary incentive delay task, an inhibitory control task, and an evocative images task, using selective antagonists for µ-opioid, dopamine D3 receptor (DRD3) and neurokinin 1 (NK1) receptors (naltrexone, GSK598809, vofopitant/aprepitant), in a placebo-controlled, randomised, crossover design. In two years, 609 scans were performed, with 155 individuals scanned at baseline. Attrition was low and the majority of individuals were sufficiently motivated to complete all five sessions (n=87). We describe herein the study design, main aims, recruitment numbers, sample characteristics, and explain the test hypotheses and anticipated study outputs. PMID:26246443

  20. Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital

    PubMed Central

    Blumenthal, Daniel M.; Bernard, Kenneth; Iyasere, Christiana

    2015-01-01

    Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included “leading a team” (98% of residents), “confronting problem employees” (93%), “coaching and developing others” (93%), and “resolving interpersonal conflict” (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees. PMID:26130876

  1. Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital.

    PubMed

    Fraser, Traci N; Blumenthal, Daniel M; Bernard, Kenneth; Iyasere, Christiana

    2015-07-01

    Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included "leading a team" (98% of residents), "confronting problem employees" (93%), "coaching and developing others" (93%), and "resolving interpersonal conflict" (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees. PMID:26130876

  2. Recruiting Quarterbacks: Strategies for Revitalizing Training in Primary Care Internal Medicine.

    PubMed

    Goroll, Allan H

    2016-02-01

    Current U.S. primary care workforce shortages and trainees' declining interest in primary care residency training, especially regarding primary care internal medicine, have many parallels with circumstances in the early 1970s, when modern adult primary care first emerged. Rediscovery of the lessons learned and the solutions developed at that time and applying them to the current situation have the potential to help engage a new generation of young physicians in the primary care mission.The author compares the internal medicine residency primary care track at the University of New Mexico, described by Brislen and colleagues in this issue, with the nation's first three-year primary care internal medicine residency track introduced at Massachusetts General Hospital in 1973. Strategies for addressing the challenges of primary care practice and improving learner attitudes toward the field are discussed. The author suggests that primary care physicians should be likened to "quarterbacks" rather than "gatekeepers" or "providers" to underscore the intensity of training, level of responsibility, degree of professionalism, and amount of compensation required for this profession. The advent of multidisciplinary team practice, modern health information technology, and fundamental payment reform promises to dramatically alter the picture of primary care, restoring its standing as one of the best job descriptions in medicine. PMID:26397701

  3. Consensus Recommendations of Pediatric Transfusion Medicine Objectives for Clinical Pathology Residency Training Programs

    PubMed Central

    Sanchez, Rosa; Sloan, Steven R.; Josephson, Cassandra D.; Ambruso, Daniel R.; Hillyer, Christopher D.; O’Sullivan, Patricia

    2010-01-01

    BACKGROUND Pediatric transfusion medicine (PTM) is a subspecialty of transfusion medicine (TM) with no formal training program and few specialists. The Pediatric Transfusion Medicine Academic Awardees (PedsTMAA) group surveyed PTM content experts to identify relevant objectives for the first formal PTM curriculum. STUDY DESIGN AND METHODS Eight North American PTM experts were invited to participate in a two-step consensus process. PTM-related objectives compiled from a review of existing training documents were organized into a survey. Experts were asked to rate each objective for relevancy for a clinical pathology trainee. Content validity indices (CVIs) and asymmetric confidence intervals (ACIs) of expert ratings and analysis of respondents’ comments were used to identify relevant objectives. RESULTS Six experts participated and reviewed 117 objectives. Based on content validity criteria (CVI ≥ 0.83 and lower-limit 95% ACI ≥ 3), a total of 65 objectives were considered relevant. Twenty-three objectives were rated “very relevant” by all the experts while some proposed objectives were determined to be not relevant, out-of-date, or inappropriate for a resident trainee level. CONCLUSION The PedsTMAA group identified 65 objectives for a PTM curriculum. Twenty-three represent a clear core set of objectives and should be considered for clinical pathology training. The next step is to consider the teaching strategies and evaluation methods that will be employed to best deliver this content addressing competency in medical knowledge. PMID:20051052

  4. Education and training in hyperbaric medicine. The Icelandic experience. An example of international scientific cooperation.

    PubMed

    Sallusti, R; Ferraù, S; Lozano Valdes, A; Gonzales, C; Jónsson, M; Gullo, A

    2001-10-01

    The authors describe their experience in the practice, education and learning in the field of hyperbaric medicine, following a project of international scientific cooperation, first in history, between Italy and Iceland. As a result of this project, the first hyperbaric facility came into use in Iceland in March 1993, initially entirely run and economically supported by the Italian side. Since 1997 the activity has been entirely financed by Icelandic National Health System with a special budget established each year according to an agreement between Icelandic and Italian Health Authorities, leaving the medical and the economical management of the Service to Italian personnel. Hyperbaric medicine is now a reality in the Icelandic medical practice. Moreover, since 1994 young Italian doctors from the University of Trieste, Italy, enrolled in the School of Specialization in Anesthesia, Intensive Care, have received training at the Service of Hyperbaric Medicine of the University of Reykjavik City Hospital, as part of their training. The educational activity, endorsed by the Italian Ministry of University and Research, consists of a theoretical part and of a practical part of operational assistance. At the end of his or her training, the resident has a full knowledge of the indications for hyperbaric oxygen therapy (HBOT) and of the related diagnostic and therapeutic procedures, is autonomous and is able to safely operate an hyperbaric chamber. An analytical report of the activity in year 2000 is also included. PMID:11740419

  5. Actress Debra Winger: “Everyone Is Touched By Addiction.” | NIH MedlinePlus the Magazine

    MedlinePlus

    ... Drug Abuse and Addiction Actress Debra Winger: “Everyone Is Touched By Addiction.” Past Issues / Fall 2011 Table ... do here, bring humanism back into medicine. Who is your audience? Ms. Winger: The Addiction Performance Project ...

  6. Innovative strategies for transforming internal medicine residency training in resource-limited settings: the Mozambique experience.

    PubMed

    Mocumbi, Ana Olga; Carrilho, Carla; Aronoff-Spencer, Eliah; Funzamo, Carlos; Patel, Sam; Preziosi, Michael; Lederer, Philip; Tilghman, Winston; Benson, Constance A; Badaró, Roberto; Nguenha, A; Schooley, Robert T; Noormahomed, Emília V

    2014-08-01

    With approximately 4 physicians per 100,000 inhabitants, Mozambique faces one of the most severe health care provider shortages in Sub-Saharan Africa. The lack of sufficient well-trained medical school faculty is one of Mozambique's major barrier to producing new physicians annually. A partnership between the Universidade Eduardo Mondlane and the University of California, San Diego, has addressed this challenge with support from the Medical Education Partnership Initiative. After an initial needs assessment involving questionnaires and focus groups of residents, and working with key members from the Ministry of Health, the Medical Council, and Maputo Central Hospital, a set of interventions was designed. The hospital's internal medicine residency program was chosen as the focus for the plan. Interventions included curriculum design, new teaching methodologies, investment in an informatics infrastructure for access to digital references, building capacity to support clinical research, and providing financial incentives to retain junior faculty. The number of candidates entering the internal medicine residency program has increased, and detailed monitoring and evaluation is measuring the impact of these changes on the quality of training. These changes are expected to improve the long-term quality of postgraduate training in general through dissemination to other departments. They also have the potential to facilitate equitable distribution of specialists nationwide by expanding postgraduate training to other hospitals and universities. PMID:25072585

  7. The role of Society for Adolescent Health and Medicine in training of health professionals.

    PubMed

    Ford, Carol A

    2016-08-01

    The Society for Adolescent Health and Medicine (SAHM) was created by health professionals committed to identifying and better addressing the health needs of adolescents and young adults, and this work has continued for nearly 50 years. The society initially focused primarily on clinical education, but has evolved to include educational activities providing clinical, research, policy, advocacy, and professional development content. Strategies have included high-quality annual meetings designed to meet the educational needs of its multi-disciplinary membership, publishing an internationally recognized journal, and developing strategic collaborations to advocate for legitimacy of the field and reform in health profession education. Historically, SAHM has been most successful at increasing specialized training in the United States among physicians, and primarily pediatricians, likely driven by the nuances of the development of adolescent medicine in this country. Successes are often linked to strategic collaborations with other professional organizations, and have been facilitated by federally funded initiatives to improve adolescent and young adult health. Recent efforts to improve professional training are focused on the use of technology, and SAHM is also currently exploring strategies to directly reach adolescents, young adults, and their parents. As the society becomes increasingly multidisciplinary and international, members have extraordinary opportunities to learn from each other, build upon lessons learned, and collaborate. Descriptions of the history of SAHM's training-focused efforts, selected highlights, and current priorities will be used to illustrate this long-standing commitment to the training of health professionals. PMID:26115503

  8. A multimethod approach for cross-cultural training in an internal medicine residency program

    PubMed Central

    Staton, Lisa J.; Estrada, Carlos; Panda, Mukta; Ortiz, David; Roddy, Donna

    2013-01-01

    Background Cultural competence training in residency is important to improve learners’ confidence in cross-cultural encounters. Recognition of cultural diversity and avoidance of cultural stereotypes are essential for health care providers. Methods We developed a multimethod approach for cross-cultural training of Internal Medicine residents and evaluated participants’ preparedness for cultural encounters. The multimethod approach included (1) a conference series, (2) a webinar with a national expert, (3) small group sessions, (4) a multicultural social gathering, (5) a Grand Rounds presentation on cross-cultural training, and (6) an interactive, online case-based program. Results The program had 35 participants, 28 of whom responded to the survey. Of those, 16 were white (62%), and residents comprised 71% of respondents (n=25). Following training, 89% of participants were more comfortable obtaining a social history. However, prior to the course only 27% were comfortable caring for patients who distrust the US system and 35% could identify religious beliefs and customs which impact care. Most (71%) believed that the training would help them give better care for patients from different cultures, and 63% felt more comfortable negotiating a treatment plan following the course. Conclusions Multimethod training may improve learners’ confidence and comfort with cross-cultural encounters, as well as lay the foundation for ongoing learning. Follow-up is needed to assess whether residents’ perceived comfort will translate into improved patient outcomes. PMID:23683845

  9. Evaluation of the educational environment of the Saudi family medicine residency training program

    PubMed Central

    Khoja, Abdullah T.

    2015-01-01

    Objectives: The study was conducted to evaluate the educational environment (EE) in Family Medicine Training Programs. Materials and Methods: A cross-sectional survey, The Postgraduate Hospital Educational Environment Measure (PHEEM), was distributed to all residents at the four training centers in the central region. Cronbach's alpha was used to test the reliability. The mean and standard deviation (SD) for each item, the overall score and the three domains were calculated. A multiple linear regression model was developed with PHEEM scores as an outcome. The Mann–Whitney–Wilcoxon test was used to compare each item based on the selected factors. Results: The overall score was 67.1/160 (SD: 20.1). The PHEEM's domains scores: 24.2/56 (SD: 7.13) for perception of role autonomy; 25.3/60 (SD: 8.88), for perception of teaching; and 17/44 (SD: 5.6), for perception of social support. Training center and Level of training were the significant outcome predictors. Centre 1 (Joint Program) significantly had better scores than Centre 2. The instrument showed great reliability with a Cronbach's alpha of 0.92. Conclusions: There are many problems in the training program. Urgent actions are needed to improve the residents' learning experience particularly during rotations. Also, the curriculum should be restructured, and effective training methods introduced using the Best Evidence in Medical Education to meet the expectations and learning needs of family physicians. PMID:25657612

  10. The medicalization of addiction treatment professionals.

    PubMed

    Roy, A Kenison; Miller, Michael M

    2012-01-01

    In a previous article, the authors described the changes initiated by recent health care legislation, and how those changes might affect the practice of medicine and the delivery of addiction services. This article reviews the same changes with respect to how they have the potential to change the practice activities of addiction physicians, addiction therapists, addiction counselors and addiction nurses, as well as the activities of administrators and service delivery financial personnel. Developments in delivery systems and the impact of those developments on professionals who work in addiction treatment are considered; current problems, potential solutions, and opportunities for clinicians under health reform are addressed. The goals envisioned for health system reform and the potential for realization of those goals via changes in addiction service delivery design and clinical practice are discussed. PMID:22880538

  11. Preparing the personal physician for practice: changing family medicine residency training to enable new model practice.

    PubMed

    Green, Larry A; Jones, Samuel M; Fetter, Gerald; Pugno, Perry A

    2007-12-01

    After two years of intensive study, in 2004 the Future of Family Medicine report concluded that the current U.S. health care system is inadequate and unsustainable, and called for changes within the specialty of family medicine to ensure the future health of the American public. With guidance and encouragement from many disciplines and health experts, a set of 10 recommendations was established to accomplish a transformative change in how family physicians serve their patients and how the essential function of primary care is achieved. From these recommendations came a period of innovation and experimentation in the training of family physicians, entitled Preparing the Personal Physician for Practice (P4). The P4 project is a carefully designed and evaluated initiative led by the American Board of Family Medicine and the Association of Family Medicine Residency Directors and administered by TransforMED, a practice redesign initiative of the American Academy of Family Physicians. Fourteen family medicine programs were chosen to participate and will put their innovations into practice from 2007 to 2012, during which time regular evaluation will be conducted. The purpose of P4 is to learn how to improve the graduate medical education of family physicians such that they are prepared to be outstanding personal physicians and to work in the new models of practice now emerging. The innovations tested by P4 residencies are expected to inspire substantial changes in the content, structure, and locations of training of family physicians and to guide future revisions in accreditation and certification requirements. PMID:18046133

  12. Senior house officers in medicine: postal survey of training and work experience.

    PubMed Central

    Baldwin, P. J.; Newton, R. W.; Buckley, G.; Roberts, M. A.; Dodd, M.

    1997-01-01

    OBJECTIVES: To describe working conditions for senior house officers in medicine in Scotland and to relate these to the quality of clinical training they receive. DESIGN: Postal questionnaire survey. SUBJECTS: All senior house officers in medicine and related specialties in post in Scotland in October 1995 (n = 437); 252 (58%) respondents. MAIN OUTCOME MEASURES: Questionnaires covered hours, working patterns, measures of workload, an attitudes to work scale, and experience of education and training. RESULTS: In the week before the questionnaire, doctors on rotas had worked a mean of 7.4 (95% confidence interval 5.8 to 9.0) hours in excess of their contracts, compared with 3.7 (2.0 to 5.5) hours for those on partial shifts. The most common reason for this was "the needs of the patients or the service." Those on partial shifts reported significantly less continuity of care with patients than those on rotas (Mann-Whitney U test, z = -4.2, P < 0.0001) or full shifts (z = -2.08, P = 0.03). Doctors in general medicine reported significantly higher measures of workload (number of acute admissions, number of times called out, and fewest hours' uninterrupted sleep) than those in subspecialties. Consultants' clinical teaching and style of conducting a ward round were significantly related to factors extracted from the attitudes to work scale. CONCLUSIONS: The quality of senior house officers' training is detrimentally affected by a variety of conditions, especially the need for closer support and supervision, the need for greater feedback, and the lack of time that consultants have to dedicate to clinical training. Efforts should be made to improve these conditions and to reinforce a close working relationship between trainee and supervising consultant. PMID:9116556

  13. Education and training for medicines development, regulation, and clinical research in emerging countries

    PubMed Central

    Kerpel-Fronius, Sandor; Rosenkranz, Bernd; Allen, Elizabeth; Bass, Rolf; Mainard, Jacques D.; Dodoo, Alex; Dubois, Dominique J.; Hela, Mandisa; Kern, Steven; Massud, Joao; Silva, Honorio; Whitty, Jeremy

    2015-01-01

    The aim of this satellite workshop held at the 17th World Congress of Basic and Clinical Pharmacology (WCP2014) was to discuss the needs, optimal methods and practical approaches for extending education and teaching of medicines development, regulation, and clinical research to Low and Middle Income Countries (LMICs). It was generally agreed that, for efficiently treating the rapidly growing number of patients suffering from non-communicable diseases, modern drug therapy has to become available more widely and with a shorter time lag in these countries. To achieve this goal many additional experts working in medicines development, regulation, and clinical research have to be trained in parallel. The competence-oriented educational programs designed within the framework of the European Innovative Medicine Initiative-PharmaTrain (IMI-PhT) project were developed with the purpose to cover these interconnected fields. In addition, the programs can be easily adapted to the various local needs, primarily due to their modular architecture and well defined learning outcomes. Furthermore, the program is accompanied by stringent quality assurance standards which are essential for providing internationally accepted certificates. Effective cooperation between international and local experts and organizations, the involvement of the industry, health care centers and governments is essential for successful education. The initiative should also support the development of professional networks able to manage complex health care strategies. In addition it should help establish cooperation between neighboring countries for jointly managing clinical trials, as well as complex regulatory and ethical issues. PMID:25926798

  14. Education and training for medicines development, regulation, and clinical research in emerging countries.

    PubMed

    Kerpel-Fronius, Sandor; Rosenkranz, Bernd; Allen, Elizabeth; Bass, Rolf; Mainard, Jacques D; Dodoo, Alex; Dubois, Dominique J; Hela, Mandisa; Kern, Steven; Massud, Joao; Silva, Honorio; Whitty, Jeremy

    2015-01-01

    The aim of this satellite workshop held at the 17th World Congress of Basic and Clinical Pharmacology (WCP2014) was to discuss the needs, optimal methods and practical approaches for extending education and teaching of medicines development, regulation, and clinical research to Low and Middle Income Countries (LMICs). It was generally agreed that, for efficiently treating the rapidly growing number of patients suffering from non-communicable diseases, modern drug therapy has to become available more widely and with a shorter time lag in these countries. To achieve this goal many additional experts working in medicines development, regulation, and clinical research have to be trained in parallel. The competence-oriented educational programs designed within the framework of the European Innovative Medicine Initiative-PharmaTrain (IMI-PhT) project were developed with the purpose to cover these interconnected fields. In addition, the programs can be easily adapted to the various local needs, primarily due to their modular architecture and well defined learning outcomes. Furthermore, the program is accompanied by stringent quality assurance standards which are essential for providing internationally accepted certificates. Effective cooperation between international and local experts and organizations, the involvement of the industry, health care centers and governments is essential for successful education. The initiative should also support the development of professional networks able to manage complex health care strategies. In addition it should help establish cooperation between neighboring countries for jointly managing clinical trials, as well as complex regulatory and ethical issues. PMID:25926798

  15. EM Talk: communication skills training for emergency medicine patients with serious illness.

    PubMed

    Grudzen, Corita R; Emlet, Lillian L; Kuntz, Joanne; Shreves, Ashley; Zimny, Erin; Gang, Maureen; Schaulis, Monique; Schmidt, Scott; Isaacs, Eric; Arnold, Robert

    2016-06-01

    The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing and small group learning with constructive feedback from master clinicians. Here, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice. PMID:26762163

  16. Win/win: creating collaborative training opportunities for behavioral health providers within family medicine residency programs.

    PubMed

    Ruddy, Nancy Breen; Borresen, Dorothy; Myerholtz, Linda

    2013-01-01

    Integrating behavioral health into primary healthcare offers multiple advantages for patients and health professionals. This model requires a new skill set for all healthcare professionals that is not emphasized in current educational models. The new skills include interprofessional team-based care competencies and expanded patient care competencies. Health professionals must learn new ways to efficiently and effectively address health behavior change, and manage behavioral health issues such as depression and anxiety. Learning environments that co-train mental health and primary care professionals facilitate acquisition of both teamwork and patient care competencies for mental health and primary care professional trainees. Family Medicine Residency programs provide an excellent opportunity for co-training. This article serves as a "how to" guide for residency programs interested in developing a co-training program. Necessary steps to establish and maintain a program are reviewed, as well as goals and objectives for a co-training curriculum and strategies to overcome barriers and challenges in co-training models. PMID:24261270

  17. [Gambling addiction].

    PubMed

    Böning, J; Meyer, G; Hayer, T

    2013-05-01

    Extensive coherent clinical, psychopathological, neurobiological and genetic similarities with substance-related addictions justify the forthcoming classification of gambling addiction under the new category "Substance Use and Addictive Disorders" in the DSM-5. Thus, gambling addiction can be regarded as the prototype of behavioral addiction. In general it should be kept in mind that isolated gambling forms are associated with varying addictive potential due to specific situational and structural game characteristics. High rates of indebtedness, suicidality, social isolation and gambling-related crime often accompany pathological gambling. As a consequence gambling addiction represents a mental disorder with a significant economic burden. In Germany 12-month prevalence rates for problem gambling in adulthood range from 0.24 % to 0.64  % and for pathological gambling from 0.20 % to 0.56 %. Because gambling products rank among the so-called demeriting (i.e. potentially harmful) social activities, player and youth protection measures to prevent gambling disorders and associated crime should be best regulated as a state monopoly. PMID:23529775

  18. Development of a Design for Evaluation of the Podiatric Medicine Training Grant Program. Final Report and Executive Summary.

    ERIC Educational Resources Information Center

    American Association of Colleges of Podiatric Medicine, Washington, DC.

    Information is presented on an evaluation design for a federal program, the Podiatric Medicine Training Grant Program. The program supports the clinical training of third- and fourth-year podiatric medical students in underserved areas. Background information is provided on: the supply and distribution of health professionals and podiatrists in…

  19. [Vaccines for the treatment of drug addiction].

    PubMed

    Zorzoli, Ermanno; Marino, Maria Giulia; Bagnato, Barbara; Franco, Elisabetta

    2016-01-01

    The treatment of drug addiction is a very wide-ranging sector within modern medicine. The use of immunotherapy in this context represents an innovative approach. The purpose of this paper is to illustrate, through a literature review, the main avenues of research and the results obtained with immunotherapy in the treatment of drug addiction. PMID:27077562

  20. Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views

    PubMed Central

    Alavi, Seyyed Salman; Ferdosi, Masoud; Jannatifard, Fereshte; Eslami, Mehdi; Alaghemandan, Hamed; Setare, Mehrdad

    2012-01-01

    Introduction: Behavioral science experts believe that all entities capable of stimulating a person can be addictive; and whenever a habit changes into an obligation, it can be considered as an addiction. Researchers also believe that there are a number of similarities as well as some differences between drug addiction and behavioral addiction diagnostic symptoms. The purpose of this study is to consider different approaches in this field. Methods: This is a descriptive research using content analysis method. First, differences and similarities of various perspectives on addiction and addiction behavior in different substances were obtained, thereafter, the data was coded and categorized, subjects were discussed and major issues were extracted. Results: Behavioral addiction such as internet addiction is similar to drug addiction except that in the former, the individual is not addicted to a substance but the behavior or the feeling brought about by the relevant action. In addition, the physical signs of drug addiction, are absent in behavioral addiction. Others have stated that behaviorally addicted individuals have certain symptoms and will undergo the same consequences brought about by addiction to alcohol and drugs as well as other obsessive behaviors. Conclusion: Similar to substance abuse prevention, programs aimed at addicted individuals and specialized training can educate adolescents about the warning signs of online addiction, in order to assist the early detection of this disorder. For prevention of behavioral addiction (such as internet addiction) authorities, cultural institutions and parents should monitor the use of internet and teach to the adolescent and children, the useful and appropriate methods of internet use. PMID:22624087

  1. Going global: considerations for introducing global health into family medicine training programs.

    PubMed

    Evert, Jessica; Bazemore, Andrew; Hixon, Allen; Withy, Kelley

    2007-10-01

    Medical students and residents have shown increasing interest in international health experiences. Before attempting to establish a global health training program in a family medicine residency, program faculty must consider the goals of the international program, whether there are champions to support the program, the resources available, and the specific type of program that best fits with the residency. The program itself should include didactics, peer education, experiential learning in international and domestic settings, and methods for preparing learners and evaluating program outcomes. Several hurdles can be anticipated in developing global health programs, including finances, meeting curricular and supervision requirements, and issues related to employment law, liability, and sustainability. PMID:17932801

  2. Genitourinary Medicine trainees' experience and training needs in the management of patients disclosing sexual violence.

    PubMed

    Sacks, Rachel; Emerson, Carol

    2014-04-01

    The British Association for Sexual Health and HIV (BASHH) Sexual Violence group assessed the level of confidence of Genitourinary Medicine (GUM) trainees in managing patients disclosing sexual violence using an online survey. Twenty-eight percent of current UK GUM trainees responded. The results demonstrated wide variation in trainees' experience and confidence in managing these patients, which was dependent on the patient type, as well as the gender of the trainee and the number of years' experience the trainee had in the specialty. There were also differences in the reported availability of training in this specialist area. Regular accessible training in identification and management of patients disclosing sexual violence is recommended for GUM trainees. PMID:24100285

  3. Heroin Addiction

    MedlinePlus

    ... the sharing of contaminated injection equipment. TODAY Our knowledge of the opioid system has led to new medications for treating pain—and for treating opioid addiction. The discovery of opiate receptors by NIH-supported researchers, along ...

  4. Training future leaders of academic medicine: internal programs at three academic health centers.

    PubMed

    Morahan, P S; Kasperbauer, D; McDade, S A; Aschenbrener, C A; Triolo, P K; Monteleone, P L; Counte, M; Meyer, M J

    1998-11-01

    The authors review the need for internal programs for leadership training at academic health centers and then describe in detail three programs of this type that have operated during the 1990s: (1) the Allegheny Leadership Institute, founded by the Allegheny Health, Education and Research Foundation, Pittsburgh, Pennsylvania; (2) the Physician Executive Management Development Program (PEMDP) of Saint Louis University School of Medicine; and (3) the University of Nebraska Medical Center Leadership Institute. Educational elements common to these programs include having a small class size and participants from many areas of academic medicine and health care, focusing on educational strategies that draw on participants' experiences and training, conducting the training away from the participants' institutions, having short sessions, using faculty from both within and outside the participants' institutions, and creating strategies to reinforce learning. Lessons learned reflect the unique context of each institution; the authors list the major lessons learned by each of the three programs they surveyed (e.g., leaders of the Saint Louis University PEMDP program believe that it is important to help participants implement desired changes in their work areas once they return to work, and are investigating how to do this). The authors conclude with an extensive list of recommendations to optimize the effects of leadership development training carried out in AHCs' internal programs (e.g., "Focus on specific skills that can be learned, and link the learning experiences to real work situations in health care and higher education") and explain why they think internal leadership institutes have at least three distinct advantages over external programs. PMID:9834697

  5. [Cocaine addiction].

    PubMed

    Pitchot, W; Scantamburlo, G; Pinto, E; Karila, L

    2013-01-01

    Cocaine is the second most commonly used illicit drug after cannabis in the general population. Cocaine is a powerful stimulating agent of the central nervous system and a highly addictogenic drug. Somatic and psychiatric consequences of cocaine addiction are major and clinically relevant. The increasing consumption of cocaine and the importance of its consequences justify an update of our knowledge about cocaine addiction. PMID:23888579

  6. Knowledge Levels and Training Needs of Disaster Medicine among Health Professionals, Medical Students, and Local Residents in Shanghai, China

    PubMed Central

    Zhang, Hongwei; Yin, Jianhua; Tan, Xiaojie; Chang, Wenjun; Ding, Yibo; Han, Yifang; Cao, Guangwen

    2013-01-01

    Background Disaster is a serious public health issue. Health professionals and community residents are main players in disaster responses but their knowledge levels of disaster medicine are not readily available. This study aimed to evaluate knowledge levels and training needs of disaster medicine among potential disaster responders and presented a necessity to popularize disaster medicine education. Methods A self-reporting questionnaire survey on knowledge level and training needs of disaster medicine was conducted in Shanghai, China, in 2012. A total of randomly selected 547 health professionals, 456 medical students, and 1,526 local residents provided intact information. The total response rate was 93.7%. Results Overall, 1.3% of these participants have received systematic disaster medicine training. News media (87.1%) was the most common channel to acquire disaster medicine knowledge. Although health professionals were more knowledgeable than community residents, their knowledge structure of disaster medicine was not intact. Medical teachers were more knowledgeable than medical practitioners and health administrators (p = 0.002). Clinicians performed better than public health physicians (p<0.001), whereas public health students performed better than clinical medical students (p<0.001). In community residents, education background significantly affected the knowledge level on disaster medicine (p<0.001). Training needs of disaster medicine were generally high among the surveyed. ‘Lecture’ and ‘practical training’ were preferred teaching methods. The selected key and interested contents on disaster medicine training were similar between health professionals and medical students, while the priorities chosen by local residents were quite different from health professionals and medical students (p<0.001). Conclusions Traditional clinical-oriented medical education might lead to a huge gap between the knowledge level on disaster medicine and the current

  7. A quantitative tool for measuring the quality of medical training in emergency medicine.

    PubMed

    Smith, Simon M; Davis, Peyton; Davies, Llion

    2015-12-01

    The most common method of assessing the quality of medical education is through a selection of qualitative assessments, usually as part of a programme evaluation. Common qualitative assessments include measurements of students' and teachers' participation, outcome measures such as assessment results, and qualitative assessments such as interviews and questionnaires of students and teachers. Programme evaluation can therefore be a process that is both laborious and subject to accusations of a lack of objectivity. As a result, the development of a quantitative tool that could be used alongside a programme evaluation may be both useful and desirable. A pragmatic scoring system, utilizing routinely collected quantitative data, termed as the Quality Assessment Tool, was developed during the 2013 academic year within the setting of an Emergency Medicine training programme in the UK. This tool was tested against the standard assessment currently used for this programme to establish whether the quantitative tool correlated with the programme evaluation. Second, the individual items within the tool were investigated to identify any correlations with the current assessment of quality established by the programme evaluation. The Quality Assessment Tool appears to be correlated to the quality of training delivered at individual training sites in a single specialty. It certainly identifies those centres delivering the highest quality of training and also identifies those centres whose training is consistently of a lower standard. The assessment tool is less accurate at ranking those training centres whose training is merely 'satisfactory'; whether this is a result of the imprecision of the tool itself or a reflection of the subjective nature of the current assessment (i.e. whether the current evaluation system lacks validity) cannot be stated. In summary, it appears to be possible to use a single quantitative tool to reliably, and with validity, measure the quality of training

  8. The research rotation: competency-based structured and novel approach to research training of internal medicine residents

    PubMed Central

    Kanna, Balavenkatesh; Deng, Changchun; Erickson, Savil N; Valerio, Jose A; Dimitrov, Vihren; Soni, Anita

    2006-01-01

    Background In the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program. PMID:17044924

  9. The Family Medicine Residency Training Initiative in Miscarriage Management: Impact on Practice in Washington State

    PubMed Central

    Darney, Blair G.; Weaver, Marcia R.; Stevens, Nancy; Kimball, Jeana; Prager, Sarah W.

    2013-01-01

    BACKGROUND AND OBJECTIVES Non-complicated spontaneous abortion cases should be counseled about the full range of management approaches, including uterine evacuation using manual vacuum aspiration (MVA). The Residency Training Initiative in Miscarriage Management (RTI-MM) is an intensive, multidimensional intervention designed to facilitate implementation of office-based management of spontaneous abortion using MVA in family medicine residency settings. The purpose of this study was to test the impact of the RTI-MM on self-reported use of MVA for management of spontaneous abortion. METHODS We used a pretest/posttest one group study design and a web-based, anonymous survey to collect data on knowledge, attitudes, perceived barriers, and practice of office-based management of spontaneous abortion. We used multivariable models to estimate incident relative risks and accounted for data clustering at the residency site level. RESULTS Our sample included 441 residents and faculty from 10 family medicine residency sites. Our findings show a positive association between the RTI-MM and self-reported use of MVA for management of spontaneous abortion (adjusted RR=9.11 [CI=4.20-19.78]) and were robust to model specification. Male gender, doing any type of management of spontaneous abortion (eg, expectant, medication), other on-site reproductive health training interventions, and support staff knowledge scores were also significant correlates of physician practice of MVA. CONCLUSIONS Our findings suggest that the RTI-MM was successful in influencing the practice of management of spontaneous abortion using MVA in this population and that support staff knowledge may impact physician practice. Integrating MVA into family medicine settings would potentially improve access to evidence-based, comprehensive care for women. PMID:23378077

  10. Establishing the need for family medicine training in intimate partner violence screening.

    PubMed

    Pagels, Patti; Kindratt, Tiffany B; Reyna, Guadalupe; Lam, Kenrick; Silver, Mandy; Gimpel, Nora E

    2015-06-01

    In 2012, the USPSTF updated its guidelines and now recommends that all women of childbearing age be screened for IPV and services provided for women who screen positive. Based on these recommendations, objectives of this study were to (1) evaluate IPV knowledge, attitudes, and practices of physicians from different specialties and (2) determine significant differences by medical specialty. We recruited (n = 183) Internal Medicine, Emergency Medicine, Family Medicine (FM) and Obstetrics/Gynecology (OB/GYN) residents and attending physicians to complete a 15-question online survey assessing knowledge, attitudes and current IPV screening practices. We evaluated associations between medical specialty and knowledge, attitudes and practice measures before and after controlling for covariates. Knowledge of how often IPV occurs in society, community resources, and screening tools were significantly different by specialty (all p's < 0.05). A majority of FM physicians (88%) reported that it is a physician's responsibility to find and treat IPV and 97% reported that IPV should be included in their training. Compared to OB/GYN physicians in multivariate analyses, FM physicians were less likely to report they were comfortable discussing IPV with their patients in crude (OR = 0.35; 95% CI = 0.13, 0.94) and adjusted models (OR = 0.20; 95% CI = 0.06, 0.60). FM physicians were also less likely to report screening female patients for IPV before (OR = 0.25; 95% CI = 0.08, 0.86) and after adjusting for confounders (OR = 0.11; 95% CI = 0.03, 0.47). Our results indicate that FM physicians have positive attitudes towards finding and treating IPV yet need enhanced training to improve their comfort level with screening for and discussing IPV with their patients. PMID:25352415

  11. Interoception and Drug Addiction

    PubMed Central

    Paulus, Martin P.; Stewart, Jennifer L.

    2013-01-01

    The role of interoception and its neural basis with relevance to drug addiction is reviewed. Interoception consists of the receiving, processing, and integrating body-relevant signals with external stimuli to affect ongoing motivated behavior. The insular cortex is the central nervous system hub to process and integrate these signals. Interoception is an important component of several addiction relevant constructs including arousal, attention, stress, reward, and conditioning. Imaging studies with drug-addicted individuals show that the insular cortex is hypo-active during cognitive control processes but hyperactive during cue reactivity and drug-specific, reward-related processes. It is proposed that interoception contributes to drug addiction by incorporating an “embodied” experience of drug uses together with the individual’s predicted versus actual internal state to modulate approach or avoidance behavior, i.e. whether to take or not to take drugs. This opens the possibility of two types of interventions. First, one may be able to modulate the embodied experience by enhancing insula reactivity where necessary, e.g. when engaging in drug seeking behavior, or attenuating insula when exposed to drug-relevant cues. Second, one may be able to reduce the urge to act by increasing the frontal control network, i.e. inhibiting the urge to use by employing cognitive training. PMID:23855999

  12. Interoception and drug addiction.

    PubMed

    Paulus, Martin P; Stewart, Jennifer L

    2014-01-01

    The role of interoception and its neural basis with relevance to drug addiction is reviewed. Interoception consists of the receiving, processing, and integrating body-relevant signals with external stimuli to affect ongoing motivated behavior. The insular cortex is the central nervous system hub to process and integrate these signals. Interoception is an important component of several addiction relevant constructs including arousal, attention, stress, reward, and conditioning. Imaging studies with drug-addicted individuals show that the insular cortex is hypo-active during cognitive control processes but hyperactive during cue reactivity and drug-specific, reward-related processes. It is proposed that interoception contributes to drug addiction by incorporating an "embodied" experience of drug uses together with the individual's predicted versus actual internal state to modulate approach or avoidance behavior, i.e. whether to take or not to take drugs. This opens the possibility of two types of interventions. First, one may be able to modulate the embodied experience by enhancing insula reactivity where necessary, e.g. when engaging in drug seeking behavior, or attenuating insula when exposed to drug-relevant cues. Second, one may be able to reduce the urge to act by increasing the frontal control network, i.e. inhibiting the urge to use by employing cognitive training. This article is part of a Special Issue entitled 'NIDA 40th Anniversary Issue'. PMID:23855999

  13. Training Veterinary Students in Shelter-Medicine: A Service-Learning Community Classroom Based Technique

    PubMed Central

    Stevens, Brenda J.; Gruen, Margaret E.

    2015-01-01

    Shelter medicine is a rapidly developing field of great importance, and shelters themselves provide abundant training opportunities for veterinary medical students. Students trained in shelter medicine have opportunities to practice zoonotic and species-specific infectious disease control, behavioral evaluation and management, primary care, as well as animal welfare, ethics, and public policy issues. Ranges of sheltering systems now exist, from brick-and-mortar facilities to networks of foster homes with no centralized facility. Exposure to a single shelter setting may not allow students to understand the full range of sheltering systems that exist; a community classroom approach balances the opportunity to introduce students to a diverse array of sheltering systems, while gaining practical experience. This article presents the details and results of a series of two-week, elective clinical rotations with a focus on field and service-learning in animal shelters. The overall aim was to provide opportunities that familiarized students with sheltering systems and provided primary care training. Other priorities included increasing awareness of public health concerns, and equipping students to evaluate shelters on design, operating protocols, infectious disease control, enrichment and community outreach. Students were required to participate in rounds, and complete a project that addressed a need recognized by them during the rotation. This article includes costs associated with the rotation, a blueprint for how the rotation was carried out at our institution, and details of shelters visited and animals treated, including a breakdown of treatments provided. Also discussed are the student projects and student feedback on this valuable clinical experience. PMID:24407109

  14. Student peer assessment in evidence-based medicine (EBM) searching skills training: an experiment

    PubMed Central

    Eldredge, Jonathan D.; Bear, David G.; Wayne, Sharon J.; Perea, Paul P.

    2013-01-01

    Background: Student peer assessment (SPA) has been used intermittently in medical education for more than four decades, particularly in connection with skills training. SPA generally has not been rigorously tested, so medical educators have limited evidence about SPA effectiveness. Methods: Experimental design: Seventy-one first-year medical students were stratified by previous test scores into problem-based learning tutorial groups, and then these assigned groups were randomized further into intervention and control groups. All students received evidence-based medicine (EBM) training. Only the intervention group members received SPA training, practice with assessment rubrics, and then application of anonymous SPA to assignments submitted by other members of the intervention group. Results: Students in the intervention group had higher mean scores on the formative test with a potential maximum score of 49 points than did students in the control group, 45.7 and 43.5, respectively (P = 0.06). Conclusions: SPA training and the application of these skills by the intervention group resulted in higher scores on formative tests compared to those in the control group, a difference approaching statistical significance. The extra effort expended by librarians, other personnel, and medical students must be factored into the decision to use SPA in any specific educational context. Implications: SPA has not been rigorously tested, particularly in medical education. Future, similarly rigorous studies could further validate use of SPA so that librarians can optimally make use of limited contact time for information skills training in medical school curricula. PMID:24163593

  15. Resident Research and Scholarly Activity in Internal Medicine Residency Training Programs

    PubMed Central

    Levine, Rachel B; Hebert, Randy S; Wright, Scott M

    2005-01-01

    OBJECTIVES 1) To describe how internal medicine residency programs fulfill the Accreditation Council for Graduate Medical Education (ACGME) scholarly activity training requirement including the current context of resident scholarly work, and 2) to compare findings between university and nonuniversity programs. DESIGN Cross-sectional mailed survey. SETTING ACGME-accredited internal medicine residency programs. PARTICIPANTS Internal medicine residency program directors. MEASUREMENTS Data were collected on 1) interpretation of the scholarly activity requirement, 2) support for resident scholarship, 3) scholarly activities of residents, 4) attitudes toward resident research, and 5) program characteristics. University and nonuniversity programs were compared. MAIN RESULTS The response rate was 78%. Most residents completed a topic review with presentation (median, 100%) to fulfill the requirement. Residents at nonuniversity programs were more likely to complete case reports (median, 40% vs 25%; P =.04) and present at local or regional meetings (median, 25% vs 20%; P =.01), and were just as likely to conduct hypothesis-driven research (median, 20% vs 20%; P =.75) and present nationally (median, 10% vs 5%; P =.10) as residents at university programs. Nonuniversity programs were more likely to report lack of faculty mentors (61% vs 31%; P <.001) and resident interest (55% vs 40%; P =.01) as major barriers to resident scholarship. Programs support resident scholarship through research curricula (47%), funding (46%), and protected time (32%). CONCLUSIONS Internal medicine residents complete a variety of projects to fulfill the scholarly activity requirement. Nonuniversity programs are doing as much as university programs in meeting the requirement and supporting resident scholarship despite reporting significant barriers. PMID:15836549

  16. Uniform Evaluation of Programs to Combat Narcotic Addiction. Final Report.

    ERIC Educational Resources Information Center

    Friends of Psychiatric Research, Inc., Baltimore, MD.

