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Sample records for after-hours family medicine

  1. Family Medicine's Waltz with Systems

    ERIC Educational Resources Information Center

    Downing, Raymond

    2012-01-01

    Family Medicine first formally confronted systems thinking with the adoption of the biopsychosocial model for understanding disease in a holistic manner; this is a description of a natural system. More recently, Family Medicine has been consciously engaged in developing itself as a system for delivering health care, an artificial system. We make…

  2. Family Medicine Specialty in Singapore

    PubMed Central

    Thomas, Santosh Lional

    2013-01-01

    Family Medicine in Singapore has its roots in a generalist ethos and found its origin as a counter culture movement to the increasing sub-specialisation of medicine which resulted in a complex healthcare system where that patients are often cared for by multiple specialists potentially resulting in fragmentation of care. The aim of the discipline of Family Medicine was to train and develop more generalist physicians so as to promote holistic care. Family physicians are the largest pool of generalists who are trained to provide general medical care to patients in the context of the person, the family and the community that they live in. PMID:24479066

  3. Who Goes into Family Medicine?

    ERIC Educational Resources Information Center

    Rezler, A. G.; Kalishman, S. G.

    The results of a study to identify criteria that could help select applicants to medical school who have a lasting commitment to family medicine are presented. During the past 15 years major efforts have been made to increase the number of family physicians in the United States. Although primary care programs attract more students whose initial…

  4. Academic family medicine in Canada.

    PubMed Central

    Hennen, B K

    1993-01-01

    Fifty years ago family practice in Canada had no academic presence. Stimulated by a number of general practitioners and with the support of the Canadian Medical Association, the College of General Practitioners of Canada (CGPC) was founded in 1954. In 1962, conferences on education for general practice attended by the Association of Canadian Medical Colleges and the CGPC led to pilot postgraduate residencies in family practice supported by Department of National Health and Welfare. The first certification examination was held in 1969 and, by 1974, all Canadian medical schools had a family medicine residency program. Today departments of family medicine contribute substantially to undergraduate education in all 16 schools. In Canada, the medical profession, governments and the medical schools have demonstrated the importance they place on appropriate education for family physicians. PMID:8477381

  5. [The flexibility of family medicine].

    PubMed

    Minguet, C; Aubrege, A; Aubart, M; Cornuz, J; di Patrizio, P; Du Boullay, D; Farghadani, H; Flammang, M; Haas, N; Kacenelenbogen, N; Kopp, M; Leners, J C; Levêque, M; Mbengue, M; Paur, H; Paur, I; Raphaël, F; Rausch, S; Shetgen, M; Stein R; Tabouring, P; Thomas, J M; Vignon, G

    2015-01-01

    We are a European academic group of family doctors and we propose a definition of flexibility in family medicine. A review of the literature shows that flexibility and complexity are emerging concepts in the field of family practice. The outcomes of a workshop at the WONCA-Europe congress in 2014 are discussed. The flexibility is a capability of the general practitioner to deal with complex clinical situations in a biomedical and societal changing world. Flexibility is framed by ethics. It could improve the quality of care, be useful against burnout and used in medical research. In conclusion, family medicine should adopt a specific definition of the flexibility describing its specificity, a useful and teachable capacity. PMID:26946851

  6. 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

  7. An innovative family medicine clerkship.

    PubMed

    Smith, S R; MacLeod, N M

    1981-10-01

    A clinical clerkship in family medicine at Brown University has been developed utilizing many innovative educational modalities. These include games, simulations, group problem solving, research projects, videotaping, case presentations, field trips, sensitivity sessions, computer assisted instruction, patient management problems, slide-tape shows, and direct clinical experiences. These modalities are described together with a new approach to evaluation. Students' evaluations of the clerkship have been excellent, providing evidence that this clerkship offers a model of learning that is both effective and enjoyable.

  8. Decision making in family medicine

    PubMed Central

    Labrecque, Michel; Ratté, Stéphane; Frémont, Pierre; Cauchon, Michel; Ouellet, Jérôme; Hogg, William; McGowan, Jessie; Gagnon, Marie-Pierre; Njoya, Merlin; Légaré, France

    2013-01-01

    Abstract Objective To compare the ability of users of 2 medical search engines, InfoClinique and the Trip database, to provide correct answers to clinical questions and to explore the perceived effects of the tools on the clinical decision-making process. Design Randomized trial. Setting Three family medicine units of the family medicine program of the Faculty of Medicine at Laval University in Quebec city, Que. Participants Fifteen second-year family medicine residents. Intervention Residents generated 30 structured questions about therapy or preventive treatment (2 questions per resident) based on clinical encounters. Using an Internet platform designed for the trial, each resident answered 20 of these questions (their own 2, plus 18 of the questions formulated by other residents, selected randomly) before and after searching for information with 1 of the 2 search engines. For each question, 5 residents were randomly assigned to begin their search with InfoClinique and 5 with the Trip database. Main outcome measures The ability of residents to provide correct answers to clinical questions using the search engines, as determined by third-party evaluation. After answering each question, participants completed a questionnaire to assess their perception of the engine’s effect on the decision-making process in clinical practice. Results Of 300 possible pairs of answers (1 answer before and 1 after the initial search), 254 (85%) were produced by 14 residents. Of these, 132 (52%) and 122 (48%) pairs of answers concerned questions that had been assigned an initial search with InfoClinique and the Trip database, respectively. Both engines produced an important and similar absolute increase in the proportion of correct answers after searching (26% to 62% for InfoClinique, for an increase of 36%; 24% to 63% for the Trip database, for an increase of 39%; P = .68). For all 30 clinical questions, at least 1 resident produced the correct answer after searching with either

  9. Family medicine residents’ practice intentions

    PubMed Central

    Grierson, Lawrence E.M.; Fowler, Nancy; Kwan, Matthew Y.W.

    2015-01-01

    Abstract Objective To assess residents’ practice intentions since the introduction of the College of Family Physicians of Canada’s Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. Design A survey based on Ajzen’s theory of planned behaviour was administered on 2 occasions. Setting McMaster University in Hamilton, Ont. Participants Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. Main outcome measures The survey was modeled so as to measure the respondents’ intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. Results The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents’ intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. Conclusion The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University. PMID:26889508

  10. Family Medicine in Rural Communities

    PubMed Central

    Hirsh, Michael; Wootton, J.S.C.

