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Sample records for addiction medicine training

  1. Training in addiction medicine in Australia.

    PubMed

    Haber, Paul S; Murnion, Bridin P

    2011-04-01

    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 established practitioners. The Chapter successfully applied to the Australian Government for recognition of AM as a medical specialty, which was finalized in November 2009. Specialist reimbursement item numbers were incorporated into that decision process and commence operating in November 2010. AChAM has designed and implemented a training scheme using a model similar to that of the RACP internal medicine training program. This comprises 3 years of basic general medical training post internship followed by 3 years of discipline-specific supervised training. The training is broadly based, with experience in both ambulatory care and inpatient care, and including physical health as well as mental health. Assessment is continuous and competency based. There is no exit examination. The overriding clinical approach rests upon the harm minimization framework consistent with long-established national drug policy in Australia and favors evidence-based treatment.

  2. 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…

  3. 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

  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. 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…

  6. 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…

  7. [Addiction].

    PubMed

    Besson, Jacques; Grivel, Jeremy; Tomei, Alexander; Falcheri, Jean-Phillipe; Rougemont-Bücking, Ansgar; Khazaal, Yasser

    2014-01-15

    The news in addiction medicine in 2013 are presented according to the new version of the DSM (DSM-5); new data on cannabinoid, highlight hypotheses on self-medication; a current status about treatment of the addiction via the internet is shown; and new therapeutic perspectives emerge from the knowledge on traumatic antecedents in addictive populations.

  8. [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

  9. 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…

  10. 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

  11. Functional neuroimaging for addiction medicine: From mechanisms to practical considerations.

    PubMed

    Ekhtiari, Hamed; Faghiri, Ashkan; Oghabian, Mohammad-Ali; Paulus, Martin P

    2016-01-01

    During last 20 years, neuroimaging with functional magnetic resonance imaging (fMRI) in people with drug addictions has introduced a wide range of quantitative biomarkers from brain's regional or network level activities during different cognitive functions. These quantitative biomarkers could be potentially used for assessment, planning, prediction, and monitoring for "addiction medicine" during screening, acute intoxication, admission to a program, completion of an acute program, admission to a long-term program, and postgraduation follow-up. In this chapter, we have briefly reviewed main neurocognitive targets for fMRI studies associated with addictive behaviors, main study types using fMRI among drug dependents, and potential applications for fMRI in addiction medicine. Main challenges and limitations for extending fMRI studies and evidences aiming at clinical applications in addiction medicine are also discussed. There is still a significant gap between available evidences from group-based fMRI studies and personalized decisions during daily practices in addiction medicine. It will be important to fill this gap with large-scale clinical trials and longitudinal studies using fMRI measures with a well-defined strategic plan for the future. PMID:26822357

  12. 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 ...

  13. Application of person-centered medicine in addiction

    PubMed Central

    Tarter, Ralph E.; Kirisci, Levent; Ridenour, Ty; Bogen, Debra

    2012-01-01

    This article discusses human individuality within a lifespan developmental perspective. The practical application of an individual differences framework for diagnosis, prevention and treatment of addiction is described. A brief overview of the methods conducive to knowledge development within the rubric of person-centered medicine that are available to practitioners working in office and clinic settings concludes the discussion. PMID:23243492

  14. Noninvasive brain stimulation for addiction medicine: From monitoring to modulation.

    PubMed

    Yavari, Fatemeh; Shahbabaie, Alireza; Leite, Jorge; Carvalho, Sandra; Ekhtiari, Hamed; Fregni, Felipe

    2016-01-01

    Addiction is a chronic relapsing brain disease with significant economical and medical burden on the societies but with limited effectiveness in the available treatment options. Better understanding of the chemical, neuronal, regional, and network alterations of the brain due to drug abuse can ultimately lead to tailoring individualized and more effective interventions. To this end, employing new assessment and intervention procedures seems crucial. Noninvasive brain stimulation (NIBS) techniques including transcranial electrical and magnetic stimulations (tES and TMS) have provided promising opportunities for the addiction medicine in two main domains: (1) providing new insights into neurochemical and neural circuit changes in the human brain cortex and (2) understanding the role of different brain regions by using NIBS and modulating cognitive functions, such as drug craving, risky decision making, inhibitory control and executive functions to obtain specific treatment outcomes. In spite of preliminary positive results, there are several open questions, which need to be addressed before routine clinical utilization of NIBS techniques in addiction to medicine, such as how to account for interindividual differences, define optimal cognitive and neural targets, optimize stimulation protocols, and integrate NIBS with other therapeutic methods. Therefore, in this chapter we revise the available literature on the use of NIBS (TMS and tES) in the diagnostic, prognostic, and therapeutic aspects of the addiction medicine.

  15. Gambling as an addictive disorder among athletes: clinical issues in sports medicine.

    PubMed

    Miller, T W; Adams, J M; Kraus, R F; Clayton, R; Miller, J M; Anderson, J; Ogilvie, B

    2001-01-01

    This article examines the role of gambling as an addictive disorder experienced by athletes, both college and professional. Gambling may often be seen as a comorbid factor with other addictions and with depression among athletes. The focus on addictions among athletes has gained considerable attention among sports medicine clinicians. Diagnostic indicators, risk and protective factors, and a stage model of addiction among athletes are addressed. An algorithm and pathway of care for athletes with an addictive disorder is offered as are recommendations that sports physicians, sports medicine specialists, coaches and counsellors need to address athletes who have an addictive disorder.

  16. Training addiction counselors to implement CBT for depression.

    PubMed

    Hepner, Kimberly A; Hunter, Sarah B; Paddock, Susan M; Zhou, Annie J; Watkins, Katherine E

    2011-07-01

    Many clients in publicly funded substance abuse treatment programs suffer from depression yet lack access to effective mental health treatment. This study sought to examine whether addiction counselors could be effectively trained to deliver group CBT for depression and to ascertain client perceptions of the treatment. Five counselors were trained in the therapy and treated 113 clients with depression symptoms. Counselors demonstrated high fidelity to the therapy and client perceptions of the therapy were positive. Our results suggest that training addiction counselors to deliver group CBT for depression is a promising integrated treatment approach for co-occurring depression and substance disorders.

  17. [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.

  18. 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

  19. 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.

  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. 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,…

  3. 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.

  4. 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…

  5. [Addiction].

    PubMed

    Besson, J; Eap, C B; Khazaal, Y; Montagrin, Y; Rihs-Middel, M; Simon, O; Tissot, H; Tomei, A; Zumwald, C; Zullino, D

    2008-01-01

    This year review emphasizes four aspects coming from addiction psychiatry: 1. Initiation and maintenance of cannabis use. 2. Methadone and heart toxicity. 3. Suicidal behaviour in gambling. 4. Treatment of addictive disorders via internet: present and future perspectives. PMID:18251208

  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. Stress psychobiology in the context of addiction medicine: from drugs of abuse to behavioral addictions.

    PubMed

    Lemieux, Andrine; al'Absi, Mustafa

    2016-01-01

    In this chapter, we briefly review the basic biology of psychological stress and the stress response. We propose that psychological stress and the neurobiology of the stress response play in substance use initiation, maintenance, and relapse. The proposed mechanisms for this include, on the one hand, the complex interactions between biological mediators of the stress response and the dopaminergic reward system and, on the other hand, mediators of the stress response and other systems crucial in moderating key addiction-related behaviors such as endogenous opioids, the sympathetic-adrenal-medullary system, and endocannabinoids. Exciting new avenues of study including genomics, sex as a moderator of the stress response, and behavioral addictions (gambling, hypersexuality, dysfunctional internet use, and food as an addictive substance) are also briefly presented within the context of stress as a moderator of the addictive process. PMID:26806770

  9. Stress psychobiology in the context of addiction medicine: from drugs of abuse to behavioral addictions.

    PubMed

    Lemieux, Andrine; al'Absi, Mustafa

    2016-01-01

    In this chapter, we briefly review the basic biology of psychological stress and the stress response. We propose that psychological stress and the neurobiology of the stress response play in substance use initiation, maintenance, and relapse. The proposed mechanisms for this include, on the one hand, the complex interactions between biological mediators of the stress response and the dopaminergic reward system and, on the other hand, mediators of the stress response and other systems crucial in moderating key addiction-related behaviors such as endogenous opioids, the sympathetic-adrenal-medullary system, and endocannabinoids. Exciting new avenues of study including genomics, sex as a moderator of the stress response, and behavioral addictions (gambling, hypersexuality, dysfunctional internet use, and food as an addictive substance) are also briefly presented within the context of stress as a moderator of the addictive process.

  10. 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.

  11. 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

  12. Experimental medicine in drug addiction: towards behavioral, cognitive and neurobiological biomarkers.

    PubMed

    Duka, Theodora; Crombag, Hans S; Stephens, David N

    2011-09-01

    Several theoretical frameworks have been developed to understand putative processes and mechanisms involved in addiction. Whilst these 'theories of addiction' disagree about importance and/or nature of a number of key psychological processes (e.g. the necessity of craving and/or the involvement of drug-value representations), a number of commonalities exist. For instance, it is widely accepted that Pavlovian associations between cues and environmental contexts and the drug effects acquired over the course of addiction play a critical role, especially in relapse vulnerability in detoxified addicts. Additionally, all theories of addiction (explicitly or implicitly) propose that chronic drug exposure produces persistent neuroplastic changes in neurobiological circuitries underlying critical emotional, cognitive and motivational processes, although disagreement exists as to the precise nature of these neurobiological changes and/or their psychological consequences. The present review, rather than limiting itself to any particular theoretical stance, considers various candidate psychological, neurobiological and/or behavioral processes in addiction and outlines conceptual and procedural approaches for the experimental medicine laboratory. The review discusses (1) extinction, renewal and (re)consolidation of learned associations between cues and drugs, (2) the drug reward value, (3) motivational states contributing to drug seeking and (4) reflective (top-down) and sensory (bottom-up) driven decision-making. In evaluating these psychological and/or behavioral processes and their relationship to addiction we make reference to putative underlying brain structures identified by basic animal studies and/or imaging studies with humans.

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. Craving to quit: psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions.

    PubMed

    Brewer, Judson A; Elwafi, Hani M; Davis, Jake H

    2013-06-01

    Humans suffer heavily from substance use disorders and other addictions. Despite much effort that has been put into understanding the mechanisms of the addictive process, treatment strategies have remained suboptimal over the past several decades. Mindfulness training, which is based on ancient Buddhist models of human suffering, has recently shown preliminary efficacy in treating addictions. These early models show remarkable similarity to current models of the addictive process, especially in their overlap with operant conditioning (positive and negative reinforcement). Further, they may provide explanatory power for the mechanisms of mindfulness training, including its effects on core addictive elements, such as craving, and the underlying neurobiological processes that may be active therein. In this review, using smoking as an example, we will highlight similarities between ancient and modern views of the addictive process, review studies of mindfulness training for addictions and their effects on craving and other components of this process, and discuss recent neuroimaging findings that may inform our understanding of the neural mechanisms of mindfulness training.

  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. 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)

  20. 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,…

  1. Satisfaction with civilian family medicine residency training

    PubMed Central

    Wolfrom, Brent; Hodgetts, Geoff; Kotecha, Jyoti; Pollock, Emily; Martin, Mary; Han, Han; Morissette, Pierre

    2016-01-01

    Abstract Objective To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. Design A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. Setting Canada. Participants General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters. Main outcome measures Satisfaction with and time spent in 7 domains of training: trauma, critical care, emergency medicine, psychiatry, occupational health, sports medicine, and base clinic training. Overall preparedness for leading a health care team, caring for a military population, working in isolated and challenging environments, and being deployed were evaluated on a 5-point Likert scale. Results Among the survey respondents (n = 135, response rate 54%), 77% agreed or strongly agreed that their family medicine residency training was relevant to their role as a general duty medical officer. Most respondents were either satisfied or very satisfied with their emergency medicine training (77%) and psychiatry training (63%), while fewer were satisfied or very satisfied with their sports medicine (47%), base clinic (41%), and critical care (43%) training. Even fewer respondents were satisfied or very satisfied with their trauma (26%) and occupational health (12%) training. Regarding overall preparedness, 57% believed that they were adequately prepared to care for a military patient population, and 52% of respondents believed they were prepared for their first posting. Fewer respondents (38%) believed they were prepared to work in isolated, austere, or challenging environments, and even fewer (32%) believed that residency training prepared them to lead a health care team. Conclusion General duty medical officers were satisfied with many aspects of

  2. 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

  3. 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

  4. [Use of hypoxic training in sports medicine].

    PubMed

    Radzievskiĭ, P A

    1997-01-01

    Examinations of high-quality athletes during their hypoxic adaptation under low-pressure mountain conditions and under normal pressures during normobaric interval hypoxic training included into the planned sports preparation of athletes indicated changes in respiration, blood flow, blood respiratory function, tissue oxygen consumption, aerobic productivity and working capacity. The use of a combined regimen was shown to have benefits in enhancing aerobic productivity and general working capacity, this was applied in sports medicine while training athletes for important tournaments.

  5. [Training in tropical medicine in France].

    PubMed

    Touze, Jean-Étienne; Laroche, Roland

    2013-10-01

    Tropical medicine was a key element of the medical structures provided by France to our former colonies and, later; to countries within the scope of our international cooperation. hI recent decades, France has drastically reduced its bilateral commitments to countries in the tropics, and especially in sub-Saharan Africa. At the same time, the teaching of tropical medicine, which was highly regarded even beyond our borders, has lost a good deal of its expertise. Initially available in a few large French centers, and ensured by teachers with extensive field experience, training in tropical medicine is now offered in many universities. However; their programs and educational objectives, focusing mainly on infectious and parasitic diseases, no longer meet the healthcare priorities of southern countries, which are facing an epidemiological transition and the rise of non communicable diseases. Few teachers now have recognized expertise in tropical medicine. These changes have had negative consequences for research programs in tropical medicine and for the image of French assistance to developing countries. In this context, the followving perspectives should be considered: 1) training in tropical medicine should be enhanced by the creation of a national diploma recognized by international bodies. 2) The creation of a doctoral course in tropical medicine is a prerequisite for achieving this goal, and the future diploma must include a significant research component. 3) Teaching in tropical medicine must become more practical and be ensured by teachers with extensive field experience. 4) Training in tropical medicine should be part of a bilateral relationship with countries in the tropics, each party contributing its expertise while respecting that of its partners. 5) Training in tropical medicine should be backed uip by high-level scientific research based on enhanced synergy of our current networks (Institute for Research and Development, Network of overseas Pasteur

  6. Behavioral Medicine Training in Postdoctoral Dental Education.

    ERIC Educational Resources Information Center

    Lockhart, Peter B.; And Others

    1992-01-01

    Carolinas Medical Center (North Carolina) initiated a behavioral training program for general practice dental residents to develop skills in handling patient anxiety/stress, obesity, and depression. The program includes monthly seminars, a clinical rotation in behavioral medicine with additional related seminars, and a month-long clinical rotation…

  7. 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

  8. Comprehensive ambulatory medicine training for categorical internal medicine residents.

    PubMed

    Bharel, Monica; Jain, Sharad; Hollander, Harry

    2003-04-01

    It is challenging to create an educational and satisfying experience in the outpatient setting. We developed a 3-year ambulatory curriculum that addresses the special needs of our categorical medicine residents with distinct learning objectives for each year of training and clinical experiences and didactic sessions to meet these goals. All PGY1 residents spend 1 month on a general medicine ambulatory care rotation. PGY2 residents spend 3 months on an ambulatory block focusing on 8 core medicine subspecialties. Third-year residents spend 2 months on an advanced ambulatory rotation. The curriculum was started in July 2000 and has been highly regarded by the house staff, with statistically significant improvements in the PGY2 and PGY3 evaluation scores. By enhancing outpatient clinical teaching and didactics with an emphasis on the specific needs of our residents, we have been able to reframe the thinking and attitudes of a group of inpatient-oriented residents. PMID:12709096

  9. Evaluation and treatment of sex addiction.

    PubMed

    Rosenberg, Kenneth Paul; Carnes, Patrick; O'Connor, Suzanne

    2014-01-01

    There have been several diagnostic labels for persistent, excessive sexual behaviors, often referred in the popular media as sex addiction. Two related diagnoses, Internet addictive disorder and hypersexual disorder, were considered for, but not included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. However, most clinicians, even those trained in sexual disorders or addiction medicine, have little to no training in treating sexual compulsivity and cybersex addiction. The authors present the historical context, proposed diagnostic criteria, evaluation protocols, comorbid disorders, speculations about the neuroscience, and treatment recommendations.

  10. Nuclear medicine training and practice in Poland.

    PubMed

    Teresińska, Anna; Birkenfeld, Bożena; Królicki, Leszek; Dziuk, Mirosław

    2014-10-01

    In Poland, nuclear medicine (NM) has been an independent specialty since 1988. At the end of 2013, the syllabus for postgraduate specialization in NM has been modified to be in close accordance with the syllabus approved by the European Union of Medical Specialists and is expected to be enforced before the end of 2014. The National Consultant in Nuclear Medicine is responsible for the specialization program in NM. The Medical Center of Postgraduate Training is the administrative body which accepts the specialization programs, supervises the training, organizes the examinations, and awards the specialist title. Specialization in NM for physicians lasts for five years. It consists of 36 months of training in a native nuclear medicine department, 12 months of internship in radiology, 3 months in cardiology, 3 months in endocrinology, 3 months in oncology, and 3 months in two other departments of NM. If a NM trainee is a specialist of a clinical discipline and/or is after a long residency in NM departments, the specialization in NM can be shortened to three years. During the training, there are obligatory courses to be attended which include the elements of anatomy imaging in USG, CT, and MR. Currently, there are about 170 active NM specialists working for 38.5 million inhabitants in Poland. For other professionals working in NM departments, it is possible to get the title of a medical physics specialist after completing 3.5 years of training (for those with a master's in physics, technical physics or biomedical engineering) or the title of a radiopharmacy specialist after completing 3 years of training (for those with a master's in chemistry or biology). At present, the specialization program in NM for nurses is being developed by the Medical Centre of Postgraduate Education. Continuing education and professional development are obligatory for all physicians and governed by the Polish Medical Chamber. The Polish Society of Nuclear Medicine (PTMN) organizes regular

  11. Nuclear medicine training and practice in Poland.

    PubMed

    Teresińska, Anna; Birkenfeld, Bożena; Królicki, Leszek; Dziuk, Mirosław

    2014-10-01

    In Poland, nuclear medicine (NM) has been an independent specialty since 1988. At the end of 2013, the syllabus for postgraduate specialization in NM has been modified to be in close accordance with the syllabus approved by the European Union of Medical Specialists and is expected to be enforced before the end of 2014. The National Consultant in Nuclear Medicine is responsible for the specialization program in NM. The Medical Center of Postgraduate Training is the administrative body which accepts the specialization programs, supervises the training, organizes the examinations, and awards the specialist title. Specialization in NM for physicians lasts for five years. It consists of 36 months of training in a native nuclear medicine department, 12 months of internship in radiology, 3 months in cardiology, 3 months in endocrinology, 3 months in oncology, and 3 months in two other departments of NM. If a NM trainee is a specialist of a clinical discipline and/or is after a long residency in NM departments, the specialization in NM can be shortened to three years. During the training, there are obligatory courses to be attended which include the elements of anatomy imaging in USG, CT, and MR. Currently, there are about 170 active NM specialists working for 38.5 million inhabitants in Poland. For other professionals working in NM departments, it is possible to get the title of a medical physics specialist after completing 3.5 years of training (for those with a master's in physics, technical physics or biomedical engineering) or the title of a radiopharmacy specialist after completing 3 years of training (for those with a master's in chemistry or biology). At present, the specialization program in NM for nurses is being developed by the Medical Centre of Postgraduate Education. Continuing education and professional development are obligatory for all physicians and governed by the Polish Medical Chamber. The Polish Society of Nuclear Medicine (PTMN) organizes regular

  12. 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

  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. Training addiction professionals in empirically-supported treatments: Perspectives from the treatment community

    PubMed Central

    Hartzler, Bryan; Rabun, Carl

    2014-01-01

    Background Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. Methods In this mixed method study, data were collected in 64 semi-structured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and two direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMM), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Results Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, ‘Seeking Safety,’ and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMM and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. Conclusions As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as

  15. A scoping review of interdisciplinary collaboration in addictions education and training.

    PubMed

    Broyles, Lauren M; Conley, James W; Harding, John D; Gordon, Adam J

    2013-01-01

    Developing a workforce of multidisciplinary healthcare professionals equipped with the knowledge and skills to collaboratively address the public health crisis of alcohol and other drug (AOD) use is critical for effectively identifying, preventing, and managing AOD conditions and their sequelae. Despite general enthusiasm for interdisciplinary education and training, little is known overall about the nature and outcomes of interdisciplinary collaboration in addictions education and training. We conducted a five-stage scoping review of the literature to provide an eight domain overview of the state of interdisciplinary collaboration in addictions education (ICAE). In our final review of 30 articles, we identified a lack of conceptual and terminological clarity around ICAE but a wide range of learners and professional collaborators in ICAE initiatives, which focused on a variety of AOD topics and used a constellation of didactic, interactive, and service-learning teaching strategies and formats. Although we found limited substantive educational or practice-oriented outcomes available for ICAE initiatives, learner and faculty feedback reflected high enthusiasm for ICAE and widespread perceptions of benefit for improved clinical care. Facilitators and barriers to the implementation of ICAE initiatives occurred at the level of the individual and the institution and ranged from pragmatic to conceptual. Emerging trends in ICAE initiatives included increased application of learning and implementation theory and extension of ICAE into research training. We conclude with recommendations to support ICAE as a new paradigm for addictions education for all health professionals.

  16. 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

  17. 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.

  18. Neuroscience of drug craving for addiction medicine: From circuits to therapies.

    PubMed

    Ekhtiari, Hamed; Nasseri, Padideh; Yavari, Fatemeh; Mokri, Azarkhsh; Monterosso, John

    2016-01-01

    Drug craving is a dynamic neurocognitive emotional-motivational response to a wide range of cues, from internal to external environments and from drug-related to stressful or affective events. The subjective feeling of craving, as an appetitive or compulsive state, could be considered a part of this multidimensional process, with modules in different levels of consciousness and embodiment. The neural correspondence of this dynamic and complex phenomenon may be productively investigated in relation to regional, small-scale networks, large-scale networks, and brain states. Within cognitive neuroscience, this approach has provided a long list of neural and cognitive targets for craving modulations with different cognitive, electrical, or pharmacological interventions. There are new opportunities to integrate different approaches for carving management from environmental, behavioral, psychosocial, cognitive, and neural perspectives. By using cognitive neuroscience models that treat drug craving as a dynamic and multidimensional process, these approaches may yield more effective interventions for addiction medicine.

  19. Addiction research centres and the nurturing of creativity
department of addictive behaviour and addiction medicine, central institute of Mental Health, Mannheim, University of Heidelberg.

    PubMed

    Mann, Karl

    2010-12-01

    Addictive behaviour is as prevalent in Germany as in other western countries, but in contrast to some European countries and the United States, very little money was given to this research field. Change came in the early 1990s, when the German government started to launch specific grants for addiction research. The first chair in addiction research was created in 1999 (Karl Mann) at the Central Institute of Mental Health Mannheim (CIMH; University of Heidelberg). The recruitment of a pre-clinical alcohol researcher as head of the department of psychopharmacology followed (Rainer Spanagel). This 'addiction research cluster' collaborates with several research groups at the CIMH (such as genetics). We inaugurated a clinical trial network which now comprises up to 20 treatment centres throughout Germany. Like most authors, we found effect sizes of different treatment modalities more in the low to moderate range, perhaps because of the heterogeneity of large patient samples. Therefore, we concentrated upon the biological basis of addiction in order to define more homogeneous 'subtypes' of patients for a better match with existing treatments. Results concerning genetics and neuroimaging (both animal and human) are promising, and could move our field towards a more personalized treatment approach. Our funding has been extended over the years, including involvement in several large European grants. We are studying substance-related problems as well as so-called 'behavioural addictions'. As a natural consequence of this development, we are deeply involved both in informing the general public on addiction issues as well as in counselling policy makers in Germany.

  20. 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

  1. 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

  2. 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)…

  3. Culture change in addictions treatment: a targeted training and technical assistance initiative affects tobacco-related attitudes and beliefs in addiction treatment settings.