    Early in 1967, the Office of Economic Opportunity was authorized to formulate and carry out programs for the prevention of narcotic addiction and the rehabilitation of narcotic addicts. Such programs were required to include provisions for the detoxification, guidance, training and job placement of narcotic addicts. The programs were aimed at…

  17. Training international medical graduate clinical fellows: the challenges and opportunities for adolescent medicine programs.

    PubMed

    Goldberg, Eudice

    2016-08-01

    Adolescent medicine achieved accreditation status first in the United States in 1994 and then in Canada in 2008 and even if it is not an accredited subspecialty in most other Western nations, it has still become firmly established as a distinct discipline. This has not necessarily been the case in some developing countries, where even the recognition of adolescence as a unique stage of human development is not always acknowledged. The program at SickKids in Toronto has prided itself in treating its international medical graduates (IMG) clinical fellows the same as their Canadian subspecialty residents by integrating them seamlessly into the training program. Although this approach has been laudable to a great extent, it may have fallen short in formally acknowledging and addressing the challenges that the IMG trainees have had to overcome. Moving forward, faculty must be trained and supports instituted that are geared specifically towards these challenges. This must be done on a formal basis to ensure both the success of the trainees as well as the overall enrichment of the fellowship training programs. PMID:26115499

  18. [Internet addiction].

    PubMed

    Korkeila, Jyrki

    2012-01-01

    Internet addiction is defined as uncontrolled and harmful use of Internet, which manifests in three forms: gaming, various sexual activities and excessive use of emails, chats or SMS messaging. Several studies have found that abuse of alcohol and other substances, depression and other health problems are associated with Internet addiction. In boys and men depression may be more a consequence of the addiction than a cause for it. ADHD seems to be a significant background factor for developing the condition. Because it is almost impossible to lead a life without Internet and computers nowadays, it is unrealistic to aim towards full abstinence. Treatment has generally followed the guidelines adapted for pathological gambling. PMID:22612024

  19. Didactic and experiential training to teach communication skills: the University of Wisconsin-Madison School of Veterinary Medicine collaborative experience.

    PubMed

    Chun, Ruthanne; Schaefer, Susan; Lotta, Corissa C; Banning, Jane A; Skochelak, Susan E

    2009-01-01

    Teaching communication skills to veterinary students is recognized as important; however, incorporation of this into an already crowded curriculum is difficult. At the University of Wisconsin-Madison School of Veterinary Medicine we provide mandatory communication lectures to freshmen and sophomores, and offer elective experiential courses to juniors and seniors. Providing both didactic and experiential training allows students to learn and practice communication techniques in a "safe" setting. Our approach to experiential training is unique in that graduate students in counseling psychology (masters and doctoral level) act as "clients" for the juniors, and professional simulated pet owners are hired for digitally captured role-plays with the seniors. A unique inter-professional partnership has been formed between the Schools of Veterinary Medicine, Education (Department of Counseling Psychology), and (Human) Medicine and Public Health to provide this experiential training for our students. The purpose of this article is to describe the communication training program at the University of Wisconsin-Madison School of Veterinary Medicine and to encourage other programs to reach across campus and partner with other colleges with the goal of improving training for all of the individuals involved. PMID:19625668

  20. The experience of addiction as told by the addicted: incorporating biological understandings into self-story.

    PubMed

    Hammer, Rachel R; Dingel, Molly J; Ostergren, Jenny E; Nowakowski, Katherine E; Koenig, Barbara A

    2012-12-01

    How do the addicted view addiction against the framework of formal theories that attempt to explain the condition? In this empirical paper, we report on the lived experience of addiction based on 63 semi-structured, open-ended interviews with individuals in treatment for alcohol and nicotine abuse at five sites in Minnesota. Using qualitative analysis, we identified four themes that provide insights into understanding how people who are addicted view their addiction, with particular emphasis on the biological model. More than half of our sample articulated a biological understanding of addiction as a disease. Themes did not cluster by addictive substance used; however, biological understandings of addiction did cluster by treatment center. Biological understandings have the potential to become dominant narratives of addiction in the current era. Though the desire for a "unified theory" of addiction seems curiously seductive to scholars, it lacks utility. Conceptual "disarray" may actually reflect a more accurate representation of the illness as told by those who live with it. For practitioners in the field of addiction, we suggest the practice of narrative medicine with its ethic of negative capability as a useful approach for interpreting and relating to diverse experiences of disease and illness. PMID:23081782

  1. The Experience of Addiction as Told by the Addicted: Incorporating Biological Understandings into Self-Story

    PubMed Central

    Hammer, Rachel R; Dingel, Molly J; Ostergren, Jenny E; Nowakowski, Katherine E; Koenig, Barbara A

    2012-01-01

    How do the addicted view addiction against the framework of formal theories that attempt to explain the condition? In this empirical paper, we report on the lived experience of addiction based on 63 semi-structured, open-ended interviews with individuals in treatment for alcohol and nicotine abuse at five sites in Minnesota. Using qualitative analysis, we identified four themes that provide insights into understanding how people who are addicted view their addiction, with particular emphasis on the biological model. More than half of our sample articulated a biological understanding of addiction as a disease. Themes did not cluster by addictive substance used; however, biological understandings of addiction did cluster by treatment center. Biological understandings have the potential to become dominant narratives of addiction in the current era. Though the desire for a “unified theory” of addiction seems curiously seductive to scholars, it lacks utility. Conceptual “disarray” may actually reflect a more accurate representation of the illness as told by those who live with it. For practitioners in the field of addiction, we suggest the practice of narrative medicine with its ethic of negative capability as a useful approach for interpreting and relating to diverse experiences of disease and illness. PMID:23081782

  2. Medicines

    MedlinePlus

    ... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...

  3. Medicines

    MedlinePlus

    ... you get better. In the United States, the Food and Drug Administration is in charge of assuring ... can cause unwanted side effects or interactions with food or other medicines you may be taking. They ...

  4. A survey study of evidence-based medicine training in US and Canadian medical schools

    PubMed Central

    Blanco, Maria A.; Capello, Carol F.; Dorsch, Josephine L.; Perry, Gerald (Jerry); Zanetti, Mary L.

    2014-01-01

    Purpose: The authors conducted a survey examining (1) the current state of evidence-based medicine (EBM) curricula in US and Canadian medical schools and corresponding learning objectives, (2) medical educators' and librarians' participation in EBM training, and (3) barriers to EBM training. Methods: A survey instrument with thirty-four closed and open-ended questions was sent to curricular deans at US and Canadian medical schools. The survey sought information on enrollment and class size; EBM learning objectives, curricular activities, and assessment approaches by year of training; EBM faculty; EBM tools; barriers to implementing EBM curricula and possible ways to overcome them; and innovative approaches to EBM education. Both qualitative and quantitative methods were used for data analysis. Measurable learning objectives were categorized using Bloom's taxonomy. Results: One hundred fifteen medical schools (77.2%) responded. Over half (53%) of the 900 reported learning objectives were measurable. Knowledge application was the predominant category from Bloom's categories. Most schools integrated EBM into other curricular activities; activities and formal assessment decreased significantly with advanced training. EBM faculty consisted primarily of clinicians, followed by basic scientists and librarians. Various EBM tools were used, with PubMed and the Cochrane database most frequently cited. Lack of time in curricula was rated the most significant barrier. National agreement on required EBM competencies was an extremely helpful factor. Few schools shared innovative approaches. Conclusions: Schools need help in overcoming barriers related to EBM curriculum development, implementation, and assessment. Implications: Findings can provide a starting point for discussion to develop a standardized competency framework. PMID:25031556

  5. TRAINING COMMUNITY VOLUTEERS IN PREVENTING ALCOHOLISM AND DRUG ADDICTION : A BASIC PROGRAMME AND ITS IMPACT ON CERTAIN VARIABLES

    PubMed Central

    Manickam, L.S.S.

    1997-01-01

    A study was conducted on 19 community volunteers and the training module they underwent is presented. The subjects were given 7 days in-training with the objectives of imparting knowledge ana skill to identify and motivate alcohol and drug dependent person, to motivate them and their family to seek treatment to provide social support to them and to organise prevention programmes in the community. Their knowledge, skills and attitudes have shown significant improvement and change as a result to training. Extraversion was found to be significantly related to change in all the above variables, psychoticism was related to attitude and self-esteem was related to improvement in skills. Need for under taking further research in this area is also emphasized. PMID:21584078

  6. Training community voluteers in preventing alcoholism and drug addiction : a basic programme and its impact on certain variables.

    PubMed

    Manickam, L S

    1997-07-01

    A study was conducted on 19 community volunteers and the training module they underwent is presented. The subjects were given 7 days in-training with the objectives of imparting knowledge ana skill to identify and motivate alcohol and drug dependent person, to motivate them and their family to seek treatment to provide social support to them and to organise prevention programmes in the community. Their knowledge, skills and attitudes have shown significant improvement and change as a result to training. Extraversion was found to be significantly related to change in all the above variables, psychoticism was related to attitude and self-esteem was related to improvement in skills. Need for under taking further research in this area is also emphasized. PMID:21584078

  7. Reflection and Outlook for the Future of Addictions Treatment and Training: An Interview with William R. Miller

    ERIC Educational Resources Information Center

    Adams, Jason B.; Madson, Michael B.

    2006-01-01

    The development of motivational interviewing (MI) has contributed to a significant change in the zeitgeist of substance abuse treatment. Dr. William Miller has been instrumental in the direction MI has taken. Dr. Miller helped develop MI, guide research and training initiatives, and as a result set a solid foundation for the future of MI. In this…

  8. Librarians in Evidence-Based Medicine Curricula: A Qualitative Study of Librarian Roles, Training, and Desires for Future Development.

    PubMed

    Maggio, Lauren A; Durieux, Nancy; Tannery, Nancy H

    2015-01-01

    This study aims to describe librarians' roles in evidence-based medicine (EBM) from the librarian perspective, identify how librarians are trained to teach, and highlight preferences for professional development. A multiinstitution qualitative study was conducted. Nine medical librarians identified by their faculty as integrated into EBM training were interviewed. Participants' descriptions indicated that they were active in curriculum development, deployment (including teaching activities), and assessment to support EBM. Participants identified direct experience and workshop participation as primary methods of learning to teach. Participants desired continuing development as teachers and requested opportunities for in-person workshops, shadowing physicians, and online training. PMID:26496397

  9. [Development of an instrument for the surveillance of quality indicators in specialized training in Preventive Medicine and Public Health].

    PubMed

    Gil-Borrelli, Christian Carlo; Latasa, Pello; Reques, Laura; Alemán, Guadalupe

    2015-01-01

    This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries. PMID:26112655

  10. New Paradigm in Training of Undergraduate Clinical Skills: the NEPTUNE-CS project at the Split University School of Medicine

    PubMed Central

    Šimunović, Vladimir J.; Hozo, Izet; Rakić, Mladen; Jukić, Marko; Tomić, Snježana; Kokić, Slaven; Ljutić, Dragan; Družijanić, Nikica; Grković, Ivica; Šimunović, Filip; Marasović, Dujomir

    2010-01-01

    Clinical skills’ training is arguably the weakest point in medical schools’ curriculum. This study briefly describes how we at the Split University School of Medicine cope with this problem. We consider that, over the last decades, a considerable advancement in teaching methodologies, tools, and assessment of students has been made. However, there are many unresolved issues, most notably: (i) the institutional value system, impeding the motivation of the teaching staff; (ii) lack of a strong mentoring system; (iii) organization, timing, and placement of training in the curriculum; (iv) lack of publications pertinent to training; and (v) unwillingness of patients to participate in student training. To improve the existing training models we suggest increased institutional awareness of obstacles, as well as willingness to develop mechanisms for increasing the motivation of faculty. It is necessary to introduce changes in the structure and timing of training and to complement it with a catalog, practicum, and portfolio of clinical skills. At Split University School of Medicine, we developed a new paradigm aimed to improve the teaching of clinical skills called “Neptune-CSS,” which stands for New Paradigm in Training of Undergraduate Clinical Skills in Split. PMID:20960586

  11. A review of published literature on emergency medicine training programs in low- and middle-income countries

    PubMed Central

    2013-01-01

    Background The objective of this review is to identify and critically evaluate the published literature on emergency medicine (EM) training programs in resource-limited health-care settings in order to provide insight for developing EM training programs in such health systems. Methods A literature search was conducted up to the end of April 2011 using MEDLINE, EMBASE, The Cochrane Library, EBM Reviews, Healthstar and Web of Science databases, using the following search terms: Emergency Medicine, Emergency Medicine Services, Education Training Residency Programs, Emergency Medical Systems and Medical Education, without limitation to income countries as outlined in the World Bank World Trade Indicators classification 2009-2010 (World Trade Indicators Country Classification by Region and Income, July 2009-July 2010). As the intent of the review was to identify and critically evaluate the literature readily available (published) to LMICs developing EM programs, the gray literature was not searched. Results The search yielded 16 articles that met the final inclusion criteria. As the majority of articles provide a narrative description of the processes and building blocks used in developing the residency programs reported, we present our results in narrative format. By providing a summary of the lessons learned to date, we hope to provide a useful starting point for other resource-limited settings interested in establishing emergency medicine specialty training programs and hope to encourage further information exchange on this matter. Conclusions The results of the review indicate that EM training is in its infancy in resource-constrained health-care systems. There are few detailed reports of these programs successes and limitations, including efforts to optimize graduate retention. Despite the paucity of currently published data on the development of EM residency training programs in these settings, this review demonstrates the need for encouraging further information

  12. [Game addiction].

    PubMed

    Mori, Akio; Iwadate, Masako; Minakawa, Nahoko T; Kawashima, Satoshi

    2015-09-01

    The purpose of this article is to analyze the South Korea and China of computer game research, and the current state of research in Japan. Excessive game actions were analyzed by PET-MRI, MRI, fMRI, NIRS, EEG. These results showed that the prefrontal cortical activity decreased during game play. Also, game addiction causes damage to the prefrontal cortex. The NIRS-EEG and simultaneous recording, during game play correspond well with the decrease of β band and oxygen-hemoglobin. The α band did not change with game play. However, oxygen-hemoglobin decreased during game play. South Korea, game addiction measures have been analyzed since 2002, but in Japan the research is recent. PMID:26394522

  13. Dealing with Addiction

    MedlinePlus

    ... more addictive than others: Drugs like crack or heroin are so addictive that they might only be used once or twice before the user loses control. Addiction means a person has no control over whether ...

  14. What Do Psychiatric Residents Think of Addiction Psychiatry as a Career?

    ERIC Educational Resources Information Center

    Renner, John A., Jr.; Karam-Hage, Maher; Levinson, Marjorie; Craig, Thomas; Eld, Beatrice

    2009-01-01

    Objective: The authors attempt to better understand the recent decline in the number of applicants to addiction psychiatry training. Methods: The Corresponding Committee on Training and Education in Addiction Psychiatry of APA's Council on Addiction Psychiatry sent out a 14-question anonymous e-mail survey to all postgraduate-year 2 (PGY-2)…

  15. Thorax, Trachea, and Lung Ultrasonography in Emergency and Critical Care Medicine: Assessment of an Objective Structured Training Concept

    PubMed Central

    Breitkreutz, Raoul; Dutiné, Martina; Scheiermann, Patrick; Kujumdshiev, Sandy; Ackermann, Hanns; Seeger, Florian Hartmut; Walcher, Felix; Hirche, Tim Oliver

    2013-01-01

    Background and Study objective. Focused lung ultrasound (LUS) examinations are important tools in critical care medicine. There is evidence that LUS can be used for the detection of acute thoracic lesions. However, no validated training method is available. The goal of this study was to develop and assess an objective structured clinical examination (OSCE) curriculum for focused thorax, trachea, and lung ultrasound in emergency and critical care medicine (THOLUUSE). Methods. 39 trainees underwent a one-day training course in a prospective educational study, including lectures in sonoanatomy and -pathology of the thorax, case presentations, and hands-on training. Trainees' pre- and posttest performances were assessed by multiple choice questionnaires, visual perception tests by interpretation video clips, practical performance of LUS, and identification of specific ultrasound findings. Results. Trainees postcourse scores of correct MCQ answers increased from 56 ± 4% to 82 ± 2% (mean± SD; P < 0.001); visual perception skills increased from 54 ± 5% to 78 ± 3% (P < 0.001); practical ultrasound skills improved, and correct LUS was performed in 94%. Subgroup analysis revealed that learning success was independent from the trainees' previous ultrasound experience. Conclusions. THOLUUSE significantly improves theoretical and practical skills for the diagnosis of acute thoracic lesions. We propose to implement THOLUUSE in emergency medicine training. PMID:24369503

  16. On-the-Job Evidence-Based Medicine Training for Clinician-Scientists of the Next Generation.

    PubMed

    Leung, Elaine Yl; Malick, Sadia M; Khan, Khalid S

    2013-08-01

    Clinical scientists are at the unique interface between laboratory science and frontline clinical practice for supporting clinical partnerships for evidence-based practice. In an era of molecular diagnostics and personalised medicine, evidence-based laboratory practice (EBLP) is also crucial in aiding clinical scientists to keep up-to-date with this expanding knowledge base. However, there are recognised barriers to the implementation of EBLP and its training. The aim of this review is to provide a practical summary of potential strategies for training clinician-scientists of the next generation. Current evidence suggests that clinically integrated evidence-based medicine (EBM) training is effective. Tailored e-learning EBM packages and evidence-based journal clubs have been shown to improve knowledge and skills of EBM. Moreover, e-learning is no longer restricted to computer-assisted learning packages. For example, social media platforms such as Twitter have been used to complement existing journal clubs and provide additional post-publication appraisal information for journals. In addition, the delivery of an EBLP curriculum has influence on its success. Although e-learning of EBM skills is effective, having EBM trained teachers available locally promotes the implementation of EBM training. Training courses, such as Training the Trainers, are now available to help trainers identify and make use of EBM training opportunities in clinical practice. On the other hand, peer-assisted learning and trainee-led support networks can strengthen self-directed learning of EBM and research participation among clinical scientists in training. Finally, we emphasise the need to evaluate any EBLP training programme using validated assessment tools to help identify the most crucial ingredients of effective EBLP training. In summary, we recommend on-the-job training of EBM with additional focus on overcoming barriers to its implementation. In addition, future studies evaluating the

  17. Development of a portfolio of learning for postgraduate family medicine training in South Africa: a Delphi study

    PubMed Central

    2012-01-01

    Background Within the 52 health districts in South Africa, the family physician is seen as the clinical leader within a multi-professional district health team. Family physicians must be competent to meet 90% of the health needs of the communities in their districts. The eight university departments of Family Medicine have identified five unit standards, broken down into 85 training outcomes, for postgraduate training. The family medicine registrar must prove at the end of training that all the required training outcomes have been attained. District health managers must be assured that the family physician is competent to deliver the expected service. The Colleges of Medicine of South Africa (CMSA) require a portfolio to be submitted as part of the uniform assessment of all registrars applying to write the national fellowship examinations. This study aimed to achieve a consensus on the contents and principles of the first national portfolio for use in family medicine training in South Africa. Methods A workshop held at the WONCA Africa Regional Conference in 2009 explored the purpose and broad contents of the portfolio. The 85 training outcomes, ideas from the WONCA workshop, the literature, and existing portfolios in the various universities were used to develop a questionnaire that was tested for content validity by a panel of 31 experts in family medicine in South Africa, via the Delphi technique in four rounds. Eighty five content items (national learning outcomes) and 27 principles were tested. Consensus was defined as 70% agreement. For those items that the panel thought should be included, they were also asked how to provide evidence for the specific item in the portfolio, and how to assess that evidence. Results Consensus was reached on 61 of the 85 national learning outcomes. The panel recommended that 50 be assessed by the portfolio and 11 should not be. No consensus could be reached on the remaining 24 outcomes and these were also omitted from the

  18. A Perspective of the Future of Nuclear Medicine Training and Certification.

    PubMed

    Arevalo-Perez, Julio; Paris, Manuel; Graham, Michael M; Osborne, Joseph R

    2016-01-01

    Nuclear Medicine (NM) has evolved from a medical subspecialty using quite basic tests to one using elaborate methods to image organ physiology and has truly become "Molecular Imaging." Concurrently, there has also been a timely debate about who has to be responsible for keeping pace with all of the components of the developmental cycle-imaging, radiopharmaceuticals, and instrumentation. Since the foundation of the American Board of NM, the practice of NM and the process toward certification have undergone major revisions. At present, the debate is focused on the inevitable future convergence of Radiology and NM. The potential for further cooperation or fusion of the American Board of Radiology and the American Board of NM is likely to bring about a new path for NM and Molecular Imaging training. If the merger is done carefully, respecting the strengths of both partners equally, there is an excellent potential to create a hybrid NM-Radiology specialty that combines Physiology and Molecular Biology with detailed anatomical imaging that sustains the innovation that has been central to NM residency and practice. We introduce a few basic trends in imaging use in the United States. These trends do not predict future use, but highlight the need for an appropriately credentialed practitioner to interpret these examination results and provide value to the health care system. PMID:26687859

  19. Train wrecks to typhoid fever: the development of railroad medicine organizations, 1850-World War I.

    PubMed

    Aldrich, M

    2001-01-01

    From their beginning American railroads developed medical arrangements to care for the large number of workers and passengers they killed or injured. After the Civil War, both labor unrest and liability concerns led them to expand and formalize these arrangements, and three forms of organization arose. Western roads, facing an almost complete lack of medical facilities, developed employee-funded hospital organizations. In the east, companies created medical organizations under a salaried chief surgeon and contracted with local physicians to provide care. A third model, pioneered by the Baltimore & Ohio Railroad in the 1880s, devised a beneficial society that provided medical care and compensation for injured workers. Although these organizations involved both contract practice and group hospitalization, the AMA seems to have ignored them. In the 1880s railroad physicians developed their own organizations, including the National Association of Railway Surgeons, in which they discussed problems of professionalization and such medical matters as "railway spine." Concern with costs and labor turnover also led the carriers into preventive medicine. Some roads provided smallpox and typhoid vaccinations, campaigned against malaria, improved passenger-car sanitation, required physical examinations of their employees, and trained them in first aid. By World War I, railroad medical organizations provided care to nearly two million employees and employment to about 10 percent of all physicians. PMID:11423683

  20. [Consensus document on ultrasound training in Intensive Care Medicine. Care process, use of the technique and acquisition of professional skills].

    PubMed

    Ayuela Azcárate, J M; Clau-Terré, F; Vicho Pereira, R; Guerrero de Mier, M; Carrillo López, A; Ochagavia, A; López Pérez, J M; Trenado Alvarez, J; Pérez, L; Llompart-Pou, J A; González de Molina, F J; Fojón, S; Rodríguez Salgado, A; Martínez Díaz, M C; Royo Villa, C; Romero Bermejo, F J; Ruíz Bailén, M; Arroyo Díez, M; Argueso García, M; Fernández Fernández, J L

    2014-01-01

    Ultrasound has become an essential tool in assisting critically ill patients. His knowledge, use and instruction requires a statement by scientific societies involved in its development and implementation. Our aim are to determine the use of the technique in intensive care medicine, clinical situations where its application is recommended, levels of knowledge, associated responsibility and learning process also implement the ultrasound technique as a common tool in all intensive care units, similar to the rest of european countries. The SEMICYUC's Working Group Cardiac Intensive Care and CPR establishes after literature review and scientific evidence, a consensus document which sets out the requirements for accreditation in ultrasound applied to the critically ill patient and how to acquire the necessary skills. Training and learning requires a structured process within the specialty. The SEMICYUC must agree to disclose this document, build relationships with other scientific societies and give legal cover through accreditation of the training units, training courses and different levels of training. PMID:24315132

  1. Meeting the challenges of global nuclear medicine technologist training in the 21st century: the IAEA Distance Assisted Training (DAT) program.

    PubMed

    Patterson, Heather E; Nunez, Margarita; Philotheou, Geraldine M; Hutton, Brian F

    2013-05-01

    Many countries have made significant investments in nuclear medicine (NM) technology with the acquisition of modern equipment and establishment of facilities, however, often appropriate training is not considered as part of these investments. Training for NM professionals is continually evolving, with a need to meet changing requirements in the workforce. Even places where established higher education courses are available, these do not necessarily cater to the practical component of training and the ever-changing technology that is central to medical imaging. The continuing advances in NM technology and growth of applications in quantitative clinical assessment place increases the pressure on technologists to learn and practice new techniques. Not only is training to understand new concepts limited but often there is inadequate training in the basics of NM and this can be a major constraint to the effective use of the evolving technology. Developing appropriate training programs for the broader international NM community is one of the goals of the International Atomic Energy Agency (IAEA). A particularly successful and relevant development has been the program on 'distance assisted training (DAT) for NM professionals'. The development of DAT was initiated in the 1990s through Australian Government funding, administered under auspices of the IAEA through its Regional Cooperative Agreement, involving most countries in Asia that are Member States of the IAEA. The project has resulted in the development of a set of training modules which are designed for use under direct supervision in the workplace, delivered through means of distance-learning. The program has undergone several revisions and peer reviews with the current version providing a comprehensive training package that is now available online. DAT has been utilized widely in Asia or the Pacific region, Latin America, and parts of Africa and Europe. Currently there are approximately 1000 registered participants

  2. Addiction to internet replies.

    PubMed

    Lee, Ook

    2009-01-01

    This research introduces a new addictive behavior in cyberspace, which is called Internet Reply Addiction. This phenomenon was found and empirically investigated in Korea where addictive behavior on Internet reply is common. This research suggests that the cause of this kind of addiction can be inferred from the Confucian cultural tradition that oppresses free expressions of individuals in real life settings. PMID:19592737

  3. The shame of addiction.

    PubMed

    Flanagan, Owen

    2013-01-01

    Addiction is a person-level phenomenon that involves twin normative failures. A failure of normal rational effective agency or self-control with respect to the substance; and shame at both this failure, and the failure to live up to the standards for a good life that the addict himself acknowledges and aspires to. Feeling shame for addiction is not a mistake. It is part of the shape of addiction, part of the normal phenomenology of addiction, and often a source of motivation for the addict to heal. Like other recent attempts in the addiction literature to return normative concepts such as "choice" and "responsibility" to their rightful place in understanding and treating addiction, the twin normative failure model is fully compatible with investigation of genetic and neuroscientific causes of addiction. Furthermore, the model does not re-moralize addiction. There can be shame without blame. PMID:24115936

  4. The Shame of Addiction

    PubMed Central

    Flanagan, Owen

    2013-01-01

    Addiction is a person-level phenomenon that involves twin normative failures. A failure of normal rational effective agency or self-control with respect to the substance; and shame at both this failure, and the failure to live up to the standards for a good life that the addict himself acknowledges and aspires to. Feeling shame for addiction is not a mistake. It is part of the shape of addiction, part of the normal phenomenology of addiction, and often a source of motivation for the addict to heal. Like other recent attempts in the addiction literature to return normative concepts such as “choice” and “responsibility” to their rightful place in understanding and treating addiction, the twin normative failure model is fully compatible with investigation of genetic and neuroscientific causes of addiction. Furthermore, the model does not re-moralize addiction. There can be shame without blame. PMID:24115936

  5. Epigenetics and addiction.

    PubMed

    Cadet, J L; McCoy, M T; Jayanthi, S

    2016-05-01

    Addictions are public health menaces. However, despite advances in addiction research, the cellular or molecular mechanisms that cause transition from recreational use to addiction remain to be elucidated. We have recently suggested that addiction may be secondary to long-term epigenetic modifications that determine the clinical course of substance use disorders. A better understanding of epigenetic mechanisms in animal models that mimic human conditions should help to usher in a new area of drug development against addiction. PMID:26841306

  6. Training Family Medicine Residents in Effective Communication Skills While Utilizing Promotoras as Standardized Patients in OSCEs: A Health Literacy Curriculum

    PubMed Central

    Pagels, Patti; Kindratt, Tiffany; Arnold, Danielle; Brandt, Jeffrey; Woodfin, Grant; Gimpel, Nora

    2015-01-01

    Introduction. Future health care providers need to be trained in the knowledge and skills to effectively communicate with their patients with limited health literacy. The purpose of this study is to develop and evaluate a curriculum designed to increase residents' health literacy knowledge, improve communication skills, and work with an interpreter. Materials and Methods. Family Medicine residents (N = 25) participated in a health literacy training which included didactic lectures and an objective structured clinical examination (OSCE). Community promotoras acted as standardized patients and evaluated the residents' ability to measure their patients' health literacy, communicate effectively using the teach-back and Ask Me 3 methods, and appropriately use an interpreter. Pre- and postknowledge, attitudes, and postdidactic feedback were obtained. We compared OSCE scores from the group that received training (didactic group) and previous graduates. Residents reported the skills they used in practice three months later. Results. Family Medicine residents showed an increase in health literacy knowledge (p = 0.001) and scored in the adequately to expertly performed range in the OSCE. Residents reported using the teach-back method (77.8%) and a translator more effectively (77.8%) three months later. Conclusions. Our innovative health literacy OSCE can be replicated for medical learners at all levels of training. PMID:26491565

  7. An Innovative Use of Case Conference to Teach Future Educators in Addiction Psychiatry.

    PubMed

    Muvvala, Srinivas B; Marienfeld, Carla; Encandela, John; Petrakis, Ismene; Edens, Ellen Lockard

    2016-06-01

    Objective An innovative course was developed for fellows enrolled in the Yale School of Medicine Addiction Psychiatry program to educate them in key principles of adult learning, apply these principles in a case conference presentation, and to improve skills in providing and receiving feedback. Methods An initial training module on educational skills was followed by individual mentorship to prepare a case presentation. A feedback module provided space to learn and practice skills in feedback delivery. Results The program showed positive results and improved confidence levels of the participants in presenting and providing/receiving feedback. Conclusions Implementing a course designed to improve teaching and feedback skills is feasible in a 1-year Addiction Psychiatry fellowship. PMID:27001311

  8. Effectively training the hospice and palliative medicine physician workforce for improved end-of-life health care in the United States.

    PubMed

    Bui, Thomas

    2012-09-01

    The widening gap between the demand for palliative care services and the supply of trained palliative care professionals has resulted in considerable end-of-life distress for patients. Without formal training in palliative medicine and end-of-life symptom management, physicians in the United States are less equipped to competently address seriously ill and dying patients' medical, emotional, and spiritual needs. Recent attempts within graduate medical education training deliberately seek to prepare a critical mass of physicians as the new hospice and palliative medicine workforce in the United States. In addition, healthcare reform proposals may re-define the National Health Service Corps (NHSC) post-graduate training over the next five years and the Hospice Medicare Benefit altogether. Healthcare policy options include steady changes at multiple levels of medical training -namely, medical school curriculum mandates, requiring all graduate physician residency training to foster patient-centered communication skills and discussions about advanced directives, and instituting palliative medicine proficiency Continuing Medical Education (CME) requirements for all states' medical licensing boards. Attracting qualified physicians to serve patients at the end of life, innovative medical school loan repayment programs and scholarships will also foster excellence in the field of hospice and palliative medicine. Correcting our current paucity of formal training in palliative medicine better utilizes hospice and restores patients' dignity at the end of life. PMID:22174315

  9. Guiding the development of family medicine training in Africa through collaboration with the Medical Education Partnership Initiative.

    PubMed

    Mash, Robert J; de Villiers, Marietjie R; Moodley, Kalay; Nachega, Jean B

    2014-08-01

    Africa's health care challenges include a high burden of disease, low life expectancy, health workforce shortages, and varying degrees of commitment to primary health care on the part of policy makers and government officials. One overarching goal of the Medical Education Partnership Initiative (MEPI) is to develop models of medical education in Sub-Saharan Africa. To do this, MEPI has created a network of universities and other institutions that, among other things, recognizes the importance of supporting training programs in family medicine. This article provides a framework for assessing the stage of the development of family medicine training in Africa, including the challenges that were encountered and how educational organizations can help to address them. A modified "stages of change" model (precontemplation, contemplation, action, maintenance, and relapse) was used as a conceptual framework to understand the various phases that countries go through in developing family medicine in the public sector and to determine the type of assistance that is useful at each phase. PMID:25072584

  10. Medicine Sellers for Prevention and Control of Sexually Transmitted Infections: Effect of a Quasi-Experimental Training Intervention in Bangladesh

    PubMed Central

    Alam, Nazmul; Alam, Anadil; Fournier, Pierre

    2015-01-01

    This study used a quasi-experimental pre-post design to test whether short training can improve medicine sellers' (MSs) practices and skills for prevention and control of sexually transmitted infections (STIs) in Bangladesh. The training included lectures, printed materials, and identification of referral sites. Difference-in-differences estimation was used to determine the effects of intervention on key primary and secondary outcomes. Advice given by the MSs in intervention group for partner treatment and condoms use increased significantly by 11% and 9%, respectively, after adjusting for baseline differences in education, religion, age, duration of training, and study site. Referral of clients to qualified service providers increased by 5% in the intervention group compared to the comparison group, but this change was not found to be statistically significant. Significantly higher proportion of MSs in the intervention group recognized the recommended medications as per the national syndromic management guidelines in Bangladesh for treatment of urethral discharge and genital ulcer symptoms. Short training intervention was found to be effective in improving MSs' practice of promoting condom use and partner treatment to the clients. We anticipate the need for broad based training programs of MSs to improve their skills for the prevention and control of STI/HIV in Bangladesh. PMID:26491678

  11. Training the teachers. The clinician-educator track of the University of Washington Pulmonary and Critical Care Medicine Fellowship Program.

    PubMed

    Adamson, Rosemary; Goodman, Richard B; Kritek, Patricia; Luks, Andrew M; Tonelli, Mark R; Benditt, Joshua

    2015-04-01

    The University of Washington was the first pulmonary and critical care medicine fellowship training program accredited by the Accreditation Council for Graduate Medical Education to create a dedicated clinician-educator fellowship track that has its own National Residency Matching Program number. This track was created in response to increasing demand for focused training in medical education in pulmonary and critical care. Through the Veterans Health Administration we obtained a stipend for a clinician-educator fellow to dedicate 12 months to training in medical education. This takes place predominantly in the second year of fellowship and is composed of several core activities: fellows complete the University of Washington's Teaching Scholars Program, a professional development program designed to train leaders in medical education; they teach in a variety of settings and receive feedback on their work from clinician-educator faculty and the learners; and they engage in scholarly activity, which may take the form of scholarship of teaching, integration, or investigation. Fellows are guided throughout this process by a primary mentor and a mentoring committee. Since funding became available in 2009, two of the three graduates to date have successfully secured clinician-educator faculty positions. Graduates uniformly believe that the clinician-educator track met their training goals better than the research-based track would have. PMID:25763811

  12. Recreational gamblers with and without parental addiction

    PubMed Central

    Schreiber, Liana Renee Nelson; Odlaug, Brian Lawrence; Grant, Jon Edgar

    2012-01-01

    Research has found that children who have parents with an addiction may be more vulnerable to developing psychopathology compared to children without parental addiction. We compared young adult, recreational gamblers with and without parental addiction on measures of gambling behavior and impulsivity. A total of 286 recreational gamblers (defined as having gambled at least five times in the past 12 months) between the ages of 18 and 29 participated in an initial intake of a longitudinal study assessing susceptibility to pathological gambling. Trained staff interviewed subjects and subjects completed cognitive testing and self-report measures. Fifty-three subjects (18.53%) reported at least one parent with an addiction (including alcohol and substance dependence and pathological gambling). Subjects with at least one addicted parent were significantly more likely to report problems resulting from gambling, have significantly greater rates of psychiatric comorbidity, and report significantly more current marijuana and tobacco use. Subjects with an addicted parent were not significantly different on measures of impulsivity. These findings suggest that even at a stage of low-risk gambling, before what has been considered a psychopathology arises, those with a possible environmental and/or genetic risk of addiction exhibit a range of problematic behaviors. PMID:22401973

  13. [Internet addiction].

    PubMed

    Nakayama, Hideki; Higuchi, Susumu

    2015-09-01

    Internet technologies have made a rapid progress, bringing convenience to daily life. On the other hand, internet use disorder and internet addiction (IA) have become reportedly serious health and social problems. In 2013, internet gaming disorder criteria have been proposed in the section of Conditions for Further Study of DSM-5. Existing epidemiological studies by questionnaire methods have reported that the prevalence of IA ranges between 2.8% and 9.9% among youths in Japan. Attention deficit hyperactivity disorder (ADHD), sleeping disorders, depression, obsessive compulsive disorder, and phobic anxiety disorder are extremely common comorbid mental disorders with IA. Some psychotherapies (e.g., cognitive behavioral therapy, motivational interviewing) and medical treatments (e.g., antidepressant drugs, methylphenidate) for comorbid mental disorders as well as rehabilitation (e.g., treatment camp) are effective for IA remission. However, some serious cases of IA may be difficult to treat, and prevention is very important. In future, the prevention, rehabilitations and treatments for IA will be more required in Japan. PMID:26394521

  14. Principles of Drug Addiction Treatment: A Research-Based Guide.

    ERIC Educational Resources Information Center

    National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

    This booklet can function as a resource for counselors, counselors in training, or anyone else who works with or knows someone who is addicted to drugs. It begins by identifying 13 principles of effective treatment for drug abusers. It then provides answers to 11 frequently asked questions regarding drug addiction treatment. Next it discusses drug…

  15. Treating the Sexually Addicted Client: Establishing a Need for Increased Counselor Awareness

    ERIC Educational Resources Information Center

    Hagedorn, W. Bryce; Juhnke, Gerald A.