    1990-01-01

    Recruitment of physicians for rural communities is a continuing problem in Canada. Medical schools can be involved through preferential admission policies. Departments of family medicine across the country are including on-site training in rural communities and are seeking to improve their rural program curriculum. The McGill rural program is described from its origins to its present state. A rural coordinator oversees 12 sites at which both residents and students are trained. One site at Shawville, Que, is described from a rural physician's point of view. Imagesp2011-ap2012-ap2014-a PMID:21233945

  11. Family Medicine: Bridge to Life.

    PubMed

    Luz, Clare

    2016-01-01

    Reflecting on the suicide of a close friend, this essay explores what comprises, and inspires a will to live, and how those in Family Medicine can address suicide risk even in the face of debilitating or terminal illness. Research indicates that the will to live is a measurable indicator of general well-being, distinct from depression, and an important predictor of a person's motivation to "hold on to life". As such, understanding what is at the heart of a desire to live should alter clinical practice. This essay offers ideas for ways in which to create bridges for patients that could help sustain life.

  12. 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

  13. Family medicine 360°: Global exchanges in family medicine

    PubMed Central

    Barata, Ana N.; Rigon, Sara

    2015-01-01

    Objective: The global world of the 21st century has created communities and cultures that are interconnected, thanks to the development both in the field of transportation and technology. In this global intercultural community, future physicians, and even more so future general practitioners (GPs)/family physicians (FPs), need to be clinically competent and culturally sensitive and flexible in order to adapt to different social settings while delivering holistic care in multiethnic teams and environments with professionalism. As such, exchange programs are exceptional opportunities for international collaboration and the development of personal and professional competencies of these health care professionals. Materials and Methods: This article presents a review of the literature on the value of exchanges as well as the results of exchange programs with educational content that are aimed at junior GPs/FPs. Results: Exchange programs have been growing in popularity, especially among junior GPs/FPs. Since its launch in 2013, The “Family Medicine 360° (FM360°) program has been receiving up to 163 inquires till date, promoting global cooperation among the World Organization of family Doctors (WONCA)'s Young Doctors’ Movementd (YDMs). Conclusions: By participating in an exchange program, future GPs/FPs are given the chance to experience intercultural communication and peer collaboration. They also develop personal and professional skills and thus, actively contribute to the growth and development of primary care all over the world. PMID:26288763

  14. The family and family medicine: should this marriage be saved?

    PubMed

    Merkel, W T

    1983-11-01

    Although there have been many noteworthy attempts to integrate a family focus into family medicine, there is little evidence that this integration has occurred in either residency education or community practice. When the specialty was founded, a family emphasis may have been politically useful as a way to differentiate the new family physician from the old general practitioner. Now, however, it is unclear what specific family-related material should be taught or who should teach it since few family practice faculty are trained in understanding families. If a practicing family physician actually wants to see a family, practical problems concerning time, space, and money arise. Furthermore, the medicolegal system is structured to protect the confidential relationship between one patient and one physician. Other obstacles to the integration include the difficult epistemological shift required to apply systems theory, the current chaos in the family field, and family medicine's need to gain professional stature by being proficient in traditional medicine. It may be time for the family and family medicine to reconsider their well-intended but ill-advised relationship. PMID:6631349

  15. Global Health in Family Medicine Summer Primer

    PubMed Central

    Rouleau, Katherine; Janakiram, Praseedha; Nicolle, Eileen; Godoy-Ruiz, Paula; Pakes, Barry N.

    2015-01-01

    Abstract Problem addressed Despite the rapid emergence of global health training across North American universities, there remains a gap in educational programs focusing on the unique role of family medicine and primary care in global health. Objective of program The objective of the Global Health in Family Medicine Summer Primer, developed in 2013 by the Department of Family and Community Medicine at the University of Toronto in Ontario, is to strengthen global health competencies among family medicine residents and faculty. Program description The course covers the meaning of global health; global health ethics; the place of family medicine, primary care, and primary health care in the global health context; epidemiology; infectious diseases; the social determinants of health; and care of vulnerable populations locally and globally. The course is delivered in an intensive 5-day format with didactic lectures, group discussions, interactive workshops, and lived-experience panels. Conclusion The Global Health in Family Medicine Summer Primer has proven to be a successful educational initiative and provides valuable lessons learned for other academic science centres in developing global health training programs for family medicine residents and faculty. PMID:26380854

  16. Night Owl: Maryland's After-Hours Reference Service.

    ERIC Educational Resources Information Center

    Duke, Deborah C.

    1994-01-01

    Discusses "Night Owl," a Maryland public library's after hours telephone reference service. Issues include project start-up, user profiles, types of questions, volume, after hours reference accessibility, security, costs, service limits, publicity, staffing, and employee turnover. Similar services in other states are cited. (Contains six…

  17. What shall we do for family medicine?

    PubMed

    Grainge Biggs, John Sydney

    2016-06-01

    In November 2014 the Pakistan Medical and Dental Council directed that Family Medicine should be taught to final year medical students. Family Medicine will be strengthened as a result. This paper considers some implications of the decision, identifying first the need for more information on primary care services, especially in the private sector, to enable planning of the curriculum and attachments to public and private units. The challenges to medical colleges in providing what will be largely experiential learning are described and the importance of training practitioners is emphasised. The urgent need to overcome the virtual absence in Pakistan of postgraduate training in Family Medicine described, and the quality standards of primary care are explored and the need for attention in the face of student learning is described. Recommendations are offered, including an advisory board on Family Medicine to audit its introduction and performance. PMID:27339579

  18. Family Medicine Mandatory Assessment of Progress

    PubMed Central

    Leung, Fok-Han; Herold, Jodi; Iglar, Karl

    2016-01-01

    Abstract Objective To report the results of a pilot in-training progress test, the Family Medicine Mandatory Assessment of Progress, taken by first- and second-year postgraduate family medicine trainees. Design Assessment of resident performance on a key-features approach multiple-choice progress test. Test questions were developed by competency content area experts. Setting University of Toronto in Ontario. Participants First- and second-year family medicine residents. Main outcome measures Construct validity was assessed based on performance on the test by first- and second-year residents, Canadian and international medical graduates, and residents with more or less than 1 month of relevant clinical experience. Results Pilot progress testing of family medicine residents (N = 255) at the University of Toronto revealed a significant 1.6% difference (P < .01) in mean scores between first- and second-year postgraduate family medicine trainees and achieved construct validity across many parameters studied. The agreement coefficients for residents being identified as the poorest performers ranged from 0.88 to 0.90 depending on the domain of practice assessed. Conclusion Competency-based progress testing using the key-features model is a valid means of assessing the progress of family medicine residents.

  19. After-Hours Work Email No Friend of The Family

    MedlinePlus

    ... balance out of kilter by blurring boundaries between business time and personal time. In 2014, researchers at ... men and women, he said. Christina Maslach, a psychology professor emerita at the University of California, Berkeley, ...

  20. A Descriptive, Retrospective Study of After-hours Calls in Hospice and Palliative Care

    PubMed Central

    Jiang, Yun; Gentry, Amanda L.; Pusateri, Margaret; Courtney, Karen L.