    PubMed

    Perka, Edward J

    2011-11-01

    Targeted training and technical assistance can have a major impact on the attitudes and beliefs of addiction service providers with respect to the treatment of tobacco dependency. Major gains have been made with the general public since the mid-1960s with respect to the reduction of tobacco use behavior and tobacco-related diseases. Tobacco use continues to be a major public health problem, and tobacco control initiatives are significantly affecting public attitudes and norms regarding tobacco use. There is, however, a specific population that has not benefited from these gains and, in fact, has been encouraged to continue smoking rather than make an attempt to quit. Individuals with a substance use disorder and/or mental health disorder have a much higher percentage of tobacco use than the general population, resulting in major health disparities. The addiction treatment and recovery community has lagged behind the general public in addressing tobacco use. New York State's project, "Integrating Tobacco Use Interventions Into Chemical Dependence Services," is a model that demonstrates how innovative regulations, and training and technical assistance developed specifically for addiction service providers, can initiate culture change with respect to tobacco use within addiction treatment settings, resulting in improved treatment outcomes and longer term stable recovery.

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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)

  9. 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…

  10. Resting state functional connectivity analysis for addiction medicine: From individual loci to complex networks.

    PubMed

    Pariyadath, Vani; Gowin, Joshua L; Stein, Elliot A

    2016-01-01

    Resting state functional connectivity (rsFC) has provided a new and valuable tool for investigating network-level dysfunction in addiction. Following the recent development of a framework of large scale network disruptions, we have been able to arrive at unique insights into craving-related aspects of addiction using rsFC. However, such network-level advancement has thus far eluded our understanding of mesocorticolimbic involvement in addiction. Given the importance of this system in vulnerability and resilience to addiction, understanding mesocorticolimbic dynamics to the same extent could provide critical insights into the disease. To this end, we review here recent studies on addiction that employ rsfC and suggest a new approach, one that combines a novel model for addiction with new experimental techniques as well as participant groups, to accelerate progress in this arena. PMID:26822358

  11. The Rehabilitation Medicine Scientist Training Program: impact and lessons learned.

    PubMed

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

    2009-03-01

    Physician scientists are seen as important in healthcare research. However, the number of physician scientists and their success in obtaining National Institutes of Health 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 was funded by a K12 grant from the National Center for Medical Rehabilitation Research, as one strategy for increasing the number of research-productive physiatrists. The Rehabilitation Medicine Scientist Training Program's structure was revised in 2001 to improve the level of preparation of incoming trainees and to provide a stronger central mentorship support network. We describe the original and revised structure of the Rehabilitation Medicine Scientist Training Program and review subjective and objective data on the productivity of the trainees who have completed the program. These data suggest that Rehabilitation Medicine Scientist Training Program 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 yrs of training.

  12. [The Sino-French emergency and disaster medicine training center].

    PubMed

    Pourriat, Jean-Louis; Dahan, Benjamin; Lapandry, Claude

    2012-01-01

    French (AP-HP) and Chinese (Beijing Health Office) hospitals, with support from the French company Total, collaborated in order to improve Chinese doctors' knowledge of emergency and disaster medicine prior to the Beijing Olympic Games. A Sino-French emergency and disaster medicine training center was subsequently opened in Beijing in 2008, with the aim of providing high-level continuous medical training for Chinese specialists in emergency medicine. Teaching in the management of critical situations was based on the use of a latest-generation simulator (Sim 3G; Laerdal). This collaboration has had both pedagogical and diplomatic benefits. PMID:23550459

  13. 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)

  14. 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.…

  15. New developments in education and training in sexual medicine.

    PubMed

    Reisman, Yacov; Eardley, Ian; Porst, Hartmut

    2013-04-01

    INTRODUCTION.: The past 12 months have been historic ones for the field of Sexual Medicine in that we have seen the creation of the European Board examination in Sexual Medicine with the title of "Fellow of the European Committee on Sexual Medicine" (FECSM) offered to successful candidates. AIM.: The study aims to promote a high standard of care in Sexual Medicine. METHODS.: An important way of promoting high standards of care is by the development of training, regulation, and assessment framework. The background to these developments and the recent educational activities of the European Society for Sexual Medicine (ESSM) are described in this article. RESULTS.: The creation of the Multidisciplinary Joint Committee on Sexual Medicine (MJCSM) under the auspices of the European Union of Medical Specialists, with the primary purpose to develop the highest possible standards of training in Sexual Medicine in Europe, made it possible to create a process for qualification in Sexual Medicine. The ESSM educational activities created opportunities to support trainees in Sexual Medicine and the first MJCSM exam was held in Amsterdam with a high overall success rate. CONCLUSION.: These activities are intended to improve quality. The FECSM examination is the first of its type and provides a real opportunity for Sexual Medicine physicians to demonstrate and document their knowledge.

  16. Neurosciences intensive care medicine in initial neurosurgical training.

    PubMed

    Pereira, E A C; Madder, H; Millo, J; Kearns, C F

    2009-04-01

    The authors describe a novel 4-month clinical placement in neurosciences intensive care medicine (NICM) undertaken in the first specialty registrar (ST1) year of neurosurgical training as part of a clinical neurosciences themed training year. Neurosurgery is unique among British surgical specialties in having pioneered themed early years in run-through training to replace basic surgical training in general surgical specialties as part of Modernising Medical Careers. After describing events leading to the new neurosurgical training, the knowledge, skills and attitudes acquired in NICM are highlighted alongside discussion of logistic aspects and future directions from an inaugural experience.

  17. A Step Forward in Teaching Addiction Counselors How to Supervise Motivational Interviewing Using a Clinical Trials Training Approach

    ERIC Educational Resources Information Center

    Martino, Steve; Gallon, Steve; Ball, Samuel A.; Carroll, Kathleen M.

    2007-01-01

    A clinical trials training approach to supervision is a promising and empirically supported method for preparing addiction counselors to implement evidence-based behavioral treatments in community treatment programs. This supervision approach has three main components: (1) direct observation of treatment sessions; (2) structured performance…

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. Differences between family and emergency medicine training before sports medicine fellowship.

    PubMed

    Christensen, Mark; Christensen, Heidi K

    2015-01-01

    Residency training clearly impacts physicians' approach toward fellowship in Primary Care Sports Medicine. Although the Accreditation Council for Graduate Medical Education sets strict standards for all programs, family medicine and emergency medicine training differ a great deal in general and provide physicians from both backgrounds varied perspectives and skill sets. The family physician acquires a substantial amount of experience in continuity of care and integration of health care into a patient's everyday life. On the other hand, the emergency physician receives exceptional training in the management of acutely ill and injured patients and leadership of a large health care team. Furthermore, while the emergency physician may be skilled in procedures such as fracture reduction and diagnostic ultrasound, the family physician is proficient in developing patient rapport and compliance with a treatment plan. Although physicians from different backgrounds may start with many differences, fellowship training is essential in bridging those gaps.

  4. Differences between family and emergency medicine training before sports medicine fellowship.

    PubMed

    Christensen, Mark; Christensen, Heidi K

    2015-01-01

    Residency training clearly impacts physicians' approach toward fellowship in Primary Care Sports Medicine. Although the Accreditation Council for Graduate Medical Education sets strict standards for all programs, family medicine and emergency medicine training differ a great deal in general and provide physicians from both backgrounds varied perspectives and skill sets. The family physician acquires a substantial amount of experience in continuity of care and integration of health care into a patient's everyday life. On the other hand, the emergency physician receives exceptional training in the management of acutely ill and injured patients and leadership of a large health care team. Furthermore, while the emergency physician may be skilled in procedures such as fracture reduction and diagnostic ultrasound, the family physician is proficient in developing patient rapport and compliance with a treatment plan. Although physicians from different backgrounds may start with many differences, fellowship training is essential in bridging those gaps. PMID:25968851

  5. Addiction treatment provider attitudes on staff capacity and evidence-based clinical training: results from a national study.

    PubMed

    Lundgren, Lena; Amodeo, Maryann; Krull, Ivy; Chassler, Deborah; Weidenfeld, Rachel; de Saxe Zerden, Lisa; Gowler, Rebekah; Lederer, Jaime; Cohen, Alexander; Beltrame, Clelia

    2011-01-01

    This national study of addiction-treatment organizations' implementation of evidence-based practices examines: (1) organizational/leadership factors associated with director (n = 212) attitudes regarding staff resistance to organizational change, and (2) organizational/staff factors associated with staff (n = 312) attitudes regarding evidence-based clinical training. Linear regression analyses, controlling for type of treatment unit, leadership/staff characteristics and organizational readiness to change, identified that directors who perceived their organization needed more guidance and had less staff cohesion and autonomy rated staff resistance to organizational change significantly higher. Staff with higher levels of education and greater agreement that their organization supported change had greater preference for evidence-based trainings. Federal addiction treatment policy should both promote education and training of treatment staff and organizational development of treatment CBOs. 

  6. Addiction treatment provider attitudes on staff capacity and evidence-based clinical training: results from a national study.

    PubMed

    Lundgren, Lena; Amodeo, Maryann; Krull, Ivy; Chassler, Deborah; Weidenfeld, Rachel; de Saxe Zerden, Lisa; Gowler, Rebekah; Lederer, Jaime; Cohen, Alexander; Beltrame, Clelia

    2011-01-01

    This national study of addiction-treatment organizations' implementation of evidence-based practices examines: (1) organizational/leadership factors associated with director (n = 212) attitudes regarding staff resistance to organizational change, and (2) organizational/staff factors associated with staff (n = 312) attitudes regarding evidence-based clinical training. Linear regression analyses, controlling for type of treatment unit, leadership/staff characteristics and organizational readiness to change, identified that directors who perceived their organization needed more guidance and had less staff cohesion and autonomy rated staff resistance to organizational change significantly higher. Staff with higher levels of education and greater agreement that their organization supported change had greater preference for evidence-based trainings. Federal addiction treatment policy should both promote education and training of treatment staff and organizational development of treatment CBOs.  PMID:21477056

  7. 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

  8. [Teaching and training in geriatric medicine in the European Union].

    PubMed

    Duursma, S

    2005-04-01

    In 1993 about 20% of the population in the 15 'old' member countries of the European Union (EU) was over 60 years of age and this percentage will increase to more than 25% in 2020. These developments play a key role for the investments in education and training to meet societies needs for health care services. In 2002 about 25% of the medical students in the 'old' EU did not receive any education in geriatric medicine. A question is who will provide the services for older people in related areas, like social care, community care, acute care in the hospitals, long-term care, permanent care and care for psychiatric patients? Geriatric medicine has been recognized as an independent specialty in 8 of the 15 member countries of the 'old' EU. In all EU member states the governments are autonomous regarding all aspects of health care services, including the recognition of specialties and specialist training programmes. A two years training in internal medicine has been recommended in the EU, followed by another four years of training in geriatric medicine. The specialist training has a hospital oriented character, however, it includes also community care and other institutionalised care like nursing homes. The curriculum should contain: biological, social, psychological and medical aspects of common diseases and disturbances in older people. A problem in many EU countries is the shortage of well trained researchers and leading persons for academic positions for geriatric medicine. In a number of countries chairs at the universities remain vacant for long periods of time or even disappear. Good services in the health care for older people need a high quality curriculum and training programme.

  9. 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.

  10. Development of an academic training program in insurance medicine.

    PubMed

    Donceel, Peter

    2008-01-01

    We outline the aims and content of an inter-university academic training program in insurance medicine in Flanders, Belgium. The program leads to the diploma of "Master of Insurance Medicine and Medico-legal Expertise." The program was re-organized in 2005-2006 and is accessible for physicians who want to practice social and/or private insurance medicine as their main medical profession or as an accessory activity. The aim of education is to prepare insurance physicians to provide high quality assessments, advice and decisions. The combined education in both social and private insurance medicine offers a broad perspective on the discipline and promotes collaboration within the specialty. The recent recognition of Insurance Medicine as a medical specialty in Belgium strengthens the position of insurance physicians as they collaborate with other medical specialists and with the management of insurance companies or the social security institute.

  11. 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

  12. The Residency Training Experience in Podiatric Medicine and Surgery.

    PubMed

    Shofler, David; Chuang, Taijung; Argade, Nina

    2015-01-01

    The podiatric medicine and surgery residency is currently characterized by 3 years of comprehensive training. Contemporary issues have recently influenced the direction of training in the profession of podiatric medicine. Formal investigation into the residency training experience has, nonetheless, been limited. The purpose of the present study was to conduct a learning needs assessment of podiatric residency training. An electronic survey was developed, with comparable versions for program directors and residents. The specific topics investigated included the use of minimum activity volume numbers, learning resources, duty hours, strengths and weaknesses of residents, motivation of hosting student externship positions, noncognitive residency traits, meetings between residents and directors, resident satisfaction, and director satisfaction. A total of 197 program directors nationwide were sent the survey electronically, and 109 (53%) responded. Of 230 residents receiving the survey, 159 (78%) responded. Several statistically significant differences, and notable similarities, were observed between the 2 groups encompassing many aspects of the survey. A majority opinion, among both directors and residents, was found that the use of procedural assessment tools might improve resident evaluation. The responding directors and residents agreed that the following 3 topics were weaknesses in podiatric training: practice management, biomechanics, and performing podiatric research. Direct feedback immediately after surgery was the most valuable learning resource reported by the residents. The results of our study reflect the current status of the podiatric medicine and surgery residency and could facilitate improvement in the residency training experience.

  13. [Training in internal medicine and its specialties: universities' proposals].

    PubMed

    Norero, C

    1996-04-01

    Medical School graduates can enter a medicine subspecialty training program upon completion of a 3 year Internal Medicine residency. The Ministry of Health has contributed to postgraduate training by defining the type of physician the country needs, and by financial support of specially (Internal Medicine) training. Before 1995, when applicants began being charged a fee, finding for subspecialty training was provided exclusively by the universities. Currently, 450 training post are available for 550 graduates from all medical schools. Of these, 59 are in Internal Medicine and 58 in its subspecialties. A quantitative analysis of 40 years of training programs in Internal Medicine by the traditional medical schools shows that only the Catholic University of Chile Medical School privileges subspecially training whereas all other schools favor general Internal Medicine training. A high number of Internal Medicine trainees never take final examination. Nevertheless, training through practice, not necessarily in a university setting, accounts for 67% of Autonomous National Corporation for Certification of Medical Specialties. CONACEM accredited subspecialists. About 63% of those who finish an Internal Medicine training program decide to go into subspecialization. It is felt that subspecialization involves technical as well as non-professional aspects, such as a philosophical stance towards the search for truth through research and creativity. An integral education in a subspecialty can only be given by the university. Non-university centers, however, can contribute to subspecialization by allowing trainees to gain access to newer technology or to larger numbers of patients. A critical question is how many subspecialists should exist in relation to the number of generalists and according to the country's health requirements. In my personal view, the proportion of subspecialists is excessive. The decision to subspecialize should not be exclusively a personal choice, but

  14. 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

  15. 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…

  16. 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

  17. 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

  18. Graduate training in community medicine at Mount Sinai: the development of the Master of Science in Community Medicine.

    PubMed

    Silver, A; Deuschle, K W

    1990-11-01

    This paper describes the philosophy, process, and outcome of the integration of independent study and classroom training with existing clinical and research experiences in The Mount Sinai Medical Center Department of Community Medicine's general preventive medicine and occupational medicine residencies leading to the creation of the Master of Science in Community Medicine.

  19. 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

  20. Reinforcement principles for addiction medicine; from recreational drug use to psychiatric disorder.

    PubMed

    Edwards, Scott

    2016-01-01

    The transition from recreational drug use to addiction can be conceptualized as a pathological timeline whereby the psychological mechanisms responsible for disordered drug use evolve from positive reinforcement to favor elements of negative reinforcement. Abused substances (ranging from alcohol to psychostimulants) are initially ingested at regular occasions according to their positive reinforcing properties. Importantly, repeated exposure to rewarding substances sets off a chain of secondary reinforcing events, whereby cues and contexts associated with drug use may themselves become reinforcing and thereby contribute to the continued use and possible abuse of the substance(s) of choice. Indeed, the powerful reinforcing efficacy of certain drugs may eclipse that of competing social rewards (such as career and family) and lead to an aberrant narrowing of behavioral repertoire. In certain vulnerable individuals, escalation of drug use over time is thought to drive specific molecular neuroadaptations that foster the development of addiction. Research has identified neurobiological elements of altered reinforcement following excessive drug use that comprise within-circuit and between-circuit neuroadaptations, both of which contribute to addiction. Central to this process is the eventual potentiation of negative reinforcement mechanisms that may represent the final definitive criterion locking vulnerable individuals into a persistent state of addiction. Targeting the neural substrates of reinforcement likely represents our best chances for therapeutic intervention for this devastating disease. PMID:26806771

  1. The teaching of liberal arts in internal medicine residency training.

    PubMed

    Povar, G J; Keith, K J

    1984-09-01

    Forty-four members of the Association of Program Directors in Internal Medicine and 58 members of the Society for Research and Education in Primary Care Internal Medicine completed questionnaires on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine. They rated economics of medical care and bioethics as essential to residency training. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. Although there was great variability in the curricula represented, over 40 percent of the respondents reported having formal lecture and/or seminar exposure to these topics in their programs. Problems encountered in implementing liberal arts programs included lack of curriculum time, limited-faculty members, and a lack of interest on the part of residents. There is a need both to arrive at a consensus among residency directors and to explore means of developing interdisciplinary faculties if the liberal arts are to form an established part of internal medicine residency training.

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. Geritalk: communication skills training for geriatric and palliative medicine fellows.

    PubMed

    Kelley, Amy S; Back, Anthony L; Arnold, Robert M; Goldberg, Gabrielle R; Lim, Betty B; Litrivis, Evgenia; Smith, Cardinale B; O'Neill, Lynn B

    2012-02-01

    Expert communication is essential to high-quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence-based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques before the course. Geriatric and palliative medicine fellows were recruited to participate in the course and 100% (n = 18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on a 5-point scale). After the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, P < .001). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, customized for the specific needs of geriatric and palliative medicine fellows, improved fellows' self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills.

  8. Training family medicine residents to care for children

    PubMed Central

    Duke, Pauline; Curran, Vernon; Hollett, Ann

    2011-01-01

    Abstract Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents’ satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same level of knowledge and confidence as residents completing an inpatient-ambulatory rotation. Intraprofessional collaboration, flexibility in scheduling, and the support of pediatric preceptors are key factors in the organization and implementation of an ambulatory rotation. PMID:21321160

  9. 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

  10. Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface.

    PubMed

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

    2014-01-10

    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.

  11. [Medicinal plants in the phytotherapy of alcohol or nicotine addiction. Implication for plants in vitro cultures].

    PubMed

    Ozarowski, Marcin; Mikołajczak, Przemyslaw Ł; Thiem, Barbara

    2013-01-01

    The increasing problem of nicotine and alcohol addiction, and small availability of drugs in the pharmacologic treatment causes that there are still looking for new drugs that could be used in addiction prevention and relief of withdrawal symptoms. Currently, attention has focused on a number of species possessed above mentioned pharmacological profile that do not occur naturally in moderate climate in Poland, including Passiflora incarnata, Pueraria lobata, Salvia miltiorrhiza, Salvia przewalskii. A rich source of biologically active compounds showing their possible benefit against addiction are plant derived both from its natural state as well as by biotechnological methods. Studies using in vitro plant cultures allow receiving material containing interesting secondary metabolites (active compounds) in the of shoots, root, callus and suspension cultures. Overview of pharmacological studies showed that several experiments carried out in animal models of alcoholism, and only few studies have been done on nicotine addiction using herbs. It has been shown that an extract of the herb Passiflora incarnata (and its benzoflavone derivative-BZF) can be an interesting plant material that could reduce the intensity of nicotine or alcohol withdrawal symptoms, however, only few studies have been published in this area. A larger amount of evidence has been provided to the anti-alcohol effect of the extract from the root of Pueraria lobata (kudzu). It is known that kudzu root extract is effective at reducing alcohol intake in animals and in humans. The three major isoflavones present in kudzu extracts, daidzin, daidzein and puerarin are responsible for the beneficial effects in reduction of alcohol consumption, although the exact mechanism by which kudzu suppresses ethanol intake remains to be clarified. It has been proven that daidzin in vitro is a strong, selective and reversible inhibitor of aldehyde dehydrogenase. Moreover, studies on the CNS receptor gene expression showed

  12. 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

  13. General medicine advanced training: lessons from the John Hunter training programme.

    PubMed

    Jackel, D; Attia, J; Pickles, R

    2014-03-01

    Recent years have seen a rapid growth in the number of advanced trainees pursuing general medicine as a specialty. This reflects an awareness of the need for broader training experiences to equip future consultant physicians with the skills to manage the healthcare challenges arising from the demographic trends of ageing and increasing comorbidity. The John Hunter Hospital training programme in general medicine has several characteristics that have led to the success in producing general physicians prepared for these challenges. These include support from a core group of committed general physicians, an appropriate and sustainable funding model, flexibility with a focus on genuine training and developing awareness of a systems approach, and strong links with rural practice.

  14. 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

  15. 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...

  16. 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…

  17. Graduate Training in Family Medicine: Two Years or Three?

    PubMed Central

    Vinger, Irving

    1979-01-01

    Graduate training in family medicine is a three year program in the United States and a two year program in Canada. For the majority of family practice residents the third year is required in order to consolidate the attitudes and skills related to continuing comprehensive health care and prevention. Without this consolidation, the application of these concepts to the practice of family health care is subject to the normal anxieties, frustrations and uncertanties which lead physicians to provide technologically oriented, episodic care. PMID:21297762

  18. 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

  19. Telephone Management Training in Internal Medicine Residencies: A National Survey of Program Directors.

    ERIC Educational Resources Information Center

    Flannery, Michael T.; And Others

    1995-01-01

    A survey of 250 accredited internal medicine training sites in the United States revealed that only 6% offered formal training in telephone medicine to their residents, usually consisting of single lectures or reading materials. A majority of respondents felt telephone management training was very important and should be part of every internal…

  20. Attitudes of anesthesiology residents toward critical care medicine training.

    PubMed

    Durbin, C G; McLafferty, C L

    1993-09-01

    The number of anesthesiology residents pursuing critical care medicine (CCM) fellowship training has been decreasing in recent years. A significant number of training positions remain unfilled each year. Possible causes of this decline were evaluated by surveying residents regarding their attitudes toward practice and training in CCM. All 38 anesthesiology programs having accredited CCM fellowships were surveyed. Four of these and one program without CCM fellowships were used to develop the survey instrument. Four programs without CCM fellowships and 34 programs with CCM fellowships make up the survey group. Returned were 640 surveys from 37 (97%) programs accounting for over 30% of the possible residents. Resident interest in pursuing CCM training decreased as year of residency increased (P < 0.0001). Residents in programs with little patient care responsibility during intensive care unit (ICU) rotations expressed less interest in CCM training (P < 0.012). The administrative role of the anesthesiology department in the ICU also influenced resident interest (P < 0.014). Written responses to open-ended questions suggested resident concerns with the following: stress of chronic care, financial consequences of additional year of training, ICU call frequency and load, ICU role ambiguity, and shared decision-making in the ICU. A recurring question was, "Are there jobs (outside of academics) for anesthesiologist intensivists?" Most residents knew a CCM anesthesiologist they admired and knew that there were unfilled fellowship positions available. Defining the job market, improving curriculum and teaching, supporting deferment of student loans, and introducing residents and medical students to the ICU earlier may increase the interest in CCM practice among anesthesiology residents.

  1. 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…

  2. Design and Implementation of a Competency-Based Transfusion Medicine Training Program in Canada.

    PubMed

    Zeller, Michelle P; Sherbino, Jonathan; Whitman, Lucinda; Skeate, Robert; Arnold, Donald M

    2016-01-01

    Transfusion medicine training in Canada is currently undergoing a transformation from a time- and process-based curriculum to a competency-based medical education framework. Transfusion medicine is the first accredited postgraduate medical education training program in Canada to adopt a purely competency-based curriculum. It is serving as an example for a number of other postgraduate medical training programs undergoing a similar transition. The purpose of this review is to highlight the elements of competency-based medical education, describe its application to transfusion medicine training, and report on the development and implementation of the new transfusion medicine curriculum in Canada.

  3. 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

  4. 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.

  5. Psychiatric training in primary care medicine residency programs. A national survey.

    PubMed

    Chin, H P; Guillermo, G; Prakken, S; Eisendrath, S

    2000-01-01

    The authors conducted a national survey to investigate the current status of psychiatric training in primary care/internal medicine residencies. Fifty-four residency training directors completed and returned the survey. The survey results show that an average of 99 hours (69.5 hours clinical plus 29.8 hours didactics) is devoted to psychiatric training during the 3 years of primary care/internal medicine residency training. Responding residency training directors indicated that psychiatric training is important (an average of 7 out of 10 on a 10-point rating scale), and 63% of respondents indicated that more training in psychiatry is needed.