    2005-01-01

    Seventeen to 37 million Americans struggle with sexual addictions (P. Carnes, 1994b; A. Cooper, D. L. Delmonico, & R. Burg, 2000; B. Morris, 1999; J. L. Wolf, 2000), yet traditionally trained addictions and offender counselors often find themselves unprepared to assist clients who are sexually addicted. This article provides a general overview of…

  16. Drug Testing Incoming Residents and Medical Students in Family Medicine Training: A Survey of Program Policies and Practices

    PubMed Central

    Bell, Paul F.; Semelka, Michael W.; Bigdeli, Laleh

    2015-01-01

    Background Despite well-established negative consequences, high rates of substance use and related disorders continue to be reported. Physicians in training are not immune from this, or the associated risks to their health and careers, while impaired physicians are a threat to patient safety. Objective We surveyed family medicine residency programs' practices relating to drug testing of medical students and incoming residents. The survey asked about the extent to which residency programs are confronted with trainees testing positive for prohibited substances, and how they respond. Methods The survey was sent to the directors of family medicine residency programs. A total of 205 directors (47.2%) completed the survey. Results A majority of the responding programs required drug testing for incoming residents (143, 68.9%). Most programs did not require testing of medical students (161, 81.7%). Few programs reported positive drug tests among incoming residents (9, 6.5%), and there was only 1 reported instance of a positive result among medical students (1, 3.3%). Respondents reported a range of responses to positive results, with few reporting that they would keep open training spots or offer supportive services for a medical student who tested positive. Conclusions Changing laws legalizing certain drugs may require corresponding changes in the focus on drug testing and associated issues in medical training; however, many residency program directors were not aware of their institution's current policies. Programs will need to reexamine drug testing policies as new generations of physicians, growing up under altered legal circumstances concerning drug use, progress to clinical training. PMID:26217424

  17. NARCOTIC DRUG ADDICTION.

    ERIC Educational Resources Information Center

    YAHRAES, HERBERT; AND OTHERS

    MUCH HAS BEEN LEARNED IN RECENT YEARS ABOUT THE NATURE OF DRUG ADDICTION, THE FACTORS WHICH LEAD A PERSON INTO ADDICTION, AND THE EFFECTIVE TREATMENT OF PERSONS WHO HAVE BECOME ADDICTED. THIS PAMPHLET SURVEYS THE NEW FINDINGS AND IS INTENDED PRIMARILY FOR (1) THOSE WHO IN THE COURSE OF THEIR PROFESSIONAL DUTIES COME IN CONTACT WITH ADDICTED…

  18. Related Addictive Disorders.

    ERIC Educational Resources Information Center

    Buck, Tina; Sales, Amos

    This paper provides an overview of addiction related to substance abuse. It provides basic information, prevalence, diagnostic criteria, assessment tools, and treatment issues for eating disorders, compulsive gambling, sex addictions, and work addictions. Eating disorders such as anorexia nervosa and bulimia nervosa, especially affect adolescents.…

  19. Outcomes of a Peer Assessment/Feedback Training Program in an Undergraduate Sports Medicine Course

    ERIC Educational Resources Information Center

    Marty, Melissa Catherine

    2010-01-01

    Peer assessment/feedback is clearly occurring in athletic training education programs. However, it remains unclear whether students would improve their ability to assess their peers and provide corrective feedback if they received formal training in how to do so. The purpose of this study was to determine the following: (1) if a peer…

  20. Survey of genitourinary medicine specialist registrars in the United Kingdom regarding genital dermatology training.

    PubMed

    Hartley, A; Bates, C M; Sashidharan, P N

    2016-07-01

    The British Association for Sexual Health and HIV Genital Dermatology Special Interest Group (SIG) conducted a survey of specialist registrar training in genital dermatology (GD) to inform future training provision provided by the group and other services. The survey shows that training in GD is variable with most trainees receiving GD training through formal lectures or ad hoc clinical teaching, with fewer trainees having access to specialist GD clinics. There is mixed confidence in diagnosis and use of topical steroids, and few trainees are independent in GD practical procedures. Many trainees feel training could be improved with requests for a formalised attachment, formal qualification and greater training in practical procedures. The GD SIG, in liaison with British Association for Sexual Health and HIV (BASHH), aims to optimise GD training for registrars. Plans for improved resources are in progress, including a practical skills course and e-learning. It is hoped this survey will also inform GD training at both local and national levels. PMID:26394999

  1. A Human Dissection Training Program at Indiana University School of Medicine-Northwest

    ERIC Educational Resources Information Center

    Talarico, Ernest F., Jr.

    2010-01-01

    As human cadavers are widely used in basic sciences, medical education, and other training and research venues, there is a real need for experts trained in anatomy and dissection. This article describes a program that gives individuals interested in clinical and basic sciences practical experience working with cadavers. Participants are selected…

  2. Training the Translational Research Teams of the Future: UC Davis - HHMI Integrating Medicine into Basic Science Program

    PubMed Central

    Knowlton, Anne A.; Rainwater, Julie A.; Chiamvimonvat, Nipavan; Bonham, Ann C.; Robbins, John A.; Henderson, Stuart; Meyers, Frederick J.

    2013-01-01

    There is a need for successful models of how to recruit, train, and retain bench scientists at the earliest stages of their careers into translational research. One recent, promising model is the University of California Davis Howard Hughes Medical Institute Integrating Medicine into Basic Science (HHMI-IMBS) program, part of the HHMI Med into Grad initiative. This article outlines the HHMI-IMBS program’s logic, design, and curriculum that guide the goal of research that moves from bedside to bench. That is, a curriculum that provides graduate students with guided translational training, clinical exposure, team science competencies and mentors from diverse disciplines that will advance the students careers in clinical translational research and re-focusing of research to answer clinical dilemmas. The data indicate that this training program provides an effective, adaptable model for training future translational researchers. HHMI-IMBS students showed improved confidence in conducting translational research, greater interest in a future translational career, and higher levels of research productivity and collaborations than a comparable group of pre-doctoral students. PMID:24127920

  3. 75 FR 69686 - Advisory Committee on Training in Primary Care Medicine and Dentistry

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... Rockville Pike, Rockville, MD 20910, which was published in the Federal Register on October 19, 2010, FR Doc. 2010-26205 (75 FR 64318). Dated: November 8, 2010. Robert Hendricks, Director, Division of Policy and... Care Medicine and Dentistry AGENCY: Health Resources and Services Administration, HHS. ACTION:...

  4. Protected clinical teaching time and a bedside clinical evaluation instrument in an emergency medicine training program.

    PubMed

    Shayne, Philip; Heilpern, Katherine; Ander, Douglas; Palmer-Smith, Victoria

    2002-11-01

    In a process that has evolved over the last four years, the Emory University Emergency Medicine Education Committee has developed an "academic attending" teaching shift incorporating a formatted lecture series with a clinical evaluation exercise (CEE). The program structures the approach to clinical teaching at the bedside, provides an objective clinical evaluation tool specific to emergency medicine residents, and provides targeted learning for medical students and residents rotating in the emergency department (ED). The CEE instrument was designed to be quick and efficient, satisfy requirements of assessment of the Accreditation Council for Graduate Medical Education (ACGME) general competencies, and incorporate the language of the "Model of the Clinical Practice of Emergency Medicine." The original program called for unstructured bedside teaching three days a week, by faculty freed from clinical duties, combined with a limited series of introductory emergency medicine lectures. The program proved more successful when concentrated in a once weekly structured educational program. The prepared, repeating lecture series has been expanded to include many of the most common ED presenting chief complaints and has significantly advanced a curriculum for medical students and visiting interns. A CEE was developed to evaluate and provide immediate feedback to residents on many of the core ACGME competencies. The CEE has been successfully used to structure the bedside educational encounter. This dedicated non-clinical "teaching" shift appears effective in meeting the educational goals of the authors' academic ED. This is a description of the program and its evolution; the program has not been formally evaluated. PMID:12414493

  5. An Evaluation of the National Library of Medicine (NLM) Training Guide Program.

    ERIC Educational Resources Information Center

    Fink, C. Dennis

    In an attempt to compare the job activities of recent graduates from librarianship and internship programs supported by the National Library of Medicine (NLM) with a comparable group of graduates from non-NLM-supported programs in librarianship, detailed questionnaires were administered to graduates from both groups. They were asked to describe…

  6. A simplified training method for soft tissue foreign body detection using ultrasound in emergency medicine residency program

    PubMed Central

    Farahmand, Shervin; Mehran, Sadjad; Arbab, Mona; Khazaeipour, Zahra; Basir-Ghafouri, Hamed; Saeedi, Morteza

    2014-01-01

    Using ultrasound for detecting soft tissue foreign bodies seems to be the preferred choice with minimum invasion and easy availability at the bedside in emergency departments. In this study, a workshop (1 hour of lecture presentation and 3 hours of interactive hands-on) was designed to evaluate the efficacy of a short course of simple interactive training to improve the ability of emergency medicine residents to detect foreign bodies with ultrasound. Eight pieces of fresh full thickness (10 × 10 × 10 cm) lamb leg muscle were used in this study. Five different types of foreign bodies, including: a piece of glass (5 × 5 × 4 mm), wood (5 × 5 × 4 mm), gravel (5 mm diameter), plastic (5 × 5 × 2 mm) and a nail (25 mm in length) were placed deep inside each lamb leg. An ultrasound machine with a 7.5 MHz linear probe was used in this study. 35 emergency medicine residents (12 PGY1, 11 PGY2 and 12 PGY3) were enrolled in this study. Pretest and post-test results were compared and analyzed. Among all 35 participants in the training session, foreign body detection was significantly improved after the workshop (p < 0.001). Overall sensitivity and specificity for differentiating the presence and absence of a foreign body with 95% confidence were 60% (75% for PGY3) and 85.7% (91.7% for PGY3), respectively. The overall accuracy increased from 20.2% to 72.8% due to this session. This study supported the possibility of using ultrasound to detect foreign bodies by emergency physicians with a very short training course. This is highly beneficial for overcrowded emergency departments.

  7. Comparison of pharmacist knowledge, perceptions and training opportunities regarding maternal-fetal medicine in Canada, Qatar and Uganda

    PubMed Central

    Bains, Serena; Kitutu, Freddy E.; Rahhal, Ala’a; Abu Samaha, Rana; Wilby, Kyle J.

    2014-01-01

    Background: Although pharmacists have great potential to modify and optimize drug therapy in pregnancy and lactation, current literature demonstrates that they do not routinely provide this care and often feel ill equipped to do so. The objective of this study was to determine pharmacists’ knowledge and perceptions of maternal-fetal medicine in Canada, Uganda and Qatar. Secondary objectives were to determine factors associated with pharmacists’ knowledge and to characterize training opportunities and resources available to practising pharmacists. Methods: A cross-sectional survey using online software (SurveyMonkey) was sent to the e-mails of potential research participants. Practising pharmacists and resident pharmacists in British Columbia, Canada; the country of Qatar; and the country of Uganda were eligible for inclusion. The survey was designed to assess knowledge and perceptions, and to create a baseline inventory of current practice and information resources used in practice. Results: The mean knowledge assessment scores of pharmacists in Canada, Qatar and Uganda were 62.9%, 53.3%, and 57.7%, respectively (p < 0.05). Pharmacists in British Columbia scored higher on knowledge assessment than pharmacists in Qatar (p < 0.05), but other country comparisons were not significant. No predefined factors (gender, years of experience, practice area or parental status) were found to be significant in determining the knowledge score. More than two-thirds of pharmacists expressed interest in participating in continuing education opportunities in maternal-fetal medicine. Conclusion: Pharmacists have differing levels of knowledge in the area of maternal-fetal medicine. Continuing education and degree curricula should be reviewed and developed to fill the knowledge gaps of student pharmacists and practising pharmacists in maternal-fetal medicine. PMID:25364351

  8. Traveling Safely with Medicines

    MedlinePlus

    ... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...

  9. Altitude training for elite endurance athletes: A review for the travel medicine practitioner.

    PubMed

    Flaherty, Gerard; O'Connor, Rory; Johnston, Niall

    2016-01-01

    High altitude training is regarded as an integral component of modern athletic preparation, especially for endurance sports such as middle and long distance running. It has rapidly achieved popularity among elite endurance athletes and their coaches. Increased hypoxic stress at altitude facilitates key physiological adaptations within the athlete, which in turn may lead to improvements in sea-level athletic performance. Despite much research in this area to date, the exact mechanisms which underlie such improvements remain to be fully elucidated. This review describes the current understanding of physiological adaptation to high altitude training and its implications for athletic performance. It also discusses the rationale and main effects of different training models currently employed to maximise performance. Athletes who travel to altitude for training purposes are at risk of suffering the detrimental effects of altitude. Altitude illness, weight loss, immune suppression and sleep disturbance may serve to limit athletic performance. This review provides an overview of potential problems which an athlete may experience at altitude, and offers specific training recommendations so that these detrimental effects are minimised. PMID:27040934

  10. Can Credit Systems Help in Family Medicine Training in Developing Countries? An Innovative Concept

    PubMed Central

    Raji, J. Beulah; Velavan, Jachin; Anbarasi, Sahaya; Grant, Liz

    2014-01-01

    There is irrefutable evidence that health systems perform best when supported by a Family Physician network. Training a critical mass of highly skilled Family Physicians can help developing countries to reach their Millennium Development Goals and deliver comprehensive patient-centered health care to their population. The challenge in developing countries is the need to rapidly train these Family Physicians in large numbers, while also ensuring the quality of the learning, and assuring the quality of training. The experience of Christian Medical College (CMC), Vellore, India and other global examples confirm the fact that training large numbers is possible through well-designed blended learning programs. The question then arises as to how these programs can be standardized. Globally, the concept of the “credit system” has become the watch-word for many training programs seeking standardization. This article explores the possibility of introducing incremental academic certifications using credit systems as a method to standardize these blended learning programs, gives a glimpse at the innovation that CMC, Vellore is piloting in this regard partnering with the University of Edinburgh and analyses the possible benefits and pitfalls of such an approach. PMID:25374849

  11. HERMES European Accreditation of Training Centres in Adult Respiratory Medicine: criteria validation and revision.

    PubMed

    Sutter, Sandy; Stolz, Daiana; Karg, Ortrud; Mitchell, Sharon; Niculescu, Alexandra; Noël, Julie-Lyn; Powell, Pippa; Skoczyński, Szymon; Verbraecken, Johan; Rohde, Gernot

    2016-03-01

    Four respiratory medicine disease categories appear in the global top 10 causes of mortality [1], resulting in 600 000 people dying from respiratory disease in Europe each year. The economic burden of respiratory diseases in Europe exceeds 380 billion euros. In a fast-developing environment, new clinical challenges have arisen for pulmonary specialists; techniques and procedures have evolved and become more complex. PMID:27066135

  12. A review of addiction.

    PubMed

    Clay, Steven W; Allen, Jason; Parran, Theorore

    2008-07-01

    Addiction to drugs and alcohol is often undiagnosed and untreated. Physicians are often unaware or have negative attitudes regarding these patients, such as the perception that treatment is ineffective. Addiction--psychological dependence with or without tolerance and withdrawal--is essentially compulsive uncontrolled substance use despite physical, psychological, or social consequences. We now have an understanding of the 2 major neurological pathways involved in addiction. First, the mesolimbic dopamine reward pathway, which is essential for survival, can be physically altered by drug abuse to result in uncontrolled cravings. Second, the decision-making prefrontal cortex, which suppresses inappropriate reward response, can also be altered by drug abuse. Thus, accelerated "go" signals and impaired "stop" signals result in uncontrolled use despite severe consequences. Further, addicts can be predisposed to addiction by genetic defects in reward pathway neurotransmission and stress-related developmental brain abnormalities. Relapse to drug use can occur because of stress or cue-related reward pathway stimulation or even by a single drug dose. Individualized treatment of addiction, including pharmacological and cognitive-behavioral interventions, can be as successful as treatment of other chronic diseases. Several pharmaceuticals are available or under study for these disorders. Waiting for the addict to "be ready" for treatment can be dangerous and detoxification alone is often ineffective. The physician's role in treating addiction includes prevention, diagnosis, brief intervention, motivational interviewing, referral, and follow-up care. An understanding of the biological reality of addiction allows physicians to understand addicts as having a brain disease. Further, the reality of effective pharmacological and cognitive-behavioral treatments for addiction allows physicians to be more optimistic in treating addicts. The challenge to the physician is to embrace the

  13. Future directions in training of veterinarians for small exotic mammal medicine: expectations, potential, opportunities, and mandates.

    PubMed

    Rosenthal, Karen

    2006-01-01

    Small exotic mammals have been companions to people for almost as long as dogs and cats have been. The challenge for veterinary medicine today is to decipher the tea leaves and determine whether small mammals are fad or transient pets or whether they will still be popular in 20 years. This article focuses on pet small-mammal medicine, as the concerns of the laboratory animal are better known and may differ profoundly from those of a pet. Dozens of species of small exotic mammals are kept as pets. These pet small-mammal species have historically served human purposes other than companionship: for hunting, for their pelts, or for meat. Now, they are common pets. At present, most veterinary schools lack courses in the medical care of these animals. Veterinary students need at least one required class to introduce them to these pets. Currently, there are no small-mammal-only residency programs. This does not correspond with current needs. The only way to judge current needs is by assessing what employers are looking for. In a recent JAVMA classified section, almost 30% of small-animal practices in suburban/urban areas were hiring veterinarians with knowledge of exotic pets. All veterinarians must recognize that pet exotic small mammals have changed the landscape of small-animal medicine. It is a reality that, today, many small-animal practices see pet exotic small mammals on a daily basis. PMID:17035210

  14. "Addiction Proneness" and Personality in Heroin Addicts

    ERIC Educational Resources Information Center

    Platt, Jerome J.

    1975-01-01

    A carefully controlled comparison of the personality characteristics of heroin addict (n=27) and nonaddict (n=20) offenders was carried out so as to avoid methodological problems associated with earlier studies. (Editor)

  15. Efficacy of Abbreviated Progressive Muscle Relaxation Training: A Quantitative Review of Behavioral Medicine Research.

    ERIC Educational Resources Information Center

    Carlson, Charles R.; Hoyle, Rick H.

    1993-01-01

    Conducted quantitative review of research in which abbreviated progressive muscle relaxation training (APRT) was used as intervention for psychophysiological and stress-related disorders. Calculated strength of association between APRT and outcome measures for 29 experiments published after 1980. APRT was most strongly associated with improvement…

  16. On Personal and Collective Dimensions of Agency in Doctoral Training: Medicine and Natural Science Programs

    ERIC Educational Resources Information Center

    Hakkarainen, Kai Pekka; Wires, Susanna; Keskinen, Jenni; Paavola, Sami; Pohjola, Pasi; Lonka, Kirsti; Pyhältö, Kirsi

    2014-01-01

    The purpose of the present study was to investigate knowledge-creating agency by examining doctoral students' accounts of their pursuits, using structured interviews. We examined all of the talk apparently related to agency of 13 doctoral students taking part in collective doctoral training in two, highly regarded Finnish research communities…

  17. Internet Addiction and Other Behavioral Addictions.

    PubMed

    Jorgenson, Alicia Grattan; Hsiao, Ray Chih-Jui; Yen, Cheng-Fang

    2016-07-01

    The Internet is increasingly influential in the lives of adolescents. Although there are many positives, there are also risks related to excessive use and addiction. It is important to recognize clinical signs and symptoms of Internet addiction (compulsive use, withdrawal, tolerance, and adverse consequences), treat comorbid conditions (other substance use disorders, attention deficit hyperactivity disorder, anxiety, depression, and hostility), and initiate psychosocial interventions. More research on this topic will help to provide consensus on diagnostic criteria and further clarify optimal management. PMID:27338971

  18. [A Perspective on Innovation for Efficient Medical Practice in View of Undergraduate and Postgraduate Education and Training in Laboratory Medicine].

    PubMed

    Kawai, Tadashi

    2015-10-01

    Continuous advances in medical laboratory technology have driven major changes in the practice of laboratory medicine over the past two decades. The importance of the overall quality of a medical laboratory has been ever-increasing in order to improve and ensure the quality and safety of clinical practice by physicians in any type of medical facility. Laboratory physicians and professional staff should challenge themselves more than ever in various ways to cooperate and contribute with practicing physicians for the appropriate utilization of laboratory testing. This will certainly lead to a decrease in inappropriate or unnecessary laboratory testing, resulting in reducing medical costs. In addition, not only postgraduate, but also undergraduate medical education/training systems must be markedly innovated, considering recent rapid progress in electronic information and communication technologies. PMID:26897851

  19. Big data and new knowledge in medicine: the thinking, training, and tools needed for a learning health system.

    PubMed

    Krumholz, Harlan M

    2014-07-01

    Big data in medicine--massive quantities of health care data accumulating from patients and populations and the advanced analytics that can give those data meaning--hold the prospect of becoming an engine for the knowledge generation that is necessary to address the extensive unmet information needs of patients, clinicians, administrators, researchers, and health policy makers. This article explores the ways in which big data can be harnessed to advance prediction, performance, discovery, and comparative effectiveness research to address the complexity of patients, populations, and organizations. Incorporating big data and next-generation analytics into clinical and population health research and practice will require not only new data sources but also new thinking, training, and tools. Adequately utilized, these reservoirs of data can be a practically inexhaustible source of knowledge to fuel a learning health care system. PMID:25006142

  20. What is addiction?

    PubMed

    Kranzler, Henry R; Li, Ting-Kai

    2008-01-01

    This issue of Alcohol Research & Health examines addiction to multiple substances--that is, combined dependence on alcohol and other drugs (AODs), including marijuana, cocaine, and opioids. It seems fitting, then, to begin the issue with a look at what constitutes "addiction." The Oxford English Dictionary (pp. 24-25) traces the term addiction to Roman law, under which addiction was a "formal giving over by sentence of court; hence, a dedication of person to a master." This notion of relinquishment of control by the addicted person is the central feature of many lay and professional definitions of the term. The study of addictive behavior crosses several disciplines, including, among others, behavioral neuroscience, epidemiology, genetics, molecular biology, pharmacology, psychology, psychiatry, and sociology. Articles in this issue examine aspects of AOD use disorders from the perspective of some of these varied disciplines. PMID:23584810

  1. Historical and cultural aspects of man's relationship with addictive drugs

    PubMed Central

    Crocq, Marc-Antoine

    2007-01-01

    Our taste for addictive psychoactive substances is attested to in the earliest human records. Historically, psychoactive substances have been used by (i) priests in religious ceremonies (eg, amanita muscaria); (ii) healers for medicinal purposes (eg, opium); or (iii) the general population in a socially approved way (eg, alcohol, nicotine, and caffeine). Our forebears refined more potent compounds and devised faster routes of administration, which contributed to abuse. Pathological use was described as early as classical Antiquity. The issue of loss of control of the substance, heralding today's concept of addiction, was already being discussed in the 17th century. The complex etiology of addiction is reflected in the frequent pendulum swings between opposing attitudes on issues that are still currently being debated, such as: is addiction a sin or a disease; should treatment be moral or medical; is addiction caused by the substance; the individual's vulnerability and psychology, or social factors; should substances be regulated or freely available. PMID:18286796

  2. Does Addiction Run in Families?

    MedlinePlus

    ... runs in some families. Addiction runs in ours." Matt's family has a history of addiction. He realizes ... may be more likely to become addicted. Read Matt's story About the National Institute on Drug Abuse ( ...

  3. [Neurobiology of behavioral addictions].

    PubMed

    Kiefer, F; Fauth-Bühler, M; Heinz, A; Mann, K

    2013-05-01

    Reward learning represents a crucial mechanism in the acquisition and maintenance of addictive behavior. The underlying neurobiological foundations and associated neurobiological pathways are identified in this review and similarities between substance abuse and behavioral addictions will be discussed. In the second section current neuroimaging findings on neurobiological mechanisms of pathological gambling and computer and internet addiction are discussed. The main focuses are on changes in neurocognitive processes, such as cue reactivity, reward and punishment processing and behavioral control. PMID:23632569

  4. Addiction and will

    PubMed Central

    Johnson, Brian

    2013-01-01

    A hypothesis about the neurobiological bases of drive, drive reduction and will in addictive illness is presented. Drive reduction seems to require both SEEKING and gratification. Will is the everyday term for our experience of drives functioning within us. Addictive drugs take over the will by altering neurotransmission in the SEEKING system. As a result of this biological change, psychological defenses are arrayed that allow partial gratification and reduce anxiety about the consequences of drug use. Repeated partial gratification of the addictive drive creates a cathexis to the drug and the drug seller. It also keeps the addicted person in a permanent state of SEEKING. The cathexis to the drug and drug seller creates a difficult situation for psychoanalytic therapists. The actively addicted patient will have one set of feelings for the analyst, and a split off set of feelings for the drug dealer. Addictive neuroses, which feature a split transference, are contrasted with Freud’s concept of transference and narcissistic neuroses. For treatment of an actively addicted patient, the treater must negotiate the split transference. By analyzing the denial system the relationship with the drug dealer ends and the hostility involved in addictive behavior enters the transference where it can be interpreted. Selling drugs that take over the will is a lucrative enterprise. The addictive drug industry, about the size of the oil and gas industry worldwide, produces many patients in need of treatment. The marketers of addictive drugs understand the psychology of inducing initial ingestion of the drugs, and of managing their addicted populations. The neuropsychoanalytic understanding of addiction might be used to create more effective public health interventions to combat this morbid and mortal illness. PMID:24062657

  5. Introduction to Behavioral Addictions

    PubMed Central

    Grant, Jon E.; Potenza, Marc N.; Weinstein, Aviv; Gorelick, David A.

    2011-01-01

    Background Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or “behavioral” addictions. Objectives Inform the discussion on the relationship between psychoactive substance and behavioral addictions. Methods: We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. Results Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions. Conclusions and Scientific Significance Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies. PMID:20560821

  6. Addiction and will.

    PubMed

    Johnson, Brian

    2013-01-01

    A hypothesis about the neurobiological bases of drive, drive reduction and will in addictive illness is presented. Drive reduction seems to require both SEEKING and gratification. Will is the everyday term for our experience of drives functioning within us. Addictive drugs take over the will by altering neurotransmission in the SEEKING system. As a result of this biological change, psychological defenses are arrayed that allow partial gratification and reduce anxiety about the consequences of drug use. Repeated partial gratification of the addictive drive creates a cathexis to the drug and the drug seller. It also keeps the addicted person in a permanent state of SEEKING. The cathexis to the drug and drug seller creates a difficult situation for psychoanalytic therapists. The actively addicted patient will have one set of feelings for the analyst, and a split off set of feelings for the drug dealer. Addictive neuroses, which feature a split transference, are contrasted with Freud's concept of transference and narcissistic neuroses. For treatment of an actively addicted patient, the treater must negotiate the split transference. By analyzing the denial system the relationship with the drug dealer ends and the hostility involved in addictive behavior enters the transference where it can be interpreted. Selling drugs that take over the will is a lucrative enterprise. The addictive drug industry, about the size of the oil and gas industry worldwide, produces many patients in need of treatment. The marketers of addictive drugs understand the psychology of inducing initial ingestion of the drugs, and of managing their addicted populations. The neuropsychoanalytic understanding of addiction might be used to create more effective public health interventions to combat this morbid and mortal illness. PMID:24062657

  7. Evaluating clinical teaching in the medicine clerkship: relationship of instructor experience and training setting to ratings of teaching effectiveness.

    PubMed

    Ramsey, P G; Gillmore, G M; Irby, D M

    1988-01-01

    A clinical teaching assessment form was used to evaluate the teaching by faculty and residents in the required third-year medicine clerkship over a two-year period. Data from 1,627 forms were analyzed for differences between groups of teachers at different experience levels and for comparison of teaching programs at different training sites. The level of involvement of instructor with student correlated with ratings by the students. Among groups of instructors, chief medical residents received the highest overall ratings. Faculty were rated higher than first-, second-, and third-year residents when degree of involvement of instructor with student was high. Ratings among faculty of different academic ranks were not significantly different. Analysis of data from different clinical settings showed that the teaching efforts by clinical faculty members in the ambulatory setting received the highest ratings from students. Although increased involvement of instructors with students or other factors may have led to the higher ratings in the ambulatory setting, the results are encouraging for the use of ambulatory teaching sites for the basic medicine clerkship. PMID:3404296

  8. Specialization training in Malawi: a qualitative study on the perspectives of medical students graduating from the University of Malawi College of Medicine

    PubMed Central

    2014-01-01

    Background There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students’ perspectives on specialization training in Malawi. Methods We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an “editing approach” to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. Results We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Conclusions Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country’s healthcare workforce and the needs of their

  9. Hidden addiction: Television

    PubMed Central

    Sussman, Steve; Moran, Meghan B.

    2013-01-01

    Background and aims: The most popular recreational pastime in the U.S. is television viewing. Some researchers have claimed that television may be addictive. We provide a review of the definition, etiology, prevention and treatment of the apparent phenomenon of television addiction. Methods: Selective review. Results: We provide a description of television (TV) addiction, including its negative consequences, assessment and potential etiology, considering neurobiological, cognitive and social/cultural factors. Next, we provide information on its prevention and treatment. Discussion and conclusions: We suggest that television addiction may function similarly to substance abuse disorders but a great deal more research is needed. PMID:25083294

  10. Anti-addiction vaccines

    PubMed Central

    Shen, Xiaoyun; Orson, Frank M.

    2011-01-01

    Despite intensive efforts to eradicate it, addiction to both legal and illicit drugs continues to be a major worldwide medical and social problem. Anti-addiction vaccines can produce the antibodies to block the effects of these drugs on the brain, and have great potential to ameliorate the morbidity and mortality associated with illicit drug intoxications. This review provides a current overview of anti-addiction vaccines that are under clinical trial and pre-clinical research evaluation. It also outlines the development challenges, ethical concerns, and likely future intervention for anti-addiction vaccines. PMID:22003367

  11. [Increasing the effectiveness of training of medical students in promoting the knowledge of medicine and hygiene].

    PubMed

    Eme'lianova, G F; Pavlov, V A; Patoka, G A

    1989-01-01

    Fifth-year students of the medical faculty prepare one of the course of lectures on the subject of healthy lifestyle promotion, using methodological literature supplied by the Chair and the necessary information. This work is carried out during hours reserved for independent training under the supervision of teachers. The students deliver these lectures to schoolchildren during days and hours specified by the timetable. The lecturing includes demonstration of visual aids. Independent training and lecturing, on the one hand, promotes positive motivation in students in relation to the most important part of their future activity--dissemination of medical and hygienic knowledge and, on the other, raises the level of hygienic education among schoolchildren. PMID:2595448

  12. [Present status and research train of thoughts in integrative medicine on unstable plaque].

    PubMed

    Zhang, Jing-chun; Chen, Ke-ji; Ahang, Wen-gao

    2005-10-01

    The changing of atherosclerosis (AS) plaque from stable to unstable is closely related to the incidence of cardio-cerebrovascular events. So, to stabilize AS plaque become the hot point of the modern study on prevention and treatment of cardio-cerebrovascular diseases. The formation of AS plaque is a very long and complicated process with the participation of many factors. However, inflammation reaction plays an important role in the formation and rupture of unstable plaque. Traditional Chinese medicine (TCM) shows latent therapeutic advantages in stabilizing AS plaque with its characteristics of multi-way, multi-link, and multi-target point and all-sided treatment as well as its rather milder adverse reactions. The paper gives a comparatively systematic retrospection of study on unstable plaque treated by integrated Chinese and Western medicine conducted in recent years. Combined with the related topics conducted by the authors, they raise the theory of "unstable plaque is induced by toxinduced by toxin and stagnation", and introduce the study on the intervention of unstable plaque by removing toxic substances and activating blood flow. They believe that the explorative study can provide objective experimental and clinical basis for TCM therapeutic method in stabilizing AS plaque. PMID:16313104

  13. How are medical students trained to locate biomedical information to practice evidence-based medicine? a review of the 2007–2012 literature

    PubMed Central

    Maggio, Lauren A.; Kung, Janice Y.

    2014-01-01

    Objectives: This study describes how information retrieval skills are taught in evidence-based medicine (EBM) at the undergraduate medical education (UGME) level. Methods: The authors systematically searched MEDLINE, Scopus, Educational Resource Information Center, Web of Science, and Evidence-Based Medicine Reviews for English-language articles published between 2007 and 2012 describing information retrieval training to support EBM. Data on learning environment, frequency of training, learner characteristics, resources and information skills taught, teaching modalities, and instructor roles were compiled and analyzed. Results: Twelve studies were identified for analysis. Studies were set in the United States (9), Australia (1), the Czech Republic (1), and Iran (1). Most trainings (7) featured multiple sessions with trainings offered to preclinical students (5) and clinical students (6). A single study described a longitudinal training experience. A variety of information resources were introduced, including PubMed, DynaMed, UpToDate, and AccessMedicine. The majority of the interventions (10) were classified as interactive teaching sessions in classroom settings. Librarians played major and collaborative roles with physicians in teaching and designing training. Unfortunately, few studies provided details of information skills activities or evaluations, making them difficult to evaluate and replicate. Conclusions: This study reviewed the literature and characterized how EBM search skills are taught in UGME. Details are provided on learning environment, frequency of training, level of learners, resources and skills trained, and instructor roles. Implications: The results suggest a number of steps that librarians can take to improve information skills training including using a longitudinal approach, integrating consumer health resources, and developing robust assessments. PMID:25031559

  14. Tobacco addiction as a psychiatric disease.

    PubMed

    Cohen, S B

    1988-09-01

    Tobacco is the most widely used addictive substance in the world. Since the Surgeon General's 1964 report, medicine has sought out the genesis of tobacco addiction (TA) and has evolved methods of treatment and prevention. Psychiatry was slower than other medical specialties to acknowledge TA as a legitimate area for psychiatric intervention, probably because the many psychiatrists who were smokers identified with their smoking patients. Since 1980, the American Psychiatric Association has recognized nicotine dependence and nicotine withdrawal as diagnostic entities. The complications of TA are in the province of other medical specialists, but psychiatrists have unique tools for treating addictive disorders. This paper describes some of the addictive qualities of tobacco, and presents illustrative cases of successful treatment of TA using hypnosis. It describes an effective cooperative community program under medical aegis, focusing on education, therapy, and prevention, which has resulted in the virtual disappearance of tobacco consumption in hospitals and schools in the community. By sharing their expertise in the treatment of individual patients, and the design of effective community programs that include education, prevention, and treatment, psychiatrists will be active leaders in the medical community's program to reduce tobacco addiction. PMID:3420439

  15. Problem-based learning at the Harvard School of Dental Medicine: self-assessment of performance in postdoctoral training.

    PubMed

    Thammasitboon, Kewalin; Sukotjo, Cortino; Howell, Howard; Karimbux, Nadeem

    2007-08-01

    Problem-based learning (PBL) was implemented into the dental curriculum at the Harvard School of Dental Medicine (HSDM) in 1994 with an expectation that this pedagogy would enhance students' critical thinking and communication skills as well as general professional competencies. Previous studies have described several aspects of the outcome of PBL curricula at the predoctoral level. However, there is no information available on the perceptions and performance of PBL graduates during their postdoctoral training in dentistry. The purpose of this study was to evaluate the effect of PBL methodology on the performance of HSDM graduates during their postdoctoral training in comparison with their non-HSDM (traditional) co-residents. Surveys containing traditional knowledge-based criteria, preclinical and clinical criteria, and PBL criteria were sent to HSDM graduates from the classes of 2002 through 2004 who were in postgraduate training programs. The HSDM and traditional graduates were asked to evaluate and compare their performance in selected areas with those of their co-residents from either a PBL curriculum or a traditional curriculum. The directors of each program were also asked to assess HSDM graduates relative to other graduates in the program based on the same aspects. Overall, HSDM graduates rated themselves more highly than non-HSDM graduates on all competencies. No significant difference between HSDM and non-HSDM responses was found in general dental knowledge, specialty specific knowledge, preclinical skills, clinical skills, communication with staff, and patient education, whereas significant differences (p<0.05) were found for communication with patients, critical thinking, independent learning, performance in small group settings, self-assessment, and teamwork. The data obtained from the program directors revealed corresponding results. The HSDM graduates' capacity for independent learning was rated as "excellent" by 65.31 percent of the directors and 80

  16. Pleasure and Addiction

    PubMed Central

    Kennett, Jeanette; Matthews, Steve; Snoek, Anke

    2013-01-01

    What is the role and value of pleasure in addiction? Foddy and Savulescu (1) have claimed that substance use is just pleasure-oriented behavior. They describe addiction as “strong appetites toward pleasure” and argue that addicts suffer in significant part because of strong social and moral disapproval of lives dominated by pleasure seeking. But such lives, they claim, can be autonomous and rational. The view they offer is largely in line with the choice model and opposed to a disease model of addiction. Foddy and Savulescu are sceptical of self-reports that emphasize the ill effects of addiction such as loss of family and possessions, or that claim an absence of pleasure after tolerance sets in. Such reports they think are shaped by social stigma which makes available a limited set of socially approved addiction narratives. We will not question the claim that a life devoted to pleasure can be autonomously chosen. Nor do we question the claim that the social stigma attached to the use of certain drugs increases the harm suffered by the user. However our interviews with addicts (as philosophers rather than health professionals or peers) reveal a genuinely ambivalent and complex relationship between addiction, value, and pleasure. Our subjects did not shy away from discussing pleasure and its role in use. But though they usually valued the pleasurable properties of substances, and this played that did not mean that they valued an addictive life. Our interviews distinguished changing attitudes towards drug related pleasures across the course of substance use, including diminishing pleasure from use over time and increasing resentment at the effects of substance use on other valued activities. In this paper we consider the implications of what drug users say about pleasure and value over the course of addiction for models of addiction. PMID:24093020

  17. Effect of handoff skills training for students during the medicine clerkship: a quasi-randomized Study.

    PubMed

    Reyes, Juan A; Greenberg, Larrie; Amdur, Richard; Gehring, James; Lesky, Linda G

    2016-03-01

    Continuity is critical for safe patient care and its absence is associated with adverse outcomes. Continuity requires handoffs between physicians, but most published studies of educational interventions to improve handoffs have focused primarily on residents, despite interns expected to being proficient. The AAMC core entrustable activities for graduating medical students includes handoffs as a milestone, but no controlled studies with students have assessed the impact of training in handoff skills. The purpose of this study was to assess the impact of an educational intervention to improve third-year medical student handoff skills, the durability of learned skills into the fourth year, and the transfer of skills from the simulated setting to the clinical environment. Trained evaluators used standardized patient cases and an observation tool to assess verbal handoff skills immediately post intervention and during the student's fourth-year acting internship. Students were also observed doing real time sign-outs during their acting internship. Evaluators assessed untrained control students using a standardized case and performing a real-time sign-out. Intervention students mean score demonstrated improvement in handoff skills immediately after the workshop (2.6-3.8; p < 0.0001) that persisted into their fourth year acting internship when compared to baseline performance (3.9-3.5; p = 0.06) and to untrained control students (3.5 vs. 2.5; p < 0.001, d = 1.2). Intervention students evaluated in the clinical setting also scored higher than control students when assessed doing real-time handoffs (3.8 vs. 3.3; p = 0.032, d = 0.71). These findings should be useful to others considering introducing handoff teaching in the undergraduate medical curriculum in preparation for post-graduate medical training. Trial Registration Number NCT02217241. PMID:26174046

  18. Bedside ultrasonography (US), Echoscopy and US point of care as a new kind of stethoscope for Internal Medicine Departments: the training program of the Italian Internal Medicine Society (SIMI).

    PubMed

    Arienti, Vincenzo; Di Giulio, Rosella; Cogliati, Chiara; Accogli, Esterita; Aluigi, Leonardo; Corazza, Gino Roberto

    2014-10-01

    In recent years, thanks to the development of miniaturized ultrasound devices, comparable to personal computers, tablets and even to smart phones, we have seen an increasing use of bedside ultrasound in internal medicine departments as a novel kind of ultrasound stethoscope. The clinical ultrasound-assisted approach has proved to be particularly useful in assessing patients with nodules of the neck, dyspnoea, abdominal pain, and with limb edema. In several cases, it has allowed a simple, rapid and precise diagnosis. Since 2005, the Italian Society of Internal Medicine and its Ultrasound Study Group has been holding a Summer School and training courses in ultrasound for residents in internal medicine. A national network of schools in bedside ultrasound was then organized for internal medicine specialists who want to learn this technique. Because bedside ultrasound is a user-dependent diagnostic method, it is important to define the limits and advantages of different new ultrasound devices, to classify them (i.e. Echoscopy and Point of Care Ultrasound), to establish appropriate different levels of competence and to ensure their specific training. In this review, we describe the point of view of the Italian Internal Medicine Society on these topics. PMID:25145290

  19. Postgraduate and research programmes in Medicine and Public Health in Rwanda: an exciting experience about training of human resources for health in a limited resources country.