    2012-01-01

    Aims Few studies have described after-hours calls in hospice patient care. This retrospective study examines the timing of after-hours telephone triage services; the reasons for access to after-hours hospice and palliative care services; and the predominant nursing interventions offered in after-hours calls in hospice and palliative care. Methods A fixed coding scheme was used to code a de-identified after-hours triage phone log of all calls between July 2005 and June 2006 (n=4,434) from a Pennsylvania hospice and palliative care services organization. Descriptive statistics were used to identify call timing pattern, call reasons, and predominant nursing interventions. Results Triage services were utilized most frequently to request assistance with signs and symptoms control (25.7%), report death (17.8%), and to request a home visit (15.3%). The top nursing interventions included updating case managers or supervisors about the needs of follow-up (29.5%), coordinating home visits (20.5%), and instructing caregivers or patients on how to control new signs and symptoms (19.8%). Conclusions A better understanding of when and why patients and their family caregivers utilize after-hours hospice triage services can assist in the design of future proactive interventions to improve care, and enhance training for new and existing hospice triage nurses. PMID:22773920

  1. Pharmacists teaching in family medicine residency programs

    PubMed Central

    Jorgenson, Derek; Muller, Andries; Whelan, Anne Marie; Buxton, Kelly

    2011-01-01

    Abstract Objective To determine the percentage of family medicine residency programs that have pharmacists directly involved in teaching residents, the types and extent of teaching provided by pharmacists in family medicine residency programs, and the primary source of funding for the pharmacists. Design Web-based survey. Setting One hundred fifty-eight resident training sites within the 17 family medicine residency programs in Canada. Participants One hundred residency program directors who were responsible for overseeing the training sites within the residency programs were contacted to determine the percentage of training sites in which pharmacists were directly involved in teaching. Pharmacists who were identified by the residency directors were invited to participate in the Web-based survey. Main outcome measures The percentage of training sites for family medicine residency that have pharmacists directly involved in teaching residents. The types and the extent of teaching performed by the pharmacists who teach in the residency programs. The primary source of funding that supports the pharmacists’ salaries. Results More than a quarter (25.3%) of family medicine residency training sites include direct involvement of pharmacist teachers. Pharmacist teachers reported that they spend a substantial amount of their time teaching residents using a range of teaching modalities and topics, but have no formal pharmacotherapy curriculums. Nearly a quarter (22.6%) of the pharmacists reported that their salaries were primarily funded by the residency programs. Conclusion Pharmacists have a role in training family medicine residents. This is a good opportunity for family medicine residents to learn about issues related to pharmacotherapy; however, the role of pharmacists as educators might be optimized if standardized teaching methods, curriculums, and evaluation plans were in place. PMID:21918131

  2. State of family medicine practice in Lebanon

    PubMed Central

    Helou, Mariana; Rizk, Grace Abi

    2016-01-01

    Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession. PMID:27453843

  3. Teaching Core Content in Family Medicine

    PubMed Central

    Rudnick, K. V.; Craven, Marilyn

    1985-01-01

    Core content in family medicine has been difficult to define, given that family practice has differed widely from physician to physician, according to locale and availability of resources. Since family medicine has been taught, educators have been attempting to define its core content—and find ways of teaching it. At the McMaster University Medical Centre Family Practice Unit we have put the problems first: residents present a problem in patient care and the group discusses the problem in relation to a precirculated article on the topic. Lecturing is kept to a minimum, and articles are chosen according to the principles of critical appraisal. An attempt at evaluation generated a positive response. PMID:21274213

  4. Hypnosis and Hypnotism in Family Medicine

    PubMed Central

    Nadeau, Gaetan

    1992-01-01

    This article attempts to define and demystify hypnosis and to present the range of its applications in family medicine. The author reviews definitions and describes hypnotic phenomena, suggestibility, and the use of suggestion, as well as traditional, semitraditional, and Ericksonian induction methods, precautions, and dangers. Clinical uses are then presented for the family physician to apply to surgery, obstetrics, pain treatment, psychosomatic disorders, and psychotherapy. Imagesp2076-a PMID:21221278

  5. Family Medicine: Reassessment of Two Educational Objectives.

    ERIC Educational Resources Information Center

    Christensen, Danis J.

    1983-01-01

    Emphasis on family medicine has resulted in three problems: definition, discrepancies between objectives and practice, and the lack of a specialized body of knowledge. Training should concentrate on simple but more effective goals, enhanced compassion and empathy, and improved communication skills, understanding of emotional needs, and counseling…

  6. Family Medicine Curriculum Guide to Substance Abuse.

    ERIC Educational Resources Information Center

    Liepman, Michael R., Ed.; And Others

    This curriculum guide on substance abuse is intended for teachers of family medicine. Comments, learning objectives, teaching hints, and evaluations of knowledge are provided for each area in all chapters. Chapter 1 focuses on the pharmacology of commonly abused drugs including depressants, opioids, stimulants, hallucinogens, inhalants, and…

  7. Generation to Generation: The Heart of Family Medicine

    ERIC Educational Resources Information Center

    Winter, Robin O.

    2012-01-01

    According to the American Board of Family Medicine, "The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity." What makes the seemingly daunting task of practicing family medicine possible is that family physicians learn to utilize similar clinical reasoning for all of their patients regardless of…

  8. 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

  9. Comparison of Research Trends in Korean and International Family Medicine in Journals of Family Medicine

    PubMed Central

    Jeon, Jin-Kyung; Lee, Jungun

    2014-01-01

    Background Research is important for the development of family medicine as a professional field in primary care. The aim of this study was to suggest directions for the development of family medicine research by analyzing research trends in original papers published in the Korean Journal of Family Medicine (KJFM) and international journals. Methods We investigated original research papers published in KJFM and 4 international journals from August 2009 to July 2010. Analysis was conducted according to research topics, authors, methods, participants, and data sources. Results 'Clinical research' was the most common research topic in both the KJFM (88.3%) and international journals (57.3%); however, international journals had more studies in other domains ('education and research,' 'health service,' and 'family medicine'). More authors other than family physicians participated in international journals than in the KJFM (58% and 3.3%, respectively). Most studies were 'cross-sectional' in KJFM (77.0%) and international journals (51.5%): however, the latter had more 'qualitative' studies, 'cohort' studies, and 'systematic reviews' than the former. The largest study population was 'visitors of health promotion center' in the KJFM and 'outpatients' in international journals. Most of the study sources were 'survey' and 'medical records' in both. Conclusion There were limitations of diversity in the papers of the KJFM. Future investigation on papers of other than family medicine journals should be planned to assess research trends of family physicians. PMID:25426274