  6. [Tropical medicine/tropical dermatology training in Tanzania and Ghana: Personal experience and selected case reports].

    PubMed

    Völker, K

    2015-05-01

    As a consultant for dermatology with special interested in tropical diseases, I accepted my employers offer (German Armed Forces) to start my training in tropical medicine and tropical dermatology in Africa. The dermatological part of the training was completed at the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania. This was followed by tropical medicine training at the Presbyterian Hospital in Agogo, Ghana. In this article, I report on my experiences in Africa and present selected case reports.

  7. ACR-SNM Task Force on Nuclear Medicine Training: report of the task force.

    PubMed

    Guiberteau, Milton J; Graham, Michael M

    2011-06-01

    The expansion of knowledge and technological advances in nuclear medicine and radiology require physicians to have more expertise in functional and anatomic imaging. The convergence of these two specialties into the new discipline of molecular imaging has also begun to place demands on residency training programs for additional instruction in physiology and molecular biology. These changes have unmasked weaknesses in current nuclear medicine and radiology training programs. Adding to the impetus for change are the attendant realities of the job market and uncertain employment prospects for physicians trained in nuclear medicine but not also trained in diagnostic radiology. With this background, the ACR and the Society of Nuclear Medicine convened the Task Force on Nuclear Medicine Training to define the issues and develop recommendations for resident training.

  8. 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.

  9. 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…

  10. 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.

  11. 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

  12. Narcotic Addiction

    PubMed Central

    Fern, B. J.

    1976-01-01

    This article presents the major features of narcotic addictions, focusing on the role of methadone as a means of controlling or removing the addiction. It concludes with some observations on society's attitude towards addicts, addictions and programs for control of addiction. PMID:21308103

  13. 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

  14. AAPM/SNMMI Joint Task Force: report on the current state of nuclear medicine physics training.

    PubMed

    Harkness, Beth A; Allison, Jerry D; Clements, Jessica B; Coffey, Charles W; Fahey, Frederic H; Gress, Dustin A; Kinahan, Paul E; Nickoloff, Edward L; Mawlawi, Osama R; MacDougall, Robert D; Pizzutiello, Robert J

    2015-09-08

    The American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) recognized the need for a review of the current state of nuclear  medicine physics training and the need to explore pathways for improving nuclear medicine physics training opportunities. For these reasons, the two organizations formed a joint AAPM/SNMMI Ad Hoc Task Force on Nuclear Medicine Physics  Training. The mission of this task force was to assemble a representative group of stakeholders to:• Estimate the demand for board-certified nuclear medicine physicists in the next 5-10 years,• Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and• Identify approaches that may be considered to facilitate the training of nuclear medicine physicists.As a result, a task force was appointed and chaired by an active member of both organizations that included representation from the AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The Task Force first met at the AAPM Annual Meeting in Charlotte in July 2012 and has met regularly face-to-face, online, and by conference calls. This manuscript reports the findings of the Task Force, as well as recommendations to achieve the stated mission.

  15. 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

  16. Redesigning residency training in internal medicine: the consensus report of the Alliance for Academic Internal Medicine Education Redesign Task Force.

    PubMed

    Meyers, Frederick J; Weinberger, Steven E; Fitzgibbons, John P; Glassroth, Jeffrey; Duffy, F Daniel; Clayton, Charles P

    2007-12-01

    Because of numerous criticisms of the content and structure of residency training, redesigning graduate medical education (GME) has become a high priority for the internal medicine community. From 2005 to 2007, the leadership of the internal medicine community, working under the auspices of the Alliance for Academic Internal Medicine Education Redesign Task Force, developed six recommendations it will pursue to improve residency education: (1) focus education around a "core" of internal medicine, which provides the framework for both the structure and content of residents' educational experiences, (2) fully adopt competency-based evaluation and advancement, which will enhance training by focusing on individual learners' needs, (3) allow for increased, resident-centered education beyond the internal medicine core, because different types of practice require customized knowledge and skills, (4) improve ambulatory training by providing patient-centered longitudinal care that addresses the conflict between inpatient and outpatient responsibilities, (5) use new faculty models that emphasize the creation of a core faculty, and (6) align institutional and programmatic resources with the goals of redesign, balancing the clinical mission of the institution with the educational goals of residency training. Adoption of these recommendations will require significant efforts, including pilot projects, faculty development, changes in accreditation requirements, and modifications of GME funding systems. Opportunities are ample for individual programs to develop creative approaches based on the framework for educational redesign outlined in this article, and for these educational and clinical redesign initiatives to work hand-in-hand for the benefit of patients, faculty, trainees, and institutions.

  17. 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

  18. Core content for wilderness medicine fellowship training of emergency medicine graduates.

    PubMed

    Lipman, Grant S; Weichenthal, Lori; Stuart Harris, N; McIntosh, Scott E; Cushing, Tracy; Caudell, Michael J; Macias, Darryl J; Weiss, Eric A; Lemery, Jay; Ellis, Mark A; Spano, Susanne; McDevitt, Marion; Tedeschi, Christopher; Dow, Jennifer; Mazzorana, Vicki; McGinnis, Henderson; Gardner, Angela F; Auerbach, Paul S

    2014-02-01

    Wilderness medicine is the practice of resource-limited medicine under austere conditions. In 2003, the first wilderness medicine fellowship was established, and as of March 2013, a total of 12 wilderness medicine fellowships exist. In 2009 the American College of Emergency Physicians Wilderness Medicine Section created a Fellowship Subcommittee and Taskforce to bring together fellowship directors, associate directors, and other interested stakeholders to research and develop a standardized curriculum and core content for emergency medicine (EM)-based wilderness medicine fellowships. This paper describes the process and results of what became a 4-year project to articulate a standardized curriculum for wilderness medicine fellowships. The final product specifies the minimum core content that should be covered during a 1-year wilderness medicine fellowship. It also describes the structure, length, site, and program requirements for a wilderness medicine fellowship.

  19. Filling the gaps between theory and daily clinical procedural skills training in family medicine.

    PubMed

    Garcia-Rodriguez, Juan Antonio

    2016-05-01

    Performance of procedures is an integral part of any family physician/general practitioner's practice. Unfortunately, discrepancy occurs between the existing theoretical methods of procedural teaching and the training imparted during real daily practice, which creates gaps that need to be overcome. This article identifies and reviews teaching gaps in family medicine training and presents suggestions to overcome them with a view to forming holistic psychomotor skills based on the learner's characteristics within the patient-centred philosophy of family medicine. PMID:27073067

  20. Principles to consider in defining new directions in internal medicine training and certification.

    PubMed

    Turner, Barbara J; Centor, Robert M; Rosenthal, Gary E

    2006-03-01

    SGIM endorses seven principles related to current thinking about internal medicine training: 1) internal medicine requires a full three years of residency training before subspecialization; 2) internal medicine residency programs must dramatically increase support for training in the ambulatory setting and offer equivalent opportunities for training in both inpatient and outpatient medicine; 3) in settings where adequate support and time are devoted to ambulatory training, the third year of residency could offer an opportunity to develop further expertise or mastery in a specific type or setting of care; 4) further certification in specific specialties within internal medicine requires the completion of an approved fellowship program; 5) areas of mastery in internal medicine can be demonstrated through modified board certification and recertification examinations; 6) certification processes throughout internal medicine should focus increasingly on demonstration of clinical competence through adherence to validated standards of care within and across practice settings; and 7) regardless of the setting in which General Internists practice, we should unite to promote the critical role that this specialty serves in patient care.

  1. 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

    ... 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). Date and Time: June 13, 2011, 1 p.m.-4 p.m. Eastern Time. June 14, 2011, 9 a.m.-Noon Eastern Time. Place: Webinar format. Status:...

  2. 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)

  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

    ... 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). Date and Time: August 29, 2013, 9:00... by section 5103(d) and re-designated by section 5303 of the Patient Protection and Affordable...

  4. 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

    ... 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). Date and Time: November 1, 2012, 10... Affordable Care Act of 2010. At this meeting, the Advisory Committee will finalize its report on the...

  5. 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)

  6. [International postgraduate training program in medicine: survey of 13 training courses, 1988-1994].

    PubMed

    Maymon, R; Seligsohn, U; Fainaru, M

    1995-09-01

    In 1988 an International Postgraduate Training Program in Medicine was established as a joint venture of the Tel Aviv University School of Continuing Medical Education and the Ministry for Foreign Affairs, Division of International Cooperation. During 1988-1994, 359 physicians participated. A survey of 271 graduates was carried out within 1-5 years following the completion of training, and 57% responded to our questionnaire. The program fulfilled the academic expectations of 78% of the trainees, and the practical clinical expectations of 80%. 95% graded the program as good-to-excellent from the sociocultural aspect. 75% and 67.5% of the trainees graded the program as good-to-excellent with regard to improvement in their theoretical and practical skills, respectively. Regretfully, only 45% have continued their ties with the host departments and only 11% have carried out joint research projects. These results imply that further attention should be paid to the trainees' real-time input, in order to increase satisfaction. Personal tutors should be nominated in each department, and should be adequately compensated. More emphasis should be given to initiation of bilateral research projects and maintenance of professional ties between the trainees and their host departments.

  7. Key informants' perspectives on development of family medicine training programs in Ethiopia.

    PubMed

    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

  8. 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…

  9. 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.

  10. 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)

  11. 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... Committee on Training in Primary Care, Medicine and Dentistry (ACTPCMD). Date and Time: November 15, 2010, 8... Advisory Committee will work on its ninth report about the primary care pipeline. Reports are submitted...

  12. Recent changes in hypoxia training at the Royal Air Force Centre of Aviation Medicine.

    PubMed

    Wrigley, A

    2015-01-01

    Hypoxia training at the Royal Air Force Centre of Aviation Medicine (RAF CAM) has traditionally involved the use of a hypobaric chamber to induce hypoxia. While giving the student experience of both hypoxia and decompression, hypobaric chamber training is not without risks such as decompression sickness and barotrauma. This article describes the new system for hypoxia training known as Scenario-Based Hypoxia Training (SBHT), which involves the subject sitting in an aircraft simulator and wearing a mask linked by hose to a Reduced Oxygen Breathing Device (ROBD). The occupational requirements to be declared fit for this new training method are also discussed. PMID:26867422

  13. Neurofeedback training for opiate addiction: improvement of mental health and craving.

    PubMed

    Dehghani-Arani, Fateme; Rostami, Reza; Nadali, Hosein

    2013-06-01

    Psychological improvements in patients with substance use disorders have been reported after neurofeedback treatment. However, neurofeedback has not been commonly accepted as a treatment for substance dependence. This study was carried out to examine the effectiveness of this therapeutic method for opiate dependence disorder. The specific aim was to investigate whether treatment leads to any changes in mental health and substance craving. In this experimental study with a pre-post test design, 20 opiate dependent patients undergoing Methadone or Buprenorphine maintenance treatment were examined and matched and randomized into two groups. While both experimental and control groups received their usual maintenance treatment, the experimental group received 30 sessions of neurofeedback treatment in addition. The neurofeedback treatment consisted of sensory motor rhythm training on Cz, followed by an alpha-theta protocol on Pz. Data from the general health questionnaire and a heroin craving questionnaire were collected before and after treatment. Multivariate analysis of covariance showed that the experimental group achieved improvement in somatic symptoms, depression, and total score in general mental health; and in anticipation of positive outcome, desire to use opioid, and relief from withdrawal of craving in comparison with the control group. The study supports the effectiveness of neurofeedback training as a therapeutic method in opiate dependence disorder, in supplement to pharmacotherapy.

  14. Pain medicine: The case for an independent medical specialty and training programs.

    PubMed

    Dubois, Michel Y; Follett, Kenneth A

    2014-06-01

    Over the last 30 years, pain has become one of the most dynamic areas of medicine and a public health issue. According to a recent Institute of Medicine report, pain affects approximately 100 million Americans at an estimated annual economic cost of $560 to $635 billion and is poorly treated overall. The American Board of Medical Specialties (ABMS) recognizes a pain subspecialty, but pain care delivery has struggled with increasing demand and developed in an inconsistent and uncoordinated fashion. Pain education is insufficient and highly variable. Multiple pain professional organizations have led to fragmentation of the field and lack of interdisciplinary agreement, resulting in confusion regarding who speaks for pain medicine. In this Perspective, the authors argue that ABMS recognition of pain medicine as an independent medical specialty would provide much needed structure and oversight for the field and would generate credibility for the specialty and its providers among medical peers, payers, regulatory and legislative agencies, and the public at large. The existing system, managed by three ABMS boards, largely excludes other specialties that contribute to pain care, fails to provide leadership from a single professional organization, provides suboptimal training exposure to pain medicine, and lengthens training, which results in inefficient use of time and educational resources. The creation of a primary ABMS conjoint board in pain medicine with its own residency programs and departments would provide better coordinated training, ensure the highest degree of competence of pain medicine specialists, and improve the quality of pain care and patient safety.

  15. Physician training in aerospace medicine--an historical review in the United States.

    PubMed

    Doarn, Charles R; Mohler, Stanley R

    2013-02-01

    The training of U.S. physicians in aviation medicine closely followed the development of reliable airplanes. This training has matured as aviation and space travel have become more routine over the past several decades. In the U.S., this training began in support of military pilots who were flying increasingly complex aircraft in the early part of the 20th century. As individuals reached into the stratosphere, low Earth orbit, and eventually to the Moon, physicians were trained not only through military efforts but in academic settings as well. This paper provides an historical summary of how physician training in aerospace medicine developed in the U.S., citing both the development of the military activities and, more importantly, the perspectives of the academic programs. This history is important as we move forward in the development of commercial space travel and the needs that such a business model will be required to meet.

  16. 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

  17. 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 ...

  18. 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. PMID:27796117

  19. 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.

  20. 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

  1. [Food addiction].

    PubMed

    Locatelli, L; Correia, J C; Golay, A

    2015-03-25

    Food addiction is a common term used in everyday language by obese patients. Although the neurobiological evidence points to some similarities between addictive mechanisms and the consumption of certain foods, this diagnosis is not yet officially recognized. After a brief history of food addiction compared to other eating disorders, we review the neurobiological processes underlying this concept. A food addiction assessment tool is presented and discussed with the current literature and new classifications of the DSM-5. The concept of food addiction needs to be rethought and requires further research.

  2. Disaster Medicine Training Through Simulations for Fourth-Year Students.

    ERIC Educational Resources Information Center

    Cloutier, Marc G.; Cowan, Michael L.

    1986-01-01

    The use of a six-day multiple-simulation exercise in the military disaster medical services training program of the Uniformed Services University of the Health Sciences is described. It is the second part of a clerkship that includes a classroom/laboratory phase using a disaster problem-solving board game. (MSE)

  3. 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)

  4. [Simulation training in pulmonary medicine: Rationale, review of the literature and perspectives].

    PubMed

    Hureaux, J; Urban, T

    2015-12-01

    Training in pulmonary medicine requires the acquisition of a great deal of knowledge, but also technical know-how and interpersonal skills. The prevailing teaching pattern is mentorship. It implies a direct transmission of knowledge, but also entails some drawbacks such as disparity in learning opportunities, subjective evaluation of the trainee and potential risks for patients. There is growing interest in simulation training as a teaching technique, where students practice their skills in a secure environment, then analyse their performance in a debriefing session. It is complementary to other learning methods (abstraction, observation or mentorship) and forms part of an ethical approach: 'never practice on a real patient for the first time'. We have reviewed the literature related to simulation training in pulmonary medicine and in particular for physical examination, technical skills, pathologies, communication with patients and therapeutic education. In most of the studies, simulation training is a way of speeding up students' training - without necessarily yielding better results - and of respecting the procedures. We then present the French regulations and official guidelines regarding the use of this training method in the teaching of medicine. Finally, we shall consider some prospects of this approach for the community of pulmonologists.

  5. Effect of twelve weeks of medicine ball training on high school baseball players.

    PubMed

    Szymanski, David J; Szymanski, Jessica M; Bradford, T Jason; Schade, Ryan L; Pascoe, David D

    2007-08-01

    This study examined the effect of 12 weeks of medicine ball training on high school baseball players. Forty-nine baseball players (age 15.4 +/- 1.2 years) were randomly assigned using a stratified sampling technique to 1 of 2 groups. Group 1 (n = 24) and group 2 (n = 25) performed the same full-body resistance exercises according to a stepwise periodized model and took 100 bat swings a day, 3 days per week, with their normal game bat for 12 weeks. Group 2 performed additional rotational and full-body medicine ball exercises 3 days per week for 12 weeks. Pre- and post-testing consisted of a 3 repetition maximum (RM) dominant and nondominant torso rotational strength and sequential hip-torso-arm rotational strength (medicine ball hitter's throw). A 3RM parallel squat and bench press were measured at 0 and after 4, 8, and 12 weeks of training. Although both groups made statistically significant increases (p < or = 0.05) in dominant (10.5 vs. 17.1%) and nondominant (10.2 vs. 18.3%) torso rotational strength and the medicine ball hitter's throw (3.0 vs. 10.6%), group 2 showed significantly greater increases in all 3 variables than group 1. Furthermore, both groups made significant increases in predicted 1RM parallel squat and bench press after 4, 8, and 12 weeks of training; however, there were no differences between groups. These data indicate that performing a 12-week medicine ball training program in addition to a stepwise periodized resistance training program with bat swings provided greater sport-specific training improvements in torso rotational and sequential hip-torso-arm rotational strength for high school baseball players.

  6. Computer-based Training in Medicine and Learning Theories.

    PubMed

    Haag, Martin; Bauch, Matthias; Garde, Sebastian; Heid, Jörn; Weires, Thorsten; Leven, Franz-Josef

    2005-01-01

    Computer-based training (CBT) systems can efficiently support modern teaching and learning environments. In this paper, we demonstrate on the basis of the case-based CBT system CAMPUS that current learning theories and design principles (Bloom's Taxonomy and practice fields) are (i) relevant to CBT and (ii) are feasible to implement using computer-based training and adequate learning environments. Not all design principles can be fulfilled by the system alone, the integration of the system in adequate teaching and learning environments therefore is essential. Adequately integrated, CBT programs become valuable means to build or support practice fields for learners that build domain knowledge and problem-solving skills. Learning theories and their design principles can support in designing these systems as well as in assessing their value.

  7. Salvaging a geriatric medicine academic program in disaster mode-the LSU training program post-Katrina.

    PubMed Central

    Cefalu, Charles A.; Schwartz, Robert S.

    2007-01-01

    Formal training in geriatric medicine in Louisiana is in its infancy. This article portrays the struggle of the sole functioning geriatric medicine training program and its trials and tribulations in a survival mode, opportunities that come with disaster as well as lessons learned post-Katrina. PMID:17534025

  8. 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…

  9. Guidelines for fellowship training in regional anesthesiology and acute pain medicine: third edition, 2014.

    PubMed

    2015-01-01

    Directors for Regional Anesthesiology and Acute Pain Medicine fellowships develop and maintain guidelines for fellowship training in the subspecialty. The first edition of the guidelines was published in 2005 with a revision published in 2010. This set of guidelines updates the 2010 revision. The guidelines address 3 major topics: organization and resources, the educational program, and the evaluation process.

  10. Effects of 12-week medicine ball training on muscle strength and power in young female handball players.

    PubMed

    Ignjatovic, Aleksandar M; Markovic, Zivorad M; Radovanovic, Dragan S

    2012-08-01

    The purpose of this study was to examine the effects of medicine ball training on the strength and power in young female handball athletes. Twenty-one young female handball players (age, 16.9 ± 1.2 years) were randomly assigned to experimental and control groups. Experimental group (n = 11) participated in a 12-week medicine ball training program incorporated into the regular training session, whereas controls (n = 10) participated only in the regular training. Performance in the medicine ball throws in standing and sitting positions, 1 repetition maximum (1RM) bench and shoulder press, and power test at 2 different loads (30 and 50% of 1RM) on bench and shoulder press were assessed at pre- and posttraining testing. The athletes participating in the medicine ball training program made significantly greater gains in all medicine ball throw tests compared with the controls (p < 0.01). Also, the experimental group made significantly greater gains in bench and shoulder press power than control group (p < 0.05). Both training groups (E) and (C) significantly (p < 0.05) increased 1RM bench and shoulder strength, with no differences observed between the groups. Additionally, medicine ball throw tests showed stronger correlation with power tests, than with 1RM tests. These data suggest that 12-week medicine ball training, when incorporated into a regular training session, can provide greater sport-specific training improvements in the upper body for young female handball players. PMID:22027860

  11. Postdoctoral training in medical informatics: a survey of National Library of Medicine-supported fellows.

    PubMed

    Aronow, D B; Payne, T H; Pincetl, S P

    1991-01-01

    The National Library of Medicine (NLM) funds training programs in medical informatics and plans to significantly increase the number of program sites in the future. The authors surveyed all NLM-funded trainees at the nine sites supported in the spring of 1988 to determine their backgrounds, current research interests, and career plans. Forty-three fellows were identified, of whom 39 returned a mailed questionnaire. All but four were physicians (89.7%), 82.1% had at least one year of postdoctoral clinical training, and 61.5% had completed a residency. Seventy-one percent of those completing residency had done so in internal medicine. The most common areas of current research were decision support/decision analysis, knowledge representation, and artificial intelligence. The overwhelming majority of the fellows planned to seek positions in a medical school on completion of their fellowships, and most preferred affiliation with a department of medical informatics or medicine.

  12. [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

  13. Expanding the scope of leadership training in medicine.

    PubMed

    Gabel, Stewart

    2014-06-01

    All physicians take a leadership role at some point in their career-some exert influence in their practices and communities as informal leaders, and others hold formal leadership roles to which they are appointed or elected. These formal leadership roles convey power to those individuals who hold such positions. Formal leadership, however, is limited in its influence unless it is accompanied by a series of personal and interpersonal competencies that characterize both formal and informal leaders.Many physicians who do not hold formal leadership roles will be called on to provide (or will wish to provide) informal leadership at various times in their careers. Both formal and informal leaders should be trained in the personal and interpersonal competencies necessary for effective leadership to advance the principles-driven and values-oriented goals inherent in the health care enterprise.In this article, the author defines leadership and describes the characteristics of formal and informal leaders, then discusses the types of leadership and the power derived from different leadership roles. He concludes by arguing in favor of expanding the scope of leadership training to include informal as well as formal leaders. PMID:24662199

  14. Expanding the scope of leadership training in medicine.

    PubMed

    Gabel, Stewart

    2014-06-01

    All physicians take a leadership role at some point in their career-some exert influence in their practices and communities as informal leaders, and others hold formal leadership roles to which they are appointed or elected. These formal leadership roles convey power to those individuals who hold such positions. Formal leadership, however, is limited in its influence unless it is accompanied by a series of personal and interpersonal competencies that characterize both formal and informal leaders.Many physicians who do not hold formal leadership roles will be called on to provide (or will wish to provide) informal leadership at various times in their careers. Both formal and informal leaders should be trained in the personal and interpersonal competencies necessary for effective leadership to advance the principles-driven and values-oriented goals inherent in the health care enterprise.In this article, the author defines leadership and describes the characteristics of formal and informal leaders, then discusses the types of leadership and the power derived from different leadership roles. He concludes by arguing in favor of expanding the scope of leadership training to include informal as well as formal leaders.

  15. 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.

  16. An Overview of United States Physician Training, Certification, and Career Pathways in Clinical Pathology (Laboratory Medicine)

    PubMed Central

    2013-01-01

    Clinical Pathology (CP) – also known as Laboratory Medicine - is a rewarding and yet under-recognized career option for United States (U.S.) and international medical school graduates. The present article outlines the training pathway toward becoming a clinical pathologist in the U.S, including undergraduate, graduate, and post-graduate phases of training. As the current state of CP residency training in the U.S. is the result of decades of curriculum reform, that progression is briefly reviewed to provide context for the shift toward competency-based education during residency and beyond. Options for fellowship training in CP subspecialties, as well as the current emphasis on Maintenance of Certification (MOC) and Maintenance of Licensure (MOL) are also discussed. This article concludes with a general overview of career pathways and options for those with CP training. PMID:27683436

  17. Potential role for psychological skills training in emergency medicine: Part 1 - Introduction and background.

    PubMed

    Lauria, Michael J; Rush, Stephen; Weingart, Scott D; Brooks, Jason; Gallo, Isabelle A

    2016-10-01

    Psychological skills training (PST) is the systematic acquisition and practice of different psychological techniques to improve cognitive and technical performance. This training consists of three phases: education, skills acquisition and practice. Some of the psychological skills developed in this training include relaxation techniques, focusing and concentration skills, positive 'self-suggestion' and visualisation exercises. Since the middle of the 20th century, PST has been successfully applied by athletes, performing artists, business executives, military personnel and other professionals in high-risk occupations. Research in these areas has demonstrated the breadth and depth of the training's effectiveness. Despite the benefits realised in other professions, medicine has only recently begun to explore certain elements of PST. The present paper reviews the history and evidence behind the concept of PST. In addition, it presents some aspects of PST that have already been incorporated into medical training as well as implications for developing more comprehensive programmes to improve delivery of emergency medical care.