    PubMed

    Kakoma, Jean Baptiste

    2016-01-01

    The area of Human Resources for Health (HRH) is the most critical challenge for the achievement of health related development goals in countries with limited resources. This is even exacerbated in a post conflict environment like Rwanda. The aim of this commentary is to report and share the genesis and outcomes of an exciting experience about training of qualified health workers in medicine and public health as well as setting - up of a research culture for the last nine years (2006 - 2014) in Rwanda. Many initiatives have been taken and concerned among others training of qualified health workers in medicine and public health. From 2006 to 2014, achievements were as follows: launching and organization of 8 Master of Medicine programmes (anesthesiology, family and community medicine, internal medicine, obstetrics & gynecology, otorhinolaryngology, pediatrics, psychiatry and surgery) and 4 Master programmes in public health (MPH, MSc Epidemiology, MSc Field Epidemiology & Laboratory Management, and Master in Hospital and Healthcare Administration); training to completion of more than 120 specialists in medicine, and 200 MPH, MSc Epidemiology, and MSc Field Epidemiology holders; revival of the Rwanda Medical Journal; organization of graduate research training (MPhil and PhD); 3 Master programmes in the pipeline (Global Health, Health Financing, and Supply Chain Management); partnerships with research institutions of great renown, which contributed to the reinforcement of the institutional research capacity and visibility towards excellence in leadership, accountability, and self sustainability. Even though there is still more to be achieved, the Rwanda experience about postgraduate and research programmes is inspiring through close interactions between main stakeholders. This is a must and could allow Rwanda to become one of the rare examples to other more well-to-do Sub - Saharan countries, should Rwanda carry on doing that. PMID:27303587

  20. Postgraduate and research programmes in Medicine and Public Health in Rwanda: an exciting experience about training of human resources for health in a limited resources country

    PubMed Central

    Kakoma, Jean Baptiste

    2016-01-01

    The area of Human Resources for Health (HRH) is the most critical challenge for the achievement of health related development goals in countries with limited resources. This is even exacerbated in a post conflict environment like Rwanda. The aim of this commentary is to report and share the genesis and outcomes of an exciting experience about training of qualified health workers in medicine and public health as well as setting - up of a research culture for the last nine years (2006 - 2014) in Rwanda. Many initiatives have been taken and concerned among others training of qualified health workers in medicine and public health. From 2006 to 2014, achievements were as follows: launching and organization of 8 Master of Medicine programmes (anesthesiology, family and community medicine, internal medicine, obstetrics & gynecology, otorhinolaryngology, pediatrics, psychiatry and surgery) and 4 Master programmes in public health (MPH, MSc Epidemiology, MSc Field Epidemiology & Laboratory Management, and Master in Hospital and Healthcare Administration); training to completion of more than 120 specialists in medicine, and 200 MPH, MSc Epidemiology, and MSc Field Epidemiology holders; revival of the Rwanda Medical Journal; organization of graduate research training (MPhil and PhD); 3 Master programmes in the pipeline (Global Health, Health Financing, and Supply Chain Management); partnerships with research institutions of great renown, which contributed to the reinforcement of the institutional research capacity and visibility towards excellence in leadership, accountability, and self sustainability. Even though there is still more to be achieved, the Rwanda experience about postgraduate and research programmes is inspiring through close interactions between main stakeholders. This is a must and could allow Rwanda to become one of the rare examples to other more well-to-do Sub - Saharan countries, should Rwanda carry on doing that. PMID:27303587

  1. Addiction: Choice or Compulsion?

    PubMed Central

    Henden, Edmund; Melberg, Hans Olav; Røgeberg, Ole Jørgen

    2013-01-01

    Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behavior under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behavior. In this article we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior. PMID:23966955

  2. Internet Addiction and Psychopathology

    ERIC Educational Resources Information Center

    Koc, Mustafa

    2011-01-01

    This study examined the relationships between university students' internet addiction and psychopathology in Turkey. The study was based on data drawn from a national survey of university students in Turkey. 174 university students completed the SCL-90-R scale and Addicted Internet Users Inventory. Results show that students who use internet six…

  3. Internet Addiction among Adolescence

    ERIC Educational Resources Information Center

    Sargin, Nurten

    2012-01-01

    Each innovation brings along many risks. One of the risks related with the Internet use is Internet addiction. The aim of this study is to examine Internet addiction in adolescence in terms of gender, Internet access at home and grades. The research design used was survey method. The study population consisted of second stage students attending…

  4. Entrustable professional activities and curricular milestones for fellowship training in pulmonary and critical care medicine: executive summary from the Multi-Society Working Group.

    PubMed

    Fessler, Henry E; Addrizzo-Harris, Doreen; Beck, James M; Buckley, John D; Pastores, Stephen M; Piquette, Craig A; Rowley, James A; Spevetz, Antoinette

    2014-10-01

    Assessment of graduate medical trainee progress via the accomplishment of competency milestones is an important element of the Next Accreditation System of the Accreditation Council for Graduate Medical Education. This article summarizes the findings of a multisociety working group that was tasked with creating the entrustable professional activities and curricular milestones for fellowship training in pulmonary medicine, critical care medicine, and combined programs. Using the Delphi process, experienced medical educators from the American College of Chest Physicians, American Thoracic Society, Society of Critical Care Medicine, and Association of Pulmonary and Critical Care Medicine Program Directors reached consensus on the detailed curricular content and expected skill set of graduates of these programs. These are now available to trainees and program directors for the purposes of curriculum design, review, and trainee assessment. PMID:25226119

  5. Attitudes about Addiction: A National Study of Addiction Educators

    ERIC Educational Resources Information Center

    Broadus, Angela D.; Hartje, Joyce A.; Roget, Nancy A.; Cahoon, Kristy L.; Clinkinbeard, Samantha S.

    2010-01-01

    The following study, funded by the National Institute of Drug Abuse (NIDA), utilized the "Addiction Belief Inventory" (ABI; Luke, Ribisl, Walton, & Davidson, 2002) to examine addiction attitudes in a national sample of U.S. college/university faculty teaching addiction-specific courses (n = 215). Results suggest that addiction educators view…

  6. Classrooms under the Influence: Addicted Families/Addicted Students.

    ERIC Educational Resources Information Center

    Powell, Richard R.; And Others

    Addiction, the focus of this book, is a social phenomenon that influences both social and academic issues in the classroom. The book is not simply about students who become addicted to chemical substances or alcohol; it is about the complex effects of addiction on the user and the impact of this addiction on other people in his or her life.…

  7. [Functional neuroimaging of addiction].

    PubMed

    Takahashi, Hidehiko

    2015-09-01

    Positron emission tomography studies investigating dopamine release by drug or reward demonstrated blunted dopamine release in relation to addiction to psychostimulants such as cocaine and amphetamine. However, recent studies reported that nicotine and gambling addiction showed opposite results. Several factors such as illness stage or neurotoxicity of substances could be considered for this discrepancy. Behavioral addiction such as gambling disorder is a good target of neuroimaging because it is free from overt neurotoxicity. However, even in gambling disorder, the results of fMRI studies investigating neural response to reward are mixed. Neuroimaging together with taking the various backgrounds of patients into account should contribute not only to a better understanding of the neurobiology of addiction but also to the development of more effective and individually tailored treatment strategies for addiction. PMID:26394506

  8. Postgraduate training in public health medicine: St George's Hospital Medical School Library public health information service.

    PubMed

    Rook, R; Adshead, F

    2001-03-01

    This article examines the development of the St George's Hospital Medical School Library public health information service. Begun in 1997 as a pilot project to support Public Health Specialist Registrars in South Thames West, it is now an established part of postgraduate training in the region. An outline of the service is described, including the evolution of the post of Public Health Librarian. Issues influencing the development of the service, and the establishment of the Librarian as part of the public health network are discussed. This is a transferable model of public health information provision, which as a centralized resource makes best use of available funding. As a LIS model it is an effective and efficient way of maximizing resources, and delivering a service to a specialist user group that is spread across a wide geographical area. PMID:11260291

  9. [Cocaine - Characteristics and addiction].

    PubMed

    Girczys-Połedniok, Katarzyna; Pudlo, Robert; Jarząb, Magdalena; Szymlak, Agnieszka

    2016-01-01

    Cocaine use leads to health, social and legal problems. The aim of this paper is to discuss cocaine action, addicts characteristics, use patterns and consequences, as well as addiction treatment methods. A literature review was based on the Medline, PubMed, Polish Medical Bibliography databases and the Silesian Library resources. The Police and Central Statistical Office statistics, as well as the World Health Organization, the European Monitoring Centre for Drugs and Drug Addiction and the National Office for Combating Drug Addiction reports were used. Cocaine leads to mood improvement, appetite decrease, physical and intellectual activity enhancement, euphoria, inflated self-esteem, social networking ease and increased sexual desire. Cocaine hydrochloride is mainly used intranasaly, but also as intravenous and subcutaneous injections. Cocaine use and first addiction treatment fall in later age compared to other psychoactive substances. There is a high men to women ratio among addicts. There is a relationship between cocaine addiction, the presence of other disorders and genetic predisposition to addiction development. Polish reports indicate higher popularity of cocaine among people with a high economic and social status. Although Poland is a country with the low percentage of cocaine use, its popularity is growing. The consequences of cocaine use concern somatic and mental health problems, socioeconomic and legal conditions. The drug plays a role in crimes and traffic accidents. Because of the risks associated with cocaine use, it has been listed in a register of drugs attached to the Act on Counteracting Drug Addiction. Addiction treatment includes psychological, pharmacological and harm reduction strategies. Med Pr 2016;67(4):537-544. PMID:27623834

  10. Process improvement of pap smear tracking in a women's medicine center clinic in residency training.

    PubMed

    Calhoun, Byron C; Goode, Jeff; Simmons, Kathy

    2011-11-01

    Application of Six-Sigma methodology and Change Acceleration Process (CAP)/Work Out (WO) tools to track pap smear results in an outpatient clinic in a hospital-based residency-training program. Observational study of impact of changes obtained through application of Six-Sigma principles in clinic process with particular attention to prevention of sentinel events. Using cohort analysis and applying Six-Sigma principles to an interactive electronic medical record Soarian workflow engine, we designed a system of timely accession and reporting of pap smear and pathology results. We compared manual processes from January 1, 2007 to February 28, 2008 to automated processes from March 1, 2008 to December 31, 2009. Using the Six-Sigma principles, CAP/WO tools, including "voice of the customer" and team focused approach, no outlier events went untracked. Applying the Soarian workflow engine to track prescribed 7 day turnaround time for completion, we identified 148 pap results in 3,936, 3 non-gynecological results in 15, and 41 surgical results in 246. We applied Six-Sigma principles to an outpatient clinic facilitating an interdisciplinary team approach to improve the clinic's reporting system. Through focused problem assessment, verification of process, and validation of outcomes, we improved patient care for pap smears and critical pathology. PMID:22103702

  11. Evidence-based medicine training in a resource-poor country, the importance of leveraging personal and institutional relationships

    PubMed Central

    Tomatis, Cristina; Taramona, Claudia; Rizo-Patrón, Emiliana; Hernández, Fiorela; Rodríguez, Patricia; Piscoya, Alejandro; Gonzales, Elsa; Gotuzzo, Eduardo; Heudebert, Gustavo; Centor, Robert M.; Estrada, Carlos A.

    2011-01-01

    Rationale, aims and objectives Efforts to implement evidence-based medicine (EBM) training in developing countries are limited. We describe the results of an international effort to improve research capacity in a developing country; we conducted a course aimed at improving basic EBM attitudes and identified challenges. Method Between 2005 and 2009, we conducted an annual 3-day course in Perú consisting of interactive lectures and case-based workshops. We assessed self-reported competence and importance in EBM using a Likert scale (1 = low, 5 = high). Results Totally 220 clinicians participated. For phase I (2005–2007), self-reported EBM competence increased from a median of 2 to 3 (P < 0.001) and the perceived importance of EBM did not change (median = 5). For phase II (2008–2009), before the course, 8–72% graded their competence very low (score of 1–2). After the course, 67–92% of subjects graded their increase in knowledge very high (score of 4–5). The challenges included limited availability of studies relevant to the local reality written in Spanish, participants’ limited time and lack of long-term follow-up on practice change. Informal discussion and written evaluation from participants were universally in agreement that more training in EBM is needed. Conclusions In an EBM course in a resource-poor country, the baseline self-reported competence and experience on EBM were low, and the course had measurable improvements of self-reported competence, perceived utility and readiness to incorporate EBM into their practices. Similar to developed countries, translational research and building the research capacity in developing countries is critical for translating best available evidence into practice. PMID:21276140

  12. Animal models and brain circuits in drug addiction.

    PubMed

    Kalivas, Peter W; Peters, Jamie; Knackstedt, Lori

    2006-12-01

    Animal models in the field of addiction are considered to be among the best available models of neuropsychiatric disease. These models have undergone a number of refinements that allow deeper understanding of the circuitry involved in initiating drug seeking and relapse. Notably, the demonstrable involvement of classic corticostriatal habit circuitry and the engagement of prefrontal cortical circuits in extinction training may have relevance to the therapeutic modulation of habit circuitry and drug addiction in humans. PMID:17200461

  13. Jumping on the Train of Personalized Medicine: A Primer for Non- Geneticist Clinicians: Part 3. Clinical Applications in the Personalized Medicine Area

    PubMed Central

    Li, Aihua; Meyre, David

    2014-01-01

    The rapid decline of sequencing costs brings hope that personal genome sequencing will become a common feature of medical practice. This series of three reviews aim to help non-geneticist clinicians to jump into the fast-moving field of personalized genetic medicine. In the first two articles, we covered the fundamental concepts of molecular genetics and the methodologies used in genetic epidemiology. In this third article, we discuss the evolution of personalized medicine and illustrate the most recent success in the fields of Mendelian and complex human diseases. We also address the challenges that currently limit the use of personalized medicine to its full potential. PMID:25598768

  14. Assessment of a Human Cadaver Model for Training Emergency Medicine Residents in the Ultrasound Diagnosis of Pneumothorax

    PubMed Central

    Adhikari, Srikar; Zeger, Wesley; Wadman, Michael; Walker, Richard; Lomneth, Carol

    2014-01-01

    Objectives. To assess a human cadaver model for training emergency medicine residents in the ultrasound diagnosis of pneumothorax. Methods. Single-blinded observational study using a human cadaveric model at an academic medical center. Three lightly embalmed cadavers were used to create three “normal lungs” and three lungs modeling a “pneumothorax.” The residents were blinded to the side and number of pneumothoraces, as well as to each other's findings. Each resident performed an ultrasound examination on all six lung models during ventilation of cadavers. They were evaluated on their ability to identify the presence or absence of the sliding-lung sign and seashore sign. Results. A total of 84 ultrasound examinations (42-“normal lung,” 42-“pneumothorax”) were performed. A sliding-lung sign was accurately identified in 39 scans, and the seashore sign was accurately identified in 34 scans. The sensitivity and specificity for the sliding-lung sign were 93% (95% CI, 85–100%) and 90% (95% CI, 81–99%), respectively. The sensitivity and specificity for the seashore sign were 80% (95% CI, 68–92%) and 83% (95% CI, 72–94%), respectively. Conclusions. Lightly embalmed human cadavers may provide an excellent model for mimicking the sonographic appearance of pneumothorax. PMID:24790999

  15. Web based provider education for competency of scope of practice (Best Practice): Medicine Department Safe training is a computer based review program (de' medri).

    PubMed

    Tabriziani, Hossein; Hatcher, Myron; Heetebry, Irene

    2005-12-01

    Medicine Department Safe training is a computer based review program named de'medici and it is an employee training program. This annual review packet serves as a generic training tool. All health-care providers with direct patient care are required by state law to complete a group of 11 modules and pass a mandatory training test to assess proficiency in these areas. They include emergency preparedness, life and fire safety, electrical safety, working safety with hazardous materials, back safety, violence in the workplace, latex allergy prevention, preventing TB in the workplace, preventing AIDS and hepatitis B and C in the workplace, radiation safety, and age related care for health-care workers. PMID:16235813

  16. Prescription Pain Medicines - An Addictive Path?

    MedlinePlus

    ... more than the number of people abusing cocaine, heroin, hallucinogens, and inhalants, combined. "The abuse of prescription ... on the receptors in the brain affected by heroin, morphine, and prescription painkillers. The tablets relieve drug ...

  17. Sports Medicine: What is a Sports Medicine Specialist?

    MedlinePlus

    ... difference between a Sports Medicine Specialist and an Orthopedic Surgeon? Both are well trained in musculoskeletal medicine. ... in the non-operative treatment of musculoskeletal conditions. Orthopedic surgeons are also trained in the operative treatment ...

  18. [Work: a potential addiction].

    PubMed

    Karila, L; Liot, K; Reynaud, M

    2010-02-01

    Although the term workaholism is widely used, there is very little consensus about its meaning. Since the seventies, workaholism has been described as a work addiction such as drug or alcohol addiction. Similarities with other addictions include craving, withdrawal, tolerance, progressive involvement, and denial. Although considerable attention has been devoted to the concept of workaholism in recent years, little empirical research has been undertaken to further the understanding of this phenomenon. The existence of different types of workaholism has been described. Questionnaires were developed to assess this concept. This heterogeneous disease has negative health, personal, family relationships and professional consequences. Many therapeutic interventions are possible for this unknown addictive trouble. The objective of this paper is to gain a better understanding and knowledge regarding the phenomenon of workaholism. Data obtained for this review are based on a Medline, EMBASE, PsycINFO, Google Scholar search of English- and French-language articles published between 1968 and 2009. PMID:20344916

  19. The Treatment of Addiction

    ERIC Educational Resources Information Center

    Chapple, P. A. L.

    1970-01-01

    Describes sociological and medical treatment appropriate to young drug experimenters and addicts. Discusses role of teachers, probation officers, school medical services, and general practitioners. Indicates necessity for long treatment period. Considers whether dependence is a disease of delinquent behavior. (AL)

  20. [Online addictive disease].

    PubMed

    Neuenschwander, Martin

    2014-10-01

    Digital media are indispensable in school, profession, family and leisure time. 1 to 6 % of all users show dsyfunctional ans addictive patterns, first of all in online and "social" media. In Switzerland over 80 % of young people own a smartphone and "pocket internet". Time of interaction with online-media (hours/day), as well as peer group pattern are markers for risk of addiction. Active music making and sports are protective factors. Family physicians are important in early recognition of "internet addictive disease". Care-givers with special experience in this field are often successful in reducing time of harmful interaction with the internet. Internet addictive disease is not yet classified in ICD and DSM-5 lists, even though it is an increasing reality. PMID:25257114

  1. Stress and Addiction

    PubMed Central

    Hildebrandt, Tom; Greif, Rebecca

    2013-01-01

    Appetitive behaviors such as substance use and eating are under significant regulatory control by the hypothalamic-pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Recent research has begun to examine how these systems interact to cause and maintain poor regulation of these appetitive behaviors. A range of potential molecular, neuroendocrine, and hormonal mechanisms are involved in these interactions and may explain individual differences in both of risk and resilience to a range of addictions. This manuscript provides a commentary on research presented during the International Society of Psychoneuroendocrinology's mini-conference on sex differences in eating and addiction with an emphasis on how HPG and HPA axis interactions affect appetitive behaviors in classic addictions and may be used to help inform the ongoing debate about the validity of food addiction. PMID:23849597

  2. Stress and addiction.

    PubMed

    Hildebrandt, Tom; Greif, Rebecca

    2013-09-01

    Appetitive behaviors such as substance use and eating are under significant regulatory control by the hypothalamic-pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Recent research has begun to examine how these systems interact to cause and maintain poor regulation of these appetitive behaviors. A range of potential molecular, neuroendocrine, and hormonal mechanisms are involved in these interactions and may explain individual differences in both risk and resilience to a range of addictions. This manuscript provides a commentary on research presented during the International Society of Psychoneuroendocrinology's mini-conference on sex differences in eating and addiction with an emphasis on how HPG and HPA axis interactions affect appetitive behaviors in classic addictions and may be used to help inform the ongoing debate about the validity of food addiction. PMID:23849597

  3. Breaking barriers in the genomics and pharmacogenetics of drug addiction

    PubMed Central

    Ho, MK; Goldman, D; Heinz, A; Kaprio, J; Kreek, MJ; Li, MD; Munafò, MR; Tyndale, RF

    2013-01-01

    Drug addictions remain a substantial health issue, with limited treatment options currently available. Despite considerable advances in the understanding of our genetic architecture, the genetic underpinning of complex disorders remains elusive. Numerous candidate genes have been implicated in the etiology and response to treatment for different addictions based on our current understanding of the neurobiology. Genome-wide association studies have also provided novel targets. However, replication of these studies is often lacking which complicates interpretation; this will improve as issues such as phenotypic characterization, the apparent “missing heritability”, the identification of functional variants, and possible gene-environment interactions are addressed. In addition, there is growing evidence that genetic information can be useful for refining the choice of addiction treatment. As genetic testing becomes more common in the practice of medicine, a variety of ethical and practical challenges, some of which are unique to drug addiction, will also need to be considered. PMID:20981002

  4. Scaling up family medicine training in Gezira, Sudan – a 2-year in-service master programme using modern information and communication technology: a survey study

    PubMed Central

    2014-01-01

    Background In 2010 the Gezira Family Medicine Project (GFMP) was initiated in Gezira state, Sudan, designed as an in-service training model. The project is a collaboration project between the University of Gezira, which aims to provide a 2-year master’s programme in family medicine for practicing doctors, and the Ministry of Health, which facilitates service provision and funds the training programme. This paper presents the programme, the teaching environment, and the first batch of candidates enrolled. Methods In this study a self-administered questionnaire was used to collect baseline data at the start of the project from doctors who joined the programme. A checklist was also used to assess the health centres where they work. A total of 188 out of 207 doctors responded (91%), while data were gathered from all 158 health centres (100%) staffed by the programme candidates. Results The Gezira model of in-service family medicine training has succeeded in recruiting 207 candidates in its first batch, providing health services in 158 centres, of which 84 had never been served by a doctor before. The curriculum is community oriented. The mean age of doctors was 32.5 years, 57% were males, and 32% were graduates from the University of Gezira. Respondents stated high confidence in practicing some skills such as asthma management and post-abortion uterine evacuation. They were least confident in other skills such as managing depression or inserting an intrauterine device. The majority of health centres was poorly equipped for management of noncommunicable diseases, as only 10% had an electrocardiography machine (ECG), 5% had spirometer, and 1% had a defibrillator. Conclusions The Gezira model has responded to local health system needs. Use of modern information and communication technology is used to facilitate both health service provision and training. The GFMP represents an example of a large-volume scaling-up programme of family medicine in Africa. PMID:24443978

  5. Perceptions and reported practices of osteopathic physicians in diagnosing and treating addiction.

    PubMed

    Kadel, F J; Vilensky, W

    1999-09-01

    The objective of this study was to assess the perceptions and reported practices of osteopathic physicians in the diagnosis and treatment of addiction. Copies of survey questions were sent to the 344 members of the West Virginia Osteopathic Society. A total of 176 (51.2%) physicians responded; of these responses, 166 surveys were used for analysis. Respondents included 130 practicing physicians and 36 physicians in internship or residency training programs. Of those responding, 133 were men and 33 were women, and ages ranged from 24 to 81 years with a mean of 41.6 years. Respondents who were graduates of the West Virginia School of Osteopathic Medicine numbered 132 (79.5%), and 99 (59.6%) were in family practice. Characteristics most commonly attributed to addiction were a chronic nature and psychological or physical dependence. More than half of the test subjects did not consider addiction to be a primary disease independent of other factors or psychiatric conditions. Respondents reported a mean addiction prevalence of 20.4%, with the most common substances reported as tobacco, alcohol, and benzodiazapines, respectively. Individual prevalence reports varied from 0% to 95% (SD +/- 20.4%). The most commonly used diagnostic tools were the CAGE (Cut down, Annoyed, Guilty, and Eye-opener) test, DSM III-R (Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised) or DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) criteria, and quantity and frequency questions. Medical sequelae such as jaundice or emphysema were the most likely reasons for the respondents to address a substance abuse problem. For referral resources, respondents were most likely to use inpatient or outpatient treatment. A mean success rate of 27.7% was reported by the 133 physicians responding. The wide variance in reported prevalence and the low success rate reported in comparison to that demonstrated in published treatment studies indicate that there is a

  6. Is fast food addictive?

    PubMed

    Garber, Andrea K; Lustig, Robert H

    2011-09-01

    Studies of food addiction have focused on highly palatable foods. While fast food falls squarely into that category, it has several other attributes that may increase its salience. This review examines whether the nutrients present in fast food, the characteristics of fast food consumers or the presentation and packaging of fast food may encourage substance dependence, as defined by the American Psychiatric Association. The majority of fast food meals are accompanied by a soda, which increases the sugar content 10-fold. Sugar addiction, including tolerance and withdrawal, has been demonstrated in rodents but not humans. Caffeine is a "model" substance of dependence; coffee drinks are driving the recent increase in fast food sales. Limited evidence suggests that the high fat and salt content of fast food may increase addictive potential. Fast food restaurants cluster in poorer neighborhoods and obese adults eat more fast food than those who are normal weight. Obesity is characterized by resistance to insulin, leptin and other hormonal signals that would normally control appetite and limit reward. Neuroimaging studies in obese subjects provide evidence of altered reward and tolerance. Once obese, many individuals meet criteria for psychological dependence. Stress and dieting may sensitize an individual to reward. Finally, fast food advertisements, restaurants and menus all provide environmental cues that may trigger addictive overeating. While the concept of fast food addiction remains to be proven, these findings support the role of fast food as a potentially addictive substance that is most likely to create dependence in vulnerable populations. PMID:21999689

  7. From one addiction to another: life after alcohol and drug abuse.

    PubMed

    Hatcher, A S

    1989-11-01

    Once the alcoholic or drug addict has stopped drinking or using drugs, other addictive behaviors are frequently adopted. These factors must be considered in planning the overall recovery program. Substances likely to be used to excess include nicotine, caffeine, sugar, chocolate, nutritional supplements and medicinal herbs. Addictive behaviors adopted by recovering persons include eating disorders, exercise and body building, workaholism, and dependency on one's own adrenalin. Breaking the cycle of addiction requires commitment to a program of self-growth and becoming responsible for one's actions. PMID:2586856

  8. Women’s impressions of their inpatient birth care as provided by family physicians in the Shizuoka Family Medicine Training Program in Japan

    PubMed Central

    2013-01-01

    Background Even though Japan faces serious challenges in women’s health care such as a rapidly aging population, attrition of obstetrical providers, and a harsh legal climate, few family medicine residency training programs in Japan include training in obstetrics, and the literature lacks research on women’s views of intra-partum pregnancy care by family physicians. Findings In this exploratory study, we conducted semi-structured qualitative interviews with five women who received their admission, intrapartum, delivery and discharge care from family medicine residents in the obstetrics ward of a community training hospital. Four women had vaginal births, and one had a Cesarean section. Three were primiparous, and two multiparous. Their ages ranged from 22–33. They found value in family physician medical knowledge and easy communication style, though despite explanation, some had trouble understanding the family physician’s scope of work. These women identified negative aspects of the hospital environment, and wanted more anticipatory guidance about what to expect physically after birth, but were enthusiastic about seeing a family doctor after discharge. Conclusions These results demonstrate the feasibility of family medicine residents providing inpatient birth care in a community hospital, and that patients are receptive to family physicians providing that care as well after discharge. Women’s primary concerns relate mostly to hospital environment issues, and better understanding the care family physicians provide. This illustrates-areas for family physicians to work for improvements. PMID:23698036

  9. Two Programs for Primary Care Practitioners: Family Medicine Training in an Affiliated University Hospital Program and Primary Care Graduate Training in an Urban Private Medical Center

    ERIC Educational Resources Information Center

    Farley, Eugene S.; Piemme, Thomas E.

    1975-01-01

    Eugene Farley describes the University of Rochester and Highland Hospital Family Medicine Program for teaching of primary care internists, primary care pediatricians, and family doctors. Thomas Piemme presents the George Washington University School of Medicine alternative, a 2-year program in an ambulatory setting leading to broad eligibility in…

  10. Opiate addiction and cocaine addiction: underlying molecular neurobiology and genetics

    PubMed Central

    Kreek, Mary Jeanne; Levran, Orna; Reed, Brian; Schlussman, Stefan D.; Zhou, Yan; Butelman, Eduardo R.

    2012-01-01

    Addictive diseases, including addiction to heroin, prescription opioids, or cocaine, pose massive personal and public health costs. Addictions are chronic relapsing diseases of the brain caused by drug-induced direct effects and persisting neuroadaptations at the epigenetic, mRNA, neuropeptide, neurotransmitter, or protein levels. These neuroadaptations, which can be specific to drug type, and their resultant behaviors are modified by various internal and external environmental factors, including stress responsivity, addict mindset, and social setting. Specific gene variants, including variants encoding pharmacological target proteins or genes mediating neuroadaptations, also modify vulnerability at particular stages of addiction. Greater understanding of these interacting factors through laboratory-based and translational studies have the potential to optimize early interventions for the therapy of chronic addictive diseases and to reduce the burden of relapse. Here, we review the molecular neurobiology and genetics of opiate addiction, including heroin and prescription opioids, and cocaine addiction. PMID:23023708

  11. The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

    PubMed Central

    2014-01-01

    Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland and train AM in PGMT. We performed the first quality evaluation of the subjectively perceived quality of this PGMT. Methods An anonymous full survey of all 214 trainers (TR) and 240 trainees (TE) in all 15 AM hospitals in Germany and Switzerland, using the ETHZ questionnaire for annual national PGMT assessments in Switzerland (CH) and Germany (D), complemented by a module for AM. Data analysis included Cronbach’s alpha to assess internal consistency questionnaire scales, 2-tailed Pearson correlation of specific quality dimensions of PGMT and department size, 2-tailed Wilcoxon Matched-Pair test for dependent variables and 2-tailed Mann–Whitney U-test for independent variables to calculate group differences. The level of significance was set at p < 0.05. Results Return rates were: D: TE 89/215 (41.39%), TR 78/184 (42.39%); CH: TE 19/25 (76%), TR 22/30 (73.33%). Cronbach’s alpha values for TE scales were >0.8 or >0.9, and >0.7 to >0.5 for TR scales. Swiss hospitals surpassed German ones significantly in Global Satisfaction with AM (TR and TE); Clinical Competency training in CON (TE) and AM (TE, TR), Error Management, Culture of Decision Making, Evidence-based Medicine, and Clinical Competency in internal medicine CON and AM (TE). When the comparison was restricted to departments of comparable size, differences remained significant for Clinical Competencies in AM (TE, TR), and Culture of Decision Making (TE). CON received better grades than AM in Global Satisfaction

  12. The Addict in Us all

    PubMed Central

    Dill, Brendan; Holton, Richard

    2014-01-01

    In this paper, we contend that the psychology of addiction is similar to the psychology of ordinary, non-addictive temptation in important respects, and explore the ways in which these parallels can illuminate both addiction and ordinary action. The incentive salience account of addiction proposed by Robinson and Berridge (1–3) entails that addictive desires are not in their nature different from many of the desires had by non-addicts; what is different is rather the way that addictive desires are acquired, which in turn affects their strength. We examine these “incentive salience” desires, both in addicts and non-addicts, contrasting them with more cognitive desires. On this account, the self-control challenge faced by addicted agents is not different in kind from that faced by non-addicted agents – though the two may, of course, differ greatly in degree of difficulty. We explore a general model of self-control for both the addict and the non-addict, stressing that self-control may be employed at three different stages, and examining the ways in which it might be strengthened. This helps elucidate a general model of intentional action. PMID:25346699

  13. Treatment of addiction and addiction-related behavior

    SciTech Connect

    Dewey, S.L.; Brodie, J.D.; Ashby, C.R. Jr.

    2000-05-02

    The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a primate suffering from substance addiction. The method includes administering to a primate an effective amount of a pharmaceutical composition including gamma vinylGABA. The present invention also provides a method of treatment of nicotine addiction by treating a patient with an effective amount of a composition including gamma vinylGABA.

  14. Treatment of addiction and addiction-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2000-01-01

    The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a primate suffering from substance addiction. The method includes administering to a primate an effective amount of a pharmaceutical composition including gamma vinylGABA. The present invention also provides a method of treatment of nicotine addiction by treating a patient with an effective amount of a composition including gamma vinylGABA.

  15. Hypotheses regarding the mechanisms of ayahuasca in the treatment of addictions.

    PubMed

    Liester, Mitchell B; Prickett, James I

    2012-01-01

    Ayahuasca is a medicinal plant mixture utilized by indigenous peoples throughout the Amazon River basin for healing purposes. The "vine of the soul" or "vine of death," as it is known in South America, contains a combination of monoamine oxidase inhibitors and N,N-dimethyltryptamine (DMT). When ingested together, these medicines produce profound alterations in consciousness. Increasingly, ayahuasca is being utilized to treat addictions. However, the mechanism of action by which ayahuasca treats addictions remains unclear. We offer four hypotheses to explain possible biochemical, physiological, psychological, and transcendent mechanisms by which ayahuasca may exert its anti-addiction effects. PMID:23061319

  16. Knowledge of, Attitudes Toward, and Experience of Complementary and Alternative Medicine in Western Medicine– and Oriental Medicine–Trained Physicians in Korea

    PubMed Central

    Lee, Sang-Il; Khang, Young-Ho; Lee, Moo-Song; Kang, Weechang

    2002-01-01

    Objectives. We compared knowledge of, attitudes toward, and experience with complementary and alternative medicine (CAM) among Western medicine–trained doctors (WMDs) and Oriental medicine–trained doctors (OMDs). Methods. In Korea, 502 WMDs and 500 OMDs were interviewed with a structured questionnaire. Results. OMDs held more favorable attitudes toward CAM than did WMDs. OMDs possessed a deeper understanding of and greater experience with CAM. OMDs more readily endorsed health beliefs congruent with CAM. Conclusions. In the future, CAM can be more readily used by OMDs than by WMDs. Because evidence for the effectiveness of CAM remains sparse, more research is needed for the prudent use of CAM in Korea. An education and training system for potential CAM providers remains to be developed. PMID:12453822

  17. The Dreams of Heroin Addicts

    ERIC Educational Resources Information Center

    Looney, Maryanne

    1972-01-01

    Few heroin addicts get high'' in their dreams. An exploration of the reasons for this failure provides some clues to the conflicts and other problems that retard an addict's progress in therapy. (Author)

  18. The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures.

    PubMed

    Narouze, Samer N; Provenzano, David; Peng, Philip; Eichenberger, Urs; Lee, Sang Chul; Nicholls, Barry; Moriggl, Bernhard

    2012-01-01

    The use of ultrasound in pain medicine for interventional axial, nonaxial, and musculoskeletal pain procedures is rapidly evolving and growing. Because of the lack of specialty-specific guidelines for ultrasonography in pain medicine, an international collaborative effort consisting of members of the Special Interest Group on Ultrasonography in Pain Medicine from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies developed the following recommendations for education and training in ultrasound-guided interventional pain procedures. The purpose of these recommendations is to define the required skills for performing ultrasound-guided pain procedures, the processes for appropriate education, and training and quality improvement. Training algorithms are outlined for practice- and fellowship-based pathways. The previously published American Society of Regional Anesthesia and Pain Medicine and European Society of Regional Anaesthesia and Pain Therapy education and teaching recommendations for ultrasound-guided regional anesthesia served as a foundation for the pain medicine recommendations. Although the decision to grant ultrasound privileges occurs at the institutional level, the committee recommends that the training guidelines outlined in this document serve as the foundation for educational training and the advancement of the practice of ultrasonography in pain medicine. PMID:23080347

  19. Addiction Studies: Exploring Students' Attitudes toward Research in a Graduate Program

    ERIC Educational Resources Information Center

    James, Raven; Simons, Lori

    2011-01-01

    An exploratory study was conducted to compare addiction studies and community counseling students' attitudes toward research. A survey of 66 addiction studies and 17 community counseling students in graduate programs was used to explore interest and self-efficacy in research and the research training environment. A pre/post test design was used to…

  20. Treating Internet Addiction with Cognitive-Behavioral Therapy: A Thematic Analysis of the Experiences of Therapists

    ERIC Educational Resources Information Center

    van Rooij, Antonius J.; Zinn, Mieke F.; Schoenmakers, Tim M.; van de Mheen, Dike

    2012-01-01

    In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program ("Lifestyle Training") to treat internet addiction. The current study evaluates this pilot treatment program by providing a…

  1. Wilderness medicine

    PubMed Central

    Sward, Douglas G.; Bennett, Brad L.

    2014-01-01

    BACKGROUND: Human activity in wilderness areas has increased globally in recent decades, leading to increased risk of injury and illness. Wilderness medicine has developed in response to both need and interest. METHODS: The field of wilderness medicine encompasses many areas of interest. Some focus on special circumstances (such as avalanches) while others have a broader scope (such as trauma care). Several core areas of key interest within wilderness medicine are discussed in this study. RESULTS: Wilderness medicine is characterized by remote and improvised care of patients with routine or exotic illnesses or trauma, limited resources and manpower, and delayed evacuation to definitive care. Wilderness medicine is developing rapidly and draws from the breadth of medical and surgical subspecialties as well as the technical fields of mountaineering, climbing, and diving. Research, epidemiology, and evidence-based guidelines are evolving. A hallmark of this field is injury prevention and risk mitigation. The range of topics encompasses high-altitude cerebral edema, decompression sickness, snake envenomation, lightning injury, extremity trauma, and gastroenteritis. Several professional societies, academic fellowships, and training organizations offer education and resources for laypeople and health care professionals. CONCLUSIONS: The future of wilderness medicine is unfolding on multiple fronts: education, research, training, technology, communications, and environment. Although wilderness medicine research is technically difficult to perform, it is essential to deepening our understanding of the contribution of specific techniques in achieving improvements in clinical outcomes. PMID:25215140

  2. Buprenorphine for opioid addiction

    PubMed Central

    Ling, Walter; Mooney, Larissa; Torrington, Matthew

    2014-01-01

    SUMMARY Buprenorphine is a partial opioid agonist of the µ-receptor, and is used as a daily dose sublingual tablet or filmstrip for managing opioid addiction. In the USA, the Drug Addiction Treatment Act of 2000 made buprenorphine the only opioid medication for opioid addiction that can be prescribed in an office-based setting. Owing to its high affinity for the µ-receptor, buprenorphine inhibits the reinforcing effect of exogenous opioids. The ceiling effect of buprenorphine's µ-agonist activity reduces the potential for drug overdose and confers low toxicity even at high doses. Buprenorphine pharmacotherapy has proven to be a treatment approach that supports recovery from addiction while reducing or curtailing the use of opioids. This article examines buprenorphine pharmacotherapy for opioid addiction, focusing on the situation in the USA, and is based on a review of pertinent literature, and the authors’ research and clinical experience. The references in this paper were chosen according to the authors’ judgment of quality and relevance, and with respect to their familiarity and involvement in related research. PMID:24654720

  3. [Addictions and action systems].