  10. Home visits in family medicine residency

    PubMed Central

    Jakubovicz, Difat; Srivastava, Anita

    2015-01-01

    Abstract Problem addressed There has been a decline in family physicians providing home visits to housebound patients. Objective of program To increase family medicine residents’ exposure to home visits; their comfort and skills in providing home visits; and their willingness to provide home visits after graduation. Program description Between 2000 and 2010, each family practice resident at St Joseph’s Health Centre Family Medicine Teaching Unit in Toronto, Ont, was assigned at least 1 housebound patient to care for longitudinally over 2 years; the rationale for this was to increase the sense of “ownership” and responsibility among residents for their assigned homebound patients. Starting in 2003, until the program’s conclusion in 2010, residents were asked to fill out surveys before and after the program to assess their comfort with and confidence in providing home visits, as well as their satisfaction with the program. Survey responses were analyzed for changes over the course of residency training. A total of 85 residents completed the home visit teaching program between 2003 and 2010 inclusive. Conclusion While residents’ willingness to provide home visits did not increase over the course of residency, their confidence in making housecalls did increase. There was also a trend toward increased confidence among residents in working with community agencies. Thus, having home visit patients be a part of resident practices might play an important role in increasing the likelihood that future family physicians will continue to care for their patients when those patients are no longer ambulatory. PMID:26052599

  11. Family medicine and the life course paradigm.

    PubMed

    Daaleman, Timothy P; Elder, Glen H

    2007-01-01

    A unique characteristic of family physicians is that they seek to understand individual patients within the context of their families and larger social environments. Unfortunately, the intellectual development of family medicine is hampered by the reliance on epidemiologic, health service, and biomedical paradigms that are limited in their contextual perspectives on patients' lives. However, another paradigm, that of the life course, represents an interdisciplinary framework that views persons in context over time. It provides an ecological understanding of individual people by examining phenomena at the nexus of social pathways, developmental or health trajectories, and social change. A life course paradigm provides a way of thinking about patients in both proximal (eg, lived lives and family) and distal (eg, health care system) contexts over a life span. Five core principles define the life course as a paradigmatic framework: (1) human development and aging as lifelong processes, (2) human agency, (3) historical time and place, (4) the timing of events in a life, and (5) linked lives. At the individual level, the life course orients physicians to the opportunities and constraints that frame the health care choices, plans, and initiatives of people who maintain health and also face illness. At the organizational level, the life course offers an intellectual infrastructure for the New Model of Family Medicine by depicting an idealized delivery system that may be longitudinally integrated. It also emphasizes health and illness trajectories by linking health and other service organizations that assist individuals at different stages of their lives.

  12. Screening for Depression Patients in Family Medicine

    PubMed Central

    Alic, Alma; Pranjic, Nurka; Selmanovic, Senada; Alibasic, Esad; Alic, Fahrudin; Ramic, Enisa; Spahic-Sarajlic, Selvedina

    2014-01-01

    ABSTRACT Goal: The aims are to establish the prevalence of newfound, unidentified cases of depressive disorder by screening with the Becks Depression scale; To establish a comparative relationship with self-identified cases of depression in the patients in the family medicine; To assess the significance of the BDI in screening practice of family medicine. Patients and methods: A prospective study was conducted anonymously by Beck's Depression scale (Beck Depression Questionnaire org.-BDI) and specially created short questionnaire. The study included 250 randomly selected patients (20-60 years), users of services in family medicine in “Dom Zdravlja” Zenica, and the final number of respondents with included in the study was 126 (51 male, 75 female; response or response rate 50.4%). Exclusion factor was previously diagnosed and treated mental disorder. Participation was voluntary and respondents acknowledge the validity of completing the questionnaire. BDI consists of 21 items. Answers to questions about symptoms were ranked according to the Likert type scale responses from 0-4 (from irrelevant to very much). Respondents expressed themselves on personal perception of depression, whether are or not depressed. Results: Depression was observed in 48% of patients compared to 31% in self estimate depression analyzed the questionnaires. The negative trend in the misrecognition of depression is -17% (48:31). Depression was significantly more frequent in unemployed compared to employed respondents (p=0.001). The leading symptom in both sexes is the perception of lost hope (59% of cases). Conclusion: All respondents in family medicine care in Zenica showed a high percentage of newly detected (17%) patients with previously unrecognized depression. BDI is a really simple and effective screening tool for the detection and identification of persons with symptoms of depression. PMID:24783910

  13. 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.

  14. [General and family medicine: a gratifying choice].

    PubMed

    Gaspar, Dina

    2006-01-01

    The problematic discussion of speciality choice have been largely studied in other countries, where we can see the same setting of the announced crises of Primary Care and the so called decline of Family Medicine. In Portugal, many authors have shown an increasing concern in the way of getting more attention by the political policies/entities for the reduction of the number of family doctors. The decline of the interest of the medical students for Family Medicine is a complex and multifactorial problem that exists at international level, as in other generalist specialities, without technical procedures and technological investment. The importance of human values in medical education, by the new challenges that we have in the XXI century medicine, puts us the question about the students we are graduating today in our schools. The educational and health system reform, and the medical schools support, may influence the choices of medical graduates and motivate them for this speciality, developing a more real and more close medical care that responds to the interests and the needs of the population. PMID:17187715

  15. 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

  16. Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

    PubMed Central

    Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

    2013-01-01

    Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

  17. Correlates of certification in family medicine in the billing patterns of Ontario general practitioners.

    PubMed Central

    Woodward, C A; Cohen, M; Ferrier, B M; Goldsmith, C H; Keane, D

    1989-01-01

    There is conflicting evidence as to whether physicians who are certified in family medicine practise differently from their noncertified colleagues and what those differences are. We examined the extent to which certification in family medicine is associated with differences in the practice patterns of primary care physicians as reflected in their billing patterns. Billing data for 1986 were obtained from the Ontario Health Insurance Plan for 269 certified physicians and 375 noncertified physicians who had graduated from Ontario medical schools between 1972 and 1983 and who practised as general practitioners or family physicians in Ontario. As a group, certificants provided fewer services per patient and billed less per patient seen per month. They were more likely than noncertificants to include counselling, psychotherapy, prenatal and obstetric care, nonemergency hospital visits, surgical services and visits to chronic care facilities in their service mix and to bill in more service categories. Certificants billed more for prenatal and obstetric care, intermediate assessments, chronic care and nonemergency hospital visits and less for psychotherapy and after-hours services than noncertificants. Many of the differences detected suggest a practice style consistent with the objectives for training and certification in family medicine. However, whether the differences observed in our study and in previous studies are related more to self-selection of physicians for certification or to the types of educational experiences cannot be directly assessed. PMID:2804847

  18. Family Medicine Curriculum Resource Project: the future.

    PubMed

    Stearns, Jeffrey A; Stearns, Marjorie A; Paulman, Paul M; Chessman, Alexander W; Davis, Ardis K; Sherwood, Roger A; Sheets, Kent J; Steele, David J; Matson, Christine C