  18. An Overview of United States Physician Training, Certification, and Career Pathways in Clinical Pathology (Laboratory Medicine)

    PubMed Central

    2013-01-01

    Clinical Pathology (CP) – also known as Laboratory Medicine - is a rewarding and yet under-recognized career option for United States (U.S.) and international medical school graduates. The present article outlines the training pathway toward becoming a clinical pathologist in the U.S, including undergraduate, graduate, and post-graduate phases of training. As the current state of CP residency training in the U.S. is the result of decades of curriculum reform, that progression is briefly reviewed to provide context for the shift toward competency-based education during residency and beyond. Options for fellowship training in CP subspecialties, as well as the current emphasis on Maintenance of Certification (MOC) and Maintenance of Licensure (MOL) are also discussed. This article concludes with a general overview of career pathways and options for those with CP training.

  19. An Overview of United States Physician Training, Certification, and Career Pathways in Clinical Pathology (Laboratory Medicine).

    PubMed

    Genzen, Jonathan R

    2013-04-01

    Clinical Pathology (CP) - also known as Laboratory Medicine - is a rewarding and yet under-recognized career option for United States (U.S.) and international medical school graduates. The present article outlines the training pathway toward becoming a clinical pathologist in the U.S, including undergraduate, graduate, and post-graduate phases of training. As the current state of CP residency training in the U.S. is the result of decades of curriculum reform, that progression is briefly reviewed to provide context for the shift toward competency-based education during residency and beyond. Options for fellowship training in CP subspecialties, as well as the current emphasis on Maintenance of Certification (MOC) and Maintenance of Licensure (MOL) are also discussed. This article concludes with a general overview of career pathways and options for those with CP training.

  20. A laboratory medicine residency training program that includes clinical consultation and research.

    PubMed

    Spitzer, E D; Pierce, G F; McDonald, J M

    1990-04-01

    We describe a laboratory medicine residency training program that includes ongoing interaction with both clinical laboratories and clinical services as well as significant research experience. Laboratory medicine residents serve as on-call consultants in the interpretation of test results, design of testing strategies, and assurance of test quality. The consultative on-call beeper system was evaluated and is presented as an effective method of clinical pathology training that is well accepted by the clinical staff. The research component of the residency program is also described. Together, these components provide training in real-time clinical problem solving and prepare residents for the changing technological environment of the clinical laboratory. At the completion of the residency, the majority of the residents are qualified laboratory subspecialists and are also capable of running an independent research program.

  1. 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 ( ...

  2. 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.

  3. Behavioral addictions.

    PubMed

    Robbins, T W; Clark, L

    2015-02-01

    Behavioral addictions are slowly becoming recognized as a valid category of psychiatric disorder as shown by the recent allocation of pathological gambling to this category in DSM-5. However, several other types of psychiatric disorder proposed to be examples of behavioral addictions have yet to be accorded this formal acknowledgment and are dispersed across other sections of the DSM-5. This brief review marks this important point in the evolution of this concept and looks to future investigation of behavioral addictions with the theoretical frameworks currently being used successfully to investigate substance addiction and obsessive-compulsive disorder, in a potentially new spectrum of impulsive-compulsive disorders.

  4. 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

  5. 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.

  6. [Food addiction - substance use disorder or behavioral addiction?].

    PubMed

    Albayrak, Özgür; Kliewer, Josephine; Föcker, Manuel; Antel, Jochen; Hebebrand, Johannes

    2015-05-01

    This article looks at food addiction as a subject situated between psychiatry, neurobiology, nutritional science, internal medicine, food industry, and public health. Essentially, the question is whether or not individual nutritional components can induce physical dependence, similar to the well-known effects of drugs such as alcohol and cocaine, or whether food addiction is rather a behavioral addiction. The literature describes many overlaps as well as differences of substance-based and non-substance-based addiction in both clinical and neurobiological terms. Until recently it was argued that food addiction appears only in the realms of obesity and eating disorders (e.g., binge-eating disorder, BED). Some studies, however, described the prevalence of food addiction symptoms and diagnoses independent of overweight or that they were in subjects who do not fulfill the criteria for BED. This article sums up the controversial discussion about the phenomenological and neurobiological classification of food addiction. Implications of food addiction for children and adolescents as well as public-health-related issues are also discussed.

  7. Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training

    PubMed Central

    Green, Michael L.; Aagaard, Eva M.; Caverzagie, Kelly J.; Chick, Davoren A.; Holmboe, Eric; Kane, Gregory; Smith, Cynthia D.; Iobst, William

    2009-01-01

    Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project requires that residency program directors objectively document that their residents achieve competence in 6 general dimensions of practice. Intervention In November 2007, the American Board of Internal Medicine (ABIM) and the ACGME initiated the development of milestones for internal medicine residency training. ABIM and ACGME convened a 33-member milestones task force made up of program directors, experts in evaluation and quality, and representatives of internal medicine stakeholder organizations. This article reports on the development process and the resulting list of proposed milestones for each ACGME competency. Outcomes The task force adopted the Dreyfus model of skill acquisition as a framework the internal medicine milestones, and calibrated the milestones with the expectation that residents achieve, at a minimum, the “competency” level in the 5-step progression by the completion of residency. The task force also developed general recommendations for strategies to evaluate the milestones. Discussion The milestones resulting from this effort will promote competency-based resident education in internal medicine, and will allow program directors to track the progress of residents and inform decisions regarding promotion and readiness for independent practice. In addition, the milestones may guide curriculum development, suggest specific assessment strategies, provide benchmarks for resident self-directed assessment-seeking, and assist remediation by facilitating identification of specific deficits. Finally, by making explicit the profession's expectations for graduates and providing a degree of national standardization in evaluation, the milestones may improve public accountability for residency training. PMID:21975701

  8. 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.

  9. 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

  10. 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

  11. 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 ...

  12. 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.

  13. Processes and Outcomes from a Medical Student Research Training Program in Integrative, Complementary, and Alternative Medicine.

    PubMed

    Dicianno, Brad E; Glick, Ronald M; Sowa, Gwendolyn A; Boninger, Michael L

    2016-10-01

    In response to the growing need to train a new generation of clinician scientists, a research program was developed to train medical students in integrative, complementary, and alternative medicine (ICAM) research early in their careers. A total of 25 students (100%) successfully completed a 10-week program. Students reported significantly increased levels of knowledge in all 7 integrative, complementary, and alternative medicine topics at the conclusion of the program. All students presented their work at one or more local research symposia. In addition, the average number of quality research outputs, which included manuscripts, awards, and abstracts presented at national and international meetings, was 1.5 per student, which exceeded benchmarks based on prior program outcomes. Results from this program may be useful when planning larger or longer-term projects aimed at attracting physicians who will become our next generation of academicians, researchers, and healers.

  14. Family medicine training in Saudi Arabia: Are there any variations among different regions?

    PubMed Central

    Abu Zuhairah, Ammar R.; Al-Dawood, Kasim M.; Khamis, Amar H.

    2015-01-01

    Aims: The aim was to compare Eastern, Makkah, and Asir regions in term of residents’ perception of the achievement of training objectives, and to assess various rotations based on residents’ perception. Settings and Design: This cross-sectional study was done among family medicine residents in the Eastern, Makkah, and Asir regions. Methodology: A questionnaire was developed by the investigator and validated by two experts. All residents, except R1 residents, were included. All data were collected by the investigator by direct contact with the residents. Statistical Analysis Used: Cronbach's alpha, analysis of variance, t-test, and univariate regression model as appropriate, were used. Results: Reliability of the questionnaire was found to be 75.4%. One hundred and seven (response rate: 83.6%) residents completed the questionnaire. There were 51 (47.7%), 27 (25.2%), and 29 (27.1%) residents in the program in the Eastern region, Makkah, and Asir, respectively. The mean age was 29.1 ± 2.5 years; half of the residents were male, most of (83.2%) were married, and more than half (54.2%) of had worked in primary health care before joining the program. Overall, 45% of the residents perceived that they had achieved the training objectives. The highest rotations as perceived by the residents were psychiatry and otolaryngology while the lowest were orthopedics and ophthalmology. There were significant differences among the study regions with regard to the rotations in family medicine, internal medicine, orthopedics, general surgery, and emergency medicine. Conclusions: Overall, a good percentage of the residents perceived that they had achieved the training objectives. The rotations differed in the studied regions. Psychiatry and otolaryngology had the highest percentage of family medicine residents who perceived that they had achieved the training objectives while lowest was in internal medicine and obstetrics and gynecology. The highest rotations as perceived by the

  15. 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

  16. Family medicine training in sub-Saharan Africa: South–South cooperation in the Primafamed project as strategy for development

    PubMed Central

    Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan

    2014-01-01

    Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. PMID:24857843

  17. Is a Single Entry Training Scheme for Intensive Care Medicine Both Inevitable and Desirable?

    PubMed

    McLean, Anthony S

    2015-09-01

    The development of Intensive Care Medicine as a recognizable branch of medicine has been underway for more than half a century, with delivery by a number of different service models. This delivery may be entirely by related medical specialties, such as anesthesiology or pulmonology; alternatively, it may be as a standalone-recognized specialty and frequently by a hybrid of these two extremes. A country may have a completely different delivery model from neighboring countries, and different models may exist within a single country. Debate about the most appropriate method of providing critical care services frequently centers around the training. However, an alternative perspective is that training regimes only follow on from another objective, namely to have Intensive Care Medicine represented in important forums by dedicated critical care physicians. A historical perspective of the development of critical care in two countries over a 40-year period is discussed, whereby a transition from a multiple specialty provision of critical care medicine to that of a single binational pathway occurred. The perceived advantages and disadvantages are outlined, offering insights into how possible future challenges in a highly complex medical specialty can be anticipated and strategies formulated. PMID:25978335

  18. Computer-based simulation training in emergency medicine designed in the light of malpractice cases

    PubMed Central

    2014-01-01

    Background Using computer-based simulation systems in medical education is becoming more and more common. Although the benefits of practicing with these systems in medical education have been demonstrated, advantages of using computer-based simulation in emergency medicine education are less validated. The aim of the present study was to assess the success rates of final year medical students in doing emergency medical treatment and evaluating the effectiveness of computer-based simulation training in improving final year medical students’ knowledge. Methods Twenty four Students trained with computer-based simulation and completed at least 4 hours of simulation-based education between the dates Feb 1, 2010 - May 1, 2010. Also a control group (traditionally trained, n =24) was chosen. After the end of training, students completed an examination about 5 randomized medical simulation cases. Results In 5 cases, an average of 3.9 correct medical approaches carried out by computer-based simulation trained students, an average of 2.8 correct medical approaches carried out by traditionally trained group (t = 3.90, p < 0.005). We found that the success of students trained with simulation training in cases which required complicated medical approach, was statistically higher than the ones who didn’t take simulation training (p ≤ 0.05). Conclusions Computer-based simulation training would be significantly effective in learning of medical treatment algorithms. We thought that these programs can improve the success rate of students especially in doing adequate medical approach to complex emergency cases. PMID:25064122

  19. [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.

  20. [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

  1. Global health and transfusion medicine: education and training in developing countries

    PubMed Central

    Eichbaum, Quentin; Shan, Hua; Goncalez, Thelma T.; Duits, A.J.; Knox, Patricia; Reilly, Jim; Andrews, David

    2016-01-01

    Education and training in transfusion medicine have improved over the past decade in developing countries but are still generally deficient for the purpose of maintaining the safety of the global blood supply. In 2009, the World Health Organization global database on blood safety indicated that only 72% of countries in the world were able to meet their training needs necessary for maintaining the safety of their local blood supply. Educational approaches in transfusion medicine vary widely between continents and world regions. In this article, we summarize a session on global health education and training in developing countries that took place at the 2012 AABB conference. The panel consisted of transfusion representatives from South America (Brazil), Asia (China), Africa (South Africa), and the Caribbean (Curaçao), as well as a description of capacitation issues in postearthquake Haiti and the pivotal role of the US President’s Emergency Plan for AIDS Relief (PEPFAR) in transfusion training and education in Africa. We present here summaries of each of these panel presentations. PMID:24689786

  2. 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.

  3. Fulfilling the Mission of Academic Medicine: Training Residents in the Health Needs of Prisoners

    PubMed Central

    Wakeman, Sarah E.

    2010-01-01

    The single mission of academic medicine is the pursuit of health for all. This mandate serves as a reminder to focus care on vulnerable and underserved populations. The 12 million Americans who cycle through correctional facilities each year are arguably among the most vulnerable populations in this country; predominantly black, with a high burden of disease and many barriers to care after release. Medical training programs should provide exposure to the health needs of prisoners. Residents could establish care with inmates prior to release and arrange follow-up in the community. This addition to training would not only provide care to this underserved group, but also would train residents in the myriad problems prisoners face, and foster social responsibility. PMID:20352517

  4. 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

  5. The impact of structured training on academic medicine in the UK.

    PubMed

    Temple, J G

    1999-09-01

    Introduction of structured training has been a recent event. The programmes have been modelled on curricula produced by the medical royal colleges. Regular assessment throughout the training has helped to achieve the designed goals. This reform encourages research for up to 1 year. However, the research year would not be funded by the normal National Health Service channels. The period of research can be extended by a year without losing the national training number. If the specialist registrars take this towards the end of year 4 then they can continue in research and acquire the certificate of 'Completion of Specialist Training' yet continue with the research for a degree by thesis. Clinical competence needs new ways of measurement without adhering to time periods of training. This will enable clinicians not to turn away from academic medicine because of longer periods of training needed prior to being appointed to a substantive academic post, compared with a colleague who is pursuing a clinical career. PMID:10718717

  6. 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

  7. 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 ...

  8. 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

  9. 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

  10. 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.

  11. 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

  12. 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

  13. Emergency medicine residents’ attitudes and opinions of in-training exam preparation

    PubMed Central

    Eastin, Travis R; Bernard, Aaron W

    2013-01-01

    Purpose Emergency Medicine (EM) residents take the American Board of Emergency Medicine (ABEM) in-training exam, and performance on this exam has been shown to correlate to performance on the ABEM qualifying exam. Though many residencies have in-training exam preparation activities, there is little data on the effectiveness of these efforts. This study aimed to elicit resident perspectives about the exam and exam preparation in order to generate hypotheses and better inform future preparation efforts. Methods Second- and third-year EM residents at a single institution were interviewed using a semi-structured format. Qualitative methodology was used to analyze the data. Results Thirteen EM residents participated in the study. Eight major themes and 18 sub-themes were identified. These were further characterized as relating to the exam itself or to exam preparation. Residents generally value the in-training exam. Sixty-nine percent noted that it provided an assessment of their current knowledge and deficiencies. Thirty-eight percent noted that it improved familiarity with the qualifying exam. Regarding exam preparation, residents stated that a question format was preferred, especially when accompanying explanations were of high quality. Additionally, practical considerations, such as portability, impacted resident selection of study tools. Conclusion Residents value the in-training exam as a marker of their academic progress and for their ability to gain familiarity with the qualifying exam. They prefer question-based preparation over text-based learning, as long as there is a detailed explanation of each answer. Educators creating structured in-training review may want to focus on question-based material with detailed explanations. PMID:24062620

  14. 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.

  15. 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

  16. 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

  17. Training veterinary students in shelter medicine: a service-learning community-classroom technique.

    PubMed

    Stevens, Brenda J; Gruen, Margaret E

    2014-01-01

    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, animal welfare, ethics, and public policy issues. A range of sheltering systems now exists, 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 introduces students to a diverse array of sheltering systems while providing practical experience. This article presents the details and results of a series of 2-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 delivered 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, animal 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.

  18. Training Leaders for the 21st Century. The American Indian Ambassadors Program: Medicine Pathways for the Future.

    ERIC Educational Resources Information Center

    Wakshul, Barbra

    1997-01-01

    For the past four years, the American Indian Ambassadors Program has selected American Indians to participate in a year-long leadership training program. The program focuses on mentorship, personal inquiry into one's medicine or power, dialog with leading Native decision makers, community-based projects, and communication-skills training. Profiles…

  19. Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors

    PubMed Central

    2010-01-01

    Background Information about the availability and effectiveness of childhood obesity training during residency is limited. Methods We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds), and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. Results The response rate was 42.2% (299/709) and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%), diagnosis (N = 282, 94.3%), diagnosis of complications (N = 249, 83.3%), and treatment (N = 242, 80.9%). However, only 18.1% (N = 54) of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p < 0.01). Didactic instruction was the most commonly used training method but was rated as only somewhat effective by 67.9% of respondents using this method. The most frequently cited significant barrier to implementing childhood obesity training was competing curricular demands (58.5%). Conclusions While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children. PMID:20163732

  20. 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

  1. Gaps in quality of diabetes care in internal medicine residency clinics suggest the need for better ambulatory care training.

    PubMed

    Lynn, Lorna; Hess, Brian J; Weng, Weifeng; Lipner, Rebecca S; Holmboe, Eric S

    2012-01-01

    To ensure that medical residents will be prepared to deliver consistently high-quality care, they should be trained in settings that provide such care. Residents in internal medicine, particularly, need to learn good care habits in order to meet the needs of patients with diabetes and other common chronic and high-impact illnesses. To assess the strength of such training, we compared the quality of medical care provided in sixty-seven US internal medicine residency ambulatory clinics with the quality of care provided by 703 practicing general internists. We found significant quality gaps in process, intermediate outcome, and patient-experience measures. These inadequacies in ambulatory training for internal medicine residents must be addressed by policy makers and educators-for example, by accelerating the movement toward new residency curricula that emphasize competency-based training.

  2. 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…

  3. 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.

  4. 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

  5. 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

  6. 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

  7. Integration of genomic medicine into pathology residency training: the stanford open curriculum.

    PubMed

    Schrijver, Iris; Natkunam, Yasodha; Galli, Stephen; Boyd, Scott D

    2013-03-01

    Next-generation sequencing methods provide an opportunity for molecular pathology laboratories to perform genomic testing that is far more comprehensive than single-gene analyses. Genome-based test results are expected to develop into an integral component of diagnostic clinical medicine and to provide the basis for individually tailored health care. To achieve these goals, rigorous interpretation of high-quality data must be informed by the medical history and the phenotype of the patient. The discipline of pathology is well positioned to implement genome-based testing and to interpret its results, but new knowledge and skills must be included in the training of pathologists to develop expertise in this area. Pathology residents should be trained in emerging technologies to integrate genomic test results appropriately with more traditional testing, to accelerate clinical studies using genomic data, and to help develop appropriate standards of data quality and evidence-based interpretation of these test results. We have created a genomic pathology curriculum as a first step in helping pathology residents build a foundation for the understanding of genomic medicine and its implications for clinical practice. This curriculum is freely accessible online.

  8. 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

  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.

  11. [Exercise addiction].

    PubMed

    Petit, A; Lejoyeux, M

    2013-01-01

    Socially valorised, sport like other forms of behaviour, can take on an addictive aspect. A review of the English and French literatures from 1979 to 2012 was conducted, using PubMed, Google Scholar, EMBASE, and PsycInfo, using the following key words alone or combined :sport, dependence, exercise, addiction. Exercise dependence is defined as a craving for physical activity that leads to extreme exercise intensity and generates physiological and psychological symptoms. Measurement scales have been proposed to make the diagnosis. No epidemiological studies have examined the prevalence of exercise dependence in the general population, although some studies suggest a frequency ranging from 10 to 80%. Disorders begin with a search for pleasure in physical effort, which then gives way to an obsession for sport resulting in a need to practice a sport more and more frequently and intensely. This addiction is more common among alcohol and illicit drug addicts than among the general population, while the rate of eating disorders can reach 40%. Personality traits most often associated are perfectionism, extraversion, and sensation seeking, while possible links between sporting activity and intensive doping will be discussed.

  12. 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

  13. Training substance abuse treatment organizations to adopt evidence-based practices: the Addiction Technology Transfer Center of New England Science to Service Laboratory.

    PubMed

    Squires, Daniel D; Gumbley, Stephen J; Storti, Susan A

    2008-04-01

    Underutilization of evidence-based treatments for substance abuse represents a longstanding problem for the field and the public health of our nation. Those who would most benefit from research advances (community treatment agencies and the clients they serve) have historically been the least likely to be exposed to innovative evidence-based methods for substance abuse treatment. To help address this gap, the Addiction Technology Transfer Center of New England (ATTC-NE), located at Brown University, has adapted and implemented an organizational change strategy intended to equip substance abuse treatment organizations and their employees with the skills needed to adopt evidence-based treatment practices. Since 2003, the ATTC-NE has worked with 54 community-based substance abuse treatment agencies from across New England using this model, which is called Science to Service Laboratory (SSL). Twenty-eight of 54 agencies completed all of the SSL components, and 26 of these 28 completer agencies (96%) successfully adopted and implemented contingency management as a result. Survey data comparing completer and dropout agencies' satisfaction with the quality, organization, and utility of the SSL indicate that both groups rated the SSL favorably. However, differences emerged with respect to organizational characteristics between completer and dropout agencies. Specifically, dropout agencies were more likely to report turnover in staff positions vital to training effort. Future directions for the model are discussed.

  14. [Heroin addiction].

    PubMed

    Hosztafi, Sándor

    2011-01-01

    Heroin is an illicit, highly addictive drug. It is either the most abused or the most rapidly acting member of opioids. Abusers describe a feeling of a surge of pleasurable sensation, named as "rush" or "high". Repeated administration of high doses of heroin results in the induction of physical dependence. Physical dependence refers to an altered physiological state produced by chronic administration of heroin which necessitates the continued administration of the drug to prevent the appearance of a characteristic syndrome, the opioid withdrawal or abstinence syndrome. Withdrawal symptoms may occur within a few hours after the last administration of heroin. Symptoms of the withdrawal include restlessness, insomnia, drug craving, diarrhea, muscle and bone pain, cold flashes with goose bumps, and leg movements. Major withdrawal symptoms peak between 48 and 72 hours after the last dose of heroin and subside after about a week. At this time, weakness and depression are pronounced and nausea and vomiting are common. Nevertheless, some chronic addicts have shown persistent withdrawal signs for many months or even years. Heroin addiction is considered as a behavioural state of compulsive drug use and a high tendency to relapse after periods of abstinence. It is generally accepted that compulsive use and relapse are typically associated with the status of heroin craving or heroin hunger that are difficult to define but appear to be powerful motivational significance in the addiction process. The route of administering heroin varies largely and may indicate the degree of seriousness of the individual's addiction. Intravenous administration seems to be the predominant method of heroin use, but recently a shift in heroin use pattern has been found, i.e. from injection to sniffing and smoking. Frequent injections coupled with widespread sharing of syringes increase the risk of contracting HIV, hepatitis B, C and other blood-borne infectious diseases. Long-term use of heroin

  15. Exercise addiction.

    PubMed

    Landolfi, Emilio

    2013-02-01

    This article examines the nature of exercise addiction. It presents a broad, congruent and discerning narrative literature review with the aim of providing a deeper understanding of the condition 'exercise addiction', including symptoms and options for treatment. In addition, guidelines are provided with respect to 'healthy' levels of exercise. Criteria used for determining the eligibility of studies evaluated in the review included the provision of relevant information in studies identified using pertinent search terms. The review highlights some of the key distinctions between healthy levels of exercise and exercise addiction. The findings suggest that an individual who is addicted to exercise will continue exercising regardless of physical injury, personal inconvenience or disruption to other areas of life including marital strain, interference with work and lack of time for other activities. 'Addicted' exercisers are more likely to exercise for intrinsic rewards and experience disturbing deprivation sensations when unable to exercise. In contrast, 'committed' exercisers engage in physical activity for extrinsic rewards and do not suffer severe withdrawal symptoms when they cannot exercise. Exercisers must acquire a sense of life-balance while embracing an attitude conducive to sustainable long-term physical, psychological and social health outcomes. Implementation of recommendations by the Canadian Society for Exercise Physiology, which states that all apparently healthy adults between 18 and 64 years of age should accumulate at least 150 minutes of moderate (5 or 6 on a scale of 0-10) to vigorous (7 or 8 on a scale of 0-10) intensity aerobic physical activity per week in bouts of 10 minutes or more, also expressed as 30 minutes per day distributed over 5 days per week, would be a good start.