    PubMed

    Loonis, E; Apter, M J

    2000-01-01

    Generalizing from some previous analyses of addiction, and introducing the concept of an action system which governs all actions which are focussed on what Brown (1988) calls "hedonic management", we argue that addictions of every kind involve an action system that displays high salience, low variety and low vicariance. Addictions also involve what Apter (1982) calls the "paratelic state". A study was carried out comparing 31 drug addicts with 29 control subjects in terms of action system variables. To measure these variables, we constructed a new instrument, the Activity-System Drawing Test, and also used the Telic Dominance Scale to measure frequency of paratelic states. Dysphoria was measured by means of the BATE (anxiety), IDA-13 (depression), SEI (self-esteem), and TAS-20 (alexithymia) instruments. Strongly significant differences were found between groups for both action system variables and dysphoria, and there were also strong correlations between both groups of variables. This supports the idea that addictions emerge from systemic properties of the action system. PMID:10858918

  4. [DGRW update: alcohol addiction].

    PubMed

    Vogelgesang, M

    2011-10-01

    First, epidemiological data and socioeconomic consequences of alcohol addiction are summarized. Research findings, in particular in intervention and evaluation, from 2009-2011 in the field of alcohol addiction treatment are then discussed concerning their relevance for rehabilitation practice. The search was based on PubMed and PSYNDEX. The interventions most frequently evaluated and found most effective in alcohol addiction treatment are cognitive-behavioural interventions. Further topics dealt with are: pharmacological relapse prevention; technologically based therapies (e. g. e-therapy); systemic interventions; 12-steps; effectiveness of addiction treatment as confirmed in large-scale catamnestic studies; treatment of addiction and comorbidity; various subgroups (like elderly people and women); as well as other new and interesting developments such as rehab case management, dovetailing of medical and vocational interventions, stepped-care interventions, rehab management category groups as well as a new focus on individual treatment experiences and the pre-eminence of the therapeutic relationship. Finally, priority areas of future research are described. PMID:21976262

  5. Pharmacogenetic aspects of addictive behaviors

    PubMed Central

    Hejazi, Nadia S.

    2007-01-01

    Addictions are illnesses of complex causation, including inheritance and a role for gene/environment interactions. Functional alleles influencing pharmacodynamic (tissue response) and pharmacokinetic (absorption, distribution, and metabolism) play a role, but these interact with diverse environmental factors including early Ife stress, underage drug exposure, availability of addictive agents, and response to clinical interventions including pharmacotherapies. Identification of genetic factors addiction thus plays an important role in the understanding of processes of addiction and origins of differential vulnerabilities and treatment responses. PMID:18286803

  6. Internet Addiction: A Logotherapeutic Approach

    ERIC Educational Resources Information Center

    Didelot, Mary J.; Hollingsworth, Lisa; Buckenmeyer, Janet A.

    2012-01-01

    Internet addiction (IA) is both the most rapidly growing addiction and the least understood addiction (Watson, 2005). For counselors, treatment issues surrounding the disease are also growing. At the forefront is the lack of understanding concerning treatment protocol to manage the challenging recovery and maintenance stages after IA behavior has…

  7. Addicts - Everything but Human Beings

    ERIC Educational Resources Information Center

    Waldorf, Dan; Reinarman, Craig

    1975-01-01

    Popular theories of drug addiction are detailed and found wanting. Naturalistic studies of addicts in their own environments are reviewed in order to demonstrate that addicts do not fit these theories which are supposed to explain them. A plea is made to pay more attention to these ethnographic studies, if more effective and humane laws and social…

  8. Attitudes of Former Drug Addicts

    ERIC Educational Resources Information Center

    Boudouris, James

    1977-01-01

    Characteristics of addicts (N=222) and their own appraisal of which treatment modality they found most successful based upon their own experiences are of primary importance in prescribing a treatment for the addict. For the long-term addict continually in and out of prisons, perhaps methadone maintenance is the solution. (Author)

  9. [Complications of cocaine addiction].

    PubMed

    Karila, Laurent; Lowenstein, William; Coscas, Sarah; Benyamina, Amine; Reynaud, Michel

    2009-06-20

    Addiction is a chronic relapsing disorder characterized by repetitive and compulsive drug-seeking behavior and drug abuse despite negative health or social consequences. Cocaine addiction is a significant worldwide public health problem, which has somatic, psychological, psychiatric, socio-economic and judicial complications. Some of the most frequent complications are cardiovascular effects (acute coronary syndrome, cardiac arrhythmias, increased blood pressure); respiratory effects (fibrosis, interstitial pneumonitis, pulmonary hypertension, alveolar haemorrhage, asthma exacerbation; emphysema), neurological effects (strokes, aneurysms, seizures, headaches); risk for contracting HIV/AIDS, hepatitis B and C, sexual transmitted disease and otolaryngologic effects. Other complications are not discussed here. The vast majority of studies indicate that there are cognitive deficits induced by cocaine addiction. Attention, visual and working memories, executive functioning are affected in cocaine users. Psychiatric complications found in clinical practice are major depressive disorders, cocaine-induced paranoia, cocaine-induced compulsive foraging and panic attacks. PMID:19642439

  10. Drug addiction in China.

    PubMed

    Lu, Lin; Wang, Xi

    2008-10-01

    Drug addiction in China began with the importation of Indian opium by the British in the 16th century and brought severe social and health problems. While drug abuse abated following the establishment of People's Republic of China, modernization and Westernization in the 1980s led to the reemergence of this problem. Drug abuse in China became epidemic, facilitating the spread of HIV/AIDS. The Chinese government has made great efforts to address these problems, focusing both on treatments of drug addiction and on harm-reduction programs. Although the new trends of drug addiction in China pose great public health challenges, these government interventions are likely to successfully stem the problem of drug abuse in the future. PMID:18991965

  11. Comparing the Performance of Allopathically and Osteopathically Trained Physicians on the American Board of Family Medicine's Certification Examination

    ERIC Educational Resources Information Center

    O'Neill, Thomas R.; Royal, Kenneth D.; Schulte, Bradley M.; Leigh, Terrence

    2009-01-01

    Background: Two medical specialty boards offer certification in family medicine: the American Board of Family Medicine (ABFM) and the American Osteopathic Board of Family Physicians (AOBFP). The AOBFP certification is offered only to graduates of osteopathic colleges; however, graduates of both osteopathic and allopathic medical schools who have…

  12. Addiction and free will

    PubMed Central

    VOHS, KATHLEEN D.; BAUMEISTER, ROY F.

    2009-01-01

    Whether people believe that they have control over their behaviors is an issue that is centrally involved in definitions of addiction. Our research demonstrates that believing in free will – that is, believing that one has control over one's actions – has societal implications. Experimentally weakening free will beliefs led to cheating, stealing, aggression, and reduced helping. Bolstering free will beliefs did not change participants’ behavior relative to a baseline condition, suggesting that most of the time people possess a belief in free will. We encourage a view of addiction that allows people to sustain a belief in free will and to take responsibility for choices and actions. PMID:19812710

  13. Drug abuse and addiction.

    PubMed

    Nessa, A; Latif, S A; Siddiqui, N I; Hussain, M A; Hossain, M A

    2008-07-01

    Among the social and medical ills of the twentieth century, substance abuse ranks as on one of the most devastating and costly. The drug problem today is a major global concern including Bangladesh. Almost all addictive drugs over stimulate the reward system of the brain, flooding it with the neurotransmitter dopamine. That produces euphoria and that heightened pleasure can be so compelling that the brain wants that feeling back again and again. However repetitive exposure induces widespread adaptive changes in the brain. As a consequence drug use may become compulsive. An estimated 4.7% of the global population aged 15 to 64 or 184 million people, consume illicit drug annually. Heroin use alone is responsible for the epidemic number of new cases of HIV/AIDS, Hepatitis and drug addicted infant born each year. Department of narcotic control (DNC) in Bangladesh reported in June 2008 that about 5 million drug addicts in the country & addicts spend at least 17 (Seventeen) billion on drugs per year. Among these drug addicts, 91% are young and adolescents population. Heroin is the most widely abused drugs in Bangladesh. For geographical reason like India, Pakistan and Myanmar; Bangladesh is also an important transit root for internationally trafficking of illicit drug. Drug abuse is responsible for decreased job productivity and attendance increased health care costs, and escalations of domestic violence and violent crimes. Drug addiction is a preventable disease. Through scientific advances we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and resume their productive lives. Most countries have legislation designed to criminalize some drugs. To decrease the prevalence of this problem in our setting; increase awareness, promoting additional research on abused and addictive drugs, and exact implementation of existing laws are strongly recommended. We should

  14. Psychostimulant addiction treatment

    PubMed Central

    Phillips, Karran A.; Epstein, David H.; Preston, Kenzie L.

    2014-01-01

    Treatment of psychostimulant addiction has been a major, and not fully met, challenge. For opioid addiction, there is strong evidence for the effectiveness of several medications. For psychostimulants, there is no corresponding form of agonist maintenance that has met criteria for regulatory approval or generally accepted use. Stimulant-use disorders remain prevalent and can result in both short-term and long-term adverse consequences. The mainstay of treatment remains behavioral interventions. In this paper, we discuss those interventions and some promising candidates in the search for pharmacological interventions. PMID:24727297

  15. Addiction as a Systems Failure: Focus on Adolescence and Smoking

    PubMed Central

    Baler, Ruben D.; Volkow, Nora D.

    2011-01-01

    Objective Scientific advances in the field of addiction have forever debunked the notion that addiction reflects a character flaw under voluntary control, demonstrating instead that it is a bona fide disease of the brain. The aim of this review is to go beyond this consensus understanding and explore the most current evidence regarding the vast number of genetic, developmental, and environmental factors whose complex interactions modulate addiction risk and trajectory. Method Focusing on childhood and adolescent smoking as a paradigm, we review the important risk factors for the development of addictions, starting at the level of genetics and closing with a focus on sociocultural and policy factors. Results A critical review of the pertinent literature provides a detailed view of the cumulative power of risk and protection factors across different phenomenological levels to modulate the risk of undesirable outcomes, particularly for young people. The result represents a compelling argument for the need to engage in comprehensive, multilevel approaches to promoting health. Conclusions Today, the field of medicine understands more about disease than about health; however it need not be that way. The view of drug addiction as a systems failure should help refocus our general approach to developing dynamic models and early comprehensive interventions that optimize the ways in which we prevent and treat a complex, developmental disorder such as drug addiction. PMID:21421173

  16. Medicine Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern medical practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for medicine are described including education and postgraduate training requirements, state licensing examinations, and application…

  17. Designing evidence-based medicine training to optimize the transfer of skills from the classroom to clinical practice: applying the four component instructional design model.

    PubMed

    Maggio, Lauren A; Cate, Olle Ten; Irby, David M; O'Brien, Bridget C

    2015-11-01

    Evidence-based medicine (EBM) skills, although taught in medical schools around the world, are not optimally practiced in clinical environments because of multiple barriers, including learners' difficulty transferring EBM skills learned in the classroom to clinical practice. This lack of skill transfer may be partially due to the design of EBM training. To facilitate the transfer of EBM skills from the classroom to clinical practice, the authors explore one instructional approach, called the Four Component Instructional Design (4C/ID) model, to guide the design of EBM training. On the basis of current cognitive psychology, including cognitive load theory, the premise of the 4C/ID model is that complex skills training, such as EBM training, should include four components: learning tasks, supportive information, procedural information, and part-task practice. The combination of these four components can inform the creation of complex skills training that is designed to avoid overloading learners' cognitive abilities; to facilitate the integration of the knowledge, skills, and attitudes needed to execute a complex task; and to increase the transfer of knowledge to new situations. The authors begin by introducing the 4C/ID model and describing the benefits of its four components to guide the design of EBM training. They include illustrative examples of educational practices that are consistent with each component and that can be applied to teaching EBM. They conclude by suggesting that medical educators consider adopting the 4C/ID model to design, modify, and/or implement EBM training in classroom and clinical settings. PMID:25993279

  18. Carrots and sticks fail to change behavior in cocaine addiction.

    PubMed

    Ersche, Karen D; Gillan, Claire M; Jones, P Simon; Williams, Guy B; Ward, Laetitia H E; Luijten, Maartje; de Wit, Sanne; Sahakian, Barbara J; Bullmore, Edward T; Robbins, Trevor W

    2016-06-17

    Cocaine addiction is a major public health problem that is particularly difficult to treat. Without medically proven pharmacological treatments, interventions to change the maladaptive behavior of addicted individuals mainly rely on psychosocial approaches. Here we report on impairments in cocaine-addicted patients to act purposefully toward a given goal and on the influence of extended training on their behavior. When patients were rewarded for their behavior, prolonged training improved their response rate toward the goal but simultaneously rendered them insensitive to the consequences of their actions. By contrast, overtraining of avoidance behavior had no effect on patient performance. Our findings illustrate the ineffectiveness of punitive approaches and highlight the potential for interventions that focus on improving goal-directed behavior and implementing more desirable habits to replace habitual drug-taking. PMID:27313048

  19. Addiction, risk, and resources.

    PubMed

    Allamani, Allaman

    2007-01-01

    Addiction is a contemporary social issue bound to the myth of self-control and control of the other, which is typical of the contemporary "market ideology" society. In its broad definition it includes not only the use and misuse of "substances" and addictive behaviors, but also the concept of risk. There is a continuum between "addicted behaviors" and behaviors that are not "addicted" but may induce and/or be related to both physical and psycho-social problems on a micro- to macrolevel. Different studies have documented substantial changes in the consumption of tobacco, drugs, alcoholic beverages, as well as "junk foods" during the last decades in various countries. All too often politicians, health administrators, and local providers believe that consumption prevention programs are able, per se, to effect such changes. In fact, the impact of factors such as international trade, globalization and societal values, among many others, are considered relevant. On the other hand, sufficient place must be given to national and community-based preventive initiatives. PMID:17558940

  20. Protein Kinases and Addiction

    PubMed Central

    Lee, Anna M.; Messing, Robert O.

    2011-01-01

    Although drugs of abuse have different chemical structures and interact with different protein targets, all appear to usurp common neuronal systems that regulate reward and motivation. Addiction is a complex disease that is thought to involve drug-induced changes in synaptic plasticity due to alterations in cell signaling, gene transcription, and protein synthesis. Recent evidence suggests that drugs of abuse interact with and change a common network of signaling pathways that include a subset of specific protein kinases. The best studied of these kinases are reviewed here and include extracellular signal-regulated kinase, cAMP-dependent protein kinase, cyclin-dependent protein kinase 5, protein kinase C, calcium/calmodulin-dependent protein kinase II, and Fyn tyrosine kinase. These kinases have been implicated in various aspects of drug addiction including acute drug effects, drug self-administration, withdrawal, reinforcement, sensitization, and tolerance. Identifying protein kinase substrates and signaling pathways that contribute to the addicted state may provide novel approaches for new pharma-cotherapies to treat drug addiction. PMID:18991950

  1. Behavioral addictions: an overview.

    PubMed

    Karim, Reef; Chaudhri, Priya

    2012-01-01

    The legitimacy of nonsubstance addictions has received increased attention from clinicians, researchers and the general population as more and more individuals report symptoms consistent with impairment of impulse control. The clinical presentation of these disorders is varied, as compulsive activities may include: gambling, eating, sex, shopping, use of the Internet or videogames or even exercising, working or falling in love. As such, there is great controversy in diagnosing, treating or even naming these conditions, as many of these behaviors are daily rituals instrumental to our ultimate survival. Historically, the phrase "impulse control disorders" described these conditions but many researchers and clinicians also use the term "behavioral addictions," "process addictions" or "impulsive-compulsive behaviors" to report behavioral pathology. This review summarizes the data of each of these behavioral addictions from epidemiology to neurobiology to treatment options. Research suggests similarities between natural and drug reward processing but clinical evidence supports the utilization of treatment modalities for these behavioral conditions that can sometimes differ from traditional drug treatment. PMID:22641961

  2. Passing on the medicinal chemistry baton: training undergraduates to be industry-ready through research projects between the University of Nottingham and GlaxoSmithKline.

    PubMed

    Macdonald, Simon J F; Fray, M Jonathan; McInally, Thomas

    2016-06-01

    In this article we describe a radically different industry-academia collaboration between the School of Chemistry, University of Nottingham, and GlaxoSmithKline (GSK), aiming to train students in research and give them an insight into medicinal chemistry as practiced in industry. The project concerns the discovery of potent and selective αvβ6 integrin antagonists to treat idiopathic pulmonary fibrosis; the synthetic chemistry is performed by a group of ten final-year undergraduates and the biological and physicochemical screening data are generated by GSK. The project planning, organisation and operation are discussed, together with some of the challenges and rewards of working with undergraduates. PMID:26852693

  3. The Past, Present, and Future of Nicotine Addiction Therapy.

    PubMed

    Prochaska, Judith J; Benowitz, Neal L

    2016-01-01

    The tobacco addiction treatment field is progressing through innovations in medication development, a focus on precision medicine, and application of new technologies for delivering support in real time and over time. This article reviews the evidence for combined and extended cessation pharmacotherapy and behavioral strategies including provider advice, individual counseling, group programs, the national quitline, websites and social media, and incentives. Healthcare policies are changing to offer cessation treatment to the broad population of smokers. With knowledge of the past and present, this review anticipates what is likely on the horizon in the clinical and public health effort to address tobacco addiction. PMID:26332005

  4. Development of residency program guidelines for interaction with the pharmaceutical industry. Education Council, Residency Training Programme in Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ont.

    PubMed Central

    1993-01-01

    Medical residency programs are likely to face increasing pressure to address their relations with the pharmaceutical industry. Our internal medicine residency program has developed guidelines that were adopted after extensive debate by residents and faculty members. The guidelines are based on the principles that residents and faculty should set the educational agenda and that the residency program should not allow gifts of any sort from industry to residents. Specific policies include obtaining and screening educational materials from the industry before residents are exposed to them, proscribing "drug lunches" and accepting industry sponsorship only when the residency program maintains complete control of the educational event being sponsored. The industry response to the guidelines was split; about half reacted negatively, and half found the guidelines acceptable. Our experience suggests that productive debate about guidelines for the interaction of residency programs with the pharmaceutical industry is possible and desirable and that explicit policies can clarify areas of ambiguity. PMID:8348422

  5. A Clinically Integrated Post-Graduate Training Programme in Evidence-Based Medicine versus ‘No Intervention’ for Improving Disability Evaluations: A Cluster Randomised Clinical Trial

    PubMed Central

    Kok, Rob; Hoving, Jan L.; Smits, Paul B. A.; Ketelaar, Sarah M.; van Dijk, Frank J. H.; Verbeek, Jos H.

    2013-01-01

    Background Although several studies have shown that teaching EBM is effective in improving knowledge, at present, there is no convincing evidence that teaching EBM also changes professional behaviour in practice. Therefore, the primary aim of this study was to evaluate the effectiveness of a clinically integrated post-graduate training programme in EBM on evidence-based disability evaluation. Methods and Findings In a cluster randomised controlled trial, fifty-four case-based learning groups consisting of 132 physicians and 1680 patients were randomly assigned to the intervention or control groups. A clinically integrated, post-graduate, 5-day training programme in evidence-based medicine, consisting of (home) assignments, peer teaching, interactive training in searching databases, lectures and brainstorming sessions was provided to the intervention group. The control group received no training. The primary outcome was evidence-based disability evaluation, as indicated by the frequency in use of evidence of sufficient quality in disability evaluation reports. There are no general EBM behaviour outcome measures available. Therefore, we followed general guidelines for constructing performance indicators and defined an a priori cut-off for determination of sufficient quality as recommended for evaluating EB training. Physicians trained in EBM performed more evidence-based disability evaluations compared to physicians in the control group (difference in absolute proportion 9.7%, 95% CI 3.5 to 15.9). The primary outcome differences between groups remained significant after both cluster-adjusted analysis and additional sensitivity analyses accounting for subjects lost to follow-up. Conclusions A EBM programme successfully improved the use of evidence in a non-hospital based medical specialty. Our findings support the general recommendations to use multiple educational methods to change physician behaviour. In addition, it appeared important that the professional context

  6. Impact of a Faculty Development Program in Addiction Psychology

    ERIC Educational Resources Information Center

    Miller, William R.; Anderson, Robert E.

    2003-01-01

    The Faculty Development Programs (FDP) were intended to increase substance abuse education in mainstream professional training programs by attracting and educating core faculty to teach about addictions. Five psychology faculty in the PhD program at the University of New Mexico participated in the only FDP funded within the discipline of…

  7. Addiction Recovery: 12-Step Programs and Cognitive-Behavioral Psychology.

    ERIC Educational Resources Information Center

    Bristow-Braitman, Ann

    1995-01-01

    Provides helping professionals with an overview of treatment issues referred to as spiritual by those recovering from alcohol and drug addictions through 12-step programs. Reviews conflicts between academically trained helping professionals and researchers, and those advocating spiritually oriented treatment programs. Discusses spiritual…

  8. Coexisting addiction and pain in people receiving methadone for addiction.

    PubMed

    St Marie, Barbara

    2014-04-01

    The aim of this qualitative study was to examine the narratives of people who experience chronic pain (lasting 6 months or more) and were receiving methadone for the treatment of their opiate addiction through a major methadone clinic. This paper featured the pathway of how the participants developed chronic pain and addiction, and their beliefs of how prescription opioids would impact their addiction in the future. Thirty-four participants who experienced chronic pain and received methadone for treatment of opiate addiction were willing to tell the story of their experiences. The findings in three areas are presented: (a) whether participants experienced addiction first or pain first and how their exposures to addictive substances influenced their experiences, (b) the significance of recreational drug use and patterns of abuse behaviors leading to chronic pain, and (c) participants' experiences and beliefs about the potential for abuse of prescription opioid used for treatment of pain. PMID:23858068

  9. Coexisting Addiction and Pain in People Receiving Methadone for Addiction

    PubMed Central

    St. Marie, Barbara

    2014-01-01

    The aim of this qualitative study was to examine the narratives of people who experience chronic pain (lasting 6 months or more) and were receiving methadone for the treatment of their opiate addiction through a major methadone clinic. This paper featured the pathway of how the participants developed chronic pain and addiction, and their beliefs of how prescription opioids would impact their addiction in the future. Thirty-four participants who experienced chronic pain and received methadone for treatment of opiate addiction were willing to tell the story of their experiences. The findings in three areas are presented: (a) whether participants experienced addiction first or pain first and how their exposures to addictive substances influenced their experiences, (b) the significance of recreational drug use and patterns of abuse behaviors leading to chronic pain, and (c) participants’ experiences and beliefs about the potential for abuse of prescription opioid used for treatment of pain. PMID:23858068

  10. Preclinical Assessment of Lisdexamfetamine as an Agonist Medication Candidate for Cocaine Addiction: Effects in Rhesus Monkeys Trained to Discriminate Cocaine or to Self-Administer Cocaine in a Cocaine Versus Food Choice Procedure

    PubMed Central

    Hutsell, Blake A.; Blough, Bruce E.; Poklis, Justin L.; Negus, S. Stevens

    2015-01-01

    Background: Chronic amphetamine treatment decreases cocaine consumption in preclinical and human laboratory studies and in clinical trials. Lisdexamfetamine is an amphetamine prodrug in which L-lysine is conjugated to the terminal nitrogen of d-amphetamine. Prodrugs may be advantageous relative to their active metabolites due to slower onsets and longer durations of action; however, lisdexamfetamine treatment’s efficacy in decreasing cocaine consumption is unknown. Methods: This study compared lisdexamfetamine and d-amphetamine effects in rhesus monkeys using two behavioral procedures: (1) a cocaine discrimination procedure (training dose = 0.32mg/kg cocaine, i.m.); and (2) a cocaine-versus-food choice self-administration procedure. Results: In the cocaine-discrimination procedure, lisdexamfetamine (0.32–3.2mg/kg, i.m.) substituted for cocaine with lower potency, slower onset, and longer duration of action than d-amphetamine (0.032–0.32mg/kg, i.m.). Consistent with the function of lisdexamfetamine as an inactive prodrug for amphetamine, the time course of lisdexamfetamine effects was related to d-amphetamine plasma levels by a counter-clockwise hysteresis loop. In the choice procedure, cocaine (0–0.1mg/kg/injection, i.v.) and food (1g banana-flavored pellets) were concurrently available, and cocaine maintained a dose-dependent increase in cocaine choice under baseline conditions. Treatment for 7 consecutive days with lisdexamfetamine (0.32–3.2mg/kg/day, i.m.) or d-amphetamine (0.032–0.1mg/kg/h, i.v.) produced similar dose-dependent rightward shifts in cocaine dose-effect curves and decreases in preference for 0.032mg/kg/injection cocaine. Conclusions: Lisdexamfetamine has a slower onset and longer duration of action than amphetamine but retains amphetamine’s efficacy to reduce the choice of cocaine in rhesus monkeys. These results support further consideration of lisdexamfetamine as an agonist-based medication candidate for cocaine addiction. PMID

  11. Food addiction: detox and abstinence reinterpreted?

    PubMed

    Shriner, Richard L

    2013-10-01

    The senior patient and/or the geriatrician are confronted with a confusing literature describing how patients interested in combating metabolic syndrome, diabesity (diabetes plus obesity) or simple obesity might best proceed. The present paper gives a brief outline of the basic disease processes that underlie metabolic pro-inflammation, including how one might go about devising the most potent and practical detoxification from such metabolic compromise. The role that dietary restriction plays in pro-inflammatory detoxification (detox), including how a modified fast (selective food abstinence) is incorporated into this process, is developed. The unique aspects of geriatric bariatric medicine are elucidated, including the concepts of sarcopenia and the obesity paradox. Important caveats involving the senior seeking weight loss are offered. By the end of the paper, the reader will have a greater appreciation for the challenges and opportunities that lie ahead for geriatric patients who wish to overcome food addiction and reverse pro-inflammatory states of ill-heath. This includes the toxic metabolic processes that create obesity complicated by type 2 diabetes mellitus (T2DM) which collectively we call diabesity. In that regard, diabesity is often the central pathology that leads to the evolution of the metabolic syndrome. The paper also affords the reader a solid review of the neurometabolic processes that effectuate anorexigenic versus orexigenic inputs to obesity that drive food addiction. We argue that these processes lead to either weight gain or weight loss by a tripartite system involving metabolic, addictive and relational levels of organismal functioning. Recalibrating the way we negotiate these three levels of daily functioning often determines success or failure in terms of overcoming metabolic syndrome and food addiction. PMID:23267844

  12. The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan.

    PubMed

    Mizuno, Atsushi; Tsugawa, Yusuke; Shimizu, Taro; Nishizaki, Yuji; Okubo, Tomoya; Tanoue, Yusuke; Konishi, Ryota; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2016-01-01

    Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014. We compared the ITE score and the hospital volume. Results A total of 2,015 participants (70.6% men; age, 27.3±2.9 years old) from 208 hospitals were retrospectively analyzed. Generalized estimating equations were used, and the results revealed that an increasing number of hospitalizations, decreasing staff number, decreasing age and PGY-2 were significantly associated with higher GM-ITE scores. Conclusion The hospital volume, such as the number of hospitalizations, is thus considered to have a positive impact on the GM-ITE scores. PMID:27301504

  13. Modular Applications with Smartphones and Smartpads in Shape, Color and Spectral Measurements for Industry, Biology and Medicine plus Science, Education and Training

    NASA Astrophysics Data System (ADS)

    Hofmann, Dr Dietrich, Prof; Eng Paul-Gerald Dittrich, B.; Düntsch, B. Eng Eric; Kraus, Daniel; Gärtner, Claudia, Dr; Klemm, Dipl-Ing Richard

    2013-09-01

    Aim of the paper is the demonstration of a paradigm shift in shape, color and spectral measurements in industry, biology and medicine as well as in measurement science, education and training. Laboratory applications will be supplemented and replaced by innovative in-field and point-of-care applications. Innovative functional modules are smartphones and/or smartpads supplemented by additional hardware apps and software apps. Specific examples are given for numerous practical applications concerning optodigital methods. The methodological classification distinguishes between different levels for combinations of hardware apps (hwapps) and software apps (swapps) with smartphones and/or smartpads. These methods are fundamental enablers for the transformation from conventional stationary working places in industry, biology, medicine plus science, education and training towards innovative mobile working places with in-field and point-of-care characteristics as well as mobile open online courses MOOCs. The innovative approach opens so far untapped enormous markets for measurement science and engineering. These working conditions will be very common due to their convenience, reliability and affordability. The fundamental enablers are smartphones and/or smartpads. A highly visible advantage of smartphones and/or smartpads is the huge number of their distribution, their worldwide connectivity via Internet and cloud services and the experienced capabilities of their users for practical operations. Young people are becoming the pioneers.

  14. Entrustable professional activities and curricular milestones for fellowship training in pulmonary and critical care medicine: report of a multisociety working group.

    PubMed

    Fessler, Henry E; Addrizzo-Harris, Doreen; Beck, James M; Buckley, John D; Pastores, Stephen M; Piquette, Craig A; Rowley, James A; Spevetz, Antoinette

    2014-09-01

    This article describes the curricular milestones and entrustable professional activities for trainees in pulmonary, critical care, or combined fellowship programs. Under the Next Accreditation System of the Accreditation Council for Graduate Medical Education (ACGME), curricular milestones compose the curriculum or learning objectives for training in these fields. Entrustable professional activities represent the outcomes of training, the activities that society and professional peers can expect fellowship graduates to be able to perform unsupervised. These curricular milestones and entrustable professional activities are the products of a consensus process from a multidisciplinary committee of medical educators representing the American College of Chest Physicians (CHEST), the American Thoracic Society, the Society of Critical Care Medicine, and the Association of Pulmonary and Critical Care Medicine Program Directors. After consensus was achieved using the Delphi process, the document was revised with input from the sponsoring societies and program directors. The resulting lists can serve as a roadmap and destination for trainees, program directors, and educators. Together with the reporting milestones, they will help mark trainees' progress in the mastery of the six ACGME core competencies of graduate medical education. PMID:24945874

  15. Fuzzy Logic in Medicine and Bioinformatics

    PubMed Central

    Torres, Angela; Nieto, Juan J.

    2006-01-01

    The purpose of this paper is to present a general view of the current applications of fuzzy logic in medicine and bioinformatics. We particularly review the medical literature using fuzzy logic. We then recall the geometrical interpretation of fuzzy sets as points in a fuzzy hypercube and present two concrete illustrations in medicine (drug addictions) and in bioinformatics (comparison of genomes). PMID:16883057

  16. Treatment of addiction and addiction-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2004-12-07

    The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a mammal suffering from substance addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. The present invention also provides a method of treatment of cocaine, morphine, heroin, nicotine, amphetamine, methamphetamine, or ethanol addiction by treating a mammal with an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof.

  17. Buprenorphine treatment for narcotic addiction: not without risks.

    PubMed

    Sansone, Randy A; Sansone, Lori A

    2015-01-01

    While most clinicians will never prescribe buprenorphine or combined buprenorphine/naloxone, familiarity with the risks of these pharmacological approaches to the treatment of narcotic addiction remains relevant. Overall, medication-assisted treatment has clearly resulted in meaningful gains for a number of individuals who are addicted to narcotics (i.e., opiates and opioids). However, a certain level of risk is inherent with these approaches. For example, both buprenorphine and buprenorphine/naloxone may be diverted and misused (e.g., intravenously injected, intranasally administered), particularly buprenorphine. Likewise, when illicitly injected, both can cause infectious complications as well as result in death from overdose. The risk of death with buprenorphine overdose appears to be heightened with the coadministration of either benzodiazepines or sedative/hypnotics. To conclude, as with all interventions in medicine, buprenorphine treatment for narcotic addiction has a clinically fluctuating risk/benefit equation that must be continually monitored. PMID:25973324

  18. Buprenorphine Treatment for Narcotic Addiction: Not Without Risks

    PubMed Central

    Sansone, Lori A.

    2015-01-01

    While most clinicians will never prescribe buprenorphine or combined buprenorphine/naloxone, familiarity with the risks of these pharmacological approaches to the treatment of narcotic addiction remains relevant. Overall, medication-assisted treatment has clearly resulted in meaningful gains for a number of individuals who are addicted to narcotics (i.e., opiates and opioids). However, a certain level of risk is inherent with these approaches. For example, both buprenorphine and buprenorphine/naloxone may be diverted and misused (e.g., intravenously injected, intranasally administered), particularly buprenorphine. Likewise, when illicitly injected, both can cause infectious complications as well as result in death from overdose. The risk of death with buprenorphine overdose appears to be heightened with the coadministration of either benzodiazepines or sedative/hypnotics. To conclude, as with all interventions in medicine, buprenorphine treatment for narcotic addiction has a clinically fluctuating risk/benefit equation that must be continually monitored. PMID:25973324

  19. A Liberal Account of Addiction

    PubMed Central

    Foddy, Bennett; Savulescu, Julian

    2014-01-01

    Philosophers and psychologists have been attracted to two differing accounts of addictive motivation. In this paper, we investigate these two accounts and challenge their mutual claim that addictions compromise a person’s self-control. First, we identify some incompatibilities between this claim of reduced self-control and the available evidence from various disciplines. A critical assessment of the evidence weakens the empirical argument for reduced autonomy. Second, we identify sources of unwarranted normative bias in the popular theories of addiction that introduce systematic errors in interpreting the evidence. By eliminating these errors, we are able to generate a minimal, but correct account, of addiction that presumes addicts to be autonomous in their addictive behavior, absent further evidence to the contrary. Finally, we explore some of the implications of this minimal, correct view. PMID:24659901

  20. The anti-addiction drug ibogaine and the heart: a delicate relation.

    PubMed

    Koenig, Xaver; Hilber, Karlheinz

    2015-01-01

    The plant indole alkaloid ibogaine has shown promising anti-addictive properties in animal studies. Ibogaine is also anti-addictive in humans as the drug alleviates drug craving and impedes relapse of drug use. Although not licensed as therapeutic drug and despite safety concerns, ibogaine is currently used as an anti-addiction medication in alternative medicine in dozens of clinics worldwide. In recent years, alarming reports of life-threatening complications and sudden death cases, temporally associated with the administration of ibogaine, have been accumulating. These adverse reactions were hypothesised to be associated with ibogaine's propensity to induce cardiac arrhythmias. The aim of this review is to recapitulate the current knowledge about ibogaine's effects on the heart and the cardiovascular system, and to assess the cardiac risks associated with the use of this drug in anti- addiction therapy. The actions of 18-methoxycoronaridine (18-MC), a less toxic ibogaine congener with anti-addictive properties, are also considered. PMID:25642835

  1. The national portfolio for postgraduate family medicine training in South Africa: a descriptive study of acceptability, educational impact, and usefulness for assessment

    PubMed Central

    2013-01-01

    Background Since 2007 a portfolio of learning has become a requirement for assessment of postgraduate family medicine training by the Colleges of Medicine of South Africa. A uniform portfolio of learning has been developed and content validity established among the eight postgraduate programmes. The aim of this study was to investigate the portfolio’s acceptability, educational impact, and perceived usefulness for assessment of competence. Methods Two structured questionnaires of 35 closed and open-ended questions were delivered to 53 family physician supervisors and 48 registrars who had used the portfolio. Categorical and nominal/ordinal data were analysed using simple descriptive statistics. The open-ended questions were analysed with ATLAS.ti software. Results Half of registrars did not find the portfolio clear, practical or feasible. Workshops on portfolio use, learning, and supervision were supported, and brief dedicated time daily for reflection and writing. Most supervisors felt the portfolio reflected an accurate picture of learning, but just over half of registrars agreed. While the portfolio helped with reflection on learning, participants were less convinced about how it helped them plan further learning. Supervisors graded most rotations, suggesting understanding the summative aspect, while only 61% of registrars reflected on rotations, suggesting the formative aspects are not yet optimally utilised. Poor feedback, the need for protected academic time, and pressure of service delivery impacting negatively on learning. Conclusion This first introduction of a national portfolio for postgraduate training in family medicine in South Africa faces challenges similar to those in other countries. Acceptability of the portfolio relates to a clear purpose and guide, flexible format with tools available in the workplace, and appreciating the changing educational environment from university-based to national assessments. The role of the supervisor in direct

  2. [Neuroscientific basic in addiction].

    PubMed

    Johann-Ridinger, Monika

    2014-10-01

    The growing evidence of Neuroscience leads to a better understanding of cerebral processes in cases of acute or chronic intake of psychotropic substances (ps). Predominantly, structures of the "reward system" contributed to the development of addiction. Chronic consumption of ps provides changing in brain equilibrium and leads to adaptations in the brain architecture. In this article, the complex responses of neurons and neuronal networks are presented in cases of chronic intake of ps. The alterations affect the cognitive, emotional and behavioral processings and influence learning and stress regulation. In summary, all cerebral adaptations are integrated in a complex model of biological, psychological and social factors and therefore, addiction arises as a consequence of combination of individual protecting and risk factors. PMID:25257111

  3. Real-Life Stories about Addiction Struggles

    MedlinePlus

    ... this page please turn Javascript on. Feature: Preventing Drug Abuse and Addiction Real-Life Stories About Addiction Struggles ... IMAGE TO PLAY THE VIDEO Read More "Preventing Drug Abuse and Addiction" Articles Scientific Research has Revolutionized our ...

  4. Signs of Heroin Abuse and Addiction

    MedlinePlus

    ... Signs of Heroin Use and Addiction Signs of Heroin Use and Addiction Listen People who are trying ... Español English Español PDF Version Download "I needed heroin just to get by." Deon was addicted to ...

  5. Wilderness Medicine.

    PubMed

    Alexander, Whitney; Bright, Steven; Burns, Patrick; Townes, David

    2016-03-01

    Wilderness medicine encompasses prevention and treatment of illness and injury, education and training, emergency medical services, and search and rescue in the wilderness. Although traumatic injuries, including minor injuries, outnumber medical illness as the cause of morbidity in the wilderness, basic understanding of the prevention and management of injury and illness, including recognition, identification, treatment, initial management, and stabilization, is essential, in addition to the ability to facilitate evacuation of affected patients. An important theme throughout wilderness medicine is planning and preparation for the best- and worst-case scenarios, and being ready for the unexpected. PMID:26900118

  6. [Addiction and personality].