    2007-01-01

    Under contract to the Health Resources and Services Administration (HRSA), the Society of Teachers of Family Medicine (STFM) created an undergraduate medical education curricular resource designed to train physicians to practice in the 21st century. An interdisciplinary group of more than 35 educators worked for 4 years to create the Family Medicine Curriculum Resource (FMCR). By consensus, the Accreditation Council for Graduate Medical Education (ACGME) competencies were adopted as the theoretical framework for this project. The FMCR provides materials for the preclerkship years, the third-year family medicine clerkship, the postclerkship year, and faculty development, as well as guidance for integrating topics of special interest to the federal government (such as, geriatrics, Healthy People 2010, genetics, informatics) into a 4-year continuum of medical education. There are challenges inherent in implementing each component of the FMCR. For example, can the ACGME competency-based approach be adapted to undergraduate medical education? Can the densely packed preclerkship years be adapted to include more focused effort on developing these competencies, and whose job is it anyway? What is "core" to being a competent clinician, and what information can be obtained when needed from medical informatics sources? Will family medicine educators embrace the FMCR recommendations for their third-year clerkships? Will exit assessment of the competency levels of graduating medical students be achieved, and can it make them more capable residents? Can faculty in different clinical and educational settings integrate the teaching of "how to learn" into their repertoire? How will faculty development innovation progress in a time of increasing emphasis on clinical productivity? Developing a common language and adoption of core competencies for all levels of medical education is imperative in a society that is focusing on improving health care quality and outcomes. The FMCR Project

  19. 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

  20. 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

  1. Revolutionary leadership and family medicine education.

    PubMed

    Saultz, John W

    2008-04-01

    Reform of the payment and delivery systems in American health care is now being discussed at the highest levels of business and government. Family medicine educators, researchers, and program leaders have an opportunity to provide substantial leadership to this process in their own communities and nationally. To do so, they must reconsider the assumptions made in creating our current systems of practice and education, and this will require new leadership skills that focus on innovation and adaptability. It will also require a more aggressive willingness to test new ideas and a new scientific method to prove or disprove their value. This essay outlines essential elements of such leadership for those responsible for the education of future generations of family physicians. PMID:18382841

  2. The Future of Family Medicine: A Collaborative Project of the Family Medicine Community

    PubMed Central

    2004-01-01

    BACKGROUND Recognizing fundamental flaws in the fragmented US health care systems and the potential of an integrative, generalist approach, the leadership of 7 national family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. The goal of the project was to develop a strategy to transform and renew the discipline of family medicine to meet the needs of patients in a changing health care environment. METHODS A national research study was conducted by independent research firms. Interviews and focus groups identified key issues for diverse constituencies, including patients, payers, residents, students, family physicians, and other clinicians. Subsequently, interviews were conducted with nationally representative samples of 9 key constituencies. Based in part on these data, 5 task forces addressed key issues to meet the project goal. A Project Leadership Committee synthesized the task force reports into the report presented here. RESULTS The project identified core values, a New Model of practice, and a process for development, research, education, partnership, and change with great potential to transform the ability of family medicine to improve the health and health care of the nation. The proposed New Model of practice has the following characteristics: a patient-centered team approach; elimination of barriers to access; advanced information systems, including an electronic health record; redesigned, more functional offices; a focus on quality and outcomes; and enhanced practice finance. A unified communications strategy will be developed to promote the New Model of family medicine to multiple audiences. The study concluded that the discipline needs to oversee the training of family physicians who are committed to excellence, steeped in the core values of the discipline, competent to provide family medicine’s basket of services within the New Model, and capable of adapting to varying patient needs and changing care technologies

  3. Help is just a phone call away: after-hours support for palliative care patients wishing to die at home.

    PubMed

    Baird-Bower, Debbie; Roach, Julie; Andrews, Morven; Onslow, Fiona; Curnin, Emma

    2016-06-01

    The 24-hour support for palliative patients is the gold standard of health care in Australia. However, in the state of Tasmania after-hours telephone support was spatially fragmented and inequitable. In 2014, hospice@HOME, a pilot programme introduced in Tasmania in that year, implemented a state-wide after-hours palliative care support service--1800HOSPICE--offering 24-hour support, 7 days a week for palliative patients, caregivers and the public. Six months of after-hours call logs in combination with additional patient data, were analysed to evaluate the use and wider implications of a state-wide after-hours palliative care support number. Family and caregivers mainly used the after-hours support to request changes to support services (25.1%), report changes in patients' overall condition (23.6%) and request acute medical assistance (16.2%). Through the use of the after-hours services by all individuals involved in the care, end-of-life patients were able to reduce ambulance contact and emergency department admission, and thereby increase their likelihood of dying at home (for patients whose preference was to die at home). Overall, 24-hour palliative care telephone support was found to be a valuable tool for all individuals involved in the care of end-of-life patients.

  4. Help is just a phone call away: after-hours support for palliative care patients wishing to die at home.

    PubMed

    Baird-Bower, Debbie; Roach, Julie; Andrews, Morven; Onslow, Fiona; Curnin, Emma

    2016-06-01

    The 24-hour support for palliative patients is the gold standard of health care in Australia. However, in the state of Tasmania after-hours telephone support was spatially fragmented and inequitable. In 2014, hospice@HOME, a pilot programme introduced in Tasmania in that year, implemented a state-wide after-hours palliative care support service--1800HOSPICE--offering 24-hour support, 7 days a week for palliative patients, caregivers and the public. Six months of after-hours call logs in combination with additional patient data, were analysed to evaluate the use and wider implications of a state-wide after-hours palliative care support number. Family and caregivers mainly used the after-hours support to request changes to support services (25.1%), report changes in patients' overall condition (23.6%) and request acute medical assistance (16.2%). Through the use of the after-hours services by all individuals involved in the care, end-of-life patients were able to reduce ambulance contact and emergency department admission, and thereby increase their likelihood of dying at home (for patients whose preference was to die at home). Overall, 24-hour palliative care telephone support was found to be a valuable tool for all individuals involved in the care of end-of-life patients. PMID:27349847

  5. Remediation plans in family medicine residency

    PubMed Central

    Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

    2015-01-01

    Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

  6. How medical schools can encourage students' interest in family medicine.

    PubMed

    Rohan-Minjares, Felisha; Alfero, Charles; Kaufman, Arthur

    2015-05-01

    The discipline of family medicine is essential to improving quality and reducing the cost of care in an effective health care system. Yet the slow growth of this field has not kept pace with national demand. In their study, Rodríguez and colleagues report on the influence of the social environment and academic discourses on medical students' identification with family medicine in four countries-the United Kingdom, Canada, France, and Spain. They conclude that these factors-the social environment and discursive activity within the medical school-influence students' specialty choices. While the discourses in Canada, France, and Spain were mostly negative, in the United Kingdom, family medicine was considered a prestigious academic discipline, well paying, and with a wide range of practice opportunities. Medical students in the United Kingdom also were exposed early and often to positive family medicine role models.In the United States, academic discourses about family medicine are more akin to those in Canada, France, and Spain. The hidden curriculum includes negative messages about family medicine, and "badmouthing" primary care occurs at many medical schools. National education initiatives highlight the importance of social determinants in medical education and the integration of public health and medicine in practice. Other initiatives expose students to family medicine role models and practice during their undergraduate training and promote primary care practice through new graduate medical education funding models. Together, these initiatives can reduce the negative effects of the social environment and create a more positive discourse about family medicine.