  16. Evaluation of Saudi family medicine training program: the application of CIPP evaluation format.

    PubMed

    Al-Khathami, Abdullah Dukhail

    2012-01-01

    The Saudi Diploma in Family Medicine (SDFM) was enacted in 2007 to fulfill the needs of qualified Primary Health Care providers in Saudi Arabia. Evaluation is not only an integral process for designing educational training programs, but an effective evaluation strategy that helps achieve program objectives and enhances the quality of learning objectives: (1) Construct a self-administered questionnaire based on Context, input, process and product (CIPP) format to seek trainees' perceptions about the SDFM program; (2) identify the strengths and weaknesses of the SDFM program in relation to the learning outcomes; and (3) define the main obstacles to achieve the outcomes. A self-administered questionnaire was designed based on the CIPP evaluation format after. its validity and reliability were tested through piloting. Then, all the SDFM program trainees were included. The study response rate was 91.2%. More than 77% of the trainees stated that they had achieved the program objectives; a significant difference was found among Saudis and non-Saudis (p = 0.002). The training period was reported by 84% as a main barrier to achieve the program objectives, particularly the hospital rotation period. Results indicate an overall satisfaction with the training objectives and the teaching methods used. These findings can be useful for the policy makers to implement the suggested recommendations and deal with obstacles to improve the SDFM program in order to provide effective and efficient primary care services.

  17. [The first national Whole-time Training Class for Western Physicians Learning Traditional Chinese Medicine in China].

    PubMed

    Sun, Qiaosi; Hu, Xiaofeng

    2015-11-01

    On 19 October, 1955, at the time when the Academy of Traditional Chinese Medicine affiliated with the Ministry of Health was established, the opening ceremony of the first Whole-time Training Class for Western Physicians Learning Systematically Traditional Chinese Medicine was also held. Altogether 84 new graduates from western medical colleges and skilled doctors of western medicine from all over the country were registered. During the 2.5 year term of training, the students learnt 16 professional courses and then practiced at the clinic, and graduated with gratifying results in July, 1958. On 11 October the same year, Chairman Mao made an important instruction to the report submitted by the Leading Party Group of the Ministry of Health, "A Report to the Party Central Committee about the situation, results and experience of Whole-time Training Class for Western Physicians Learning Traditional Chinese Medicine", by pointing out that "in the future, the Training Class for Western Physicians Learning Traditional Chinese Medicine should be held across the country hereafter. This is a top issue and is not to be ignored".

  18. 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

  19. [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.

  20. 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 ...

  1. Supporting whistleblowers in academic medicine: training and respecting the courage of professional conscience.

    PubMed

    Faunce, T; Bolsin, S; Chan, W-P

    2004-02-01

    Conflicts between the ethical values of an organisation and the ethical values of the employees of that organisation can often lead to conflict. When the ethical values of the employee are considerably higher than those of the organisation the potential for catastrophic results is enormous. In recent years several high profile cases have exposed organisations with ethical weaknesses. Academic medical institutions have exhibited such weaknesses and when exposed their employees have almost invariably been vindicated by objective inquiry. The mechanisms that work to produce such low ethical standards in what should be exemplary organisations are well documented and have been highlighted recently. The contribution of elements of medical training in eroding ethical standards of medical students have also been emphasised recently and strategies proposed to reduce or reverse this process. The ability to rapidly change the ethical and professional culture of graduate medical trainees may help to deal with some of the perceived problems of declining ethical standards in academic medicine.

  2. Building interactive virtual environments for simulated training in medicine using VRML and Java/JavaScript.

    PubMed

    Korocsec, D; Holobar, A; Divjak, M; Zazula, D

    2005-12-01

    Medicine is a difficult thing to learn. Experimenting with real patients should not be the only option; simulation deserves a special attention here. Virtual Reality Modelling Language (VRML) as a tool for building virtual objects and scenes has a good record of educational applications in medicine, especially for static and animated visualisations of body parts and organs. However, to create computer simulations resembling situations in real environments the required level of interactivity and dynamics is difficult to achieve. In the present paper we describe some approaches and techniques which we used to push the limits of the current VRML technology further toward dynamic 3D representation of virtual environments (VEs). Our demonstration is based on the implementation of a virtual baby model, whose vital signs can be controlled from an external Java application. The main contributions of this work are: (a) outline and evaluation of the three-level VRML/Java implementation of the dynamic virtual environment, (b) proposal for a modified VRML Timesensor node, which greatly improves the overall control of system performance, and (c) architecture of the prototype distributed virtual environment for training in neonatal resuscitation comprising the interactive virtual newborn, active bedside monitor for vital signs and full 3D representation of the surgery room. PMID:16520145

  3. Building interactive virtual environments for simulated training in medicine using VRML and Java/JavaScript.

    PubMed

    Korocsec, D; Holobar, A; Divjak, M; Zazula, D

    2005-12-01

    Medicine is a difficult thing to learn. Experimenting with real patients should not be the only option; simulation deserves a special attention here. Virtual Reality Modelling Language (VRML) as a tool for building virtual objects and scenes has a good record of educational applications in medicine, especially for static and animated visualisations of body parts and organs. However, to create computer simulations resembling situations in real environments the required level of interactivity and dynamics is difficult to achieve. In the present paper we describe some approaches and techniques which we used to push the limits of the current VRML technology further toward dynamic 3D representation of virtual environments (VEs). Our demonstration is based on the implementation of a virtual baby model, whose vital signs can be controlled from an external Java application. The main contributions of this work are: (a) outline and evaluation of the three-level VRML/Java implementation of the dynamic virtual environment, (b) proposal for a modified VRML Timesensor node, which greatly improves the overall control of system performance, and (c) architecture of the prototype distributed virtual environment for training in neonatal resuscitation comprising the interactive virtual newborn, active bedside monitor for vital signs and full 3D representation of the surgery room.

  4. Training in subspecialty internal medicine. On the chessboard of health care reform. Association of Subspecialty Professors.

    PubMed

    1994-11-15

    Many reform-minded observers of the U.S. health care system have asked recently whether we are training too many subspecialists in internal medicine. Of course, the answer to this question may not be the same for all subspecialties or all manners of professional career, but any proposed answer has extended consequences for the entire health care system and the patients it serves. Some have even begun to advocate a firm ceiling on the numbers of subspecialty training positions in the future. Who, in fact, should be deciding such matters? These decisions are complex and not easily made by government, consumers, or insurance companies on their own, nor should they. These decisions are best made by a profession willing to examine and regulate itself where necessary. Recent legislative initiatives have made it abundantly clear that others are more than willing to act on our behalf, if we cannot. Whatever process is adopted for making such decisions, it needs to be fair, efficient, flexible, and responsive to unexpected demands in the future, including new practice economics, the availability of research funds, and medical innovation.

  5. [Perception of training in doctor-patient communication for students at faculty of medicine].

    PubMed

    Richard, S; Pardoen, D; Piquard, D; Fostier, P; Thomas, J M; Vervier, J F; Verbanck, P

    2012-01-01

    Doctor-patient communication is the heart of any medical practice. The technology of medicine today is focused on knowledge, its application and know-how, rather than skills of being, of knowing and of knowing when to do nothing. In 2005, Belgian High Council of Health emphasizes a quantitative and qualitative reduction of communication aspects within the initial medical training. The aim of our study is to investigate Belgian and foreign students perception of how the doctor-patient communication was taught during their studies. A questionnaire was sent by email to 300 Belgian and foreign Universities. We obtained 13.6% of answers of 99 students belonging to 41 Faculties from 22 countries. 55.6% of respondents thought to be well trained in the doctor-patient communication. 85.9% of students received theoretical courses out of which only 64.6% have the opportunity to enhance their apprenticeship by practical work. Majority of respondents required more practical work in learning to communicate. All of them agree on that they would like more applied practical communication incorporated into their curriculum. Like wise the society that calls for doctors with increased communication skills and communication researchers who emphasize the central role of the doctor-patient communication in the clinical and therapeutic approach, students are also seeking longitudinal transdisciplinary learning, including more practical practices.

  6. 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

  7. 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)…

  8. 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 ...

  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.

  10. New paradigm in training of undergraduate clinical skills: the NEPTUNE-CS project at the Split University School of Medicine.

    PubMed

    Simunovic, Vladimir J; Hozo, Izet; Rakic, Mladen; Jukic, Marko; Tomic, Snjezana; Kokic, Slaven; Ljutic, Dragan; Druzijanic, Nikica; Grkovic, Ivica; Simunovic, Filip; Marasovic, Dujomir

    2010-10-01

    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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

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

    PubMed Central

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

    2013-01-01

    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. Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine.

    PubMed

    Sawyer, Taylor; White, Marjorie; Zaveri, Pavan; Chang, Todd; Ades, Anne; French, Heather; Anderson, JoDee; Auerbach, Marc; Johnston, Lindsay; Kessler, David

    2015-08-01

    Acquisition of competency in procedural skills is a fundamental goal of medical training. In this Perspective, the authors propose an evidence-based pedagogical framework for procedural skill training. The framework was developed based on a review of the literature using a critical synthesis approach and builds on earlier models of procedural skill training in medicine. The authors begin by describing the fundamentals of procedural skill development. Then, a six-step pedagogical framework for procedural skills training is presented: Learn, See, Practice, Prove, Do, and Maintain. In this framework, procedural skill training begins with the learner acquiring requisite cognitive knowledge through didactic education (Learn) and observation of the procedure (See). The learner then progresses to the stage of psychomotor skill acquisition and is allowed to deliberately practice the procedure on a simulator (Practice). Simulation-based mastery learning is employed to allow the trainee to prove competency prior to performing the procedure on a patient (Prove). Once competency is demonstrated on a simulator, the trainee is allowed to perform the procedure on patients with direct supervision, until he or she can be entrusted to perform the procedure independently (Do). Maintenance of the skill is ensured through continued clinical practice, supplemented by simulation-based training as needed (Maintain). Evidence in support of each component of the framework is presented. Implementation of the proposed framework presents a paradigm shift in procedural skill training. However, the authors believe that adoption of the framework will improve procedural skill training and patient safety.

  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. 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.

  20. The hyper-sentient addict: an exteroception model of addiction

    PubMed Central

    DeWitt, Samuel J.; Ketcherside, Ariel; McQueeny, Tim M.; Dunlop, Joseph P.; Filbey, Francesca M.

    2016-01-01

    Background Exteroception involves processes related to the perception of environmental stimuli important for an organism's ability to adapt to its environment. As such, exteroception plays a critical role in conditioned response. In addiction, behavioral and neuroimaging studies show that the conditioned response to drug-related cues is often associated with alterations in brain regions including the precuneus/posterior cingulate cortex, an important node within the default mode network dedicated to processes such as self-monitoring. Objective This review aimed to summarize the growing, but largely fragmented, literature that supports a central role of exteroceptive processes in addiction. Methods We performed a systematic review of empirical research via PubMed and Google Scholar with keywords including ‘addiction’, ‘exteroception’, ‘precuneus’, and ‘self-awareness’, to identify human behavioral and neuroimaging studies that report mechanisms of self-awareness in healthy populations, and altered selfawareness processes, specifically exteroception, in addicted populations. Results Results demonstrate that exteroceptive processes play a critical role in conditioned cue response in addiction and serve as targets for interventions such as mindfulness training. Further, a hub of the default mode network, namely, the precuneus, is (i) consistently implicated in exteroceptive processes, and (ii) widely demonstrated to have increased activation and connectivity in addicted populations. Conclusion Heightened exteroceptive processes may underlie cue-elicited craving, which in turn may lead to the maintenance and worsening of substance use disorders. An exteroception model of addiction provides a testable framework from which novel targets for interventions can be identified. PMID:26154169

  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. Current Pre- and Post-Graduate Vocational Education and Training in Laboratory Medicine and Microbiology in Poland

    PubMed Central

    Owczarek, Henryk

    2010-01-01

    The status of Polish medical laboratories in continuously changing. Since 2001 the legal framework was established for the clinical chemists employed in medical and microbiological laboratories. Since that time, the job performance by clinical chemists is limited only to the specialist, member of the Polish Chamber of Laboratory Diagnosticians. According to that legal act, graduate in laboratory medicine is certified to perform the professional activities in medical or microbiological laboratories without further vocational training. After graduating from biology, chemistry, pharmacy or veterinary medicine, a person can perform the job only under supervision of a certified clinical chemist. Several Medical Universities have organized the system of post-graduation education for such graduates. The main courses taught are basic pathology, internal medicine, hematology, immunology, and clinical chemistry. In addition, the Ministry of Health and Chamber of Laboratory Diagnosticians are organizing and supervising the higher level of post-graduate education for clinical chemists, the education and vocational training which leads to the title of specialist in clinical chemistry or similar area in laboratory medicine. The professional qualification of such person are evaluated during the final exam at the national level. The specialist is eligible to act as director of clinical laboratories.

  3. Current Pre- and Post-Graduate Vocational Education and Training in Laboratory Medicine and Microbiology in Poland

    PubMed Central

    Owczarek, Henryk

    2010-01-01

    The status of Polish medical laboratories in continuously changing. Since 2001 the legal framework was established for the clinical chemists employed in medical and microbiological laboratories. Since that time, the job performance by clinical chemists is limited only to the specialist, member of the Polish Chamber of Laboratory Diagnosticians. According to that legal act, graduate in laboratory medicine is certified to perform the professional activities in medical or microbiological laboratories without further vocational training. After graduating from biology, chemistry, pharmacy or veterinary medicine, a person can perform the job only under supervision of a certified clinical chemist. Several Medical Universities have organized the system of post-graduation education for such graduates. The main courses taught are basic pathology, internal medicine, hematology, immunology, and clinical chemistry. In addition, the Ministry of Health and Chamber of Laboratory Diagnosticians are organizing and supervising the higher level of post-graduate education for clinical chemists, the education and vocational training which leads to the title of specialist in clinical chemistry or similar area in laboratory medicine. The professional qualification of such person are evaluated during the final exam at the national level. The specialist is eligible to act as director of clinical laboratories. PMID:27683359

  4. [Psychophysiology of sports addiction (exercises addiction)].

    PubMed

    Krivoshchekov, S G; Lushnikov, O N

    2011-01-01

    Addiction is a prevalent and growing concern in all aspects of our modern society. There are considerable concerns for the growing frequency of addictions to drugs, alcohol, gambling, eating, and even sex. Though exercise is generally accepted as a positive behaviour that has many benefits associated with enhanced physical and psychological wellbeing, there is an increasing awareness that exercise addiction is becoming a common phenomenon. Theories regarding how exercise can become addictive, and studies of withdrawal from exercise are reviewed. Several physiological mechanisms, including endogenous opioids, catecholamines, functional asymmetry of brain activity and thermoregulation have been implicated in exercise dependence.

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

    PubMed

    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

  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. Failing to diagnose and failing to treat an addicted client: Two potentially life-threatening clinical errors.

    PubMed

    Liese, Bruce S; Reis, Daniel J

    2016-09-01

    Psychotherapists risk making 2 types of errors with clients who struggle with addictive behaviors: failure to addictive behaviors and failure to effectively addictive behaviors. Given the high prevalence of addictive behaviors in clinical populations, therapists are in a unique position to assist individuals with these problems. It is assumed that therapists possess general diagnostic and treatment skills and yet many do not diagnose or do not treat addictive behaviors. Reasons for making these errors include prohibitive beliefs and limited knowledge about addictive behaviors. We offer specific recommendations to reduce these psychotherapy errors. These include: (a) more deliberate screening and diagnosis of addictive behaviors, (b) increased application of empirically supported addiction treatments, (c) required education and training in addictive behaviors, (d) modification of prohibitive attitudes about addressing addictive behaviors, and (e) increased attention paid to the addictive behaviors by professional psychotherapy organizations. (PsycINFO Database Record PMID:27631864

  8. Failing to diagnose and failing to treat an addicted client: Two potentially life-threatening clinical errors.

    PubMed

    Liese, Bruce S; Reis, Daniel J

    2016-09-01

    Psychotherapists risk making 2 types of errors with clients who struggle with addictive behaviors: failure to addictive behaviors and failure to effectively addictive behaviors. Given the high prevalence of addictive behaviors in clinical populations, therapists are in a unique position to assist individuals with these problems. It is assumed that therapists possess general diagnostic and treatment skills and yet many do not diagnose or do not treat addictive behaviors. Reasons for making these errors include prohibitive beliefs and limited knowledge about addictive behaviors. We offer specific recommendations to reduce these psychotherapy errors. These include: (a) more deliberate screening and diagnosis of addictive behaviors, (b) increased application of empirically supported addiction treatments, (c) required education and training in addictive behaviors, (d) modification of prohibitive attitudes about addressing addictive behaviors, and (e) increased attention paid to the addictive behaviors by professional psychotherapy organizations. (PsycINFO Database Record

  9. [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.

  10. [Safety of nicotine addiction treatment].

    PubMed

    Korzeniowska, Katarzyna; Cieślewicz, Artur; Jabłecka, Anna

    2013-01-01

    Not all smoking addicts can succeed in quitting smoking with willpower only. These people may use nicotine replacement therapy (patches, gums, lozenges, sublingual tablets, inhalers), medicines (bupropion, varenicline and cytisine) and psychological aid. Each drug, besides its therapeutic effect, creates the risk of adverse reactions which number and severity is not always accepted by the patient. The aim of the study was to analyze adverse effects of bupropion, varenicline and cytisine formulations reported by patients. From July 2011 to June 2013 Regional Centre for Monitoring Adverse Drug Reactions (Department of Clinical Pharmacology, Department of Cardiology, Poznan University of Medical Sciences) recorded 32 suspected adverse reactions to the use of drugs for the treatment of nicotine addiction (12 after the preparation of cytisine and varenicline, 8 after preparations of bupropion). High determination caused that none of the patients withdrew from the therapy because of adverse effects.

  11. 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…

  12. A Canadian perspective on addiction treatment.

    PubMed

    El-Guebaly, Nady

    2014-01-01

    This paper presents a synopsis of addiction treatment in Canada, along with some available comparative figures with other North American countries. Within the framework of Canada's Medicare, a largely single-payer system, addiction and psychiatric disorders are insured on par with other medical disorders. Canada's strategy recognizes the four pillars of prevention, treatment, harm reduction, and enforcement. The Canadian Alcohol and Drug Use Monitoring Survey is the yearly main source of data on alcohol and illicit drug use. The main features of the Canadian addiction treatment network are identified as a "top 10" list, outlining early identification and intervention, assessment, and referral; detoxification; ambulatory care/day treatment programs; residential care; hospitals; concurrent disorders networks and regionalization; drug specific strategies; mutual help; behavioral addictions; and training, qualification, and research.

  13. 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…

  14. 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…

  15. 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.…

  16. 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.

  17. 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

  18. [Postgraduates' training as laboratory physicians/clinical pathologists in Japan--board certification of JSLM as a mandatory requirement for chairpersons of laboratory medicine].

    PubMed

    Kumasaka, Kazunari

    2002-04-01

    The educational committee of the Japanese Society of Laboratory Medicine(JSLM) proposed a revised laboratory medicine residency curriculum in 1999 and again in 2001. The committee believes that present undergraduate clinical training is insufficient and that Japanese medical graduates need clinical training for two years after graduation. This two years training should be a precondition for further postgraduate training in laboratory medicine and should include fundamental clinical skills(communication skills, physical examination and common laboratory procedures such as Gram's stain, Wright-Giemsa stain and urinalysis). After the two years training, the minimal training period of laboratory medicine should be three years, and should include: 1) Principles, instrumentation and techniques of each discipline including clinical chemistry, clinical hematology, clinical microbiology, clinical immunology, blood banking and other specific areas. 2) The use of laboratory information in a medical setting. 3) Interaction of the laboratory physician with laboratory staff, physicians and patients. With good on-the-job training and 24 hours on-call duties, laboratory physicians are expected to perform their tasks, including laboratory management, effectively. They should have appropriate educational background and should be well motivated. The background and duties of the laboratory physicians often reflect the institutional needs and personal philosophy of the chairperson of their department. At the moment, few senior physicians in Japan have qualifications in laboratory medicine and are unable, therefore, to provide the necessary guidance to help the laboratory physicians in their work. I therefore believe that the board certification of JSLM should be regarded as mandatory for chairpersons of laboratory medicine. Our on-call service system can enhance the training in laboratory medicine, and improve not only laboratory quality assurance but patients' care as well.

  19. [Postgraduates' training as laboratory physicians/clinical pathologists in Japan--board certification of JSLM as a mandatory requirement for chairpersons of laboratory medicine].

    PubMed

    Kumasaka, Kazunari

    2002-04-01

    The educational committee of the Japanese Society of Laboratory Medicine(JSLM) proposed a revised laboratory medicine residency curriculum in 1999 and again in 2001. The committee believes that present undergraduate clinical training is insufficient and that Japanese medical graduates need clinical training for two years after graduation. This two years training should be a precondition for further postgraduate training in laboratory medicine and should include fundamental clinical skills(communication skills, physical examination and common laboratory procedures such as Gram's stain, Wright-Giemsa stain and urinalysis). After the two years training, the minimal training period of laboratory medicine should be three years, and should include: 1) Principles, instrumentation and techniques of each discipline including clinical chemistry, clinical hematology, clinical microbiology, clinical immunology, blood banking and other specific areas. 2) The use of laboratory information in a medical setting. 3) Interaction of the laboratory physician with laboratory staff, physicians and patients. With good on-the-job training and 24 hours on-call duties, laboratory physicians are expected to perform their tasks, including laboratory management, effectively. They should have appropriate educational background and should be well motivated. The background and duties of the laboratory physicians often reflect the institutional needs and personal philosophy of the chairperson of their department. At the moment, few senior physicians in Japan have qualifications in laboratory medicine and are unable, therefore, to provide the necessary guidance to help the laboratory physicians in their work. I therefore believe that the board certification of JSLM should be regarded as mandatory for chairpersons of laboratory medicine. Our on-call service system can enhance the training in laboratory medicine, and improve not only laboratory quality assurance but patients' care as well. PMID

  20. 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.

  1. The genetic basis of addictive disorders.

    PubMed

    Ducci, Francesca; Goldman, David

    2012-06-01

    Addictions are common, chronic, and relapsing diseases that develop through a multistep process. The impact of addictions on morbidity and mortality is high worldwide. Twin studies have shown that the heritability of addictions ranges from 0.39 (hallucinogens) to 0.72 (cocaine). Twin studies indicate that genes influence each stage from initiation to addiction, although the genetic determinants may differ. Addictions are by definition the result of gene × environment interaction. These disorders, which are in part volitional, in part inborn, and in part determined by environmental experience, pose the full range of medical, genetic, policy, and moral challenges. Gene discovery is being facilitated by a variety of powerful approaches, but is in its infancy. It is not surprising that the genes discovered so far act in a variety of ways: via altered metabolism of drug (the alcohol and nicotine metabolic gene variants), via altered function of a drug receptor (the nicotinic receptor, which may alter affinity for nicotine but as discussed may also alter circuitry of reward), and via general mechanisms of addiction (genes such as monoamine oxidase A and the serotonin transporter that modulate stress response, emotion, and behavioral control). Addiction medicine today benefits from genetic studies that buttress the case for a neurobiologic origin of addictive behavior, and some general information on familially transmitted propensity that can be used to guide prevention. A few well-validated, specific predictors such as OPRM1, ADH1B, ALDH2, CHRNA5, and CYP26 have been identified and can provide some specific guidance, for example, to understand alcohol-related flushing and upper GI cancer risk (ADH1B and AKLDH2), variation in nicotine metabolism (CYP26), and, potentially, naltrexone treatment response (OPRM1). However, the genetic predictors available are few in number and account for only a small portion of the genetic variance in liability, and have not been integrated

  2. [Development of standards for education and training in family and community medicine - contributions by WONCA IberoAmerica (CIMF)].

    PubMed

    Demarzo, Marcelo Marcos Piva; Marin, Anibal; Padula Anderson, Maria Inez; De Castro Filho, Eno Dias; Kidd, Michael

    2011-02-01

    The WONCA Education Working Party (WEP) is developing a set of standards for medical student education, postgraduate training in family medicine / general practice and continuing professional development for family doctors. At this point the contributions by WONCA world regions are very important, and for this reason the main objective of this report is to present the standards developed by the Iberoamerican WONCA Region (CIMF). To be comprehensive and effective, standards should reflect regional realities and so the contributions from CIMF may reinforce and strengthen the key initiative of WEP and the implementation of the standards throughout the world. PMID:21145135

  3. 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

  4. 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…

  5. 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…

  6. Exercise training as vascular medicine: direct impacts on the vasculature in humans.

    PubMed

    Green, Daniel J

    2009-10-01

    Exercise training decreases cardiovascular risk, but effects on traditional risk factors do not fully account for this benefit. Exercise directly impacts upon arterial shear stress, a stimulus to antiatherogenic adaptation in vascular function and remodeling. This review considers the impact of exercise training on vascular adaptation in large and small arteries in humans.