    PubMed

    Franques, P; Auriacombe, M; Tignol, J

    2000-01-01

    Within the field of substance abuse, it is now widely admitted that the addictive personality does not exist. No one personality type is predisposed to addiction. The predisposition to drug dependence involves many different factors: psychological, social, familial, biological. None of these factors can be the sole determinant of drug dependence. Keeping that in mind, it is of interest to review the recent data on the relationship between personality traits or disorders and opiate and cocaine dependence. Using DSM and ICD categorical assessment, no single personality disorder emerged, instead a range of personality disorders has been evaluated in opiate and cocaine dependent subjects. Every type of personality disorders (PD) existed but cluster BPD were the most common (especially antisocial personality disorder in opiate addicts). However, it is noteworthy that a large minority to a majority of subjects did not display any king of PD. The implication of these results is that antisocial PD is probably over-diagnosed in drug dependence clinical settings. The studies reviewed failed to demonstrate that personality disorders were strong predictors of outcome in opiate or cocaine dependence. However, opiate dependent PD subjects entering treatment had more severe problems and lower retention rate than non PD subjects. But the amount of improvement was not significantly different between PD subjects and non PD subjects. This demonstrated that substance dependent PD patients could benefit from treatment whose intensity and duration must be adjusted. There is good support for the idea that Sensation Seeking trait is a vulnerability factor to substance abuse. But after dependence develops, sensation seeking is probably irrelevant to continued use of the drugs. This break between the psychopathology of vulnerability of substance abuse and the psychopathology of dependence raises the question of the existence of dramatically different factors involved in both phases of

  7. What is sexual addiction?

    PubMed

    Levine, Stephen B

    2010-01-01

    Married men labeled as sexual addicts seek help after being discovered to have had broken monogamy rules for sexual behavior through their use of masturbation, pornography, cybersex, commercial sex involvement, paraphilic pursuits, or affairs. This study analyzed the sexual patterns and dynamics of 30 men who presented to 1 clinician between 2005 and 2009. Their important differences were captured by a 6-category spectrum: (a) no sexual excess beyond breaking the spouse's restrictive rules (n = 2), (b) discovery of husband's longstanding sexual secrets (n = 5), (c) new discovery of the joys of commercial sex (n = 4), (d) the bizarre or paraphilic (n = 7), (e) alternate concept of normal masculinity (n = 5), and (f) spiraling psychological deterioration (n = 7). Only the men with a spiraling psychological deterioration-about 25% of the sample with sexual issues-could reasonably be described as having a sexual addiction. This group experienced significant psychological failures before the onset of their deterioration. Another 25% were adequately defined as paraphilic. Half of the sample was not adequately described using addiction, compulsivity, impulsivity, and relationship incapacity models. The authors discuss the implications of these findings for DSM-5 and treatment. PMID:20432125

  8. Mitoepigenetics and drug addiction.

    PubMed

    Sadakierska-Chudy, Anna; Frankowska, Małgorzata; Filip, Małgorzata

    2014-11-01

    Being the center of energy production in eukaryotic cells, mitochondria are also crucial for various cellular processes including intracellular Ca(2+) signaling and generation of reactive oxygen species (ROS). Mitochondria contain their own circular DNA which encodes not only proteins, transfer RNA and ribosomal RNAs but also non-coding RNAs. The most recent line of evidence indicates the presence of 5-methylcytosine and 5-hydroxymethylcytosine in mitochondrial DNA (mtDNA); thus, the level of gene expression - in a way similar to nuclear DNA - can be regulated by direct epigenetic modifications. Up to now, very little data shows the possibility of epigenetic regulation of mtDNA. Mitochondria and mtDNA are particularly important in the nervous system and may participate in the initiation of drug addiction. In fact, some addictive drugs enhance ROS production and generate oxidative stress that in turn alters mitochondrial and nuclear gene expression. This review summarizes recent findings on mitochondrial function, mtDNA copy number and epigenetics in drug addiction. PMID:24956109

  9. Online Tobacco Cessation Training and Competency Assessment for Complementary and Alternative Medicine (CAM) Practitioners: Protocol for the CAM Reach Web Study

    PubMed Central

    Howerter, Amy; Eaves, Emery R; Hall, John R; Buller, David B; Gordon, Judith S

    2016-01-01

    Background Complementary and alternative medicine (CAM) practitioners, such as chiropractors, acupuncturists, and massage therapists, are a growing presence in the US health care landscape and already provide health and wellness care to significant numbers of patients who use tobacco. For decades, conventional biomedical practitioners have received training to provide evidence-based tobacco cessation brief interventions (BIs) and referrals to cessation services as part of routine clinical care, whereas CAM practitioners have been largely overlooked for BI training. Web-based training has clear potential to meet large-scale training dissemination needs. However, despite the exploding use of Web-based training for health professionals, Web-based evaluation of clinical skills competency remains underdeveloped. Objective In pursuit of a long-term goal of helping CAM practitioners integrate evidence-based practices from US Public Health Service Tobacco Dependence Treatment Guideline into routine clinical care, this pilot protocol aims to develop and test a Web-based tobacco cessation training program tailored for CAM practitioners. Methods In preparation for a larger trial to examine the effect of training on CAM practitioner clinical practice behaviors around tobacco cessation, this developmental study will (1) adapt an existing in-person tobacco cessation BI training program that is specifically tailored for CAM therapists for delivery via the Internet; (2) develop a novel, Web-based tool to assess CAM practitioner competence in tobacco cessation BI skills, and conduct a pilot validation study comparing the competency assessment tool to live video role plays with a standardized patient; (3) pilot test the Web-based training with 120 CAM practitioners (40 acupuncturists, 40 chiropractors, 40 massage therapists) for usability, accessibility, acceptability, and effects on practitioner knowledge, self-efficacy, and competency with tobacco cessation; and (4) conduct

  10. Precision in Addiction Care: Does It Make a Difference?

    PubMed Central

    van der Stel, Jaap

    2015-01-01

    This perspective article explores the possibilities of precision in addiction care — even better individually fitted or tailor-made care — and examines what changes we need to make in order to realize sensible progress in epidemiological key figures. The first part gives a short review on the development of addiction care and tries to answer the question of where we stand now and what has been achieved in addiction science through the development and evaluation of interventions in the past decades. Following this analysis, attention will be paid to what lies ahead. This second part focuses on the question of how addiction care can deal with the consequences of the emerging paradigm of personalized or precision medicine, which is based on the fundamental assumption that individual differences matter. Finally, some limitations and conditions as well as tasks and goals for progress are raised. In conclusion, it is argued that integration of addiction care in (mental) health care in the future is desirable. PMID:26604867

  11. Postgraduate training for family medicine in a rural district hospital in South Africa: Appropriateness and sufficiency of theatre procedures as a sentinel indicator

    PubMed Central

    Plessis, Dawie Du; Alfred Kapp, Paul; Giddy, Laurel

    2016-01-01

    Background Since 2007, the postgraduate training of family physicians for South African district hospitals has been formalised. This training differs from European and North American programmes as up to 30% of the skills needed rely on district hospital surgical, obstetrics and anaesthetics procedures, particularly in rural areas, as outlined in the national unit standards. The aim of this study was to evaluate the appropriateness and sufficiency of learning opportunities for these skills in a rural district hospital. Methods A descriptive, cross-sectional study was undertaken of the number and type of procedures performed in theatre for a 1-year period and compared with the required procedural skills stipulated in the national unit standards. Descriptive statistical analyses were used to analyse categorical data. Results Three thousand seven hundred and forty-one procedures were performed during the study period. Anaesthesia was the most common procedure, followed by Caesarean section. There were adequate opportunities for teaching most core skills. Conclusions Sufficient and appropriate learning opportunities exist for postgraduate family medicine training in all the core skills performed in a theatre according to the national unit standards. PMID:27380781

  12. Anti-addiction drug ibogaine inhibits hERG channels: a cardiac arrhythmia risk.

    PubMed

    Koenig, Xaver; Kovar, Michael; Boehm, Stefan; Sandtner, Walter; Hilber, Karlheinz

    2014-03-01

    Ibogaine, an alkaloid derived from the African shrub Tabernanthe iboga, has shown promising anti-addictive properties in animals. Anecdotal evidence suggests that ibogaine is also anti-addictive in humans. Thus, it alleviates drug craving and impedes relapse of drug use. Although not licensed as therapeutic drug, and despite evidence that ibogaine may disturb the rhythm of the heart, this alkaloid is currently used as an anti-addiction drug in alternative medicine. Here, we report that therapeutic concentrations of ibogaine reduce currents through human ether-a-go-go-related gene potassium channels. Thereby, we provide a mechanism by which ibogaine may generate life-threatening cardiac arrhythmias. PMID:22458604

  13. Treatment of addiction and addiction-related behavior

    SciTech Connect

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2005-05-10

    The present invention relates to the use of a composition that increases central nervous system GABA levels in a mammal, for the treatment of addiction to drugs of abuse and modification of behavior associated with addiction to drugs of abuse in said mammal.

  14. Integrative Medicine in Preventive Medicine Education

    PubMed Central

    Jani, Asim A.; Trask, Jennifer; Ali, Ather

    2016-01-01

    During 2012, the USDHHS’s Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center established a multidisciplinary steering committee, versed in integrative medicine, whose primary aim was to develop integrative medicine core competencies for incorporation into preventive medicine graduate medical education training. The competency development process was informed by central integrative medicine definitions and principles, preventive medicine’s dual role in clinical and population-based prevention, and the burgeoning evidence base of integrative medicine. The steering committee considered an interdisciplinary integrative medicine contextual framework guided by several themes related to workforce development and population health. A list of nine competencies, mapped to the six general domains of competence approved by the Accreditation Council of Graduate Medical Education, was operationalized through an iterative exercise with the 12 grantees in a process that included mapping each site’s competency and curriculum products to the core competencies. The competencies, along with central curricular components informed by grantees’ work presented elsewhere in this supplement, are outlined as a roadmap for residency programs aiming to incorporate integrative medicine content into their curricula. This set of competencies adds to the larger efforts of the IMPriME initiative to facilitate and enhance further curriculum development and implementation by not only the current grantees but other stakeholders in graduate medical education around integrative medicine

  15. Inadequate analgesia in emergency medicine.

    PubMed

    Rupp, Timothy; Delaney, Kathleen A

    2004-04-01

    Review of emergency department pain management practices demonstrates pain treatment inconsistency and inadequacy that extends across all demographic groups. This inconsistency and inadequacy appears to stem from a multitude of potentially remediable practical and attitudinal barriers that include (1) a lack of educational emphasis on pain management practices in nursing and medical school curricula and postgraduate training programs; (2) inadequate or nonexistent clinical quality management programs that evaluate pain management; (3) a paucity of rigorous studies of populations with special needs that improve pain management in the emergency department, particularly in geriatric and pediatric patients; (4) clinicians' attitudes toward opioid analgesics that result in inappropriate diagnosis of drug-seeking behavior and inappropriate concern about addiction, even in patients who have obvious acutely painful conditions and request pain relief; (5) inappropriate concerns about the safety of opioids compared with nonsteroidal anti-inflammatory drugs that result in their underuse (opiophobia); (6) unappreciated cultural and sex differences in pain reporting by patients and interpretation of pain reporting by providers; and (7) bias and disbelief of pain reporting according to racial and ethnic stereotyping. This article reviews the literature that describes the prevalence and roots of oligoanalgesia in emergency medicine. It also discusses the regulatory efforts to address the problem and their effect on attitudes within the legal community. PMID:15039693

  16. Harry Potter: Agency or Addiction?

    ERIC Educational Resources Information Center

    Mills, Alice

    2010-01-01

    This article considers limitations on agency for characters in the Harry Potter novels, in particular, how far they are driven by an addictive yearning for their beloved dead. As well as Harry's yearning for his dead parents, Dumbledore's guilt, Snape's longing and Slughorn's craving can be read as evidence of addiction rather than love, while the…

  17. [Cognitive remediation in addictions treatment].

    PubMed

    Pedrero-Perez, E J; Rojo-Mota, G; Ruiz-Sanchez de Leon, J M; Llanero-Luque, M; Puerta-Garcia, C

    2011-02-01

    More recent theories of addiction suggest that neurocognitive mechanisms, such as attentional processing, cognitive control, and reward processing play a key role in the development or maintenance of addiction. Ultimately, the addiction (with or without substances) is based on the alteration of brain decision-making processes. The neurosciences, particularly those responsible for behavior modification, must take into account the neurobiological processes underlying the observable behavior. Treatments of addiction usually do not take into account these findings, which may be at the base of the low retention rates and high dropout rates of addicted patients. Considered as an alteration of brain functioning, addiction could be addressed successfully through cognitive rehabilitation treatments used in other clinical pathologies such as brain damage or schizophrenia. Although there are few studies, it is suggest that intervention to improve patients' cognitive functioning can improve the efficiency of well-established cognitive-behavioral therapies, such as relapse prevention. This paper reviews the available evidence on cognitive rehabilitation in treating addiction as well as in other pathologies, in order to formulate interventions that may be included in comprehensive rehabilitation programs for people with addictive disorders. PMID:21287493

  18. What Is a Pediatric Sports Medicine Specialist?

    MedlinePlus

    ... Email Print Share What is a Pediatric Sports Medicine Specialist? Page Content Article Body If your child ... teens. What Kind of Training Do Pediatric Sports Medicine Specialists Have? Pediatric sports medicine specialists are medical ...

  19. American Academy of Home Care Medicine

    MedlinePlus

    ... Newsletter Certification/Training Donate Featured Members Home Care Medicine in America The American Academy of Home Care ... Resources with the American Academy of Home Care Medicine. The American Academy of Home Care Medicine understands ...

  20. Sports Medicine and Athletic Training in the 21st Century: Bridging the Gap between Research and Clinical Practice

    ERIC Educational Resources Information Center

    Guskiewicz, Kevin M.

    2008-01-01

    Sport and recreational activity is a vital part of today's society, and athletic training researchers are playing an important role in gaining a better understanding of how to promote safe and healthy participation for athletes of all ages. This article aims to illustrate the importance of research to prevent and effectively treat sport and…

  1. Changes and Challenges in Rural Graduate Medical Education: The Family Medicine Spokane Rural Training Track Experience in Colville, Wash.

    ERIC Educational Resources Information Center

    Maudlin, Robert K.; Newkirk, Gary R.; Snook, Michael D.; Cooper, Gloria

    2000-01-01

    Rural community-based graduate medical education programs in family practice generate highly trained physicians who typically settle and practice in rural communities. In response to federal funding cutbacks and revised accreditation requirements that threatened its program, the Colville, Washington, Mount Carmel Hospital agreed to fully fund its…

  2. Revising the formal, retrieving the hidden: Undergraduate curricular reform in medicine and the scientific, institutional, & social transformation of the clinical training environment

    NASA Astrophysics Data System (ADS)

    Jagosh, Justin J.

    2009-12-01

    In 2004, members of the McGill University Faculty of Medicine began implementing a new curriculum for undergraduate medical education entitled, Physicianship: The Physician as Professional and Healer. The initiative underscores the idea that physician training entails cultivating not only scientific knowledge and technical skill, but a mindset guided by intrinsic principles of doctoring. Although the McGill case exemplifies a wide-spread paradigm shift in medical teaching, there is a dearth of analysis concerning the degree of congruency between the objectives of formal undergraduate curricular revision and the so-called 'hidden curriculum' of the hospital training environment. With Physicianship as a point of departure, this dissertation maps evolutionary patterns in clinical medicine and, using qualitative methods, analyzes the perspectives of twenty physician-educators on curricular reform and the transforming clinical training environment. Physicians interviewed were generally supportive of the new curricular initiative. Concerns were raised, however, that many recent changes within the teaching hospital environment interfere with students' cultivation of professional and healer attributes. These changes were organized into three main themes: scientific, institutional, and social. Physicians expressed concern that what is often considered beneficial for patients is often detrimental for medical training. For example, increased use of diagnostic technologies has improved patient care but reduces opportunities for trainees' clinical skill development. Concern was raised that the concept of selfless service has been undermined through recent shift-work regulations and a culture gap between older and younger generation physicians. Alternatively, some perceived new policies of the clinical environment to be more conducive to physicians' self-care and quality of life. Younger trainees were often described as more competent in managing medical information, more open

  3. Animal studies of addictive behavior.

    PubMed

    Vanderschuren, Louk J M J; Ahmed, Serge H

    2013-04-01

    It is increasingly recognized that studying drug taking in laboratory animals does not equate to studying genuine addiction, characterized by loss of control over drug use. This has inspired recent work aimed at capturing genuine addiction-like behavior in animals. In this work, we summarize empirical evidence for the occurrence of several DSM-IV-like symptoms of addiction in animals after extended drug use. These symptoms include escalation of drug use, neurocognitive deficits, resistance to extinction, increased motivation for drugs, preference for drugs over nondrug rewards, and resistance to punishment. The fact that addiction-like behavior can occur and be studied in animals gives us the exciting opportunity to investigate the neural and genetic background of drug addiction, which we hope will ultimately lead to the development of more effective treatments for this devastating disorder. PMID:23249442

  4. Internet addiction in young people.

    PubMed

    Ong, Say How; Tan, Yi Ren

    2014-07-01

    In our technology-savvy population, mental health professionals are seeing an increasing trend of excessive Internet use or Internet addiction. Researchers in China, Taiwan and Korea have done extensive research in the field of Internet addiction. Screening instruments are available to identify the presence of Internet addiction and its extent. Internet addiction is frequently associated with mental illnesses such as anxiety, depression, conduct disorder and attention deficit hyperactivity disorder (ADHD). Treatment modalities include individual and group therapies, cognitive behavioural therapy (CBT), family therapy and psychotropic medications. A significant proportion of Singapore adolescents engaging in excessive Internet use are also diagnosed to have concomitant Internet addiction. Despite the presence of a variety of treatment options, future research in this area is needed to address its growing trend and to minimise its negative psychological and social impact on the individuals and their families. PMID:25142474

  5. [Can we treat sexual addiction ?].

    PubMed

    Inescu Cismaru, A; Andrianne, R; Triffaux, F; Triffaux, J-M

    2013-01-01

    Sexual addiction or sexual dependence is characterized by hypersexuality, impaired regulation of sexual desire and sexual compulsivity, including having sex with uncontrolled excessive frequency (5 to 15 sexual acts per day for more than 6 months, from 15 years old). Between 3% and 6% of the adult population (> or =18 years) would have the characteristics of sexual addiction, disorder prevalent in the male population. The addictive processes affect three behavioral domains : motivation-reward, affect regulation and behavioral inhibition. Sex addiction is usually accompanied by other addictions, such as abuse of drugs or alcohol or sex toys that enhance sexual performance. Psychiatric comorbidities can be found : anxiety disorders, mood disorders. Several forms of treatment have been tried, using medication, cognitive-behavioral therapy and psychotherapy sessions alternated with exposure therapy in virtual reality. In this article, we will discuss the multiple definitions of hypersexuality and the possibilities of therapeutic approaches. PMID:23888589

  6. Internet gaming addiction: current perspectives.

    PubMed

    Kuss, Daria J

    2013-01-01

    In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual's context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive for public health care and insurance providers. The holistic approach adopted here not only highlights empirical research that

  7. Internet gaming addiction: current perspectives

    PubMed Central

    Kuss, Daria J

    2013-01-01

    In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual’s context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive for public health care and insurance providers. The holistic approach adopted here not only highlights empirical research that

  8. A new approach in training pre-clinical medical undergraduates in community medicine in Pondicherry, South India.

    PubMed

    Rotti, S B; Soudarssanane, M B; Srinivasa, D K; Kumar, V S; Premarajan, K C; Pradhan, P

    1992-01-01

    Pre-clinical medical undergraduates are taught Community Medicine using a variety of teaching methods keeping the didactic lectures to the minimum in conformity with the latest recommendations of Medical Council of India. Five of the total twelve topics were taught using group discussion during 1988-89. The present paper gives the details of lesson plans for two topics. Evaluation was done based on the results of the written test, opinions expressed by the students and on the spot observation by the faculty members. Suggestions given by the students to improve the sessions have also been highlighted. PMID:1293466

  9. Use of morbidity and mortality conferences to analyze causes of death at sea: a useful tool in the process of training in maritime medicine.

    PubMed

    Vallé, Baptiste; Bounes, Vincent; Dehours, Emilie; Roux, Patrick; Concina, François; Tabarly, Julien; Pujos, Michel; Ducassé, Jean-Louis

    2011-01-01

    BACKGROUND. Morbidity and mortality conferences (MandMC) are collective reviews of records of patients, whose evolution was marked by an undesirable event: death or the occurrence of complications. The MandMC aim to improve the quality of care. This article intends to present three cases analyzed in MandMC in the French Telemedical Assistance Service (TMAS). MATERIAL AND METHODS. Three cases were selected according to the occurrence of a death at sea or according to particular cases of pathology on board. The case presentation was done in plenary session in our French TMAS, describing the facts, analyzing the defective processes, and suggesting possible improvements for each case. RESULTS. Description of 3 cases: Gastroenteritis in Papua New Guinea with septic shock; traumatic brain injury on a training boat with organizational and evacuation problems, and fever in the Gulf of Guinea with negative thick blood smear test. CONCLUSIONS. The MandMC tend to develop in all medical fields and are of particular interest in maritime medicine. The achievement of MandMC in our TMAS highlighted some difficulties in our daily work: diagnosis difficulty in tele-consultation and organizational or operational difficulties related to maritime medicine. However, we hope that the proposals for improvement will be applied to improve the quality of maritime medical care. PMID:21910113

  10. The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan

    PubMed Central

    Shimizu, Taro; Tsugawa, Yusuke; Tanoue, Yusuke; Konishi, Ryota; Nishizaki, Yuji; Kishimoto, Mitsumasa; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2013-01-01

    Background It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven. Objective We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals. Methods To assess the knowledge base of medicine, we conducted the General Medicine InTraining Examination (GM-ITE) for second-year residents in the last month of their residency. The items of the exam were developed based on the outcomes designated by the Japanese Ministry of Health, Labor, and Welfare. The educational environment was evaluated using the Postgraduate Hospital Educational Environment Measure (PHEEM) score, which was assessed by a mailed survey 2 years prior to the exam. A mixed-effects linear regression model was employed for the analysis of variables associated with a higher score. Results Twenty-one teaching hospitals participated in the study and a total of 206 residents (67 women) participated and completed the exam. There were no residents who declined to participate in the exam. The mean GM-ITE score was 58 (standard deviation 8.4). The mixed-effects linear regression analysis showed that a higher PHEEM score was associated with a higher GM-ITE score (P = 0.02). Having a department of general medicine, and hospital location in a provincial community (versus an urban setting), were also shown to have a significant relationship with the higher score (P = 0.03, and P = 0.02, respectively). Conclusion We found that the performance of the medical knowledge base of resident physicians was significantly associated with the educational environment of their hospitals. Improvement of the educational environment in teaching hospitals might be crucial for enhancing the performance of resident physicians in Japan. PMID:23930077

  11. Childhood Food Addiction and the Family

    ERIC Educational Resources Information Center

    Carlisle, Kristy L.; Buser, Juleen K.; Carlisle, Robert M.

    2012-01-01

    Food addiction among children is a concerning issue. Few empirical studies have examined the relevance of food addiction among pediatric samples, but emerging evidence suggests that some children experience their eating patterns as addictive. The present review will discuss the issue of food addiction among children, and will also attend to the…

  12. Improving childhood malaria treatment and referral practices by training patent medicine vendors in rural south-east Nigeria

    PubMed Central

    2009-01-01

    Background Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC) from untrained drug vendors. Self-medication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendors to improve access to early effective malaria treatment, which underscores the need for interventions to improve treatment obtained from these outlets. This study aimed to determine the feasibility and impact of training rural drug vendors on community-based malaria treatment and advice with referral of severe cases to a health facility. Methods A drug vendor-training programme was carried out between 2003 and 2005 in Ugwuogo-Nike, a rural community in south-east Nigeria. A total of 16 drug vendors were trained and monitored for eight months. The programme was evaluated to measure changes in drug vendor practice and knowledge using exit interviews. In addition, home visits were conducted to measure compliance with referral. Results The intervention achieved major improvements in drug selling and referral practices and knowledge. Exit interviews confirmed significant increases in appropriate anti-malarial drug dispensing, correct history questions asked and advice given. Improvements in malaria knowledge was established and 80% compliance with referred cases was observed during the study period, Conclusion The remarkable change in knowledge and practices observed indicates that training of drug vendors, as a means of communication in the community, is feasible and strongly supports their inclusion in control strategies aimed at improving prompt effective treatment of malaria with referral of severe cases. PMID:19930561

  13. A curricular model for the training of physician scientists: the evolution of the Duke University School of Medicine curriculum.

    PubMed

    O'Connor Grochowski, Colleen; Halperin, Edward Charles; Buckley, Edward George

    2007-04-01

    Duke University School of Medicine offers an unusual doctor of medicine educational program. The core basic sciences are taught in year one, core clinical clerkships are completed in the second year, the entire third year is devoted to scholarly investigation, and elective rotations are fulfilled in the fourth year. The creation of this unique structure presented many challenges and is the product of a desire of key faculty 40 years ago to change radically the way medical education was taught. Over the years, improvements have been made, but the underlying principles of these visionary leaders have been retained: inquire not just acquire, flexibility of choice, and in-depth exploration. In the spirit of innovation that was established 40 years ago, leaders and faculty at Duke developed a new curricular model in 2004, called Foundation for Excellence, which is anchored in integrated, interdisciplinary innovation. The authors describe the process of curricular reform and provide a detailed overview of this unique approach to medical education. In keeping with Duke's mission to graduate clinician-researchers and clinician-educators, reducing the basic science curriculum to one year created a year saved, which students are now required to devote to scholarly pursuits. The authors argue that adopting a similar one-year basic science curriculum would make instructional time available for other schools to achieve their own institutional goals. PMID:17414195

  14. Intertemporal bargaining in addiction.

    PubMed

    Ainslie, George

    2013-01-01

    The debate between disease models of addiction and moral or voluntarist models has been endless, and often echoes the equally endless debate between determinism and free will. I suggest here that part of the problem comes from how we picture the function of motivation in self-control. Quantitative experiments in both humans and non-humans have shown that delayed reward loses its effectiveness in proportion to its delay. The resulting instability of preference is best controlled by a recursive self-prediction process, intertemporal bargaining, which is the likely mechanism of both the strength and the experienced freedom of will. In this model determinism is consistent with more elements of free will than compatibilist philosophers have heretofore proposed, and personal responsibility is an inseparable, functional component of will. Judgments of social responsibility can be described as projections of personal responsibility, but normative responsibility in addiction is elusive. The cited publications that are under the author's control can be downloaded from www.picoeconomics.org. PMID:23966954

  15. Treatment of addiction to ethanol and addictive-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2001-01-01

    The present invention provides a highly efficient method for treating alcohol addiction and for changing addiction-related behavior of a mammal suffering from alcohol addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. In one embodiment, the method of the present invention includes administering to the mammal an effective amount of a composition which increase central nervous system GABA levels wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of alcohol.

  16. Cross-Cultural Training in Motivational Interviewing

    ERIC Educational Resources Information Center

    Miller, William R.; Hendrickson, Stacey M. L.; Venner, Kamilla; Bisono, Ani; Daugherty, Mikyta; Yahne, Carolina E.

    2008-01-01

    This study evaluated the cross-cultural transportability of motivational interviewing (MI), an evidence-based addiction treatment method. Free clinical training in MI was offered in separate targeted workshops for 86 African American, Native American, and Spanish-speaking addiction treatment providers. Audiotaped pre- and posttraining clinical…

  17. [Addiction therapy. Limits, problems, perspectives].

    PubMed

    Kalapos, Miklós Péter

    2014-01-01

    In health care, tending is a process, which offers for the patients a continuous watching on, a control, a treatment, and the prevention of worsening of their medical status as well as the reduction of their complaints. In the article, some fundamental segments of tending in addictology are reviewed, particularly paying attention to whom, how, where and how long to take care. On the basis of literature, the author stresses whatever method is used to treat addict patients it is more beneficial to society than the avoidance of any intervention due to the negligence of the problem. Addictology has lost a lot from its power in Hungary. The author recommends the introduction of the methods of health quality assurance to decrease the effect of negative trends seen in addictology. The paper also deals with special patient groups including homeless clients, adolescents, elderly and pregnant patients as well as health care professionals. The author critically mentions the double communication of society, the dual-face character of politics and has the opinion that competences are not clear making the situation confused. As a mistake of the point of view is it regarded that the addictological problems are classified as to belonging to the authority of psychiatry. It is emphasized that multidisciplinary approach is needed to understand the problem and to treat the client. General screening for addictological diseases does not seem possible in the light of low capacity of the system, but the screening of adolescents and pregnant women is definitely recommended. And finally, a financial support for medicines to prevent craving, a moratorium for the continuous changing of rules and law, the sponsoring of harm reduction programs as well as a better utilization of opportunities offered by local drug coordinating boards are proposed. PMID:25411227

  18. Impact of inpatient caseload, emergency department duties, and online learning resource on General Medicine In-Training Examination scores in Japan

    PubMed Central

    Kinoshita, Kensuke; Tsugawa, Yusuke; Shimizu, Taro; Tanoue, Yusuke; Konishi, Ryota; Nishizaki, Yuji; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2015-01-01

    Background Both clinical workload and access to learning resource are important components of educational environment and may have effects on clinical knowledge of residents. Methods We conducted a survey with a clinical knowledge evaluation involving postgraduate year (PGY)-1 and -2 resident physicians at teaching hospitals offering 2-year postgraduate training programs required for residents in Japan, using the General Medicine In-Training Examination (GM-ITE). An individual-level analysis was conducted to examine the impact of the number of assigned patients and emergency department (ED) duty on the residents’ GM-ITE scores by fitting a multivariable generalized estimating equations. In hospital-level analysis, we evaluated the relationship between for the number of UpToDate reviews for each hospital and for the hospitals’ mean GM-ITE score. Results A total of 431 PGY-1 and 618 PGY-2 residents participated. Residents with four or five times per month of the ED duties exhibited the highest mean scores compared to those with greater or fewer ED duties. Those with largest number of inpatients in charge exhibited the highest mean scores compared to the residents with fewer inpatients in charge. Hospitals with the greater UpToDate topic viewing showed significantly greater mean score. Conclusion Appropriate ED workload and inpatient caseload, as well as use of evidence-based electronic resources, were associated with greater clinical knowledge of residents. PMID:26586961

  19. Giving OD Antidote to Those Using Powerful Painkillers Might Save Lives

    MedlinePlus

    ... Medicine Fellowship Program, Addiction Consult Service and Fellow Immersion Training Program, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston University ...

  20. Transcriptional Mechanisms of Drug Addiction

    PubMed Central

    2012-01-01

    Regulation of gene expression is considered a plausible mechanism of drug addiction given the stability of behavioral abnormalities that define an addicted state. Numerous transcription factors, proteins that bind to regulatory regions of specific genes and thereby control levels of their expression, have been implicated in the addiction process over the past decade or two. Here we review the growing evidence for the role played by several prominent transcription factors, including a Fos family protein (ΔFosB), cAMP response element binding protein (CREB), and nuclear factor kappa B (NFκB), among several others, in drug addiction. As will be seen, each factor displays very different regulation by drugs of abuse within the brain's reward circuitry, and in turn mediates distinct aspects of the addiction phenotype. Current efforts are geared toward understanding the range of target genes through which these transcription factors produce their functional effects and the underlying molecular mechanisms involved. This work promises to reveal fundamentally new insight into the molecular basis of addiction, which will contribute to improved diagnostic tests and therapeutics for addictive disorders. PMID:23430970

  1. Effects of Six Weeks of Medicine Ball Training on Throwing Velocity, Throwing Precision, and Isokinetic Strength of Shoulder Rotators in Female Handball Players.

    PubMed

    Raeder, Christian; Fernandez-Fernandez, Jaime; Ferrauti, Alexander

    2015-07-01

    The aim of this study was to investigate the effects of 6 weeks of medicine ball training (MBT) on throwing velocity, throwing precision, and isokinetic strength of shoulder rotators in competitive female handball players. Twenty-eight players (mean ± SD; age: 20.8 ± 3.3 years, height: 170.5 ± 5.6 cm, body mass: 65.2 ± 8.0 kg) were randomly assigned to an MBT group (TG; n = 15) and a control group (CG; n = 13). TG performed a supervised MBT program, 3 times a week for a total of 6 weeks, focusing on handball-specific movement patterns. Both groups, TG and CG, also conducted a supervised shoulder injury prevention program with elastic tubes, as part of the warm-up, finishing with regular handball throws. Results showed a significant group × time interaction in throwing velocity (p < 0.001) with the TG posttest results being significantly higher compared with CG (d = 2.1), and also a significant main time effect (p < 0.001), with an increase in throwing velocity of 14% (d = 3.0) and 3.7% (d = 0.3) for both TG and CG, respectively. Throwing precision did not significantly differ between groups and time points. Isokinetic strength measures revealed a significant group × time interaction (p ≤ 0.05) with the TG posttest results being significantly higher compared with CG (d = 0.9) and also a significant main time effect (p < 0.01) with an increase of 15% (d = 0.9) in concentric shoulder internal rotation at 180°·s⁻¹ in the dominant arm in TG, whereas no significant changes occurred in CG. The present results indicate that 6 weeks of MBT elicit significant improvements in functional performance (i.e., throwing velocity) in female handball players, whereas throwing precision remained unaffected. Medicine ball training exercises seem to be a useful and inexpensive strength training strategy in enhancing functional performance by closely mimicking sport-specific movement activities. PMID:26102258

  2. Genetic signatures of heroin addiction

    PubMed Central

    Chen, Shaw-Ji; Liao, Ding-Lieh; Shen, Tsu-Wang; Yang, Hsin-Chou; Chen, Kuang-Chi; Chen, Chia-Hsiang

    2016-01-01

    Abstract Heroin addiction is a complex psychiatric disorder with a chronic course and a high relapse rate, which results from the interaction between genetic and environmental factors. Heroin addiction has a substantial heritability in its etiology; hence, identification of individuals with a high genetic propensity to heroin addiction may help prevent the occurrence and relapse of heroin addiction and its complications. The study aimed to identify a small set of genetic signatures that may reliably predict the individuals with a high genetic propensity to heroin addiction. We first measured the transcript level of 13 genes (RASA1, PRKCB, PDK1, JUN, CEBPG, CD74, CEBPB, AUTS2, ENO2, IMPDH2, HAT1, MBD1, and RGS3) in lymphoblastoid cell lines in a sample of 124 male heroin addicts and 124 male control subjects using real-time quantitative PCR. Seven genes (PRKCB, PDK1, JUN, CEBPG, CEBPB, ENO2, and HAT1) showed significant differential expression between the 2 groups. Further analysis using 3 statistical methods including logistic regression analysis, support vector machine learning analysis, and a computer software BIASLESS revealed that a set of 4 genes (JUN, CEBPB, PRKCB, ENO2, or CEBPG) could predict the diagnosis of heroin addiction with the accuracy rate around 85% in our dataset. Our findings support the idea that it is possible to identify genetic signatures of heroin addiction using a small set of expressed genes. However, the study can only be considered as a proof-of-concept study. As the establishment of lymphoblastoid cell line is a laborious and lengthy process, it would be more practical in clinical settings to identify genetic signatures for heroin addiction directly from peripheral blood cells in the future study. PMID:27495086

  3. Genetic signatures of heroin addiction.

    PubMed

    Chen, Shaw-Ji; Liao, Ding-Lieh; Shen, Tsu-Wang; Yang, Hsin-Chou; Chen, Kuang-Chi; Chen, Chia-Hsiang

    2016-08-01

    Heroin addiction is a complex psychiatric disorder with a chronic course and a high relapse rate, which results from the interaction between genetic and environmental factors. Heroin addiction has a substantial heritability in its etiology; hence, identification of individuals with a high genetic propensity to heroin addiction may help prevent the occurrence and relapse of heroin addiction and its complications. The study aimed to identify a small set of genetic signatures that may reliably predict the individuals with a high genetic propensity to heroin addiction. We first measured the transcript level of 13 genes (RASA1, PRKCB, PDK1, JUN, CEBPG, CD74, CEBPB, AUTS2, ENO2, IMPDH2, HAT1, MBD1, and RGS3) in lymphoblastoid cell lines in a sample of 124 male heroin addicts and 124 male control subjects using real-time quantitative PCR. Seven genes (PRKCB, PDK1, JUN, CEBPG, CEBPB, ENO2, and HAT1) showed significant differential expression between the 2 groups. Further analysis using 3 statistical methods including logistic regression analysis, support vector machine learning analysis, and a computer software BIASLESS revealed that a set of 4 genes (JUN, CEBPB, PRKCB, ENO2, or CEBPG) could predict the diagnosis of heroin addiction with the accuracy rate around 85% in our dataset. Our findings support the idea that it is possible to identify genetic signatures of heroin addiction using a small set of expressed genes. However, the study can only be considered as a proof-of-concept study. As the establishment of lymphoblastoid cell line is a laborious and lengthy process, it would be more practical in clinical settings to identify genetic signatures for heroin addiction directly from peripheral blood cells in the future study. PMID:27495086

  4. The national portfolio of learning for postgraduate family medicine training in South Africa: experiences of registrars and supervisors in clinical practice

    PubMed Central

    2013-01-01

    Background In South Africa the submission of a portfolio of learning has become a national requirement for assessment of family medicine training. A national portfolio has been developed, validated and implemented. The aim of this study was to explore registrars’ and supervisors’ experience regarding the portfolio’s educational impact, acceptability, and perceived usefulness for assessment of competence. Methods Semi-structured interviews were conducted with 17 purposively selected registrars and supervisors from all eight South African training programmes. Results The portfolio primarily had an educational impact through making explicit the expectations of registrars and supervisors in the workplace. This impact was tempered by a lack of engagement in the process by registrars and supervisors who also lacked essential skills in reflection, feedback and assessment. The acceptability of the portfolio was limited by service delivery demands, incongruence between the clinical context and educational requirements, design of the logbook and easy availability of the associated tools. The use of the portfolio for formative assessment was strongly supported and appreciated, but was not always happening and in some cases registrars had even organised peer assessment. Respondents were unclear as to how the portfolio would be used for summative assessment. Conclusions The learning portfolio had a significant educational impact in shaping work-place based supervision and training and providing formative assessment. Its acceptability and usefulness as a learning tool should increase over time as supervisors and registrars become more competent in its use. There is a need to clarify how it will be used in summative assessment. PMID:24207009

  5. The forgotten educational needs of the house staff: training internal medicine residents to address end-of-life issues.

    PubMed

    Kerai, Sara Moore; Wheeler, Margot

    2013-01-01

    An intervention was conducted, aimed at providing residents in internal medicine with communication skills to address end-of-life issues with patients. Residents participated in two 1-hour educational sessions designed to teach a communication protocol, enhance listening skills, and to provide practice in effective communication in a safe, small-group format. An anonymous on-line survey assessed the effectiveness of the intervention. Twenty-five residents completed the intervention. There was a trend toward increased comfort level in addressing end-of-life issues among residents who completed the intervention, versus a comparison group. Residents who completed the intervention reported that using the words "death" and "dying" with patients and families was an important teaching point. PMID:23977790

  6. Opiate Addicted and Non-Addicted Siblings in a Slum Area

    ERIC Educational Resources Information Center

    Glaser, Daniel; And Others

    1971-01-01

    Compares addicted and non-addicted siblings of families residing in and around a slum block in New York. Data supporting an ideographic relative deprivation-differential anticipation" explanation for current opiate addiction in the U. S. was produced. (JM)

  7. Considering the Definition of Addiction

    PubMed Central

    Sussman, Steve; Sussman, Alan N.

    2011-01-01

    The definition of addiction is explored. Elements of addiction derived from a literature search that uncovered 52 studies include: (a) engagement in the behavior to achieve appetitive effects, (b) preoccupation with the behavior, (c) temporary satiation, (d) loss of control, and (e) suffering negative consequences. Differences from compulsions are suggested. While there is some debate on what is intended by the elements of addictive behavior, we conclude that these five constituents provide a reasonable understanding of what is intended by the concept. Conceptual challenges for future research are mentioned. PMID:22073026

  8. Epigenetic Mechanisms of Drug Addiction

    PubMed Central

    Feng, Jian; Nestler, Eric J.

    2013-01-01

    Epigenetic regulation can mediate long-lasting changes in gene expression, which makes it an attractive mechanism for the stable behavioral abnormalities that characterize drug addiction. Recent research has unveiled numerous types of epigenetic modifications within the brain’s reward circuitry in animal models of drug addiction. In this review, we summarize the latest advances in the field, focusing on histone modifications, DNA methylation, and non-coding RNAs. We also highlight several areas for future research. Unraveling the highly complex epigenetic mechanisms of addiction is adding to our understanding of this syndrome and has the potential to trigger novel approaches for better diagnosis and therapy. PMID:23374537

  9. Drug addiction and periodontal diseases

    PubMed Central

    Saini, Gurpreet Kaur; Gupta, N. D.; Prabhat, K. C.