  7. Health Is Primary: Family Medicine for America’s Health

    PubMed Central

    Phillips, Robert L.; Pugno, Perry A.; Saultz, John W.; Tuggy, Michael L.; Borkan, Jeffrey M.; Hoekzema, Grant S.; DeVoe, Jennifer E.; Weida, Jane A.; Peterson, Lars E.; Hughes, Lauren S.; Kruse, Jerry E.; Puffer, James C.

    2014-01-01

    PURPOSE More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to “renew the specialty to meet the needs of people and society,” some of which bore important fruit. Family Medicine for America’s Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). METHODS Family Medicine for America’s Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. RESULTS The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of

  8. [Family medicine in Mexico: Present and future].

    PubMed

    Varela-Rueda, Carlos E; Reyes-Morales, Hortensia; Albavera-Hernández, Cidronio; Ochoa-Díaz-López, Héctor; Gómez-Dantés, Héctor; García-Peña, Carmen

    2016-01-01

    Analyzing the challenges and the future scenario of Family Medicine is a priority to address challenges such as the reduction of benefits granted by social security; to adapt their practice to the changing health profile; and to curb demand for specialized services and contain the high costs of care in the second and third level. The program is aimed at three professional roles: medical care, research, and education. It is imperative review these in the light of changing demographic conditions, the type of health needs arising from new social determinants, the public expectations for greater participation in their care, and the evolution of the health system itself with the advancement of technology and a variety of organizational options with frequently limited resources. For primary care, as the core of a health system that covers principles of equity, solidarity, universality, participation, decentralization, and intra- and inter-sectorial coordination, it is necessary to put at the center of the primary care team the family doctor and not an administrator, who plays an important role in supporting the care team, but can not take the lead. PMID:26927655

  9. [Family medicine in Mexico: Present and future].

    PubMed

    Varela-Rueda, Carlos E; Reyes-Morales, Hortensia; Albavera-Hernández, Cidronio; Ochoa-Díaz-López, Héctor; Gómez-Dantés, Héctor; García-Peña, Carmen

    2016-01-01

    Analyzing the challenges and the future scenario of Family Medicine is a priority to address challenges such as the reduction of benefits granted by social security; to adapt their practice to the changing health profile; and to curb demand for specialized services and contain the high costs of care in the second and third level. The program is aimed at three professional roles: medical care, research, and education. It is imperative review these in the light of changing demographic conditions, the type of health needs arising from new social determinants, the public expectations for greater participation in their care, and the evolution of the health system itself with the advancement of technology and a variety of organizational options with frequently limited resources. For primary care, as the core of a health system that covers principles of equity, solidarity, universality, participation, decentralization, and intra- and inter-sectorial coordination, it is necessary to put at the center of the primary care team the family doctor and not an administrator, who plays an important role in supporting the care team, but can not take the lead.

  10. Family medicine education in India: A panoramic view

    PubMed Central

    Pati, Sanghamitra; Sharma, Anjali; Pati, Sandipana; Zodpey, Sanjay

    2015-01-01

    Introduction: In the recent years, there has been renewed interest in strengthening primary care for improved health services delivery. Family medicine with its holistic principles is an effective approach for building primary care workforce in resource constraint settings. Even though this discipline is well established and mainstreamed in Western countries, the same is yet to occur in low- and middle-income nations. India with its paradigm shift for universal health coverage is strategically poised to embrace family medicine as a core component of its health system. However, till date, a clear picture of family medicine teaching across the country is yet to be available. Methods: This paper makes an attempt to assess the landscape of family medicine teaching in India with an aim to contribute to a framework for bolstering its teaching and practice in coming years. The objective was to obtain relevant information through a detailed scan of the health professional curricula as well as mapping independent academic programs. Specific areas of interest included course content, structure, eligibility criteria, and accreditation. Results: Our findings indicate that teaching of family medicine is still in infancy in India and yet to be mainstreamed in health professional education. There are variations in family medicine teaching across academic programs. Conclusion: It is suggested that both medical and nursing colleges should develop dedicated Departments of Family Medicine for both undergraduate and postgraduate teaching. Further, more number of standalone diploma courses adopting blended learning methods should be made available for in-service practitioners. PMID:26985405

  11. Hospital grand rounds in family medicine. Content and educational structure.

    PubMed Central

    Lewkonia, R.; Sosnowski, M.; Murray, F.

    1996-01-01

    OBJECTIVE: To investigate hospital grand rounds in family medicine, to examine their content and organization, and to recommend improved educational structures for these ubiquitous continuing medical education events. DATA SELECTION: Retrospective analysis of titles and content of 358 family medicine grand rounds offered in the department of family medicine of a large urban hospital from mid-1983 to the end of 1994. FINDINGS: Only 10% of family medicine grand rounds were presented by family physicians. Most grand rounds were in the form of specialists exhibiting their own interests in a lecture format. Analysis of grand rounds titles showed no consistent pattern of topics but an emphasis on practical aspects of medical care. Patient-based presentations were uncommon, as were grand rounds with more than one speaker. CONCLUSIONS: The content and mix of topics appeared appropriate, but in the absence of a curricular structure, or evaluation of learning gain, it is difficult to assess the value of grand rounds. PMID:9222579

  12. [Effects of family medicine education on medical students' attitudes].

    PubMed

    Chou, M C; Lee, M C

    1991-07-01

    Undergraduate education is considered to be one of the main contributory factors for the development of family medicine through increasing the number of medical graduates opting for a career in family practice. To evaluate the effects of family medicine education on student's attitudes, 140 fifth year medical students were asked in 1989 to fill in a questionnaire both before and after their curricula. The average age of the 123 students who completed the questionnaire on both occasions was 24.9 years; 106 were males; 17 were tuition free and 26 took additional family medicine clerkships. On aggregate, the students' disposition toward family medicine before their curricula appeared to be uncertain. Mean scores on the attitude scale did not significantly differ between socioeconomic subgroups before the curricula. After the curricula, students' attitudes were significantly altered, especially toward the future development of family medicine in Taiwan. However, their disposition toward family practice as a career changed the least. The degree of alteration in students' attitude toward family medicine before and after the curricula was related to the intensity of the course and to their socioeconomic backgrounds.