  7. Training the translational research teams of the future: UC Davis-HHMI Integrating Medicine into Basic Science program.

    PubMed

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

    2013-10-01

    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 paper 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 authors have collected data on 55 HHMI-IMBS students to date. Many of these students are still completing their graduate work. In the current study the authors compare the initial two cohorts (15 students) with a group of 29 control students to examine the program success and outcomes. 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 predoctoral students.

  8. Training the translational research teams of the future: UC Davis-HHMI Integrating Medicine into Basic Science program.

    PubMed

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

    2013-10-01

    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 paper 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 authors have collected data on 55 HHMI-IMBS students to date. Many of these students are still completing their graduate work. In the current study the authors compare the initial two cohorts (15 students) with a group of 29 control students to examine the program success and outcomes. 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 predoctoral students. PMID:24127920

  9. 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

  10. Does integrated training in evidence-based medicine (EBM) in the general practice (GP) specialty training improve EBM behaviour in daily clinical practice? A cluster randomised controlled trial

    PubMed Central

    Kortekaas, M F; Bartelink, M E L; Zuithoff, N P A; van der Heijden, G J M G; de Wit, N J; Hoes, A W

    2016-01-01

    Objectives Evidence-based medicine (EBM) is an important element in the general practice (GP) specialty training. Studies show that integrating EBM training into clinical practice brings larger benefits than stand-alone modules. However, these studies have neither been performed in GP nor assessed EBM behaviour of former trainees in daily clinical practice. Setting GP specialty training in the Netherlands. Participants All 82 third year GP trainees who started their final third year in 2011 were approached for inclusion, of whom 79 (96%) participated: 39 in the intervention group and 40 in the control group. Intervention Integrated EBM training, in which EBM is embedded closely within the clinical context by joint assignments for the trainee and supervisor in daily practice, and teaching sessions based on dilemmas from actual patient consultations. Comparison Stand-alone EBM training at the institute only. Primary and secondary outcomes Our primary outcome was EBM behaviour, assessed by measuring guideline adherence (incorporating rational, motivated deviation) and information-seeking behaviour. Our secondary outcomes were EBM attitude and EBM knowledge. Data were acquired using logbooks and questionnaires, respectively. Analyses were performed using mixed models. Results Logbook data were available from 76 (96%) of the participating trainees at baseline (7614 consultations), 60 (76%) at the end of the third year (T1, 4973 consultations) and 53 (67%) 1 year after graduation (T2, 3307 consultations). We found no significant differences in outcomes between the 2 groups, with relative risks for guideline adherence varying between 0.96 and 0.99 (95% CI 0.86 to 1.11) at T1, and 0.99 and 1.10 (95% CI 0.92 to 1.25) at T2, and for information-seeking behaviour between 0.97 and 1.16 (95% CI 0.70 to 1.91) and 0.90 and 1.10 (95% CI 0.70 to 1.32), respectively. Conclusions Integrated EBM training compared with stand-alone EBM training does not improve EBM behaviour, attitude

  11. "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)

  12. A legislative history of federal assistance for health professions training in primary care medicine and dentistry in the United States, 1963-2008.

    PubMed

    Reynolds, P Preston

    2008-11-01

    This article reviews the legislative history of Title VII of the United States Public Health Service Act. It describes three periods of federal support for health professions training in medicine and dentistry. During the first era, 1963 to 1975, federal support led to an increase in the overall production of physicians and dentists, primarily through grants for construction, renovation, and expansion of schools. The second period, 1976 to 1991, witnessed a shift in federal support to train physicians, dentists, and physician assistants in the fields of primary care defined as family medicine, general internal medicine, and general pediatrics. During this era, divisions of general internal medicine and general pediatrics, and departments of family medicine, were established in nearly every medical and osteopathic medical school. All three disciplines conducted primary care residencies, medical student clerkships, and faculty development programs. The third period, 1992 to present, emphasized the policy goals of caring for vulnerable populations, greater diversity in the health professions, and curricula innovations to prepare trainees for the future practice of medicine and dentistry. Again, Title VII grantees met these policy goals by designing curricula and creating clinical experiences to teach care of the homeless, persons with HIV, the elderly, and other vulnerable populations. Many grantees recruited underrepresented minorities into their programs as trainees and as faculty, and all of them designed and implemented new curricula to address emerging health priorities.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

  13. The EC4 European syllabus for post-graduate training in clinical chemistry and laboratory medicine: version 4--2012.

    PubMed

    Wieringa, Gijsbert; Zerah, Simone; Jansen, Rob; Simundic, Ana-Maria; Queralto, José; Solnica, Bogdan; Gruson, Damien; Tomberg, Karel; Riittinen, Leena; Baum, Hannsjörg; Brochet, Jean-Philippe; Buhagiar, Gerald; Charilaou, Charis; Grigore, Camelia; Johnsen, Anders H; Kappelmayer, Janos; Majkic-Singh, Nada; Nubile, Giuseppe; O'Mullane, John; Opp, Matthias; Pupure, Silvija; Racek, Jaroslav; Reguengo, Henrique; Rizos, Demetrios; Rogic, Dunja; Špaňár, Július; Štrakl, Greta; Szekeres, Thomas; Tzatchev, Kamen; Vitkus, Dalius; Wallemacq, Pierre; Wallinder, Hans

    2012-08-01

    Laboratory medicine's practitioners across the European community include medical, scientific and pharmacy trained specialists whose contributions to health and healthcare is in the application of diagnostic tests for screening and early detection of disease, differential diagnosis, monitoring, management and treatment of patients, and their prognostic assessment. In submitting a revised common syllabus for post-graduate education and training across the 27 member states an expectation is set for harmonised, high quality, safe practice. In this regard an extended 'Core knowledge, skills and competencies' division embracing all laboratory medicine disciplines is described. For the first time the syllabus identifies the competencies required to meet clinical leadership demands for defining, directing and assuring the efficiency and effectiveness of laboratory services as well as expectations in translating knowledge and skills into ability to practice. In a 'Specialist knowledge' division, the expectations from the individual disciplines of Clinical Chemistry/Immunology, Haematology/Blood Transfusion, Microbiology/ Virology, Genetics and In Vitro Fertilisation are described. Beyond providing a common platform of knowledge, skills and competency, the syllabus supports the aims of the European Commission in providing safeguards to increasing professional mobility across European borders at a time when demand for highly qualified professionals is increasing and the labour force is declining. It continues to act as a guide for the formulation of national programmes supplemented by the needs of individual country priorities.

  14. 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

  15. 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

  16. 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.

  17. Current considerations regarding food addiction.

    PubMed

    Schulte, Erica M; Joyner, Michelle A; Potenza, Marc N; Grilo, Carlos M; Gearhardt, Ashley N

    2015-04-01

    "Food addiction" is an emerging area, and behavioral and biological overlaps have been observed between eating and addictive disorders. Potential misconceptions about applying an addiction framework to problematic eating behavior may inhibit scientific progress. Critiques of "food addiction" that focus on descriptive differences between overeating and illicit drugs are similar to early criticisms of the addictiveness of tobacco. Although food is necessary for survival, the highly processed foods associated with addictive-like eating may provide little health benefit. Individual differences are important in determining who develops an addiction. If certain foods are addictive, the identification of possible risk factors for "food addiction" is an important next step. Not all treatments for addiction require abstinence. Addiction interventions that focus on moderation or controlled use may lead to novel approaches to treating eating-related problems. Finally, addiction-related policies that focus on environmental (instead of educational) targets may have a larger public health impact in reducing overeating.

  18. Current considerations regarding food addiction.

    PubMed

    Schulte, Erica M; Joyner, Michelle A; Potenza, Marc N; Grilo, Carlos M; Gearhardt, Ashley N

    2015-04-01

    "Food addiction" is an emerging area, and behavioral and biological overlaps have been observed between eating and addictive disorders. Potential misconceptions about applying an addiction framework to problematic eating behavior may inhibit scientific progress. Critiques of "food addiction" that focus on descriptive differences between overeating and illicit drugs are similar to early criticisms of the addictiveness of tobacco. Although food is necessary for survival, the highly processed foods associated with addictive-like eating may provide little health benefit. Individual differences are important in determining who develops an addiction. If certain foods are addictive, the identification of possible risk factors for "food addiction" is an important next step. Not all treatments for addiction require abstinence. Addiction interventions that focus on moderation or controlled use may lead to novel approaches to treating eating-related problems. Finally, addiction-related policies that focus on environmental (instead of educational) targets may have a larger public health impact in reducing overeating. PMID:25749750

  19. 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 ( ...

  20. The complexity of team training: what we have learned from aviation and its applications to medicine

    PubMed Central

    Hamman, W

    2004-01-01

    Errors in health care that compromise patient safety are tied to latent failures in the structure and function of systems. Teams of people perform most care delivered today, yet training often remains focused on individual responsibilities. Training programmes for all healthcare workers need to increase the educational experience of working in interdisciplinary teams. The complexities of team training require a multifunctional (systems) approach, which crosses organisational divisions to allow communication, accountability, and creation and maintenance of interdisciplinary teams. This report identifies challenges for medical education in performing the research, identifying performance measurements, and modifying educational curricula for the advancement of interdisciplinary teams, based on the complexity of team training identified in commercial aviation. PMID:15465959

  1. 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

  2. The genetics of the opioid system and specific drug addictions.

    PubMed

    Levran, Orna; Yuferov, Vadim; Kreek, Mary Jeanne

    2012-06-01

    Addiction to drugs is a chronic, relapsing brain disease that has major medical, social, and economic complications. It has been established that genetic factors contribute to the vulnerability to develop drug addiction and to the effectiveness of its treatment. Identification of these factors may increase our understanding of the disorders, help in the development of new treatments and advance personalized medicine. In this review, we will describe the genetics of the major genes of the opioid system (opioid receptors and their endogenous ligands) in connection to addiction to opioids, cocaine, alcohol and methamphetamines. Particular emphasis is given to association and functional studies of specific variants. We will provide information on the sample populations and the size of each study, as well as a list of the variants implicated in association with addiction-related phenotypes, and with the effectiveness of pharmacotherapy for addiction.

  3. 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

  4. 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:...

  5. 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.

  6. Faculty Training in Evidence-Based Medicine: Improving Evidence Acquisition and Critical Appraisal

    ERIC Educational Resources Information Center

    Nicholson, Laura J.; Warde, Carole M.; Boker, John R.

    2007-01-01

    Introduction: Evidence-based medicine (EBM) integrates published clinical evidence with patient values and clinical expertise, the output of which is informed medical decision making. Key skills for evidence-based practice include acquisition and appraisal of clinical information. Faculty clinicians often lack expertise in these skills and are…

  7. 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…

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

    PubMed

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

    2014-08-01

    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.

  9. Genetics of opiate addiction.

    PubMed

    Reed, Brian; Butelman, Eduardo R; Yuferov, Vadim; Randesi, Matthew; Kreek, Mary Jeanne

    2014-11-01

    Addiction to MOP-r agonists such as heroin (and also addiction to prescription opioids) has reemerged as an epidemic in the twenty first century, causing massive morbidity. Understanding the genetics contributing to susceptibility to this disease is crucial for the identification of novel therapeutic targets, and also for discovery of genetic markers which would indicate relative protection or vulnerability from addiction, and relative responsiveness to pharmacotherapy. This information could thus eventually inform clinical practice. In this review, we focus primarily on association studies of heroin and opiate addiction, and further describe the studies which have been replicated in this field, and are thus more likely to be useful for translational efforts.

  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. 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

  12. A Comparison between Emergency Medicine Residency Training Programs in the United States and Saudi Arabia from the Residents' Perception

    PubMed Central

    2014-01-01

    Objectives. This study was designed to compare the trainees' perception of emergency medicine (EM) training in the United States (US) and Saudi Arabia (SA) and to identify residents' levels of confidence and points of satisfaction in education, procedural skills, and work environment. Method. An IRB-exempt anonymous web-based survey was distributed to five EM residency training programs in the USA and three residency regions in SA. Results. 342 residents were polled with a 20% response rate (16.8% USA and 25.8% SA). The Saudi residents responded less positively to the questions about preparation for their boards' examinations, access to multiple educational resources, and weekly academic activities. The Saudi trainees felt less competent in less common procedures than US trainees. American trainees also more strongly agree that they have more faculty interest in their education compared to the Saudi trainees. The Saudi residents see more patients per hour compared to their US peers. Conclusion. These findings may be due to the differences in training techniques including less formal didactics and simulation experience in SA and more duty hour regulations in the USA. PMID:24563784

  13. The Master of Science in clinical epidemiology degree program of the Perelman School of Medicine at the University of Pennsylvania: a model for clinical research training.

    PubMed

    Strom, Brian L; Kelly, Thomas O; Norman, Sandra A; Farrar, John T; Kimmel, Stephen E; Lautenbach, Ebbing; Feldman, Harold I

    2012-01-01

    An innovative training program to provide clinical research training for clinicians was created in 1979 at the University of Pennsylvania School of Medicine, now the Perelman School of Medicine. The program's principal and continuing aim is to provide trainees mentored experiences and the training needed to become skilled independent investigators able to conduct clinical research and develop academic careers as independent clinical investigators.The authors identify the vision that led to the creation of the master of science in clinical epidemiology (MSCE) degree program and describe today's training program, including administration, oversight, participating faculty, and trainees. They also describe the program's core curriculum, elective options, seminars on ongoing research, training in the responsible conduct of research, professional development activities, and the development and completion of a closely mentored clinical research project.Approximately 35 new trainees enter the two- to three-year program annually. Funding is provided primarily by National Institutes of Health-funded training programs and supplemented by private industry, private foundations, and employee-based benefits. More than 500 individuals have received or are currently receiving training through the MSCE program. A large percentage of former trainees maintain full-time positions in academic medicine today.The authors identify some challenges that have been met and insights regarding funding, faculty, trainees, and curriculum. Ongoing challenges include recruiting trainees from some selected highly paid, procedure-oriented specialties, maintaining sufficient mentors for the continually increasing numbers of trainees, and distinguishing applicants who truly desire a primary research career from others.

  14. 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.

  15. Call for fellowship programs in stem cell-based regenerative and cellular medicine: new stem cell training is essential for physicians.

    PubMed

    Knoepfler, Paul S

    2013-03-01

    Stem cell-based regenerative and cellular medicine is an exciting, emerging area of medical practice. While bone marrow transplantation, a stem cell-based therapy, has been a part of medicine for decades, in recent years newer and more diverse forms of stem cell-based therapies are being used to treat a rapidly growing population of patients in the USA as well as worldwide. Nonetheless, to this author's knowledge, there is currently not a single academic medical fellowship training program in the USA that specifically prepares physicians for treating patients with stem cell-based therapies other than bone marrow or hematopoietic stem cell transplantation. An increasing number of physicians untrained in stem cell-based regenerative and cellular medicine are nonetheless transplanting stem cells into hundreds if not thousands of patients for a striking diversity of conditions. Furthermore, as stem cell technology advances, a growing number of physicians with academic affiliations may look to legitimately practice regenerative and cellular medicine. What little training that physicians can currently obtain must be found on an ad hoc basis. This article should act as a call for the development of formal academic medical fellowship programs to train physicians in the practice of cellular and regenerative medicine. The USA is used here as an example of a medical sphere in which it can be argued that such training would be helpful, however such programs would be quite helpful globally.

  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. [Addictions and pregnancy : how to ruin a pregnancy].

    PubMed

    Emonts, P; Masson, V; Chantraine, F; Kridelka, F; Nisolle, M

    2013-01-01

    Pregnant women are well aware that any addiction during pregnancy can be harmful to the child. In spite of this knowledge, many continue to smoke, to drink alcohol, to consume illicit drugs or to absorb medicines because these dependences are particularly strong. Tobacco, alcohol, cocaine and ecstasy represent the most dangerous substances as regards foetal damage. The period of pregnancy is the optimal moment to stop these addictions. It is therefore essential to raise awareness among the general public, policy makers, and physicians of the fact that addictions during pregnancy cause a disparity in terms of future health and life expectancy of the unborn child.

  18. [Contribution of emergency medicine by neurologists in the western countries: residency training is the key].

    PubMed

    Nodera, Hiroyuki

    2013-01-01

    Neurologists in the United States actively involve in neurological emergency. Two factors have enabled such active contribution: (1) US residency training programs in neurology focus on management of neurological emergency as their initial training aims. Junior residents receive many lectures in emergent neurology in the initial month. (2) The numbers of the faculty members in neurology department in the US teaching hospitals are much more than those in Japan, such that each faculty member can share the teaching activities. Although the US teaching and residency systems in neurological emergency cannot be directly imported to Japan, devotion to emergency care in neurological diseases by neurologists should be incorporated into management and education in Japan.

  19. 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

  20. Regression analysis of radial artery pulse palpation as a potential tool for traditional Chinese medicine training education.

    PubMed

    Huang, Po-Yu; Lin, Wen-Chen; Chiu, Bill Yuan-Chi; Chang, Hen-Hong; Lin, Kang-Ping

    2013-12-01

    Pulse palpation was an important part of the traditional Chinese medicine (TCM) vascular examination. It is challenging for new physicians to learn to differentiate between palpations of various pulse types, due to limited comparative learning time with established masters, and so normally it takes many years to master the art. The purpose of this study was to introduce an offline TCM skill evaluation and comparison system that makes available learning of palpation without the master's presence. We record patient's radial artery pulse using an existing pressure-based pulse acquisition system, then annotate it with teachers' evaluation when palpating the same patient, assigned as likelihood of it being each pulse type, e.g. wiry, slippery, hesitant. These training data were separated into per-doctor and per-skill databases for evaluation and comparison purposes, using the following novel procedure: each database was used as training data to a panel of time-series data-mining algorithms, driven by two validation tests, with the created training models evaluated in mean-squared-error. Each validation of the panel and training data yielded an array of error terms, and we chose one to quantitatively evaluate palpation techniques, giving way to compute self consistency and mutual-similarity across different practitioners and techniques. Our experiment of two practitioners and 396 per-processing samples yielded the following: one of the physicians has much higher value of self-consistency for all tested pulse types. Also, the two physicians have high similarity in how they palpate the slipper pulse (P) type, but very dissimilar for hesitant (H) type. This system of skill comparisons may be more broadly applied in places where supervised learning algorithms can detect and use meaningful features in the data; we chose a panel of algorithms previously shown to be effective for many time-series types, but specialized algorithms may be added to improve feature-specific aspect

  1. 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…

  2. Counseling Compulsive Resume Addiction.

    ERIC Educational Resources Information Center

    Karp, Marshall J.

    Compulsive Resume Addiction (CRA) is a condition where applicants become dependent on their written credentials to get new employment. It is similar to other addictions in that the person manifests short-term, gratification-seeking behavior with the long term cost in self-esteem and self-confidence. Applicants get stuck in thinking that a better…

  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. 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…

  5. 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

  6. 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…

  7. [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

  8. 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.

  9. [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.

  10. [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

  11. [Addictive behavior disorders].

    PubMed

    Masaki, Daiki; Tsuchida, Hideto; Kitabayashi, Yurinosuke; Tani, Naosuke; Fukui, Kenji

    2007-10-01

    "Addiction" used to remind anyone of the use or abuse of chemical substances. In recent years, however, researchers and clinicians have begun to classify other excessive behaviors including gambling, eating shopping and self-injury into the addictive behavior. Above all, pathological gambling and bulimia nervosa patients often make trouble for psychiatrists and psychologists, not only for their family. On the other hand, the neural substrata underlying substance dependence have been revealed. Especially, it is implicated that the mesolimbic neuron plays a crucial role on the reward system. The recent studies suggest that reduced activation of the reward system might be related to the addictive behaviors such as pathological gambling, binge eating and sexual behavior. Further biological researches about the addictive behavior would help our deeper understanding of its disorders. As to the pharmacotherapy, many studies have demonstrated the efficacy of selective serotonin reuptake inhibitors (SSRIs) in treating the addictive behaviors.

  12. [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

  13. [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.

  14. 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

  15. Laboratory Medicine Specialization Teaching and Training in Italy with a Glance to Some European and Non-European Countries

    PubMed Central

    2010-01-01

    The Italian Ministry of Education, University and Research has recently reformed the medical schools of specialization in accordance with a series of EC Directives. Four different curricula have been defined into the class of “Diagnostics and Laboratory Medicine”, respectively: Anatomic Pathology, Clinical Biochemistry, Clinical Pathology, and Microbiology & Virology. Each curriculum is based on a scheme of 300 credits, that includes formal educational activities) and practical activities distributed on a five years’ period. The four curricula share a common course of either formal or practical activities. Main training and professional objectives are in favour of: a) the principles of appropriateness and of evidence based medicine, b) the acquisition of either on-the-bench experience and practice, or skills in organizing and managing the laboratory activities and personnel c) the understanding of data and phenomena relevant to the patients in a clinically oriented vision, d) the ability to translate research results into diagnostic advantages, e) the values of humanism and ethics. When comparing the Italian curriculum with some European and non-European curricula in Laboratory Medicine, many similarities are apparent: above all, the medical pertinence of the profession is increasingly affirmed in favour of a consultancy role to be played by the specialist in Laboratory Medicine at the clinical level. Main conclusions: a) the education, skill and expertise required for laboratory specialists regard now a broad variety of issues, b) these embrace not only technical, scientific and organizational aspects, but even the ability to develop consultative capacities in different diagnostic areas, c) moreover the implicit translational aspects in the profession require the adoption of innovative and multifaceted curricula. PMID:27683357

  16. Laboratory Medicine Specialization Teaching and Training in Italy with a Glance to Some European and Non-European Countries

    PubMed Central

    2010-01-01

    The Italian Ministry of Education, University and Research has recently reformed the medical schools of specialization in accordance with a series of EC Directives. Four different curricula have been defined into the class of “Diagnostics and Laboratory Medicine”, respectively: Anatomic Pathology, Clinical Biochemistry, Clinical Pathology, and Microbiology & Virology. Each curriculum is based on a scheme of 300 credits, that includes formal educational activities) and practical activities distributed on a five years’ period. The four curricula share a common course of either formal or practical activities. Main training and professional objectives are in favour of: a) the principles of appropriateness and of evidence based medicine, b) the acquisition of either on-the-bench experience and practice, or skills in organizing and managing the laboratory activities and personnel c) the understanding of data and phenomena relevant to the patients in a clinically oriented vision, d) the ability to translate research results into diagnostic advantages, e) the values of humanism and ethics. When comparing the Italian curriculum with some European and non-European curricula in Laboratory Medicine, many similarities are apparent: above all, the medical pertinence of the profession is increasingly affirmed in favour of a consultancy role to be played by the specialist in Laboratory Medicine at the clinical level. Main conclusions: a) the education, skill and expertise required for laboratory specialists regard now a broad variety of issues, b) these embrace not only technical, scientific and organizational aspects, but even the ability to develop consultative capacities in different diagnostic areas, c) moreover the implicit translational aspects in the profession require the adoption of innovative and multifaceted curricula.

  17. [What are the competencies that public health physician should have today? A proposal for a shared training program at three Hygiene and Preventive Medicine residency training schools in Rome (Italy)].

    PubMed

    D'Andrea, Elvira; Lucaroni, Francesca; Parente, Paolo; Damiani, Gianfranco; La Torre, Giuseppe; Mancinelli, Sandro; Bucci, Roberto; De Vito, Corrado; Maurici, Massimo; De Vito, Elisabetta; Franco, Elisabetta; Villari, Paolo; Ricciardi, Walter

    2016-01-01

    To acquire essential knowledge and skills for Public Health practice, residents in Hygiene and Preventive Medicine programs should be provided with excellent training. On behalf of the Roman Public Health Academy (ARSP), the authors, representing the three Hygiene and Preventive Medicine residency training programs in Rome (Italy) aimed to propose a training program to be shared by the above three schools. Firstly, they performed a scientific literature review to identify the core competencies that a public health specialist should have acquired at the end of training. Ten areas (macro-areas or domains) relevant to Public Health practice were defined. The authors then identified the main characteristics that the proposed training program should have, which include: enhancement of community healthcare services and optimization of local resources to create/strengthen exchange and cooperation networks; possibility to adapt the training proposal to an international setting; adoption of a training approach that can respond effectively to a changing health system; customization of training on the basis of residents' individual abilities and motivations, so that their individual strengths can be enhanced; achievement of educational excellence, in compliance with ethical requirements. PMID:27336955

  18. [What are the competencies that public health physician should have today? A proposal for a shared training program at three Hygiene and Preventive Medicine residency training schools in Rome (Italy)].