    2013-01-01

    The prevalence of drug addiction is increasing globally. Drug abuse damages many parts of the body such as oral cavity, lungs, liver, brain, heart etc., Addicts suffer from physical, psychological, emotional and behavioral problems. Their nutrition is also compromised. There is certainly an impact of all these factors on the health of periodontium. Dentists should be aware of the effects of drugs while treating the drug addicts. This article correlates the studies done on the impact of abused drugs such as alcohol, tobacco, opiates, cannabis, amphetamines etc., on general and periodontal health. PMID:24174750

  10. Mothering through addiction: a survival strategy among Puerto Rican addicts.

    PubMed

    Hardesty, M; Black, T

    1999-09-01

    In this article, the importance of motherhood in the lives of Puerto Rican addicts is examined. Using a life history method, the authors interviewed 20 Latina females in various stages of recovery from addiction to crack-cocaine or heroin. Their lives as mothers took place in a context of poverty, marginalization, and abuse. Motherhood provided an identity and a line of work that grounded them amidst this dislocation. As their life options became more restricted over time, motherhood provided a lifeline through addiction and into recovery. While using drugs, they relied on a number of strategies to maintain mothering. In recovery, children became the markers of success in a treatment program. These findings challenge public images of female addicts as parents. PMID:10558370

  11. Is the Current BST ePortfolio fulfilling its Role in the Training of Clinical Medicine SHOs?

    PubMed

    Grennan, S; Crowley, S; Quidwai, S; Barrett, O; Kooblall, M

    2016-01-01

    While the objective recording of clinical competencies in an electronic portfolio (ePortfolio) has become a key aspect of basic specialist training (BST), it continues to divide opinion. We surveyed medical trainees and their supervisors in the Dublin region examining their views of the ePortfolio and workplace-based assessments (WPBAs). Responses were received from 27 of 149 (18.1%) SHOs and 24 of 307 (7.9%) consultants. Our results highlight significant dissatisfaction amongst trainees with 20 (74.1%) stating that the ePortfolio is not an effective educational tool. Consultants had more mixed views. While 16 (66.7%) reported that feedback sessions were useful for trainee development, only 4 (16.7%) found the ePortfolio to be useful in highlighting trainees' strengths and weaknesses. Although other studies have emphasised its educational potential, our results suggest that practical barriers, such as time constraints and a lack of training, lead to poor engagement and a negative view of the ePortfolio. PMID:26904792

  12. Treatment of addiction and addiction-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2003-07-15

    The present invention provides a method for changing addiction-related behavior of a mammal suffering from addiction to a combination of abused drugs. The method includes administering to the mammal an effective amount of gamma vinylGABA (GVG) or a pharmaceutically acceptable salt thereof, or an enantiomer or a racemic mixture thereof, wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of the combination of abused drugs.

  13. Treatment of PCP addiction and PCP addiction-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2002-01-01

    The present invention provides a method for changing addiction-related behavior of a mammal suffering from addiction to phencyclidine (PCP). The method includes administering to the mammal an effective amount of gamma vinylGABA (GVG) or a pharmaceutically acceptable salt thereof, or an enantiomer or a racemic mixture thereof, wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of PCP.

  14. Mechanisms of Nicotine Addiction

    SciTech Connect

    McGehee, Daniel

    2002-06-26

    Nicotine reinforces the use of tobacco products primarily through its interaction with specific receptor proteins within the brain's reward centers. A critical step in the process of addiction for many drugs, including nicotine, is the release of the neurotransmitter dopamine. A single nicotine exposure will enhance dopamine levels for hours, however, nicotinic receptors undergo both activation and then desensitization in minutes, which presents an important problem. How does the time course of receptor activity lead to the prolonged release of dopamine? We have found that persistent modulation of both inhibitory and excitatory synaptic connections by nicotine underlies the sustained increase in dopamine release. Because these inputs express different types of nicotinic receptors there is a coordinated shift in the balance of synaptic inputs toward excitation of the dopamine neurons. Excitatory inputs are turned on while inhibitory inputs are depressed, thereby boosting the brain's reward system.

  15. Mechanisms of Nicotine Addiction

    SciTech Connect

    McGehee, Daniel

    2009-06-26

    Nicotine reinforces the use of tobacco products primarily through its interaction with specific receptor proteins within the brain’s reward centers. A critical step in the process of addiction for many drugs, including nicotine, is the release of the neurotransmitter dopamine. A single nicotine exposure will enhance dopamine levels for hours, however, nicotinic receptors undergo both activation and then desensitization in minutes, which presents an important problem. How does the time course of receptor activity lead to the prolonged release of dopamine? We have found that persistent modulation of both inhibitory and excitatory synaptic connections by nicotine underlies the sustained increase in dopamine release. Because these inputs express different types of nicotinic receptors there is a coordinated shift in the balance of synaptic inputs toward excitation of the dopamine neurons. Excitatory inputs are turned on while inhibitory inputs are depressed, thereby boosting the brain’s reward system.

  16. Clinical Space Medicine Panel

    NASA Technical Reports Server (NTRS)

    Baisden, Denise L.; Billica, Roger (Technical Monitor)

    2000-01-01

    The practice of space medicine is diverse. It includes routine preventive medical care of astronauts and pilots, the development of inflight medical capability and training of flight crews as well as the preflight, inflight, and postflight medical assessment and monitoring. The Johnson Space Center Medical Operations Branch is a leader in the practice of space medicine. The papers presented in this panel will demonstrate some of the unique aspects of space medicine.

  17. Correlation of the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination Given in July to Intern American Board of Emergency Medicine in-training Examination Scores: A Predictor of Performance?

    PubMed Central

    Hiller, Katherine; Franzen, Doug; Heitz, Corey; Emery, Matthew; Poznanski, Stacy

    2015-01-01

    Introduction There is great variation in the knowledge base of Emergency Medicine (EM) interns in July. The first objective knowledge assessment during residency does not occur until eight months later, in February, when the American Board of EM (ABEM) administers the in-training examination (ITE). In 2013, the National Board of Medical Examiners (NBME) released the EM Advanced Clinical Examination (EM-ACE), an assessment intended for fourth-year medical students. Administration of the EM-ACE to interns at the start of residency may provide an earlier opportunity to assess the new EM residents’ knowledge base. The primary objective of this study was to determine the correlation of the NBME EM-ACE, given early in residency, with the EM ITE. Secondary objectives included determination of the correlation of the United States Medical Licensing Examination (USMLE) Step 1 or 2 scores with early intern EM-ACE and ITE scores and the effect, if any, of clinical EM experience on examination correlation. Methods This was a multi-institutional, observational study. Entering EM interns at six residencies took the EM-ACE in July 2013 and the ABEM ITE in February 2014. We collected scores for the EM-ACE and ITE, age, gender, weeks of clinical EM experience in residency prior to the ITE, and USMLE Step 1 and 2 scores. Pearson’s correlation and linear regression were performed. Results Sixty-two interns took the EM-ACE and the ITE. The Pearson’s correlation coefficient between the ITE and the EM-ACE was 0.62. R-squared was 0.5 (adjusted 0.4). The coefficient of determination was 0.41 (95% CI [0.3–0.8]). For every increase of one in the scaled EM-ACE score, we observed a 0.4% increase in the EM in-training score. In a linear regression model using all available variables (EM-ACE, gender, age, clinical exposure to EM, and USMLE Step 1 and Step 2 scores), only the EM-ACE score was significantly associated with the ITE (p<0.05). We observed significant colinearity among the EM

  18. Tobacco Addiction: Diagnosis and Treatment

    PubMed Central

    Hatsukami, Dorothy K.; Stead, Lindsay F.; Gupta, Prakash C.

    2015-01-01

    Tobacco use is associated with 5 million deaths per year worldwide and is considered as one of the leading causes of premature death. Comprehensive tobacco control programs can significantly reduce the prevalence of tobacco use. An important component of a comprehensive program is the provision of treatment for tobacco addiction. Treatment involves targeting multiple aspects of addiction including the underlying neurobiology and behavioral processes. Furthermore, building an infrastructure in health systems that encourage and facilitate cessation and expanding the accessibility of treatments are necessary. While current pharmacological and behavioral treatments are effective in improving cessation success, the rate of relapse to smoking remains high, demonstrating the strong addictive nature of nicotine. The future of treatment resides in better patient matching to treatment, combination or novel medications, and conceptualizing nicotine addiction as a chronic disorder which may require long-term treatment. PMID:18555914

  19. [Addictive behavior among the elderly].

    PubMed

    Menecier, Pascal; Fernandez, Lydia

    2012-12-01

    Addictive behavior still persists among the elderly, mainly concerning substance abuse, such as alcohol, tobacco or psychotropic drugs and addictive practices such as gambling. Illegal substances or cyber-addictions appear much less often. The environment (place of residence or care) and/or economic factors may influence behavior and practices. The incidence of somatic illness or psychiatric disorders, such as cognitive impairment among the elderly patients, complicates even further the presentation of addictive disorders and their treatment. The age factor does not seem to lessen the suffering felt by the patient and care is required in an equal manner for all ages. Prevention (maintenance of personal autonomy and quality of life throughout the ageing process) plays an essential role along with the offer of care. The lack of scientific data such as the absence of validation for adult care among the elderly, leave wide scope for epidemiological, clinical and theoretical research. PMID:23040954

  20. Understanding Drug Abuse and Addiction

    MedlinePlus

    ... addiction. For example: Photo by © Aleshyn_Andrei /Shutterstock Biology . The genes that people are born with account ... Passes Tests in Animals Childhood Maltreatment Changes Cortical Network Architecture and May Raise Risk for Substance Use ...

  1. Cocaine Addiction: Psychology and Neurophysiology.

    ERIC Educational Resources Information Center

    Gawin, Frank H.

    1991-01-01

    The clinical characteristics of cocaine addiction, cocaine abstinence symptoms, and the short-term and long-term neurochemical actions of cocaine are discussed. The relative therapeutic value of various medications and treatment programs are discussed. (KR)

  2. Treatment Approaches for Drug Addiction

    MedlinePlus

    ... Charts Emerging Trends and Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine ... Scientists are developing other medications to treat stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. People who use ...

  3. Attentional bias modification for addictive behaviors: clinical implications.

    PubMed

    Cox, W Miles; Fadardi, Javad S; Intriligator, James M; Klinger, Eric

    2014-06-01

    When a person has a goal of drinking alcohol or using another addictive substance, the person appears to be automatically distracted by stimuli related to the goal. Because the attentional bias might propel the person to use the substance, an intervention might help modify it. In this article, we discuss techniques that have been developed to help people overcome their attentional bias for alcohol, smoking-related stimuli, drugs, or unhealthy food. We also discuss how these techniques are being adapted for use on mobile devices. The latter would allow people with an addictive behavior to use the attentional training in privacy and as frequently as needed. The attentional training techniques discussed here appear to have several advantages. They are inexpensive, can be fun to use, and have flexibility in when, where, and how often they are used. The evidence so far also suggests that they are effective. PMID:24642267

  4. Breaking barriers in the genomics and pharmacogenetics of drug addiction.

    PubMed

    Ho, M K; Goldman, D; Heinz, A; Kaprio, J; Kreek, M J; Li, M D; Munafò, M R; Tyndale, R F

    2010-12-01

    Drug addiction remains a substantial health issue with limited treatment options currently available. Despite considerable advances in the understanding of human genetic architecture, the genetic underpinning of complex disorders remains elusive. On the basis of our current understanding of neurobiology, numerous candidate genes have been implicated in the etiology and response to treatment for different addictions. Genome-wide association (GWA) studies have also identified novel targets. However, replication of these studies is often lacking, and this complicates interpretation. The situation is expected to improve as issues such as phenotypic characterization, the apparent "missing heritability," the identification of functional variants, and possible gene-environment (G × E) interactions are addressed. In addition, there is growing evidence that genetic information can be useful in refining the choice of addiction treatment. As genetic testing becomes more common in the practice of medicine, a variety of ethical and practical challenges, some of which are unique to drug addiction, will also need to be considered. PMID:20981002

  5. Substance abuse precedes Internet addiction.

    PubMed

    Lee, Young Sik; Han, Doug Hyun; Kim, Sun Mi; Renshaw, Perry F

    2013-04-01

    The purpose of the current study was to evaluate possible overlapping substance abuse and internet addiction in a large, uniformly sampled population, ranging in age from 13 to 18 years. Participants (N=73,238) in the current study were drawn from the 6th Korea Youth Risk Behavior Web-based Survey (KYRBWS-V) for students from 400 middle schools and 400 high schools in 16 cities within South Korea. Of adolescent internet users, 85.2% were general users (GU), 11.9% were users with potential risk for internet addiction (PR), and 3.0% were users with high risk for internet addiction (HR). There was a difference in the number of students with alcohol drinking among the GU, PR, and HR groups (20.8% vs 23.1% vs 27.4%). There was a difference in the number of students who smoked among the GS, PR, and HR groups (11.7% vs 13.5% vs 20.4%). There was a difference in the number of students with drug use among the GU, PR, and HR groups (1.7% vs 2.0% vs 6.5%). After adjusting for sex, age, stress, depressed mood, and suicidal ideation, smoking may predict a high risk for internet addiction (OR=1.203, p=0.004). In addition, drug use may predict a high risk for internet addiction (OR=2.591, p<0.001). Because students with a high risk for internet addiction have vulnerability for addictive behaviors, co-morbid substance abuse should be evaluated and, if found, treated in adolescents with internet addiction. PMID:23384457

  6. Palliative medicine in Britain.

    PubMed

    Doyle, Derek

    In Britain, Palliative Medicine was recognized as a subspecialty of Internal Medicine exactly 20 years after Cicely Saunders founded St Christopher's, at exactly the same time that government was at last recognizing the worth and the needs of general practice. Both had far-reaching effects and implications for patients, doctors, and the future of medicine. For Palliative Medicine it meant units wishing to train specialists going through a rigorous selection process; the development of an equally rigorous training program for the doctors who had already gained a higher qualification before starting Palliative Medicine, demonstrating the need for and benefits of palliative medicine to the sceptics in the profession and, now, continuing to recruit the staff for the steadily increasing number of new services. Today there are more Palliative Medicine consultants/specialists than there are oncologists and neurologists combined, with Hospital Palliative Care Teams in every major hospital and cancer center. With nine Chairs in Palliative Medicine, there is now a drive for research and professional education. The specialty faces major challenges, however, ranging from training to care for patients with non-malignant disease to enabling patients to die in the place of their choice-something that rarely happens today; from defining what is distinctive or unique about palliative medicine to clarifying the respective place of general practice and the specialty. Most would agree that the biggest challenge for the young, thriving specialty is how to share its principles with other doctors wherever they work. PMID:18051021

  7. Nuclear Medicine

    MedlinePlus

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  8. Exercise rehabilitation for smartphone addiction

    PubMed Central

    Kim, Hyunna

    2013-01-01

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction. PMID:24409425

  9. Addiction: Beyond dopamine reward circuitry

    SciTech Connect

    Volkow, N.D.; Wang, G.; Volkow, N.D.; Wang, G.-J.; Fowler, J.S.; Tomasi, D.; Telang, F.

    2011-09-13

    Dopamine (DA) is considered crucial for the rewarding effects of drugs of abuse, but its role in addiction is much less clear. This review focuses on studies that used PET to characterize the brain DA system in addicted subjects. These studies have corroborated in humans the relevance of drug-induced fast DA increases in striatum [including nucleus accumbens (NAc)] in their rewarding effects but have unexpectedly shown that in addicted subjects, drug-induced DA increases (as well as their subjective reinforcing effects) are markedly blunted compared with controls. In contrast, addicted subjects show significant DA increases in striatum in response to drug-conditioned cues that are associated with self-reports of drug craving and appear to be of a greater magnitude than the DA responses to the drug. We postulate that the discrepancy between the expectation for the drug effects (conditioned responses) and the blunted pharmacological effects maintains drug taking in an attempt to achieve the expected reward. Also, whether tested during early or protracted withdrawal, addicted subjects show lower levels of D2 receptors in striatum (including NAc), which are associated with decreases in baseline activity in frontal brain regions implicated in salience attribution (orbitofrontal cortex) and inhibitory control (anterior cingulate gyrus), whose disruption results in compulsivity and impulsivity. These results point to an imbalance between dopaminergic circuits that underlie reward and conditioning and those that underlie executive function (emotional control and decision making), which we postulate contributes to the compulsive drug use and loss of control in addiction.

  10. Exercise rehabilitation for smartphone addiction.

    PubMed

    Kim, Hyunna

    2013-01-01

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction. PMID:24409425

  11. Addiction surplus: the add-on margin that makes addictive consumptions difficult to contain.

    PubMed

    Adams, Peter J; Livingstone, Charles

    2015-01-01

    Addictive consumptions generate financial surpluses over-and-above non-addictive consumptions because of the excessive consumption of addicted consumers. This add-on margin or 'addiction surplus' provides a powerful incentive for beneficiaries to protect their income by ensuring addicted consumers keep consuming. Not only that, addiction surplus provides the financial base that enables producers to sponsor activities which aim to prevent public health initiatives from reducing consumption. This paper examines the potency of addiction surplus to engage industry, governments and communities in an on-going reliance on addiction surplus. It then explores how neo-liberal constructions of a rational consumer disguise the ethical and exploitative dynamics of addiction surplus by examining ways in which addictive consumptions fail to conform to notions of autonomy and rationality. Four measures are identified to contain the distorting effects of addiction surplus. PMID:25175598

  12. Predictors of addiction treatment providers' beliefs in the disease and choice models of addiction.

    PubMed

    Russell, Christopher; Davies, John B; Hunter, Simon C

    2011-03-01

    Addiction treatment providers working in the United States (n = 219) and the United Kingdom (n = 372) were surveyed about their beliefs in the disease and choice models of addiction, as assessed by the 18-item Addiction Belief Scale of J. Schaler (1992). Factor analysis of item scores revealed a three-factor structure, labeled "addiction is a disease," "addiction is a choice," and "addiction is a way of coping with life," and factor scores were analyzed in separate hierarchical multiple regression analyses. Controlling for demographic and addiction history variables, treatment providers working in the United States more strongly believe addiction is a disease, whereas U.K.-based providers more strongly believe that addiction is a choice and a way of coping with life. Beliefs that addiction is a disease were stronger among those who provide for-profit treatment, have stronger spiritual beliefs, have had a past addiction problem, are older, are members of a group of addiction professionals, and have been treating addiction longer. Conversely, those who viewed addiction as a choice were more likely to provide public/not-for-profit treatment, be younger, not belong to a group of addiction professionals, and have weaker spiritual beliefs. Additionally, treatment providers who have had a personal addiction problem in the past were significantly more likely to believe addiction is a disease the longer they attend a 12-step-based group and if they are presently abstinent. PMID:21036516

  13. [Addiction--who is not affected?].

    PubMed

    Bäwert, Andjela; Fischer, Gabriele

    2005-12-01

    Addiction and addiction-related behaviour increased during the past decades. Several substances with psychoactive attributes, like opioids, cocaine or alcohol, can lead to dependence with physical and/or mental symptoms. In addition to substance-related addiction, non-substance-related dependence requires special attention. Increasing numbers of workaholics and patients suffering from internet-addiction, gambling or eating-disorders can be observed. To meet international treatment standards for addiction, diversification of therapy is necessary and, additionally, gender-related aspects in development and treatment of dependence and addiction-related behaviour are essential for state-of-the-art therapy of this patient population. PMID:16425010

  14. A Framework for the Specificity of Addictions

    PubMed Central

    Sussman, Steve; Leventhal, Adam; Bluthenthal, Ricky N.; Freimuth, Marilyn; Forster, Myriam; Ames, Susan L.

    2011-01-01

    Research over the last two decades suggests that a wide range of substance and behavioral addictions may serve similar functions. Yet, co-occurrence of addictions has only been reported among a minority of addicts. “Addiction specificity” pertains to a phenomenon in which one pattern of addictive behaviors may be acquired whereas another is not. This paper presents the PACE model as a framework which might help explain addiction specificity. Pragmatics, attraction, communication, and expectation (PACE) variables are described, which may help give some direction to future research needs in this arena. PMID:21909314

  15. Design and evaluation of an IPE module at the beginning of professional training in medicine, nursing, and physiotherapy

    PubMed Central

    Zirn, Lena; Körner, Mirjam; Luzay, Leonie; Sandeck, Florian; Müller-Fröhlich, Christa; Straub, Christine; Stößel, Ulrich; Silbernagel, Waltraud; Fischer, Julia

    2016-01-01

    Aim: Interprofessional education (IPE) is a central feature of modern education in the health care professions. Despite this, empirically founded and systematically structured IPE courses are absent from many curricula. To answer the WHO’s call for improved interprofessional collaboration in the health care system, a seminar was designed, implemented and evaluated. The target group consisted of students beginning nursing and medical studies (first and second semesters) and physiotherapy students (first year of training). The aim was to develop a basic IPE module focusing not only on the demands placed by academia and politics, but also the interests of the target group. This module was evaluated on the basis of the modified four-level Kirkpatrick approach. Method: Based on focus group interviews analyzed qualitatively using Mayring’s content analysis, it was possible to define five learning objectives and develop four practice-oriented modules. The seminar was then implemented and evaluated using written pre- and post-seminar evaluations and group discussions. Results: Analysis confirmed the success of the IPE concept in that the seminar was positively rated by attendees not only in terms of their immediate reactions, but also attitude, knowledge and skills according to Kirkpatrick. Conclusion: In the future, it is intended to offer the IPE module on a permanent basis and assess the competencies acquired in the seminar using observation. Courses to ensure sustained learning outcomes would also be desirable. PMID:27280135

  16. Substitution treatment for opioid addicts in Germany

    PubMed Central

    Michels, Ingo Ilja; Stöver, Heino; Gerlach, Ralf

    2007-01-01

    Background After a long and controversial debate methadone maintenance treatment (MMT) was first introduced in Germany in 1987. The number of patients in MMT – first low because of strict admission criteria – increased considerably since the 1990s up to some 65,000 at the end of 2006. In Germany each general practitioner (GP), who has completed an additional training in addiction medicine, is allowed to prescribe substitution drugs to opioid dependent patients. Currently 2,700 GPs prescribe substitution drugs. Psychosocial care should be made available to all MMT patients. Results The results of research studies and practical experiences clearly indicate that patients benefit substantially from MMT with improvements in physical and psychological health. MMT proves successful in attaining high retention rates (65 % to 85 % in the first years, up to 50 % after more than seven years) and plays a major role in accessing and maintaining ongoing medical treatment for HIV and hepatitis. MMT is also seen as a vital factor in the process of social re-integration and it contributes to the reduction of drug related harms such as mortality and morbidity and to the prevention of infectious diseases. Some 10 % of MMT patients become drug-free in the long run. Methadone is the most commonly prescribed substitution medication in Germany, although buprenorphine is attaining rising importance. Access to MMT in rural areas is very patchy and still constitutes a problem. There are only few employment opportunities for patients participating in MMT, although regular employment is considered unanimously as a positive factor of treatment success. Substitution treatment in German prisons is heterogeneous in access and treatment modalities. Access is very patchy and the number of inmates in treatment is limited. Nevertheless, substitution treatment plays a substantial part in the health care system provided to drug users in Germany. Conclusion In Germany, a history of substitution

  17. Wilderness Medicine Newsletter, 1996.

    ERIC Educational Resources Information Center

    Weber, Holly A., Ed.; And Others

    1996-01-01

    This document consists of the six issues of the "Wilderness Medicine Newsletter" published during 1996. The newsletter addresses the treatment and prevention of medical emergencies in the wilderness and training resources. Issues typically include feature articles, interviews with doctors in the wilderness, conferences and training courses,…

  18. Epigenetic Mechanisms of Drug Addiction

    PubMed Central

    Nestler, Eric J.

    2013-01-01

    Drug addiction involves potentially life-long behavioral abnormalities that are caused in vulnerable individuals by repeated exposure to a drug of abuse. The persistence of these behavioral changes suggests that long-lasting changes in gene expression, within particular regions of the brain, may contribute importantly to the addiction phenotype. Work over the past decade has demonstrated a crucial role for epigenetic mechanisms in driving lasting changes in gene expression in diverse tissues, including brain. This has prompted recent research aimed at characterizing the influence of epigenetic regulatory events in mediating the lasting effects of drugs of abuse on the brain in animal models of drug addiction. This review provides a progress report of this still early work in the field. As will be seen, there is robust evidence that repeated exposure to drugs of abuse induces changes within the brain’s reward regions in three major modes of epigenetic regulation—histone modifications such as acetylation and methylation, DNA methylation, and non-coding RNAs. In several instances, it has been possible to demonstrate directly the contribution of such epigenetic changes to addiction-related behavioral abnormalities. Studies of epigenetic mechanisms of addiction are also providing an unprecedented view of the range of genes and non-genic regions that are affected by repeated drug exposure and the precise molecular basis of that regulation. Work is now needed to validate key aspects of this work in human addiction and evaluate the possibility of mining this information to develop new diagnostic tests and more effective treatments for addiction syndromes. PMID:23643695

  19. Epigenetic mechanisms of drug addiction.

    PubMed

    Nestler, Eric J

    2014-01-01

    Drug addiction involves potentially life-long behavioral abnormalities that are caused in vulnerable individuals by repeated exposure to a drug of abuse. The persistence of these behavioral changes suggests that long-lasting changes in gene expression, within particular regions of the brain, may contribute importantly to the addiction phenotype. Work over the past decade has demonstrated a crucial role for epigenetic mechanisms in driving lasting changes in gene expression in diverse tissues, including brain. This has prompted recent research aimed at characterizing the influence of epigenetic regulatory events in mediating the lasting effects of drugs of abuse on the brain in animal models of drug addiction. This review provides a progress report of this still early work in the field. As will be seen, there is robust evidence that repeated exposure to drugs of abuse induces changes within the brain's reward regions in three major modes of epigenetic regulation-histone modifications such as acetylation and methylation, DNA methylation, and non-coding RNAs. In several instances, it has been possible to demonstrate directly the contribution of such epigenetic changes to addiction-related behavioral abnormalities. Studies of epigenetic mechanisms of addiction are also providing an unprecedented view of the range of genes and non-genic regions that are affected by repeated drug exposure and the precise molecular basis of that regulation. Work is now needed to validate key aspects of this work in human addiction and evaluate the possibility of mining this information to develop new diagnostic tests and more effective treatments for addiction syndromes. This article is part of a Special Issue entitled 'NIDA 40th Anniversary Issue'. PMID:23643695

  20. The Globalization of Addiction Research: Capacity Building Mechanisms and Selected Examples

    PubMed Central

    Rawson, Richard A.; Woody, George; Kresina, Thomas F.; Gust, Steve

    2014-01-01

    Over the past decade, the amount and variety of addiction research around the world has increased substantially. Researchers in the United States, Western Europe, United Kingdom, Canada, and Australia have significantly contributed to knowledge about addiction and its treatment. However, the nature and context of substance use disorders (SUDs) and the populations using drugs are far more diverse than is reflected in studies done in Western cultures. To stimulate new research from a diverse set of cultural perspectives, the National Institute on Drug Abuse (NIDA) has promoted the development of addiction research capacity and skills around the world for over 25 years. This review will describe the programs NIDA has developed to sponsor international research and research fellows and will provide some examples of the work NIDA has supported. NIDA fellowships have allowed 496 individuals from 96 countries to be trained in addiction research. The United Arab Emirates and Saudi Arabia have recently developed funding to support addiction research to study SUD problems that impact their societies with NIDA guidance.. Examples from Malaysia, Tanzania, Brazil, Russian Federation, Ukraine, Republic of Georgia, Iceland, China, and Vietnam are used to illustrate research being conducted with NIDA support. Health services research, collaboratively funded by NIH and the Department of State, addresses a range of addiction service development questions in low- and middle-income countries. Findings have expanded the understanding of addiction and its treatment and are enhancing the ability of practitioners and policy makers to address SUDs using data to guide their decision-making. PMID:25747927

  1. Physical strain of handcycling: An evaluation using training guidelines for a healthy lifestyle as defined by the American College of Sports Medicine

    PubMed Central

    Hettinga, Florentina J.; de Groot, Sonja; van Dijk, Frank; Kerkhof, Faes; Woldring, Ferry; van der Woude, Luc

    2013-01-01

    Objective Developments in assistive technology such as handcycling provide attractive possibilities to pursue a healthy lifestyle for patients with spinal cord injury. The objective of the study is to evaluate physical stress and strain of handcycling against training guidelines as defined by the American College of Sports Medicine (ACSM). Design Seven able-bodied males conducted an incremental peak exercise handcycling test on a treadmill. In addition, two indoor treadmill (1.3 m/second with an inclination of 0.7% and 1.0 m/second with an inclination of 4.8%) and three outdoor over ground exercise bouts were performed (1.7, 3.3, and 5.0 m/second). One individual handcycled a representative 8-km-distance outdoors. Outcome measures Physical stress and strain were described in terms of absolute and relative power output, oxygen uptake (VO2), gross efficiency (GE), and heart rate (HR). Also, local perceived discomfort (LPD) was determined. Results Relative handcycling exercise intensities varied between 23.3 ± 4.2 (below the ACSM lower limit of 46%VO2peak) and 72.5 ± 15.1%VO2peak (well above the ACSM lower limit), with GE ranging from 6.0 ± 1.5% at the lower to 13.0 ± 2.6% at the higher exercise intensities. Exercise intensities were performed at 49.8 ± 4.2 to 80.1 ± 10.5%HRpeak. LPD scores were low to moderate (<27 ± 7). Conclusion Handcycling is relatively efficient and exercise intensities > 46%VO2peak were elicited. However, exercise load seems to be underestimated using %HRpeak. LPD was not perceived as limiting. Physiological stress and strain in able-bodied individuals appear to be comparable to individuals with a paraplegia. To understand individualize and optimize upper-body training, different training programs must be evaluated. PMID:23820153

  2. The "addicted" spine.

    PubMed

    Spiga, Saturnino; Mulas, Giovanna; Piras, Francesca; Diana, Marco

    2014-01-01

    Units of dendritic branches called dendritic spines represent more than simply decorative appendages of the neuron and actively participate in integrative functions of "spinous" nerve cells thereby contributing to the general phenomenon of synaptic plasticity. In animal models of drug addiction, spines are profoundly affected by treatments with drugs of abuse and represent important sub cellular markers which interfere deeply into the physiology of the neuron thereby providing an example of the burgeoning and rapidly increasing interest in "structural plasticity". Medium Spiny Neurons (MSNs) of the Nucleus Accumbens (Nacc) show a reduced number of dendritic spines and a decrease in TH-positive terminals upon withdrawal from opiates, cannabinoids and alcohol. The reduction is localized "strictly" to second order dendritic branches where dopamine (DA)-containing terminals, impinging upon spines, make synaptic contacts. In addition, long-thin spines seems preferentially affected raising the possibility that cellular learning of these neurons may be selectively hampered. These findings suggest that dendritic spines are affected by drugs widely abused by humans and provide yet another example of drug-induced aberrant neural plasticity with marked reflections on the physiology of synapses, system structural organization, and neuronal circuitry remodeling. PMID:25324733

  3. Hypothalamic opioid-melanocortin appetitive balance and addictive craving.

    PubMed

    Reece, Albert Stuart

    2011-01-01

    Whilst the parallels between drug and food craving are receiving increasing attention, the recently elucidated complex physiology of the hypothalamic appetite regulatory centres has been largely overlooked in the efforts to understand drug craving which is one of the most refractory and problematic aspects of drug and behavioural addictions. Important conceptual gains could be made by researchers from both appetite and addiction neuroscience if they were to have an improved understanding of each others' disciplines. It is well known in addiction medicine that the use of many substances is elevated in opiate dependency. There is voluminous evidence of very high rates of drug use in opiate agonist maintained patients, and the real possibility exists that opiate agonist therapy therefore increases drug craving. Conversely, opiate antagonist therapy with naloxone or naltrexone has been shown to reduce most chemical and behavioural addictions, and naltrexone is now being developed together with bupropion as the anti-obesity drug "Contrave". Hypothalamic melanocortins, particularly α-MSH, are known to constitute the main brake to consumptive behaviour of food. There is a well described antagonism between melanocortins and opioids at many loci including the hypothalamus. Administration of exogenous opiates is known to both suppress α-MSH and to stimulate hedonic food consumption. Opiate maintenance programs are associated with weight gain. As monoamines, opioids and cannabinoids are known to be involved in appetite regulation, and as endorphin opioids are known to be perturbed in other addictions, further exploration of the hypothalamic appetite regulatory centre would appear to be an obvious, albeit presently largely overlooked, locus in which to study drug and other craving mechanisms. PMID:20926200

  4. FDA Approves Implant to Battle Opioid Addiction

    MedlinePlus

    ... gov/medlineplus/news/fullstory_159050.html FDA Approves Implant to Battle Opioid Addiction Experts say steady dosing ... 26, 2016 (HealthDay News) -- A new long-acting implant that can help treat people addicted to heroin ...

  5. Behavioral Therapy, Incentives Enhance Addiction Treatment

    MedlinePlus

    ... Research News From NIH Behavioral Therapy, Incentives Enhance Addiction Treatment Past Issues / Summer 2006 Table of Contents ... that people who are trying to end their addiction to marijuana can benefit from a treatment program ...

  6. Pain Raises Risk of Opioid Addiction

    MedlinePlus

    ... fullstory_160033.html Pain Raises Risk of Opioid Addiction Men and younger people had higher odds of ... had a 41 percent higher risk of opioid addiction than those with no pain. That increased risk ...

  7. Behavioral Therapy, Incentives Enhance Addiction Treatment

    MedlinePlus

    ... News From NIH Behavioral Therapy, Incentives Enhance Addiction Treatment Past Issues / Summer 2006 Table of Contents For ... their addiction to marijuana can benefit from a treatment program that combines motivational incentives with cognitive-behavioral ...

  8. FDA Approves Implant to Battle Opioid Addiction

    MedlinePlus

    ... 159050.html FDA Approves Implant to Battle Opioid Addiction Experts say steady dosing eliminates need to take ... U.S. Food and Drug Administration. "Opioid abuse and addiction have taken a devastating toll on American families. ...

  9. Signs of Cocaine Abuse and Addiction

    MedlinePlus

    ... Signs of Cocaine Use and Addiction Signs of Cocaine Use and Addiction Listen After the "high" of ... Version Download "My life was built around getting cocaine and getting high." Stacey is recovering from her ...

  10. Signs of Drug Abuse and Addiction

    MedlinePlus

    ... Download "I feel so helpless against his addiction." Matt's brother Stephen is addicted to meth. Matt wants to help Stephen, but he isn't sure how. Read Matt's story About the National Institute on Drug Abuse ( ...

  11. Evidence-Based and Best Practice Addiction Treatment Resources: A Primer for Librarians.

    ERIC Educational Resources Information Center

    Lacroix, Sheila I.

    2002-01-01

    Introduces concepts, such as evidence-based medicine and best practices, explores these concepts in terms of addiction treatment, discusses practice guidelines, offers suggestions to find and select science-based resources, and explores the librarian's or information specialist's role in the dissemination of this information. (LRW)

  12. The Addictive Dimensionality of Obesity

    PubMed Central

    Volkow, Nora D.; Wang, Gene-Jack; Tomasi, Dardo; Baler, Ruben D.

    2016-01-01

    Our brains are hardwired to respond and seek immediate rewards. Thus, it is not surprising that many people overeat, which in some can result in obesity, whereas others take drugs, which in some can result in addiction. Though food intake and body weight are under homeostatic regulation, when highly palatable food is available, the ability to resist the urge to eat hinges on self-control. There is no homeostatic regulator to check the intake of drugs (including alcohol); thus, regulation of drug consumption is mostly driven by self-control or unwanted effects (i.e., sedation for alcohol). Disruption in both the neurobiological processes that underlie sensitivity to reward and those that underlie inhibitory control can lead to compulsive food intake in some individuals and compulsive drug intake in others. There is increasing evidence that disruption of energy homeostasis can affect the reward circuitry and that overconsumption of rewarding food can lead to changes in the reward circuitry that result in compulsive food intake akin to the phenotype seen with addiction. Addiction research has produced new evidence that hints at significant commonalities between the neural substrates underlying the disease of addiction and at least some forms of obesity. This recognition has spurred a healthy debate to try and ascertain the extent to which these complex and dimensional disorders overlap and whether or not a deeper understanding of the crosstalk between the homeostatic and reward systems will usher in unique opportunities for prevention and treatment of both obesity and drug addiction. PMID:23374642

  13. [Does really sex addiction exist?].

    PubMed

    Echeburúa, Enrique

    2012-01-01

    Hypersexual Disorder has been proposed as a new psychiatric disorder for DSM-V, characterized by an increased frequency and intensity of sexually motivated fantasies, arousal, urges, and enacted behavior in association with an impulsivity component. Excessive appetitive and consummatory behaviors, including hypersexuality, can become a non-chemical addiction. Sexual addiction afflicts people having paraphilic or nonparaphilic behaviors associated with progressive risk-taking sexual behaviors, escalation or progression of sexual behaviors (tolerance), loss of control and significant adverse psychosocial consequences, such as unplanned pregnancy, pair-bond dysfunction, marital separation, financial problems and sexually transmitted diseases including HIV. The most common behaviors involved in sexual addiction are fantasy sex, compulsive masturbation, pornography, cybersex, voyeuristic sex, anonymous sex and multiple sexual partners. These behaviors are intended to reduce anxiety and other dysphoric affects (e.g., shame and depression). Axis I psychiatric diagnosis, especially mood disorders, psychoactive substance abuse disorders and attention deficit hyperactivity disorders, are common comorbid disorders with sexual addiction. There are significant gaps in the current scientific knowledge base regarding the clinical course, development risk factors and family history and data on women with sexual addiction are lacking. PMID:23241714

  14. The Purpose in Chronic Addiction

    PubMed Central

    Pickard, Hanna

    2012-01-01

    I argue that addiction is not a chronic, relapsing, neurobiological disease characterized by compulsive use of drugs or alcohol. Large-scale national survey data demonstrate that rates of substance dependence peak in adolescence and early adulthood and then decline steeply; addicts tend to “mature out” in their late twenties or early thirties. The exceptions are addicts who suffer from additional psychiatric disorders. I hypothesize that this difference in patterns of use and relapse between the general and psychiatric populations can be explained by the purpose served by drugs and alcohol for patients. Drugs and alcohol alleviate the severe psychological distress typically experienced by patients with comorbid psychiatric disorders and associated problems. On this hypothesis, consumption is a chosen means to ends that are rational to desire: Use is not compulsive. The upshot of this explanation is that the orthodox view of addiction as a chronic, relapsing neurobiological disease is misguided. I delineate five folk psychological factors that together explain addiction as purposive action: strong and habitual desire; willpower; motivation; functional role; and decision and resolve. I conclude by drawing lessons for research and effective treatment. PMID:22724074

  15. Addiction research centres and the nurturing of creativity: University of Michigan Addiction Research Center (UMARC): Development, Evolution, and Direction

    PubMed Central

    Zucker, Robert A.