  13. Attractiveness of family medicine for medical students

    PubMed Central

    Vanasse, Alain; Orzanco, Maria Gabriela; Courteau, Josiane; Scott, Sarah

    2011-01-01

    Abstract Objective To examine the association between students’ personal characteristics, backgrounds, and medical schools and their intention to enter a family medicine (FM) specialty. Design Descriptive study using data from the 2007 National Physician Survey. Setting Canada. Participants Clinical (n = 1109) and preclinical (n = 829) medical student respondents to the 2007 National Physician Survey. Main outcome measures The main variable was hoping to enter an FM specialty, and 40 independent variables were included in regression and classification-tree models. Results Fewer than 1 medical student in 3 (30.2% at the preclinical level and 31.4% at the clinical level) hoped to enter into an FM career. Those who did were more likely to be female, were slightly older, were more frequently married or living with partners, were typically born in Canada, and were more likely to have previous exposure to non-urban environments. The most important predictor for both populations was the debt related to medical studies, which acted in the opposite direction of whether or not students were interested in research. Students interested in research were attracted by specialties with high earning potential, while those not interested in research looked for short residency programs, such as FM, so they could begin to pay off debt sooner. Therefore, the interest in research appears to be inversely related to the choice of FM. Conclusion Less than one-third of medical students were looking for residencies in FM in Canada. This is far below the goals of 45% set at the national level and 50% set by some provinces like Quebec. Debt and interest in research have strong influences on the choice of residency by medical students. PMID:21673198

  14. Defining competency-based evaluation objectives in family medicine

    PubMed Central

    Donoff, Michel; Lawrence, Kathrine; Allen, Tim; Brailovsky, Carlos; Crichton, Tom; Bethune, Cheri; Laughlin, Tom; Wetmore, Stephen

    2012-01-01

    Abstract Objective To develop and describe observable evaluation objectives for assessing competence in professionalism, which are grounded in the experience of practising physicians. Design Modified nominal group technique. Setting The College of Family Physicians of Canada in Mississauga, Ont. Participants An expert group of 7 family physicians and 1 educational consultant, all of whom had experience in assessing competence in family medicine. Group members represented the Canadian context with respect to region, sex, language, community type, and experience. Methods Using an iterative process, the expert group defined a list of observable behaviours that are indicative of professionalism, or not, in the family medicine setting. Themes relate to professional behaviour in family medicine; specific observable behaviours are those that family physicians believe are indicative of professionalism for each theme. Main findings The expert group identified 12 themes and 140 specific observable behaviours to assist in the observation and discussion of professional behaviour in family medicine workplace settings. Conclusion Competency-based education literature emphasizes the importance of formative evaluation and feedback. Such feedback is particularly challenging in the domain of professionalism because of its personal nature and the potential for emotional reactions. Effective dialogue between learners and teachers begins with clear expectations and reference to descriptions of relevant, specific behaviour. This research has generated a competency-based resource to assist the assessment of professional behaviour in family medicine educational programs. PMID:23064939

  15. Complementary and Alternative Medicine: Core Competencies for Family Nurse Practitioners.

    ERIC Educational Resources Information Center

    Burman, Mary E.

    2003-01-01

    Directors of family nurse practitioner education programs (n=141) reported inclusion of some complementary/alternative medicine content (CAM), most commonly interviewing patients about CAM, critical thinking, evidence-based medicine, laws, ethics, and spiritual/cultural beliefs. Definition of CAM was medically, not holistically based. More faculty…

  16. Workshops for Faculty Development in Family Medicine. Evaluation Report.

    ERIC Educational Resources Information Center

    Reineke, Robert A.; Welch, Wayne W.

    An evaluation was conducted of four faculty development workshops sponsored by the Society of Teachers of Family Medicine for faculty in family practice residency programs. Objectives of the evaluation were to determine the extent to which the workshops achieved the specified educational objectives and to assess the operational aspects of the…

  17. 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

  18. Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

    ERIC Educational Resources Information Center

    Silk, Hugh; Shields, Sara

    2012-01-01

    Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…

  19. General practice after-hours incentive funding: a rationale for change.

    PubMed

    Neil, Amanda L; Nelson, Mark R; Richardson, Tracy; Mann-Leonard, Meghan; Palmer, Andrew J

    2015-07-20

    After-hours incentive funding for general practice was introduced in 1998 through the introduction of the Practice Incentives Program (PIP). In 2010, a national audit of the PIP identified after-hours incentive funding as having the greatest levels of non-compliance across 12 PIP components. The audit specified the need for secondary data sources to ensure practice compliance. In this article, we examine the drivers of the 1998-2013 PIP mechanism to inform development of a fair, transparent and auditable after-hours incentive funding scheme for Tasmania. The PIP after-hours incentive funding mechanism paid, at diminishing levels, for anticipated burden of care (practice size), claimed method of providing care (stream) and remoteness of practice. Increasing remoteness rather than practice size or stream is the primary determinant of urgent after-hours attendances per practice in Tasmania; after-hours attendances to residential aged care facilities are unrelated to individual practice location or stream but concentrated in urban areas. The PIP after-hours incentive funding mechanism does not preferentially support practices that provide after-hours care and arguably led to perverse incentives. A new after-hours incentive funding mechanism embodying pre-specified objectives - such as support for (unavoidable) burden and/or provision of care to residential aged care facilities - is required. Claimed provision is considered an inappropriate funding determinant. PMID:26175246

  20. General practice after-hours incentive funding: a rationale for change.

    PubMed

    Neil, Amanda L; Nelson, Mark R; Richardson, Tracy; Mann-Leonard, Meghan; Palmer, Andrew J

    2015-07-20

    After-hours incentive funding for general practice was introduced in 1998 through the introduction of the Practice Incentives Program (PIP). In 2010, a national audit of the PIP identified after-hours incentive funding as having the greatest levels of non-compliance across 12 PIP components. The audit specified the need for secondary data sources to ensure practice compliance. In this article, we examine the drivers of the 1998-2013 PIP mechanism to inform development of a fair, transparent and auditable after-hours incentive funding scheme for Tasmania. The PIP after-hours incentive funding mechanism paid, at diminishing levels, for anticipated burden of care (practice size), claimed method of providing care (stream) and remoteness of practice. Increasing remoteness rather than practice size or stream is the primary determinant of urgent after-hours attendances per practice in Tasmania; after-hours attendances to residential aged care facilities are unrelated to individual practice location or stream but concentrated in urban areas. The PIP after-hours incentive funding mechanism does not preferentially support practices that provide after-hours care and arguably led to perverse incentives. A new after-hours incentive funding mechanism embodying pre-specified objectives - such as support for (unavoidable) burden and/or provision of care to residential aged care facilities - is required. Claimed provision is considered an inappropriate funding determinant.