    PubMed

    D'Andrea, Elvira; Lucaroni, Francesca; Parente, Paolo; Damiani, Gianfranco; La Torre, Giuseppe; Mancinelli, Sandro; Bucci, Roberto; De Vito, Corrado; Maurici, Massimo; De Vito, Elisabetta; Franco, Elisabetta; Villari, Paolo; Ricciardi, Walter

    2016-01-01

    To acquire essential knowledge and skills for Public Health practice, residents in Hygiene and Preventive Medicine programs should be provided with excellent training. On behalf of the Roman Public Health Academy (ARSP), the authors, representing the three Hygiene and Preventive Medicine residency training programs in Rome (Italy) aimed to propose a training program to be shared by the above three schools. Firstly, they performed a scientific literature review to identify the core competencies that a public health specialist should have acquired at the end of training. Ten areas (macro-areas or domains) relevant to Public Health practice were defined. The authors then identified the main characteristics that the proposed training program should have, which include: enhancement of community healthcare services and optimization of local resources to create/strengthen exchange and cooperation networks; possibility to adapt the training proposal to an international setting; adoption of a training approach that can respond effectively to a changing health system; customization of training on the basis of residents' individual abilities and motivations, so that their individual strengths can be enhanced; achievement of educational excellence, in compliance with ethical requirements.

  19. 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

  20. Sex differences in addictive disorders.

    PubMed

    Fattore, Liana; Melis, Miriam; Fadda, Paola; Fratta, Walter

    2014-08-01

    Gender-dependent differences in the rate of initiation and frequency of misuse of addicting drugs have been widely described. Yet, men and women also differ in their propensity to become addicted to other rewarding stimuli (e.g., sex, food) or activities (e.g., gambling, exercising). The goal of the present review is to summarize current evidence for gender differences not only in drug addiction, but also in other forms of addictive behaviours. Thus, we first reviewed studies showing gender-dependent differences in drug addiction, food addiction, compulsive sexual activity, pathological gambling, Internet addiction and physical exercise addiction. Potential risk factors and underlying brain mechanisms are also examined, with particular emphasis given to the role of sex hormones in modulating addictive behaviours. Investigations on factors allowing the pursuit of non-drug rewards to become pathological in men and women are crucial for designing gender-appropriate treatments of both substance and non-substance addictions.

  1. Sex differences in addictive disorders.

    PubMed

    Fattore, Liana; Melis, Miriam; Fadda, Paola; Fratta, Walter

    2014-08-01

    Gender-dependent differences in the rate of initiation and frequency of misuse of addicting drugs have been widely described. Yet, men and women also differ in their propensity to become addicted to other rewarding stimuli (e.g., sex, food) or activities (e.g., gambling, exercising). The goal of the present review is to summarize current evidence for gender differences not only in drug addiction, but also in other forms of addictive behaviours. Thus, we first reviewed studies showing gender-dependent differences in drug addiction, food addiction, compulsive sexual activity, pathological gambling, Internet addiction and physical exercise addiction. Potential risk factors and underlying brain mechanisms are also examined, with particular emphasis given to the role of sex hormones in modulating addictive behaviours. Investigations on factors allowing the pursuit of non-drug rewards to become pathological in men and women are crucial for designing gender-appropriate treatments of both substance and non-substance addictions. PMID:24769267

  2. New approaches to addiction treatment based on learning and memory.

    PubMed

    Kiefer, Falk; Dinter, Christina

    2013-01-01

    Preclinical studies suggest that physiological learning processes are similar to changes observed in addicts at the molecular, neuronal, and structural levels. Based on the importance of classical and instrumental conditioning in the development and maintenance of addictive disorders, many have suggested cue-exposure-based extinction training of conditioned, drug-related responses as a potential new treatment of addiction. It may also be possible to facilitate this extinction training with pharmacological compounds that strengthen memory consolidation during cue exposure. Another potential therapeutic intervention would be based on the so-called reconsolidation theory. According to this hypothesis, already-consolidated memories return to a labile state when reactivated, allowing them to undergo another phase of consolidation-reconsolidation, which can be pharmacologically manipulated. These approaches suggest that the extinction of drug-related memories may represent a viable treatment strategy in the future treatment of addiction.

  3. New approaches to addiction treatment based on learning and memory.

    PubMed

    Kiefer, Falk; Dinter, Christina

    2013-01-01

    Preclinical studies suggest that physiological learning processes are similar to changes observed in addicts at the molecular, neuronal, and structural levels. Based on the importance of classical and instrumental conditioning in the development and maintenance of addictive disorders, many have suggested cue-exposure-based extinction training of conditioned, drug-related responses as a potential new treatment of addiction. It may also be possible to facilitate this extinction training with pharmacological compounds that strengthen memory consolidation during cue exposure. Another potential therapeutic intervention would be based on the so-called reconsolidation theory. According to this hypothesis, already-consolidated memories return to a labile state when reactivated, allowing them to undergo another phase of consolidation-reconsolidation, which can be pharmacologically manipulated. These approaches suggest that the extinction of drug-related memories may represent a viable treatment strategy in the future treatment of addiction. PMID:21735361

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. Addressing the leadership gap in medicine: residents' need for systematic leadership development training.

    PubMed

    Blumenthal, Daniel M; Bernard, Ken; Bohnen, Jordan; Bohmer, Richard

    2012-04-01

    All clinicians take on leadership responsibilities when delivering care. Evidence suggests that effective clinical leadership yields superior clinical outcomes. However, few residency programs systematically teach all residents how to lead, and many clinicians are inadequately prepared to meet their day-to-day clinical leadership responsibilities. The purpose of this article is twofold: first, to make the case for the need to refocus residency education around the development of outstanding "frontline" clinical leaders and, second, to provide an evidence-based framework for designing formal leadership development programs for residents. The authors first present a definition of clinical leadership and highlight evidence that effective frontline clinical leadership improves both clinical outcomes and satisfaction for patients and providers. The authors then discuss the health care "leadership gap" and describe barriers to implementing leadership development training in health care. Next, they present evidence that leaders are not just "born" but, rather, can be "made," and offer a set of best practices to facilitate the design of leadership development programs. Finally, the authors suggest approaches to mitigating barriers to implementing leadership development programs and highlight the major reasons why health care delivery organizations, residency programs, and national accreditation bodies must make comprehensive leadership education an explicit goal of residency training. PMID:22361800

  10. Addressing the leadership gap in medicine: residents' need for systematic leadership development training.

    PubMed

    Blumenthal, Daniel M; Bernard, Ken; Bohnen, Jordan; Bohmer, Richard

    2012-04-01

    All clinicians take on leadership responsibilities when delivering care. Evidence suggests that effective clinical leadership yields superior clinical outcomes. However, few residency programs systematically teach all residents how to lead, and many clinicians are inadequately prepared to meet their day-to-day clinical leadership responsibilities. The purpose of this article is twofold: first, to make the case for the need to refocus residency education around the development of outstanding "frontline" clinical leaders and, second, to provide an evidence-based framework for designing formal leadership development programs for residents. The authors first present a definition of clinical leadership and highlight evidence that effective frontline clinical leadership improves both clinical outcomes and satisfaction for patients and providers. The authors then discuss the health care "leadership gap" and describe barriers to implementing leadership development training in health care. Next, they present evidence that leaders are not just "born" but, rather, can be "made," and offer a set of best practices to facilitate the design of leadership development programs. Finally, the authors suggest approaches to mitigating barriers to implementing leadership development programs and highlight the major reasons why health care delivery organizations, residency programs, and national accreditation bodies must make comprehensive leadership education an explicit goal of residency training.

  11. 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

  12. 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

  13. 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

  14. [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.

  15. [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

  16. 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.

  17. 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

  18. Biological substrates of addiction

    PubMed Central

    Joffe, Max E.; Grueter, Carrie A.

    2014-01-01

    This review is an introduction to addiction, the reward circuitry, and laboratory addiction models. Addiction is a chronic disease hallmarked by a state of compulsive drug seeking that persists despite negative consequences. Most of the advances in addiction research have centered on the canonical and contemporary drugs of abuse, however, addictions to other activities and stimuli also exist. Substances of abuse have the potential to induce long-lasting changes in the brain at the behavioral, circuit and synaptic levels. Addiction-related behavioral changes involve initiation, escalation and obsession to drug seeking and much of the current research is focused on mapping these manifestations to specific neural pathways. Drug abuse is well known to recruit components of the mesolimbic dopamine system, including the nucleus accumbens and ventral tegmental area. In addition, altered function of a wide variety of brain regions is tightly associated with specific manifestations of drug abuse. These regions peripheral to the mesolimbic pathway likely play a role in specific observed comorbidities and endophenotypes that can facilitate, or be caused by, substance abuse. Alterations in synaptic structure, function and connectivity, as well as epigenetic and genetic mechanisms are thought to underlie the pathologies of addiction. In preclinical models, these persistent changes are studied at the levels of molecular pharmacology and biochemistry, ex vivo and in vivo electrophysiology, radiography and behavior. Coordinating research efforts across these disciplines and examining cell type- and circuit-specific phenomena are crucial components for translating preclinical findings to viable medical interventions that effectively treat addiction and related disorders. PMID:24999377

  19. 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.

  20. 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

  1. [Neurobiology of addictive behavior].

    PubMed

    Ivlieva, N Iu

    2011-01-01

    Addictive behavior developes after repeated substance use and it typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to the drug use than to other activities. Relapse, the resumption of drug taking after periods of abstinence, remains the major problem for the treatment of addiction. The process of drug addiction shares striking commonalities with neural plasticity associated with natural reward learning and memory and is caused primarily by drug-induced sensitization in the brain mesocorticolimbic systems that attribute incentive salience to reward-associated stimuli. The switch from controlled to compulsive drug seeking represents a transition at the neural level from prefrontal cortical to striatal control. Current neurophysiologic evidence suggests that the development of addiction is to some extent due to neurochemical stimulation of the midbrain dopaminergic system that is traditionally considered as a 'common neural currency' for rewards of most kinds. Addictions are a result of the interplay of multiple genetic and environmental factors. They are characterized by phenotypic and genetic heterogeneity as well as polygenicity. Environmental factors are crucial in addiction vulnerability and resistese too.

  2. Geriatric medicine training for family practice residents in the 21st century: a report from the Residency Assistance Program/Harfford Geriatrics Initiative.

    PubMed

    Warshaw, Gregg; Murphy, John; Buehler, James; Singleton, Stacy

    2003-01-01

    Increasing the quality and quantity of geriatric medicine training for family practice residents is a particular challenge for community-based programs. With support from the John A. Hartford Foundation of New York City, the American Academy of Family Physicians (AAFP) implemented in 1995 a multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. This report summarizes the initial results of the regional geriatric medicine curriculum retreats for residency directors. The goals of the retreats were to build recognition among the residency directors of the skills that future family physicians will require to be successful providers of primary care to older adults and to allow the residency directors to identify and develop solutions to barriers to improving geriatric medicine training for residents. Forty-six program directors participated in the three retreats between February 2000 and February 2001. The participants represented 52 programs and rural tracks in all geographic regions, small and large programs, and urban and rural settings. The program directors developed a consensus on the geriatric medicine knowledge, skills, and attitudes that should be expected of all family practice residency graduates; developed a list of basic, required educational resources for each family practice residency program; and proposed solutions to common obstacles to successful curriculum development.

  3. 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.

  4. Clinical management of immuno-suppression in athletes associated with exercise training: sports medicine considerations.

    PubMed

    Hackney, Anthony Carl

    2013-01-01

    The Overtraining Syndrome (OTS) is a physically debilitating medical condition that results in athletes being totally compromised in their capacity to perform and compete. Many physiological systems are affected by the process of overtraining and the development of the OTS which results from it; but one system in particular, the immune, is highly susceptible to degradation resulting in a reduction in overall health and physical performance. The aim of this paper is to review; 1) the evidence-based proactive steps and actions to take to greatly reduce the risk of development of an infection or a compromised immune system in athletes; and 2) the course of action for clinicians to take when they are dealing with an athlete displaying overt signs of an infection and, or inflammation. Evidenced reported here within support that it is essential for clinicians to take practical preventative and management steps - actions with athletes (involved in intensive exercise training) in order to help preserve and maintain a healthy and robust immune system if they are going to perform optimally.

  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. Parenting attitudes of addict mothers.

    PubMed

    Wellisch, D K; Steinberg, M R

    1980-08-01

    Parenting attitudes of female heroin addicts were investigated in a single factor design which compared addict mothers, addict non-mothers, nonaddict mothers, and nonaddict nonmothers. A principal components factor analysis was performed on the PARI and used as the dependent measure. A factor labeled "authoritarian overinvolvement" emerged which significantly differentiated between groups. Further, the effects of mothering and addiction proved to be additive such that addict mothers were extremely high on this scale. This result was discussed in terms of the parental home environment of addict women.

  7. "Eating addiction", rather than "food addiction", better captures addictive-like eating behavior.

    PubMed

    Hebebrand, Johannes; Albayrak, Özgür; Adan, Roger; Antel, Jochen; Dieguez, Carlos; de Jong, Johannes; Leng, Gareth; Menzies, John; Mercer, Julian G; Murphy, Michelle; van der Plasse, Geoffrey; Dickson, Suzanne L

    2014-11-01

    "Food addiction" has become a focus of interest for researchers attempting to explain certain processes and/or behaviors that may contribute to the development of obesity. Although the scientific discussion on "food addiction" is in its nascent stage, it has potentially important implications for treatment and prevention strategies. As such, it is important to critically reflect on the appropriateness of the term "food addiction", which combines the concepts of "substance-based" and behavioral addiction. The currently available evidence for a substance-based food addiction is poor, partly because systematic clinical and translational studies are still at an early stage. We do however view both animal and existing human data as consistent with the existence of addictive eating behavior. Accordingly, we stress that similar to other behaviors eating can become an addiction in thus predisposed individuals under specific environmental circumstances. Here, we introduce current diagnostic and neurobiological concepts of substance-related and non-substance-related addictive disorders, and highlight the similarities and dissimilarities between addiction and overeating. We conclude that "food addiction" is a misnomer because of the ambiguous connotation of a substance-related phenomenon. We instead propose the term "eating addiction" to underscore the behavioral addiction to eating; future research should attempt to define the diagnostic criteria for an eating addiction, for which DSM-5 now offers an umbrella via the introduction on Non-Substance-Related Disorders within the category Substance-Related and Addictive Disorders.

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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.

  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. Addiction, the Addict, and Career: Considerations for the Employment Counselor

    ERIC Educational Resources Information Center

    Graham, Matthew D.

    2006-01-01

    Employment counselors have been resistant to working with persons in recovery from addiction except under the strictest of criteria. This article examines the relationship between this resistance and the concepts of addiction and addict. Following this is an examination of substance abuse recovery and practical suggestions on incorporating…

  15. 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)

  16. 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

  17. 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…

  18. 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…

  19. 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

  20. 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 ...

  1. 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…

  2. 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)

  3. Addictive sexual behavior.

    PubMed

    Myers, W A

    1994-01-01

    Case material is presented from two patients suffering from addictive sexual behavior. The term addiction is used because of the intense, driven quality of the behavior and because of its mood-elevating effects. Psychodynamically, the patients' sexual acts helped to undo feelings of rejection at the hands of their mothers and to enhance feelings of lovability and of self-esteem. The behavior also helped to neutralize powerful feelings of rage toward the mother. In one patient, the acts also helped to ease inner turmoil related to an underlying attention deficit disorder. I speculate that some adults with addictive sexual behavior may have underlying attention deficit disorders. In both my patients, the sexual behaviors served the self-regulatory function of alleviating inner feelings of anhedonia and depression. When they decreased their sexual activities during the course of the treatment, they required adjunctive antidepressant medication. The underlying meaning of the medication and countertransference attitudes toward such patients are explored.

  4. 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…

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. Religion and addiction.

    PubMed

    Gostečnik, Christian; Cvetek, Mateja; Poljak, Saša; Repič, Tanja; Cvetek, Robert

    2012-12-01

    Religion with its rituals can become an object of addiction, especially when a child while growing up experiences neglect and abuse. It is also very common that such individuals transfer their feelings of anger, rage and sometimes even true hatred to God. Then God becomes the substitute for their displaced vengeance (upon those who abused them as children).

  13. 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

  14. 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

  15. 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.

  16. 76 FR 81899 - TRICARE; Removal of the Prohibition to Use Addictive Drugs in the Maintenance Treatment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... potential for a drug of addiction (e.g. the ] substitution of methadone for heroin). The current regulation... the public is to make these submissions available for public viewing on the Internet at http://www... drug of addiction. However, medicine is constantly evolving including in the area of drug...

  17. 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…

  18. Negative addiction to exercise: are there differences between genders?

    PubMed Central

    Modolo, Vladimir Bonilha; Antunes, Hanna Karen M; de Gimenez, Paula Regina Borba; De Mello Santiago, Marisa Lucia; Tufik, Sergio; de Mello, Marco Túlio

    2011-01-01

    INTRODUCTION: Regular physical exercise has numerous benefits. However, there is a subset of the exercising population who may develop a compulsion to exercise excessively and who may, as a consequence, display physiological and psychological changes that have a direct influence on their quality of life. OBJECTIVE: Our objective was to determine if there are differences between male and female athletes' scores on measures of negative addiction symptoms, quality of life, mood and sleep. Methods: 144 female and 156 male athletes participated in this study by answering the following questionnaires: Negative Addiction Scale, Beck Depression Inventory, Trait Anxiety Inventory, Profile of Mood States, SF-36 Quality of Life, Pittsburgh Sleep Quality and Epworth Sleepiness Scale. RESULTS: Higher dedication to training sessions in the male group, and members of the female group with symptoms of negative addiction to exercise showed a lower score on vigor observed by the Profile of Mood States compared to the males in both situations. We also observed depression symptoms in both members of groups who had negative addiction symptoms when compared with their peers without symptoms, and these figures were even higher in females compared with the male group in the same situation. CONCLUSION: No differences were seen in the development of negative addiction exercise symptoms in males and females and there were no changes in the quality of life and mood of these athletes. Further studies of eating disorders associated with changes in body image perception could contribute to a better understanding of negative addiction to exercise. PMID:21484043

  19. 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

  20. Food addiction and bulimia nervosa.

    PubMed

    Meule, Adrian; von Rezori, Vittoria; Blechert, Jens

    2014-09-01

    In individuals with obesity and binge eating disorder (BED), eating patterns can show addictive qualities, with similarities to substance use disorders on behavioural and neurobiological levels. Bulimia nervosa (BN) has received less attention in this regard, despite their regular binge eating symptoms. The Yale Food Addiction Scale (YFAS) was developed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for substance use disorders, and food addiction can be diagnosed when at least three addiction symptoms are endorsed and a clinically significant impairment or distress is present. Although the prevalence of food addiction diagnoses is increased in individuals with obesity and BED, recent studies which used the YFAS showed that there are also individuals with normal weight who can be classified as being 'food addicted'. Based on self-reported eating disorder symptoms, women with current (n=26) or remitted (n=20) BN, and a control group of women matched for age and body mass index (n=63) completed the YFAS and other measures. Results revealed that all patients with current BN received a food addiction diagnosis according to the YFAS while only six (30%) women with remitted BN did. None of the women in the control group received a food addiction diagnosis. Results provide support for the notion that BN can be described as addiction-like eating behaviour and suggest that food addiction most likely improves when BN symptoms remit.

  1. 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.

  2. 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…

  3. 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.

  4. 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

  5. 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

  6. Treatment of addiction and addiction-related behavior

    SciTech Connect

    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.

  7. 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.

  8. Disordered gambling: a behavioral addiction.

    PubMed

    Clark, Luke; Limbrick-Oldfield, Eve H

    2013-08-01

    Developments in psychiatry have ratified the existence of behavioral addictions, that certain activities such as gambling or video-game play may be considered addictive in the absence of exogenous (i.e. drug-induced) stimulation of brain reinforcement circuitry. This article describes recent advances in understanding the neurobiological basis of behavioral addiction, with a focus on pathological gambling as the prototypical disorder. We describe positron emission tomography (PET) studies characterizing dopaminergic transmission, and functional imaging studies of reward processing and gambling-related cognitive distortions. The current evidence not only indicates changes in pathological gamblers in core circuitry implicated in drug addiction, but also highlights some subtle differences. Behavioral addictions can also provide experimental traction on distinguishing vulnerability markers for addictions from the active detrimental effects of chronic drug use.

  9. [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

  10. [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.

  11. [Environment and addictive behaviors].

    PubMed

    Touzeau, Didier; Raynal, Marie-Line

    2012-12-01

    Consumer society creates the emergence of addictive behaviors and environments of the subject "shape" the use of psychoactive substances. The family approach is to search out a guilt of members to understand family dynamics and enable young people to emancipate themselves from the family model. The social environment contributes to the marginalization of drug users "pathologizing" his conduct. Offer help without preconditions and a relationship based on a therapeutic alliance can contribute decisively to the recovery of an addict. The prison is a place of initiation of use and consumption of psychoactive substances despite the offer of specialized treatment. Measures of risk reduction of HCV/HIV infection and alternatives to incarceration should complete it. At workplace, consumption can be considered as a mean of doping to be more "efficient", but also as an attempt to withstand the stresses and changes in working conditions in the context of individualization and a loss of marks related to the new way of organizing work.

  12. 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

  13. 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 ...

  14. [Therapy in heroin addiction].

    PubMed

    Hosztafi, Sáandor; Fürst, Zsuzsanna

    2014-09-01

    Heroin addiction is one of the most devastating and expensive of public health problems. The most effective treatment is opioid replacement therapy. Replacement of heroin, a short-acting euphoriant with methadone or other opioids that have significantly longer duration of action provides a number of therapeutic benefits. Opioid detoxification has a role in both preventing acute withdrawal and maintaining long-term abstinence. Opioid-based detoxification is based on the principle of cross-tolerance, in which one opioid is replaced with another one that is slowly tapered. For the treatment of heroin addicts a wide range of psychosocial and pharmacotherapeutic treatments are available; of these, methadone maintenance therapy has the most evidence of benefit. Methadone maintenance reduces and/or eliminates the use of heroin, reduces the death rate and criminality associated with heroin use, and allows patients to improve their health and social productivity. In addition, enrollment in methadone maintenance has the potential to reduce the transmission of infectious diseases associated with heroin injection, such as hepatitis and HIV. The principal effects of methadone maintenance are to relieve narcotic craving, suppress the abstinence syndrome, and block the euphoric effects associated with heroin. There is growing interest in expanding treatment into primary care, allowing opioid addiction to be managed like other chronic illnesses. Buprenorphine which is a long-acting partial agonist was also approved as pharmacotherapy for opioid dependence. Opioid antagonists can reduce heroin self-administration and opioid craving in detoxified addicts. Naltrexone, which is a long-acting competitive antagonist at the opioid receptors, blocks the subjective and objective responses produced by intravenous opioids. Naltrexone is employed to accelerate opioid detoxification by displacing heroin and as a maintenance agent for detoxified formerly heroin-dependent patients who want to

  15. Treatment of internet addiction.

    PubMed

    Huang, Xui-qin; Li, Meng-chen; Tao, Ran

    2010-10-01

    Internet addiction (IA) is a prevalent, highly comorbid, and significantly impairing disorder. Although many psychotherapeutic approaches and psychotropic medications have been recommended and some of the psychotherapeutic approaches and a few pharmacotherapy strategies have been studied, treatment of IA is generally in its early stages. This article reviews theoretical descriptions of psychotherapy and the effects of psychosocial treatment and pharmacologic treatment. We also outline our own treatment model of IA.