    2010-01-01

    A historical summary is provided of the evolution of the University of Michigan Addiction Research Center (UMARC) since its origins in 1988. Begun as an NIH research center within a Department of Psychiatry and focused solely on alcohol and aging, early work emphasized treatment efficacy, differential outcome studies, and characterization of the neurophysiological and behavioral manifestations of chronic alcoholism. Over the last fifteen years, UMARC has extended its research focus along a number of dimensions: Its developmental reach has been extended etiologically by studies of risk early in the life span, and by way of work on earlier screening and the development of early, brief treatment interventions. The addiction focus has expanded to include other drugs of abuse. Levels of analysis have also broadened, with work on the molecular genetics and brain neurophysiology underlying addictive processes on the one hand, and examination of the role of the social environment in long term course of disorder on the other. Activities have been facilitated by several research training programs and by collaborative relationships with other universities around the United States and in Poland. Since 2002, a program for research infrastructure development and collaboration has been carried on, initially with Poland and more recently with Ukraine, Latvia, and Slovakia. A blueprint for the future includes expanded characterization of the neurobiology and genetics of addictive processes, the developmental environment, as well as programmatic work to address the public health implications of our ability to identify risk for disorder very early in life. PMID:20331547

  16. [The place of cyber addiction in teenagers' addictive behavior].

    PubMed

    Valleur, Marc

    2013-01-01

    The easy access which modern teenagers have to new technologies favours their excessive use of video games, as they seek to escape potential existential difficulties. This harmful aspect should not mask the creative potential of games for the majority of teenagers. Treatment for young people with a gaming addiction is based on psychotherapy and takes into account the family dimension of the problem. This article presents an interview with Marc Valleur, a psychiatrist and head physician at Marmottan hospital specialising in the care and support of people with addictions. PMID:24409575

  17. A Meaning-Centered Therapy for Addictions

    ERIC Educational Resources Information Center

    Thompson, Geoff

    2012-01-01

    This article describes a treatment for addictions, based on the idea that addiction is a response to living a life that has little personal meaning. First, it presents the theory of Meaning-Centered Therapy (MCT) as developed by Paul Wong, particularly the need to understand intoxication from the addict's perspective. Next, it presents the…

  18. Medication-assisted therapy for opioid addiction.

    PubMed

    Tai, Betty; Saxon, Andrew J; Ling, Walter

    2013-12-01

    The "Medication-Assisted Therapy for Opioid Addiction" session was chaired by Dr. Betty Tai and had three presenters. The presenters (and their topics) were: Dr. Andrew J. Saxon (Methadone and Buprenorphine for Treatment of Opioid Addiction and HIV Risk Reduction), Dr. Walter Ling (Opioid Antagonist Treatment for Opioid Addiction), and Dr. Betty Tai (Chronic Care Model for Substance Use Disorder). PMID:25264415

  19. Tobacco Addiction: 'Why Do I Smoke?' Quiz

    MedlinePlus

    MENU Return to Web version Tobacco Addiction | “Why do I smoke?" Quiz Why do I smoke? If you learn the answer to this question, it will be easier to ... m hooked." In addition to having a psychological addiction to smoking, you may also be physically addicted ...

  20. The Dynamics of a Heroin Addiction Epidemic

    ERIC Educational Resources Information Center

    DuPont, Robert L.; Greene, Mark H.

    1973-01-01

    Discusses recent trends in heroin addiction in Washington, D.C. In 1969 a comprehensive, multimodal treatment program for addicts was introduced and a major law enforcement commitment was made to reduce the heroin supply. These factors, together with changing community attitudes, may be responsible for a remarkable decline in heroin addiction. (JR)

  1. A Survey of Attitudes Toward Drug Addiction.

    ERIC Educational Resources Information Center

    Doctor, Ronald M.; Sieveking, Nicholas A.

    The purpose of this survey was to assess public attitudes about drug addiction, addicts, and treatment for this condition. Four reference groups were sampled: (1) law-enforcement representatives; (2) college student non-users; (3) student users of marihuana; and (4) post-withdrawal narcotic addicts. Data was obtained from a questionnaire…

  2. [The activity of drug addiction service of the Russian Federation: an assessment of statistical parameters and an analysis of results].

    PubMed

    Koshkina, E A; Kirzhanova, V V; Babicheva, L P; Mugantseva, L A

    2013-01-01

    The authors studied changes in the structure of drug addiction services, the dynamics of outpatient and inpatient referrals for drug addiction treatment and effectiveness of drug addiction services in 2011 compared to the preceding period. There was a reduction of availability of drug treatment services due to the reduction of the number of drug addiction units and the depletion of human resource potential. The lack of structural development of rehabilitation sector of drug care services and low rates of its development as well as the decrease in the number of patients seeking treatment are highlighted. It has been concluded that the drug addiction services require reorganization of its regulatory and legal framework and need innovative organizational and management decisions and human resources trained in innovative thinking and technologies. PMID:23887460

  3. [Workaholism, another form of addiction].

    PubMed

    Scheen, A J

    2013-01-01

    Workaholism belongs to the behavioural addictions, also called ((without substances)) addictions, and is rather common in our society. The differential diagnosis must distinguish a hard worker, who has pleasure in his/her job, still profits from leisure time and maintains an excellent quality of life, from a true workaholic, who is prisoner of this compulsive behaviour that has negative consequences on his mental and physical health, his social and familial relationships and finally, his work performance itself. We describe here the various typologies of this mental disorder, its mode of evolution, its diagnostic approach, its multiple negative consequences for both patient and family as well as the main principles of management based on cognitive-behavioural therapy of this disorder that may be considered as a true addiction. PMID:23888592

  4. Modeling nicotine addiction in rats.

    PubMed

    Caille, Stephanie; Clemens, Kelly; Stinus, Luis; Cador, Martine

    2012-01-01

    Among the human population, 15% of drug users develop a pathological drug addiction. This figure increases substantially with nicotine, whereby more than 30% of those who try smoking develop a nicotine addiction. Drug addiction is characterized by compulsive drug-seeking and drug-taking behaviors (craving), and loss of control over intake despite impairment in health, social, and occupational functions. This behavior can be accurately modeled in the rat using an intravenous self-administration (IVSA) paradigm. Initial attempts at establishing nicotine self-administration had been problematic, yet in recent times increasingly reliable models of nicotine self-administration have been developed. The present article reviews different characteristics of the nicotine IVSA model that has been developed to examine nicotine reinforcing and motivational properties in rats. PMID:22231818

  5. The addiction to negativity.

    PubMed

    Lane, R C; Hull, J W; Foehrenbach, L M

    1991-01-01

    In this paper, we have described a type of resistance that has attracted increasing psychoanalytic attention in recent years. Patients exposed to intense negativity during early life may develop an addiction to negative experience as adolescents and adults, and this may constitute a central organizing feature of their personality. In almost all patients, however, some moments of negativity may be observed. We have traced the developmental origins of an attachment to negativity, drawing especially on psychoanalytic investigations of preoedipal pathology. Manifestations and derivatives of early negativity include anhedonia, attachment to physical pain, fear of success, masochism, deprivation of self and others, and negative voyeurism. In discussing the dynamic functions of negativity, we place particular emphasis on two motives: the patient's desires for revenge against early objects that have been a source of deprivation and frustration; and the defensive function of negativity in helping to express as well as ward off dangerous wishes to merge with the object. Deviant forms of autoerotism are likely to be used by these patients to deal with the reactivation of early experiences of neglect and rejection. When negativity is used as a defense or method of relating to others it can lead to a severe disruption of the psychotherapeutic relationship. We have reviewed suggestions for the management of extreme negativity in treatment. Resolution of the therapist's countertransference reactions, especially induced feelings of frustration, rage, and helplessness, is crucial. Emphasis also has been placed on the patient's desires for revenge against self and object, and the manner in which these may be understood and eventually resolved. Only when patient and therapist begin to investigate the adaptive functions of extreme negativity can this pathological symptom be resolved and the patient's awareness of self and sense of autonomy be enhanced. PMID:1763149

  6. Neuropharmacology of alcohol addiction.

    PubMed

    Vengeliene, V; Bilbao, A; Molander, A; Spanagel, R

    2008-05-01

    Despite the generally held view that alcohol is an unspecific pharmacological agent, recent molecular pharmacology studies demonstrated that alcohol has only a few known primary targets. These are the NMDA, GABA(A), glycine, 5-hydroxytryptamine 3 (serotonin) and nicotinic ACh receptors as well as L-type Ca(2+) channels and G-protein-activated inwardly rectifying K(+) channels. Following this first hit of alcohol on specific targets in the brain, a second wave of indirect effects on a variety of neurotransmitter/neuropeptide systems is initiated that leads subsequently to the typical acute behavioural effects of alcohol, ranging from disinhibition to sedation and even hypnosis, with increasing concentrations of alcohol. Besides these acute pharmacodynamic aspects of alcohol, we discuss the neurochemical substrates that are involved in the initiation and maintenance phase of an alcohol drinking behaviour. Finally, addictive behaviour towards alcohol as measured by alcohol-seeking and relapse behaviour is reviewed in the context of specific neurotransmitter/neuropeptide systems and their signalling pathways. The activity of the mesolimbic dopaminergic system plays a crucial role during the initiation phase of alcohol consumption. Following long-term, chronic alcohol consumption virtually all brain neurotransmission seems to be affected, making it difficult to define which of the systems contributes the most to the transition from controlled to compulsive alcohol use. However, compulsive alcohol drinking is characterized by a decrease in the function of the reward neurocircuitry and a recruitment of antireward/stress mechanisms comes into place, with a hypertrophic corticotropin-releasing factor system and a hyperfunctional glutamatergic system being the most important ones. PMID:18311194

  7. Diabetes Medicines

    MedlinePlus

    ... Financial Help for Diabetes Care Diabetes Statistics Diabetes Medicines What do diabetes medicines do? Over time, high levels of blood glucose, ... your diabetes medicines, food choices, and physical activity. Medicines for My Diabetes Ask your doctor what type ...

  8. The effect of psychiatric symptoms on the internet addiction disorder in Isfahan's University students

    PubMed Central

    Alavi, Seyyed Salman; Maracy, Mohammad Reza; Jannatifard, Fereshte; Eslami, Mehdi

    2011-01-01

    BACKGROUND: Internet addiction disorder is an interdisciplinary phenomenon and it has been studied from different viewpoints in terms of various sciences such as medicine, computer, sociology, law, ethics, and psychology. The aim of this study was to determine the association of psychiatric symptoms with Internet addiction while controlling for the effects of age, gender, marital status, and educational levels. It is hypothesized, that high levels of Internet addiction are associated with psychiatric symptoms and are specially correlated with obsessive-compulsive disorder symptoms. METHODS: In a cross-sectional study, a total number of 250 students from Isfahan's universities were randomly selected. Subjects completed the demographic questionnaire, the Young Diagnostic Questionnaire (YDQ) and the Symptom Checklist-90-Revision (SCL-90-R). Data was analyzed using the multiple logistic regression method. RESULTS: There was an association between psychiatric symptoms such as somatization, sensitivity, depression, anxiety, aggression, phobias, and psychosis with exception of paranoia; and diagnosis of Internet addiction controlling for age, sex, education level, marital status, and type of universities. CONCLUSIONS: A great percentage of youths in the population suffer from the adverse effects of Internet addiction. It is necessary for psychiatrists and psychologists to be aware of the mental problems caused by Internet addiction. PMID:22091309

  9. Treatment of addiction and addiction-related behavior

    SciTech Connect

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2003-01-01

    The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a mammal suffering from substance addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. The present invention also provides a method of treatment of cocaine, morphine, heroin, nicotine, amphetamine, methamphetamine, or ethanol addiction by treating a mammal with an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. In one embodiment, the method of the present invention includes administering to the mammal an effective amount of a composition which increases central nervous system GABA levels wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of drugs of abuse. The composition includes GVG, gabapentin, valproic acid, progabide, gamma-hydroxybutyric acid, fengabine, cetylGABA, topiramate or tiagabine or a pharmaceutically acceptable salt thereof, or an enantiomer or a racemic mixture thereof.

  10. The Nociceptin Receptor as an Emerging Molecular Target for Cocaine Addiction.

    PubMed

    Lutfy, Kabirullah; Zaveri, Nurulain T

    2016-01-01

    Cocaine addiction is a global public health and socioeconomic issue that requires pharmacological and cognitive therapies. Currently there are no FDA-approved medications to treat cocaine addiction. However, in preclinical studies, interventions ranging from herbal medicine to deep-brain stimulation have shown promise for the therapy of cocaine addiction. Recent developments in molecular biology, pharmacology, and medicinal chemistry have enabled scientists to identify novel molecular targets along the pathways involved in drug addiction. In 1994, a receptor that showed a great deal of homology to the traditional opioid receptors was characterized. However, endogenous and exogenous opioids failed to bind to this receptor, which led scientists to name it opioid receptor-like receptor, now referred to as the nociceptin receptor. The endogenous ligand of NOPr was identified a year later and named orphanin FQ/nociceptin. Nociceptin and NOPr are widely distributed throughout the CNS and are involved in many physiological responses, such as food intake, nociceptive processing, neurotransmitter release, etc. Furthermore, exogenous nociceptin has been shown to regulate the activity of mesolimbic dopaminergic neurons, glutamate, and opioid systems, and the stress circuit. Importantly, exogenous nociceptin has been shown to reduce the rewarding and addictive actions of a number of drugs of abuse, such as psychostimulants, alcohol, and opioids. This paper reviews the existing literature on the role of endogenous nociceptin in the rewarding and addictive actions of cocaine. The effect of exogenous nociceptin on these processes is also reviewed. Furthermore, the effects of novel small-molecule NOPr ligands on these actions of cocaine are discussed. Overall, a review of the literature suggests that NOPr could be an emerging target for cocaine addiction pharmacotherapy. PMID:26810001

  11. Phenomenology and treatment of behavioural addictions.

    PubMed

    Grant, Jon E; Schreiber, Liana R N; Odlaug, Brian L

    2013-05-01

    Behavioural addictions are characterized by an inability to resist an urge or drive resulting in actions that are harmful to oneself or others. Behavioural addictions share characteristics with substance and alcohol abuse, and in areas such as natural history, phenomenology, and adverse consequences. Behavioural addictions include pathological gambling, kleptomania, pyromania, compulsive buying, compulsive sexual behaviour, Internet addiction, and binge eating disorder. Few studies have examined the efficacy of pharmacological and psychological treatment for the various behavioural addictions, and therefore, currently, no treatment recommendations can be made. PMID:23756285

  12. [Pathological gambling and computergame-addiction. Current state of research regarding two subtypes of behavioural addiction].

    PubMed

    Wölfling, K; Müller, K W

    2010-04-01

    Behavioral addictions, like pathological gambling and computer game addiction (or internet addiction), have become a growing concern in research and public interest. Currently similarities between behavioral addictions and substance dependency are controversially discussed in the scientific community. Unfortunately a mismatch exists between the large number of people seeking treatment and the small number of scientific studies on pathological gambling and computer game addiction. Prevalence of pathological gambling among the German population is estimated to be 0.2-0.5%. These estimations are comparable to prevalence rates reported for drug dependency. Latest research states that about 3% of German adolescents and young adults are believed to suffer from computer game addiction. Therefore, it is important to enhance investigations regarding the clinical and neuroscientific basis of computer game addiction. This review offers a summary of current results of research regarding pathological gambling and internet addiction. The phenomenological description of these two disorders is meant to allow a deeper understanding of behavioral addictions. PMID:20195558

  13. Association between morningness/eveningness, addiction severity and psychiatric disorders among individuals with addictions.

    PubMed

    Kervran, Charlotte; Fatséas, Mélina; Serre, Fuschia; Taillard, Jacques; Beltran, Virginie; Leboucher, Juliette; Debrabant, Romain; Alexandre, Jean-Marc; Daulouède, Jean-Pierre; Philip, Pierre; Auriacombe, Marc

    2015-10-30

    Studies have shown that Evening-Type (ET) subjects used more stimulating and sedative substances, and presented more psychiatric disorders than Morning-Type (MT) subject. However, there is a lack of data on the chronotype of patients with addiction. The aim of our study was to describe chronotype and associated factors in a sample of outpatients beginning treatment for addiction. Subjects were assessed with the Morningness-Eveningness questionnaire of Hörne & Ostberg, the Addiction Severity Index and the Mini International Neuropsychiatric Interview. In the 333 subjects with an addiction, 20% were MT and 32% were ET. When comparing ET to MT, multivariate analysis showed that ET was significantly associated with poly-problematic addiction, non-substance addictions, cannabis addiction, and mood disorders, but not with severity of addiction. MT was associated with antisocial personality disorder. Results suggested that chronotype was associated with specific addiction pattern and psychiatric disorders. PMID:26250146

  14. [Internet addiction--a case report].

    PubMed

    Pejović-Milovancević, Milica; Popović-Deusić, Smiljka; Draganić-Gajić, Saveta; Lecić-Tosevski, Dusica

    2009-01-01

    Some addictions cannot be connected with substance abuse (pathological gambling, video games playing, binge eating, compulsive physical activity, emotional relationship addiction, TV addiction). Since 1995, Internet addiction has been accepted as a clinical entity with profound negative effect on social, familial, educational and economical personal functioning. The diagnosis of Internet addiction could be established if the person spends more than 38 hours per week on the Internet exempting online professional needs. Basic symptoms are the increased number of hours spent in front of the computer along with the Internet use, development of abstinent syndrome if the Internet access is prohibited, sleep inversion, neglect of basic social requirements and personal hygiene, many somatic symptoms developed due to prolonged sitting or monitor watching, dissocial behaviour. In this paper, data about the Internet addiction are presented and a case report of an adolescent with developed Internet addiction. PMID:19370973

  15. Binge Eating Disorder and Food Addiction

    PubMed Central

    Gearhardt, Ashley N.; White, Marney A.; Potenza, Marc N.

    2013-01-01

    Binge eating disorder (BED) shares many characteristics with addictive behaviors (e.g., diminished control, continued use despite negative consequences), and a body of scientific literature is building to support addiction conceptualizations of problematic eating. Despite similarities, BED and “food addiction” may represent unique yet overlapping conditions. Although the exploration of food addiction is relatively new, understanding the relationship between food addiction and BED may be informative in understanding the mechanisms underlying the development and maintenance of problematic eating. In the following paper, we 1) examine the theoretical similarities and differences between BED and addiction, 2) review recent empirical evidence that speak to the relationship between BED and food addiction and 3) discuss the implications of associations between BED and food addiction with respect to clinical interventions. PMID:21999695

  16. Using Meditation in Addiction Counseling

    ERIC Educational Resources Information Center

    Young, Mark E.; DeLorenzi, Leigh de Armas; Cunningham, Laura

    2011-01-01

    Meditation has been studied as a way of reducing stress in counseling clients since the 1960s. Alcoholics Anonymous, Narcotics Anonymous, and new wave behavior therapies incorporate meditation techniques in their programs. This article identifies meditation's curative factors and limitations when using meditation in addiction settings.

  17. Internet Addiction: Stability and Change

    ERIC Educational Resources Information Center

    Huang, Chiungjung

    2010-01-01

    This longitudinal study examined five indices of stability and change in Internet addiction: structural stability, mean-level stability, differential stability, individual-level stability, and ipsative stability. The study sample was 351 undergraduate students from end of freshman year to end of junior year. Convergent findings revealed stability…

  18. Children of Alcoholics/Addicts.

    ERIC Educational Resources Information Center

    Towers, Richard L.

    The purpose of this booklet is to raise the awareness of teachers and other school personnel about the needs and characteristics of the children of alcoholics and addicts and to explain what schools can do to help. The booklet discusses: (1) risk factors for children of alcoholics and substance abusers, including the psychological, emotional, and…

  19. Schooling in an Addicted Society.

    ERIC Educational Resources Information Center

    Molnar, Alex

    1988-01-01

    Social consensus concerning drug use and abuse may be only skin deep. Despite numerous "anti" campaigns, Reagan administration is saying "no" to funding for drug treatment and prevention programs, while tobacco advertising and growing incentives continue unabated. Despite these and other societal addictions, schools must reason calmly and offer…

  20. Addiction research centres and the nurturing of creativity; the Research Institute on Addictions, University at Buffalo.

    PubMed

    Connors, Gerard J; Walitzer, Kimberly S

    2012-07-01

    The Research Institute on Addictions (RIA) was established in 1970 as a research component of the New York State Department of Mental Hygiene. After three decades of serving as a research component of New York State agencies concerned with alcohol and substance abuse, RIA was legislatively transferred to the University at Buffalo in 1999. Today, RIA's cadre of senior research scientists are engaged individually and collaboratively on a multitude of addictions-related studies. The majority of the Institute's ongoing research studies relate to one or more of the following seven broad research domains: causes and consequences of alcohol, marijuana and other drug use; biological and neuroscience; gambling behavior; gender-related studies; dissemination and professional training; treatment; and youth, families and relationships. In this paper, an overview of the structure of the Institute is provided, along with a description of the organizational and scientific culture at RIA. Further information about the Institute, its scientists and its activities can be found at http://www.ria.buffalo.edu. PMID:21470324

  1. Serotonergic hallucinogens and emerging targets for addiction pharmacotherapies.

    PubMed

    Ross, Stephen

    2012-06-01

    Only time will tell if serotonergic hallucinogen-assisted psychotherapy treatment paradigms for SUDs will prove to be safe and effective in double-blind, placebo-controlled clinical trials. If they are, they would truly constitute a novel psychopharmacologic-psychosocial treatment paradigm to treat addictive disorders, although the risk of adverse psychological events would have to be controlled through a careful screening process and the risk of misuse of the substances or developing use syndromes would have to be considered, although the overall risk would be low because, as mentioned, SHs are unlike all other drugs of abuse in that they do not appear to produce dependence syndromes. There effects on the NA and DA range from inhibition to slight activation, all this without producing addiction. The ability of these medicinal tools to treat a range of addictive, psychiatric, and existential disorders is remarkable in scope and possibility. They truly represent a potential paradigmatic shift within the field of psychiatry, too interesting to not explore further. PMID:22640760

  2. The 2015 Academic College of Emergency Experts in India's INDO-US Joint Working Group White Paper on Establishing an Academic Department and Training Pediatric Emergency Medicine Specialists in India.

    PubMed

    Mahajan, Prashant; Batra, Prerna; Shah, Binita R; Saha, Abhijeet; Galwankar, Sagar; Aggrawal, Praveen; Hassoun, Ameer; Batra, Bipin; Bhoi, Sanjeev; Kalra, Om Prakash; Shah, Dheeraj

    2015-01-01

    The concept of pediatric emergency medicine (PEM) is virtually nonexistent in India. Suboptimally, organized prehospital services substantially hinder the evaluation, management, and subsequent transport of the acutely ill and/or injured child to an appropriate facility. Furthermore, the management of the ill child at the hospital level is often provided by overburdened providers who, by virtue of their training, lack experience in the skills required to effectively manage pediatric emergencies. Finally, the care of the traumatized child often requires the involvement of providers trained in different specialities, which further impedes timely access to appropriate care. The recent recognition of Doctor of Medicine (MD) in Emergency Medicine (EM) as an approved discipline of study as per the Indian Medical Council Act provides an unprecedented opportunity to introduce PEM as a formal academic program in India. PEM has to be developed as a 3-year superspeciality course (in PEM) after completion of MD/Diplomate of National Board (DNB) Pediatrics or MD/DNB in EM. The National Board of Examinations (NBE) that accredits and administers postgraduate and postdoctoral programs in India also needs to develop an academic program - DNB in PEM. The goals of such a program would be to impart theoretical knowledge, training in the appropriate skills and procedures, development of communication and counseling techniques, and research. In this paper, the Joint Working Group of the Academic College of Emergency Experts in India (JWG-ACEE-India) gives its recommendations for starting 3-year DM/DNB in PEM, including the curriculum, infrastructure, staffing, and training in India. This is an attempt to provide an uniform framework and a set of guiding principles to start PEM as a structured superspeciality to enhance emergency care for Indian children. PMID:26807394

  3. The 2015 Academic College of Emergency Experts in Indias INDO-US Joint Working Group White Paper on Establishing an Academic Department and Training Pediatric Emergency Medicine Specialists in India.

    PubMed

    Mahajan, Prashant; Batra, Prerna; Shah, Binita R; Saha, Abhijeet; Galwankar, Sagar; Aggrawal, Praveen; Hassoun, Ameer; Batra, Bipin; Bhoi, Sanjeev; Kalra, Om Prakash; Shah, Dheeraj

    2015-12-01

    The concept of pediatric emergency medicine (PEM) is virtually nonexistent in India. Suboptimally organized prehospital services substantially hinder the evaluation, management, and subsequent transport of the acutely ill and/or injured child to an appropriate facility. Furthermore, the management of the ill child at the hospital level is often provided by overburdened providers who, by virtue of their training, lack experience in the skills required to effectively manage pediatric emergencies. Finally, the care of the traumatized child often requires the involvement of providers trained in different specialities, which further impedes timely access to appropriate care. The recent recognition of Doctor of Medicine in Emergency Medicine as an approved discipline of study as per the Indian Medical Council Act provides an unprecedented opportunity to introduce PEM as a formal academic program in India. PEM has to be developed as a 3 year superspeciality course after completion of MD Diplomate of National Board (DNB) Pediatrics or MD DNB in EM. The National Board of Examinations that accredits and administers postgraduate and postdoctoral programs in India also needs to develop an academic program DNB in PEM. The goals of such a program would be to impart theoretical knowledge, training in the appropriate skills and procedures, development of communication and counseling techniques, and research. In this paper, the Joint Working Group of the Academic College of Emergency Experts in India (JWG ACEE India) gives its recommendations for starting 3 year DM DNB in PEM, including the curriculum, infrastructure, staffing, and training in India. This is an attempt to provide an uniform framework and a set of guiding principles to start PEM as a structured superspeciality to enhance emergency care for Indian children. PMID:26713991

  4. The 2015 Academic College of Emergency Experts in India's INDO-US Joint Working Group White Paper on Establishing an Academic Department and Training Pediatric Emergency Medicine Specialists in India

    PubMed Central

    Mahajan, Prashant; Batra, Prerna; Shah, Binita R; Saha, Abhijeet; Galwankar, Sagar; Aggrawal, Praveen; Hassoun, Ameer; Batra, Bipin; Bhoi, Sanjeev; Kalra, Om Prakash; Shah, Dheeraj

    2015-01-01

    The concept of pediatric emergency medicine (PEM) is virtually nonexistent in India. Suboptimally, organized prehospital services substantially hinder the evaluation, management, and subsequent transport of the acutely ill and/or injured child to an appropriate facility. Furthermore, the management of the ill child at the hospital level is often provided by overburdened providers who, by virtue of their training, lack experience in the skills required to effectively manage pediatric emergencies. Finally, the care of the traumatized child often requires the involvement of providers trained in different specialities, which further impedes timely access to appropriate care. The recent recognition of Doctor of Medicine (MD) in Emergency Medicine (EM) as an approved discipline of study as per the Indian Medical Council Act provides an unprecedented opportunity to introduce PEM as a formal academic program in India. PEM has to be developed as a 3-year superspeciality course (in PEM) after completion of MD/Diplomate of National Board (DNB) Pediatrics or MD/DNB in EM. The National Board of Examinations (NBE) that accredits and administers postgraduate and postdoctoral programs in India also needs to develop an academic program – DNB in PEM. The goals of such a program would be to impart theoretical knowledge, training in the appropriate skills and procedures, development of communication and counseling techniques, and research. In this paper, the Joint Working Group of the Academic College of Emergency Experts in India (JWG-ACEE-India) gives its recommendations for starting 3-year DM/DNB in PEM, including the curriculum, infrastructure, staffing, and training in India. This is an attempt to provide an uniform framework and a set of guiding principles to start PEM as a structured superspeciality to enhance emergency care for Indian children. PMID:26807394

  5. Geriatric Medicine Training for Family Practice Residents in the 21st Century: A Report from the Residency Assistance Program/Hartford Geriatrics Initiative.

    ERIC Educational Resources Information Center

    Warshaw, Gregg; Murphy, John; Buehler, James; Singleton, Stacy

    2003-01-01

    Summarizes the initial results of the regional geriatric medicine curriculum retreats for family practice residency directors provided as part of the American Academy of Family Physicians multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. (EV)

  6. Teaching Evidence-Based Addiction Practice: Project MATCH Comes to the Classroom.

    ERIC Educational Resources Information Center

    Hohman, Melinda; Loughran, Hilda

    2003-01-01

    Describes a teaching model used to train students in different methods of substance abuse treatment. Addiction Studies students and graduate social work students received treatment manuals that were used in Project MATCH study, three methods of treatment were used. Students reported surprise at the level of sophistication in substance abuse…

  7. If These Walls Could Talk: Reflective Practice in Addiction Studies among Undergraduates in New Zealand

    ERIC Educational Resources Information Center

    Shepherd, Robin

    2010-01-01

    This exploratory study examined reflective practice among a class of students studying a "communities and addictions" course as part of the undergraduate health science degree. Most reflective practice publications are focused on medical or teachers' training rather than undergraduates in general. This is surprising given that reflective practice…

  8. A Million Little Lessons: The Evaluation and Use of Mass Media in Counselor Addiction Education

    ERIC Educational Resources Information Center

    Robertson, Stacie L.

    2006-01-01

    Mental health counselors, school counselors, and rehabilitation counselors, much like other professional counselors, encounter clients whose lives are somehow affected by substance use and addictions. Although counselors regularly encounter substance-dependent clients, spouses, children, and/or employers affected by substance abuse, training in…

  9. Towards an animal model of food addiction.

    PubMed

    de Jong, Johannes W; Vanderschuren, Louk J M J; Adan, Roger A H

    2012-01-01

    The dramatically increasing prevalence of obesity, associated with potentially life-threatening health problems, including cardiovascular diseases and type II diabetes, poses an enormous public health problem. It has been proposed that the obesity epidemic can be explained by the concept of 'food addiction'. In this review we focus on possible similarities between binge eating disorder (BED), which is highly prevalent in the obese population, and drug addiction. Indeed, both behavioral and neural similarities between addiction and BED have been demonstrated. Behavioral similarities are reflected in the overlap in DSM-IV criteria for drug addiction with the (suggested) criteria for BED and by food addiction-like behavior in animals after prolonged intermittent access to palatable food. Neural similarities include the overlap in brain regions involved in food and drug craving. Decreased dopamine D2 receptor availability in the striatum has been found in animal models of binge eating, after cocaine self-administration in animals as well as in drug addiction and obesity in humans. To further explore the neurobiological basis of food addiction, it is essential to have an animal model to test the addictive potential of palatable food. A recently developed animal model for drug addiction involves three behavioral characteristics that are based on the DSM-IV criteria: i) extremely high motivation to obtain the drug, ii) difficulty in limiting drug seeking even in periods of explicit non-availability, iii) continuation of drug-seeking despite negative consequences. Indeed, it has been shown that a subgroup of rats, after prolonged cocaine self-administration, scores positive on these three criteria. If food possesses addictive properties, then food-addicted rats should also meet these criteria while searching for and consuming food. In this review we discuss evidence from literature regarding food addiction-like behavior. We also suggest future experiments that could

  10. Epigenetic and Proteomic Expression Changes Promoted by Eating Addictive-Like Behavior.

    PubMed

    Mancino, Samantha; Burokas, Aurelijus; Gutiérrez-Cuesta, Javier; Gutiérrez-Martos, Miriam; Martín-García, Elena; Pucci, Mariangela; Falconi, Anastasia; D'Addario, Claudio; Maccarrone, Mauro; Maldonado, Rafael

    2015-11-01

    An increasing perspective conceptualizes obesity and overeating as disorders related to addictive-like processes that could share common neurobiological mechanisms. In the present study, we aimed at validating an animal model of eating addictive-like behavior in mice, based on the DSM-5 substance use disorder criteria, using operant conditioning maintained by highly palatable chocolate-flavored pellets. For this purpose, we evaluated persistence of food-seeking during a period of non-availability of food, motivation for food, and perseverance of responding when the reward was associated with a punishment. This model has allowed identifying extreme subpopulations of mice related to addictive-like behavior. We investigated in these subpopulations the epigenetic and proteomic changes. A significant decrease in DNA methylation of CNR1 gene promoter was revealed in the prefrontal cortex of addict-like mice, which was associated with an upregulation of CB1 protein expression in the same brain area. The pharmacological blockade (rimonabant 3 mg/kg; i.p.) of CB1 receptor during the late training period reduced the percentage of mice that accomplished addiction criteria, which is in agreement with the reduced performance of CB1 knockout mice in this operant training. Proteomic studies have identified proteins differentially expressed in mice vulnerable or not to addictive-like behavior in the hippocampus, striatum, and prefrontal cortex. These changes included proteins involved in impulsivity-like behavior, synaptic plasticity, and cannabinoid signaling modulation, such as alpha-synuclein, phosphatase 1-alpha, doublecortin-like kinase 2, and diacylglycerol kinase zeta, and were validated by immunoblotting. This model provides an excellent tool to investigate the neurobiological substrate underlying the vulnerability to develop eating addictive-like behavior. PMID:25944409

  11. Lifestyle Medicine Education

    PubMed Central

    Pojednic, Rachele M.; Phillips, Edward M.

    2015-01-01

    The actual causes of premature adult deaths, the preponderance of noncommunicable chronic diseases, and their associated costs are related to unhealthy behaviors, such as poor nutrition, physical inactivity, and tobacco use. Although recommended as the first line of prevention and management, providers often do not provide behavioral change counseling in their care. Medical education in lifestyle medicine is, therefore, proposed as a necessary intervention to allow all health providers to learn how to effectively and efficiently counsel their patients toward adopting and sustaining healthier behaviors. Lifestyle medicine curricula, including exercise, nutrition, behavioral change, and self-care, have recently evolved in all levels of medical education, together with implementation initiatives like Exercise is Medicine and the Lifestyle Medicine Education (LMEd) Collaborative. The goal of this review is to summarize the existing literature and to provide knowledge and tools to deans, administrators, faculty members, and students interested in pursuing lifestyle medicine training or establishing and improving an LMEd program within their institution. PMID:26413038

  12. Diabetes Medicines

    MedlinePlus

    ... choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends on your type of diabetes, ... pills. Combination pills contain two kinds of diabetes medicine in one tablet. Some people take pills and ...

  13. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  14. Aerospace Medicine

    NASA Technical Reports Server (NTRS)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  15. The Teen Addiction Severity Index around the globe: the Tower of Babel revisited.

    PubMed

    Kaminer, Yifrah

    2008-01-01

    The objectives of this article are, first, to provide a brief review of screening and assessment of adolescents substance use and substance use disorders; second, to describe the work done with the Teen Addiction Severity Index (T-ASI) in different countries; and third, to address challenges and opportunities in order to improve international collaboration between health professionals responsible for providing substance abuse services for youth and families. It is recommended that the International Society of Addiction Medicine (ISAM) sponsor and coordinate the efforts to disseminate the benefits accrued from already developed assessment and treatment of substance use disorders of youth into different countries and regions. Addiction professionals representing a myriad of cultures, ethnic, and racial groups would be encouraged to translate the assessments into relevant languages and dialects and with the support of the original authors conduct reverse translation and then test the psychometric properties before a wider use commences. PMID:19042210

  16. Neuroimaging for drug addiction and related behaviors

    PubMed Central

    Parvaz, Muhammad A.; Alia-Klein, Nelly; Woicik, Patricia A.; Volkow, Nora D.; Goldstein, Rita Z.

    2012-01-01

    In this review, we highlight the role of neuroimaging techniques in studying the emotional and cognitive-behavioral components of the addiction syndrome by focusing on the neural substrates subserving them. The phenomenology of drug addiction can be characterized by a recurrent pattern of subjective experiences that includes drug intoxication, craving, bingeing, and withdrawal with the cycle culminating in a persistent preoccupation with obtaining, consuming, and recovering from the drug. In the past two decades, imaging studies of drug addiction have demonstrated deficits in brain circuits related to reward and impulsivity. The current review focuses on studies employing positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and electroencephalography (EEG) to investigate these behaviors in drug-addicted human populations. We begin with a brief account of drug addiction followed by a technical account of each of these imaging modalities. We then discuss how these techniques have uniquely contributed to a deeper understanding of addictive behaviors. PMID:22117165

  17. Hypomanic personality trait in cocaine addiction.

    PubMed

    Lemere, F; Smith, J W

    1990-04-01

    An analysis of 292 private patients treated for cocaine addiction showed the following. Comorbid Axis I psychiatric disorders were found in 19% and preaddiction Axis I disorders in 9% of these patients. Psychopathology at the time of treatment appeared to be more the result of than the cause of the addiction. Of these patients 63% had become addicted pursuing euphoria. A definitive nonpathologic unipolar hypomanic subtype of cocaine addict was observed in 13% of these 292 patients. This was manifested more as a trait than a disorder. This subgroup had been reasonably well adjusted, fun-loving and action oriented extroverts before their addiction. The rush and lifestyle of cocaine fit the imperatives of their personality. In a significant subtype of cocaine addict, an underlying hypomanic personality trait is ego-syntonic with the abuse of cocaine. PMID:2346798

  18. Neuroimaging for drug addiction and related behaviors

    SciTech Connect

    Parvaz M. A.; Parvaz, M.A.; Alia-Klein, N.; Woicik,P.A.; Volkow, N.D.; Goldstein, R.Z.

    2011-10-01

    In this review, we highlight the role of neuroimaging techniques in studying the emotional and cognitive-behavioral components of the addiction syndrome by focusing on the neural substrates subserving them. The phenomenology of drug addiction can be characterized by a recurrent pattern of subjective experiences that includes drug intoxication, craving, bingeing, and withdrawal with the cycle culminating in a persistent preoccupation with obtaining, consuming, and recovering from the drug. In the past two decades, imaging studies of drug addiction have demonstrated deficits in brain circuits related to reward and impulsivity. The current review focuses on studies employing positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and electroencephalography (EEG) to investigate these behaviors in drug-addicted human populations. We begin with a brief account of drug addiction followed by a technical account of each of these imaging modalities. We then discuss how these techniques have uniquely contributed to a deeper understanding of addictive behaviors.

  19. The neural rejuvenation hypothesis of cocaine addiction.

    PubMed

    Dong, Yan; Nestler, Eric J

    2014-08-01

    A leading hypothesis guiding current molecular and cellular research into drug addiction conceptualizes key aspects of addiction as a form of memory in which common neuroplasticity mechanisms that mediate normal learning and memory processes are 'hijacked' by exposure to drugs of abuse to produce pathologic addiction-related memories. Such addiction-related memories are particularly robust and long-lasting and once formed are less amenable to updating. Here we propose a neural rejuvenation hypothesis of cocaine addiction. According to this hypothesis, repeated exposure to drugs of abuse induces some plasticity mechanisms normally associated with brain development within the reward circuitry that mediate the highly efficient and unusually stable memory abnormalities that characterize addiction. PMID:24958329

  20. The Neural Rejuvenation Hypothesis of Cocaine Addiction

    PubMed Central

    Dong, Yan; Nestler, Eric J.

    2014-01-01

    A leading hypothesis guiding current molecular and cellular research of drug addiction conceptualizes key aspects of addiction as a form of memory, in which common neuroplasticity mechanisms that mediate normal learning and memory processes are “hijacked” by exposure to drugs of abuse to produce pathologic addiction-related memories. Such addiction-related memories are particularly robust and long-lasting and once formed, less amenable to updating. Here, we propose the Neural Rejuvenation Hypothesis of Cocaine Addiction: that repeated exposure to drugs of abuse induces some plasticity mechanisms that are normally associated with brain development within the brain’s reward circuitry, which mediate the highly efficient and unusually stable memory abnormalities that characterize addiction. PMID:24958329