  16. Food addiction and neuroimaging.

    PubMed

    Zhang, Yi; von Deneen, Karen M; Tian, Jie; Gold, Mark S; Liu, Yijun

    2011-01-01

    Obesity has become a serious epidemic and one of the leading global health problems. However, much of the current debate has been fractious, and etiologies of obesity have been attributed to eating behavior (i.e. fast food consumption), personality, depression, addiction or genetics. One of the interesting new hypotheses for explaining the development of obesity involves a food addiction model, which suggests that food is not eaten as much for survival as pleasure and that hedonic overeating is relevant to both substance-related disorders and eating disorders. Accumulating evidence has shown that there are a number of shared neural and hormonal pathways as well as distinct differences in these pathways that may help researchers discover why certain individuals continue to overeat despite health and other consequences, and becomes more and more obese. Functional neuroimaging studies have further revealed that pleasant smelling, looking, and tasting food has reinforcing characteristics similar to drugs of abuse. Many of the brain changes reported for hedonic eating and obesity are also seen in various types of addictions. Most importantly, overeating and obesity may have an acquired drive similar to drug addiction with respect to motivation and incentive craving. In both cases, the desire and continued satisfaction occur after early and repeated exposure to stimuli. The acquired drive for eating food and relative weakness of the satiety signal would cause an imbalance between the drive and hunger/reward centers in the brain and their regulation. In the current paper, we first provide a summary of literature on food addition from eight different perspectives, and then we proposed a research paradigm that may allow screening of new pharmacological treatment on the basis of functional magnetic resonance imaging (fMRI).

  17. The instrumental rationality of addiction.

    PubMed

    Pickard, Hanna

    2011-12-01

    The claim that non-addictive drug use is instrumental must be distinguished from the claim that its desired ends are evolutionarily adaptive or easy to comprehend. Use can be instrumental without being adaptive or comprehensible. This clarification, together with additional data, suggests that Müller & Schumann's (M&S's) instrumental framework may explain addictive, as well as non-addictive consumption. PMID:22074973

  18. Visiting Educational Scholarship Training Program at the University of Miami, Miller School of Medicine: A Global Opportunity to Learn.

    PubMed

    Galardi, Nicholas; Ciminero, Matthew; Thaller, Seth; Salgado, Christopher

    2015-06-01

    The Visiting Educational Scholarship Training Program, started by the University of Miami's Division of Plastic and Reconstructive Surgery, was designed to uphold the institution's founding mission: the education of our future medical leaders as well as the promotion of health of our local, regional, national, and international communities. It offers the opportunity for international medical students and training physicians to be educated and get exposure to the field of plastic surgery in a United States training institution.

  19. [The importance of sports medicine field tests as a means of training control in northern endurance sports].

    PubMed

    Baumgartl, P; Aigner, A

    1985-05-31

    In endurance sports heart frequency at the aerobic threshold (2 mmol/l lactate) is recommended for extensive training and heart rate at the anaerobic threshold (4 mmol/l lactate) for intensive training. Both values could be estimated by means of exercise tests in the laboratory as well as in the field. However for training-recommendations only data estimated on a specific exercise procedure should be used.

  20. 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

  1. [Are eating disorders addictions?].

    PubMed

    Kinzl, Johann F; Biebl, Wilfried

    2010-01-01

    The various eating disorders, anorexia nervosa, bulimia nervosa, and binge-eating disorder, are characterized by severe disturbances in eating behavior and are seen as typical "psychosomatic disorders". The subdivision of anorexia nervosa into two subtypes, namely "anorexia nervosa restricting type" and "anorexia nervosa bulimic type" has proved to be very good. It is to be assumed that eating disorders are not a homogeneous group, and that the various subtypes of eating disorders are also heterogeneous at several levels. Co-morbid psychiatric disorders, especially affective disorders, anxiety disorders, substance-related disorders, and personality disorders, are often found in eating- disordered patients. Many anorectics of the restrictive type and orthorectics show co-morbid psychiatric disorders such as anxiety disorders, obsessive-compulsive disorders, and avoidant or obsessive-compulsive personality disorders, while a co-morbidity of affective disorders, addiction, personality disorders, especially multi-impulsivity and borderline personality disorder, is frequently found in anorectics of bulimic type, bulimics, and binge eaters. Addictive behavior manifests itself in permanent preoccupation with food and eating, withdrawal symptoms, continuation of disturbed eating behavior in spite of negative consequences, loss of control, and frequent relapse. There are some indications that there is a basic psychological disturbance common to eating disorders, especially bulimia nervosa, and to substance-related disorders, namely a personality disorder with an emotional instability and multi-impulsivity. The possible associations between eating disorders and mental disorders, particularly addictions, will be discussed.

  2. Racism and perinatal addiction.

    PubMed

    Neuspiel, D R

    1996-01-01

    Recent publicity and policy have targeted drug use by non-white women, particularly during pregnancy and parenthood. This emphasis on women of color is discordant with the population demographics of substance use and addiction, although morbidity and mortality related to drugs is often greater among nonwhites. Women with addictive disorders that are exacerbated by their social environments are blamed for their behavior. Meanwhile, drug treatment and primary health care services for these women are woefully inadequate. Among newborns testing positive for cocaine, those with black mothers are more likely to be discharged to non-maternal care, which may perpetuate family disruption. There are multiple reasons for true and perceived ethnic differences in substance use, addiction, and related social and medical harm. Such harm may be worsened by the racism inherent in U.S. drug policy. The scapegoating of non-white drug-using women and the paucity of treatment for them may be related to political and economic imperatives of society in maintaining and pacifying exploited groups.

  3. Pharmacogenetic aspects of addictive behaviors.

    PubMed

    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 life stress, underage drug exposure, availability of addictive agents, and response to clinical interventions including pharmacotherapies. Identification of genetic factors in addiction thus plays an important role in the understanding of processes of addiction and origins of differential vulnerabilities and treatment responses. PMID:18286803

  4. 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…

  5. M.D.-Ph.D. Training at the Johns Hopkins University School of Medicine, 1962-1991.

    ERIC Educational Resources Information Center

    McClellan, Deborah A.; Talalay, Paul

    1992-01-01

    A review of the combined M.D.-Ph.D training program at Johns Hopkins Medical School (Maryland) found that, of 109 students who earned both degrees since 1980, 42 have completed all training and are now in career positions. Most (81 percent) are in full-time academic posts, with 14 percent in research institutes and the remaining 5 percent in…

  6. 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

  7. Treatment of addiction and addiction-related behavior

    DOEpatents

    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.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. 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…

  14. [Exercise addiction: a literature review].

    PubMed

    Demetrovics, Zsolt; Kurimay, Tamás

    2008-01-01

    Exercise in appropriate quantity and of proper quality contributes significantly to the preserve our health. On the contrary, excessive exercise may be harmful to health. The term 'exercise addiction' has been gaining increasing recognition to describe the latter phenomenon. The exact definition of exercise addiction and its potential associations with other disorders is still under study, although according to the authors this phenomenon can be primarily described as a behavioral addiction. Accordingly, exercise addiction, among other behavioral and mental disorders, can be well describe within the obsessive-compulsive spectrum suggested by Hollander (1993). There are several tools used to assess exercise addiction. The authors here present the Hungarian version of the Exercise Dependence Scale (Hausenblas és Downs, 2002) and the Exercise Addiction Inventory (Terry, Szabo és Griffiths, 2004). Exercise addiction has many symptoms in common and also shows a high comorbidity with eating disorders and body image disorders. It may be more closely associated with certain sports but more data is needed to demonstrate this specificity with more certainty. Sel-evaluation problems seem to have a central role in the etiology from a psychological aspect. The relevance of neurohormonal mechanisms is less clear. The authors emphasize the importance of further research on exercise addiction. One important question to be answered is if this disorder is an independent entity to be classified as a distinct clinical disorder or is it rather a subgroup of another disorder.

  15. Game Addiction and Academic Achievement

    ERIC Educational Resources Information Center

    Sahin, Mehmet; Gumus, Yusuf Yasin; Dincel, Sezen

    2016-01-01

    The primary aim of this study was to investigate the correlation between game addiction and academic achievement. The secondary aim was to adapt a self-report instrument to measure game addiction. Three hundred and seventy high school students participated in this study. Data were collected via an online questionnaire that included a brief…

  16. [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

  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.

  18. Performance on the American Osteopathic Board of Internal Medicine certifying examination 1986-2002 of various demographic groups and the impact of AOA reentry resolutions on allopathic-trained candidates taking the examination.

    PubMed

    Slick, Gary L

    2004-07-01

    The authors report the performance levels and pass rates of various candidate demographic groups and the effect on performance of delaying taking the certifying examination. They also report on the effect American Osteopathic Association reentry resolutions have on allopathic-trained candidates entering the osteopathic certification process in internal medicine. Included in the study were all candidates for the American Osteopathic Board of Internal Medicine certifying examination for the period between 1986 and 2002. Investigators performed group analysis based on type of residency track leading to board eligibility, as well as on the number of retake candidates, candidates reestablishing board eligibility 6 or more years after completion of residency training, and allopathic-trained candidates. Results indicate that medicine-track candidates performed better than any other study demographic group, including allopathic-trained candidates. A delay in taking the certifying examination after completion of residency results in lower candidate performance and pass rates. Various AOA reentry resolutions have not been successful in the repatriating of allopathic internal medicine-trained candidates into the certification process. Candidates in larger training programs have similar mean performance levels and pass rates as candidates in smaller programs.

  19. 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.

  20. Personality dimensions of opiate addicts.

    PubMed

    Vukov, M; Baba-Milkic, N; Lecic, D; Mijalkovic, S; Marinkovic, J

    1995-02-01

    A survey of 80 opiate addicts included in a detoxification program was conducted at the Institute on Addictions in Belgrade. In addition to a dependence diagnosis and mental disorders based on DSM-III-R, we applied a Tridimensional Personality Questionnaire (TPQ) that measures the 3 major personality dimensions: novelty-seeking (NS), harm avoidance (HA) and reward dependence (RD). When compared with a control group (a sample of Yugoslav undergraduate students), the opiate addicts demonstrate significantly high NS dimension as well as significant divergences of HA and RD subscales. The surveyed opiate addicts demonstrate a high percentage of personality disorders specifically in cluster B. The personality dimensions of opiate addicts showed certain temperament traits, such as: impulsiveness, shyness with strangers, fear of uncertainty and dependence. NS, HA and RD determined by temperament specifics may be an etiological factor in forming of a personality disorder, an affective disorder as well as of a drug choice.

  1. Animal Studies of Addictive Behavior

    PubMed Central

    Ahmed, Serge H.

    2013-01-01

    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

  2. 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

  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.

  4. [Pharmacopsychoses during drug addiction].

    PubMed

    Cottereau, M J; Lôo, H; Poirier, M F; Deniker, P

    1975-01-01

    Widespread use of certain drugs (amphetamines, L.S.D., hypnotics) in France, allowed us to observe more than 200 cases of acute or chronic psychoses among addicts. Sometimes these are transitory outburst but the occurrence of a delusional psychosis with long range evolution raises a difficult diagnosis problem in relation to functional psychoses. The emphasis should be put on respective roles of the drug and of a predisposed mental state. Circumstances of beginning, apparently direct relationship between drug taking and pathological symptoms, therapy efficiency, absence of earlier pathological traits (as in many of our patients) and relapse when intoxication starts again, are in favour of a pharmacological origin of the troubles.

  5. 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

  6. 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

  7. Graduate Medical Education Training in Clinical Epidemiology, Critical Appraisal, and Evidence-Based Medicine: A Critical Review of Curricula.

    ERIC Educational Resources Information Center

    Green, Michael L.

    1999-01-01

    A study systematically reviewed published literature on graduate medical-education curricula in clinical epidemiology, critical appraisal, and evidence-based medicine (EBM). The 18 reports found in the search provide useful guidelines for medical educators but many suffer from incomplete descriptions and inadequate curriculum evaluations.…

  8. 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

  9. 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…

  10. 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

  11. Addiction as excessive appetite.

    PubMed

    Orford, J

    2001-01-01

    The excessive appetite model of addiction is summarized. The paper begins by considering the forms of excessive appetite which a comprehensive model should account for: principally, excessive drinking, smoking, gambling, eating, sex and a diverse range of drugs including at least heroin, cocaine and cannabis. The model rests, therefore, upon a broader concept of what constitutes addiction than the traditional, more restricted, and arguably misleading definition. The core elements of the model include: very skewed consumption distribution curves; restraint, control or deterrence; positive incentive learning mechanisms which highlight varied forms of rapid emotional change as rewards, and wide cue conditioning; complex memory schemata; secondary, acquired emotional regulation cycles, of which 'chasing', 'the abstinence violation effect' and neuroadaptation are examples; and the consequences of conflict. These primary and secondary processes, occurring within diverse sociocultural contexts, are sufficient to account for the development of a strong attachment to an appetitive activity, such that self-control is diminished, and behaviour may appear to be disease-like. Giving up excess is a natural consequence of conflict arising from strong and troublesome appetite. There is much supportive evidence that change occurs outside expert treatment, and that when it occurs within treatment the change processes are more basic and universal than those espoused by fashionable expert theories. PMID:11177517

  12. 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.

  13. 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

  14. Effectively addressing addiction requires changing the language of addiction.

    PubMed

    Richter, Linda; Foster, Susan E

    2014-02-01

    Public knowledge and attitudes about addiction are largely inconsistent with scientific evidence. The gap between the facts and public and professional perceptions is due in part to the language used to describe the disease and those who have it. A key step in modifying public attitudes and improving how health professionals and policymakers address addiction is to better align the language of addiction with the scientific evidence. Unless we clarify the language, those with the disease will continue to experience the stigma associated with it and attempts to deliver comprehensive and effective evidence-based prevention, treatment, and disease management will be profoundly compromised. PMID:24226552

  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. [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.

  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. 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

  19. 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

  20. 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…

  1. 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)

  2. Addiction between therapy and criminalization.

    PubMed

    Birklbauer, Alois; Schmidthuber, Kathrin

    2014-12-01

    The present paper delves into the question of whether and to what extent it is appropriate to leave addiction problems between the conflicting priorities of therapy and criminalization. After outlining the issue the criminal addictive behaviour including crimes associated with drug misuse and with obtaining drugs is described. Subsequently it is discussed if and how you could make allowances for addiction-related legal insanity in the criminal law sector. Following a few remarks on the principle of "voluntary therapy instead of penal sanction" as a way to alleviate the strict law on narcotic drugs misuse a summary and an outlook with criminal-political demands complete the issue.

  3. 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

  4. Drug addiction and periodontal diseases.

    PubMed

    Saini, Gurpreet Kaur; Gupta, N D; Prabhat, K C

    2013-09-01

    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

  5. Addiction between therapy and criminalization.

    PubMed

    Birklbauer, Alois; Schmidthuber, Kathrin

    2014-12-01

    The present paper delves into the question of whether and to what extent it is appropriate to leave addiction problems between the conflicting priorities of therapy and criminalization. After outlining the issue the criminal addictive behaviour including crimes associated with drug misuse and with obtaining drugs is described. Subsequently it is discussed if and how you could make allowances for addiction-related legal insanity in the criminal law sector. Following a few remarks on the principle of "voluntary therapy instead of penal sanction" as a way to alleviate the strict law on narcotic drugs misuse a summary and an outlook with criminal-political demands complete the issue. PMID:25377376

  6. 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…

  7. 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.

  8. Treatment of PCP addiction and PCP addiction-related behavior

    SciTech Connect

    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.

  9. 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

  10. 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 ...

  11. Shelter Staffs' Perceived Knowledge and Skill Level Regarding the Addictive Process.

    ERIC Educational Resources Information Center

    Miller, Geri; Gatscher, Eva

    2001-01-01

    This study examined domestic violence shelter workers' perceptions about their knowledge, skills, and training interests regarding the addictive process. More experienced workers perceived themselves as having less knowledge and fewer skills than did less experienced workers. Shelter workers expressed overall interest in training, and authors…

  12. Addiction and Cognition

    PubMed Central

    Gould, Thomas J.

    2010-01-01

    The brain regions and neural processes that underlie addiction overlap extensively with those that support cognitive functions, including learning, memory, and reasoning. Drug activity in these regions and processes during early stages of abuse foster strong maladaptive associations between drug use and environmental stimuli that may underlie future cravings and drug-seeking behaviors. With continued drug use, cognitive deficits ensue that exacerbate the difficulty of establishing sustained abstinence. The developing brain is particularly susceptible to the effects of drugs of abuse; prenatal, childhood, and adolescent exposures produce long-lasting changes in cognition. Patients with mental illness are at high risk for substance abuse, and the adverse impact on cognition may be particularly deleterious in combination with cognitive problems related to their mental disorders. PMID:22002448

  13. 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.

  14. 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.

  15. 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

  16. 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 ...

  17. 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 ...

  18. Cleveland Clinic Lerner College of Medicine: an innovative approach to medical education and the training of physician investigators.

    PubMed

    Fishleder, Andrew J; Henson, Lindsey C; Hull, Alan L

    2007-04-01

    Cleveland Clinic Lerner College of Medicine (CCLCM) is an innovative, five-year medical education track within Case Western Reserve University School of Medicine (Case) with a focused mission to attract and educate a limited number of highly qualified persons who seek to become physician investigators. CCLCM curriculum governance, faculty appointments and promotions, and admissions committees are integrated with respective Case committees. The CCLCM curriculum is based on faculty-defined professional attributes that graduates are expected to develop. These attributes were used to create curricular and assessment principles that guided the development of an integrated basic science, clinical science, and research curriculum, conducted in an active learning environment. An organ-system approach is used to solidify an understanding of basic science discipline threads in the context of relevant clinical problems presented in PBL and case-based discussion formats. Clinical skills are introduced in the first year as part of the two-year longitudinal experience with a family practice or internal medicine physician. The research program provides all students with opportunities to learn and experience basic and translational research and clinical research before selecting a research topic for their 12- to 15-month master-level thesis project. All Case students participate in required and elective clinical curriculum after the second year, but CCLCM students return to the Cleveland Clinic on selected Friday afternoons for program-specific research and professionalism-learning activities. A unique portfolio-based assessment system is used to assess student achievements in nine competency areas, seven of which reflect the Accreditation Council for Graduate Medical Education competencies.

  19. Cleveland Clinic Lerner College of Medicine: an innovative approach to medical education and the training of physician investigators.

    PubMed

    Fishleder, Andrew J; Henson, Lindsey C; Hull, Alan L

    2007-04-01

    Cleveland Clinic Lerner College of Medicine (CCLCM) is an innovative, five-year medical education track within Case Western Reserve University School of Medicine (Case) with a focused mission to attract and educate a limited number of highly qualified persons who seek to become physician investigators. CCLCM curriculum governance, faculty appointments and promotions, and admissions committees are integrated with respective Case committees. The CCLCM curriculum is based on faculty-defined professional attributes that graduates are expected to develop. These attributes were used to create curricular and assessment principles that guided the development of an integrated basic science, clinical science, and research curriculum, conducted in an active learning environment. An organ-system approach is used to solidify an understanding of basic science discipline threads in the context of relevant clinical problems presented in PBL and case-based discussion formats. Clinical skills are introduced in the first year as part of the two-year longitudinal experience with a family practice or internal medicine physician. The research program provides all students with opportunities to learn and experience basic and translational research and clinical research before selecting a research topic for their 12- to 15-month master-level thesis project. All Case students participate in required and elective clinical curriculum after the second year, but CCLCM students return to the Cleveland Clinic on selected Friday afternoons for program-specific research and professionalism-learning activities. A unique portfolio-based assessment system is used to assess student achievements in nine competency areas, seven of which reflect the Accreditation Council for Graduate Medical Education competencies. PMID:17414197

  20. [Addiction, satisfaction, perception and beliefs about the causes of success in Spanish masters athletes].

    PubMed

    A, Zarauz Sancho; F, Ruiz-Juan; F, Arbinaga Ibarzábal

    2014-01-01

    The aim of this study was to know the addiction to training and the relationship between this and the intrinsic satisfaction, perceptions and beliefs about the causes of success in their sport in a heterogeneous sample of 401 Spanish master athletes (over 35 years of age) who completed the questionnaire electronically. Also, get sufficiently robust predictive models, by sex, of their addiction according to these psychological variables. On one hand, it was found that addiction to training was moderate in men and women, and being cause from different causes than in other populations of athletes. On the other, that it was predicted by high ego orientation and/or low task orientation. In addition, each of the less desirable subscales of addiction (tolerance, lack of control and abstinence and craving), although with significant differences by sex, were usually predicted by the also less desirable subscales of intrinsic satisfaction, perception and beliefs on the causes for success. By contrast, the most desirable subscale of addiction (pleasure and relaxation), although predicted by the most desirable and positive subscale of intrinsic satisfaction (fun), there was no gender matching in the prediction by the subscales of perceived beliefs on the causes for success. These data, taken all-together, indicates that their training addiction should be treated fostering task orientation and fun, while trying to reduce as far much as possible ego orientation.

  1. [Addiction, satisfaction, perception and beliefs about the causes of success in Spanish masters athletes].

    PubMed

    A, Zarauz Sancho; F, Ruiz-Juan; F, Arbinaga Ibarzábal

    2014-01-01

    The aim of this study was to know the addiction to training and the relationship between this and the intrinsic satisfaction, perceptions and beliefs about the causes of success in their sport in a heterogeneous sample of 401 Spanish master athletes (over 35 years of age) who completed the questionnaire electronically. Also, get sufficiently robust predictive models, by sex, of their addiction according to these psychological variables. On one hand, it was found that addiction to training was moderate in men and women, and being cause from different causes than in other populations of athletes. On the other, that it was predicted by high ego orientation and/or low task orientation. In addition, each of the less desirable subscales of addiction (tolerance, lack of control and abstinence and craving), although with significant differences by sex, were usually predicted by the also less desirable subscales of intrinsic satisfaction, perception and beliefs on the causes for success. By contrast, the most desirable subscale of addiction (pleasure and relaxation), although predicted by the most desirable and positive subscale of intrinsic satisfaction (fun), there was no gender matching in the prediction by the subscales of perceived beliefs on the causes for success. These data, taken all-together, indicates that their training addiction should be treated fostering task orientation and fun, while trying to reduce as far much as possible ego orientation. PMID:25225728

  2. 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

  3. 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

  4. 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 ...

  5. Optogenetics: potentials for addiction research.

    PubMed

    Cao, Zhen Fang Huang; Burdakov, Denis; Sarnyai, Zoltán

    2011-10-01

    Research on the biology of addiction has advanced significantly over the last 50 years expanding our understanding of the brain mechanisms underlying reward, reinforcement and craving. Novel experimental approaches and techniques have provided an ever increasing armory of tools to dissect behavioral processes, neural networks and molecular mechanisms. The ultimate goal is to reintegrate this knowledge into a coherent, mechanistic framework of addiction to help identify new treatment. This can be greatly facilitated by using tools that allow, with great spatial and temporal specificity, to link molecular changes with altered activation of neural circuits and behavior. Such specificity can now be achieved by using optogenetic tools. Our review describes the general principles of optogenetics and its use to understand the links between neural activity and behavior. We also provide an overview of recent studies using optogenetic tools in addiction and consider some outstanding questions of addiction research that are particularly amenable for optogenetic approaches.

  6. [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.

  7. 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.

  8. Imaging the Addicted Human Brain

    PubMed Central

    Fowler, Joanna S.; Volkow, Nora D.; Kassed, Cheryl A.; Chang, Linda

    2007-01-01

    Modern imaging techniques enable researchers to observe drug actions and consequences as they occur and persist in the brains of abusing and addicted individuals. This article presents the five most commonly used techniques, explains how each produces images, and describes how researchers interpret them. The authors give examples of key findings illustrating how each technique has extended and deepened our knowledge of the neurobiological bases of drug abuse and addiction, and they address potential clinical and therapeutic applications. PMID:17514067

  9. 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.

  10. 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

  11. Exercise rehabilitation for smartphone addiction.

    PubMed

    Kim, Hyunna

    2013-12-31

    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.

  12. 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

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. 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

  18. 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

  19. 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

  20. Modeling Addictive Consumption as an Infectious Disease*

    PubMed Central

    Alamar, Benjamin; Glantz, Stanton A.

    2011-01-01

    The dominant model of addictive consumption in economics is the theory of rational addiction. The addict in this model chooses how much they are going to consume based upon their level of addiction (past consumption), the current benefits and all future costs. Several empirical studies of cigarette sales and price data have found a correlation between future prices and consumption and current consumption. These studies have argued that the correlation validates the rational addiction model and invalidates any model in which future consumption is not considered. An alternative to the rational addiction model is one in which addiction spreads through a population as if it were an infectious disease, as supported by the large body of empirical research of addictive behaviors. In this model an individual's probability of becoming addicted to a substance is linked to the behavior of their parents, friends and society. In the infectious disease model current consumption is based only on the level of addiction and current costs. Price and consumption data from a simulation of the infectious disease model showed a qualitative match to the results of the rational addiction model. The infectious disease model can explain all of the theoretical results of the rational addiction model with the addition of explaining initial consumption of the addictive good. PMID:21339848