  1. Topics for Family Medicine Research in Obstetrics

    PubMed Central

    Hogg, William E.; Calonge, Ned

    1988-01-01

    Primarily because of improvements in care of the low-birthweight neonate, Canada's neonatal mortality rates have declined significantly over the last 20 years. To make further improvement, research is now focused on the prevention of prematurity. However, benefits from the implementation of such research and the maintenance of the current neonatal mortality rate depend on the availability of obstetric care providers in rural areas. The recent trend among family physicians to drop the practice of obstetrics significantly jeopardizes access to obstetric care for inhabitants of rural areas, and a significant body of literature suggests that such declines in access will be accompanied by an increase in the neonatal death rate. A logical research agenda for rural family physicians would include the forecasting of the effect of the decrease in obstetric care manpower, follwed by the study of factors behind this trend, and the evaluation programs designed to prevent family physicians abandoning obstetric practice. PMID:21253225

  2. Results of the 2004 national resident matching program: family medicine.

    PubMed

    Pugno, Perry A; McPherson, Deborah S; Schmittling, Gordon T; Fetter, Gerald T; Kahn, Norman B

    2004-09-01

    The results of the 2004 National Resident Matching Program (NRMP) reflect a leveling in the recent trend of declining student interest in family medicine residency training in the United States. Compared with the 2003 Match, 34 more positions (36 fewer US seniors) were filled in family medicine residency programs through the NRMP in 2004, at the same time as 14 fewer (four fewer US seniors) in primary care internal medicine, 10 more in pediatrics-primary care (one more US senior), and 35 more (38 more US seniors) in internal medicine-pediatric programs. In comparison, one less position (one more US senior) was filled in anesthesiology and seven fewer (five more US seniors) in diagnostic radiology, two "marker" disciplines that have shown increases over the past several years. Many different forces, including student perspectives of the demands, rewards, and prestige of the specialty; the turbulence and uncertainty of the health care environment; liability protection issues; and the impact of faculty and resident role models, continue to influence medical student career choices. A total of 165 more positions (12 more US seniors) were filled in categorical internal medicine while 164 more positions (15 more US seniors) were filled in categorical pediatrics programs, where trainees perceive options for either practicing as generalists or entering subspecialty fellowships, depending on the market. With the needs of the nation, especially for rural and underserved populations, continuing to offer opportunities for family physicians, family medicine experienced a slight increase through the 2004 NRMP. The 2004 NRMP suggests that the trend away from family medicine and primary care careers may be leveling off. PMID:15343417

  3. Results of the 2005 national resident matching program: family medicine.

    PubMed

    Pugno, Perry A; Schmittling, Gordon T; Fetter, Gerald T; Kahn, Norman B

    2005-09-01

    The results of the 2005 National Resident Matching Program (NRMP) reflect a currently stable level of student interest in family medicine residency training in the United States. Compared with the 2004 Match, 19 more positions (66 fewer US seniors) were filled in family medicine residency programs through the NRMP in 2005, at the same time as four fewer (18 fewer US seniors) in primary care internal medicine, seven more in pediatrics-primary care (three fewer US seniors), and 12 fewer (21 fewer US seniors) in internal medicine-pediatrics programs. In comparison, 25 more positions (four more US seniors) were filled in anesthesiology but two fewer (14 fewer US seniors) in diagnostic radiology, two "marker" disciplines that have shown increases over the past several years. Many different forces, including student perspectives of the demands, rewards, and prestige of the specialty, the turbulence and uncertainty of the health care environment, lifestyle issues, and the impact of faculty and resident role models, continue to influence medical student career choices. Seven more positions (57 more US seniors) were filled in categorical internal medicine while 48 more positions (68 more US seniors) were filled in categorical pediatrics programs, where trainees perceive options for either practicing as generalists or entering subspecialty fellowships, depending on the market. With the needs of the nation, especially for rural and underserved populations, continuing to offer opportunities for family physicians, family medicine experienced another slight increase through the 2005 NRMP. The 2005 NRMP results suggest that interest in family medicine and primary care careers continues to be stable. PMID:16145633

  4. [Family and community medicine and the university. SESPAS report 2010].

    PubMed

    Casado Vicente, Verónica; Bonal Pitz, Pablo; Cucalón Arenal, José Manuel; Serrano Ferrández, Elena; Suárez Gonzalez, Félix

    2012-03-01

    Family and community medicine is an academic subject, a medical specialty and a health profession with distinct dimensions: healthcare, teaching, research and management. In this discipline, the object of knowledge is the person, understood as a whole. Family medicine, as an academic subject, and primary care, as a health education setting, should be incorporated into the core graduate and postgraduate curricula. The absence of these elements leads to training bias and has major repercussions on quality, coordination and patient safety. The development of the Health Professions Act and the construction of the European Higher Education Area (EHEA) have created a favorable climate for the presence of this discipline in the university. Since the 1960s, family medicine has been consolidated as an academic subject with its own departments in almost all European universities, and a significant number of family physicians are teachers. A balance has been achieved between the hospital-based system (based on theory, disease, and the biological model) and the patient-centred model (based on problem solving, community-oriented and the bio-psycho-social model). The introduction of family and community medicine as a specific subject, and as a transverse subject and as an option in practicals, represents the adaptation of the educational system to social needs. This adaptation also represents a convergence with other European countries and the various legal requirements protecting this convergence. However, this new situation requires a new structure (departments) and faculty (professors and associate and assistant professors). PMID:22055214

  5. The Evolution of Family Medicine Resident Projects at Dalhousie University

    PubMed Central

    O'Connor, John F.

    1989-01-01

    The Dalhousie Family Medicine Residency Program has always attempted to meet the research objectives of the College of Family Physicians of Canada. From a “Monitored Reading and Research” program, where projects were encouraged, the department developed a program which involved a mandatory project, preferably involving research, that is formally and objectively evaluated and supervised by faculty. The background, rationale, and problems encountered, as well as attempted solutions, are outlined. PMID:21249037

  6. Frequently asked questions about family medicine in India.

    PubMed

    Kumar, Raman

    2016-01-01

    Family medicine (FM) is an independent and distinct medical specialty in the developed countries such as USA, UK, Australia, and Canada since 1960s. FM teaching is imparted at undergraduate and postgraduate levels in countries such as Nepal, Pakistan, and Sri Lanka. Family practice is the practicing vocation of the majority doctors in India. The practitioners of FM include general practitioners, family physicians, FM specialists, and medical officers in the public sector. Medical students are largely unaware about FM career as this concept is not introduced at MBBS level. Faculty and senior doctors from other disciplines are also not able to answer the queries related to FM as they themselves also have gone through the same education system for last three decades, largely unexposed to the concept of academic family medicine. This article is a compilation of frequently asked questions, and their appropriate responses, presented here to dispel myths and misinformation about FM specialty. The answers are deliberated upon by Dr. Raman Kumar the founder president of the Academy of Family Physicians of India and the chief editor of the Journal of Family Medicine and Primary Care. This article was originally published as an interview in Docplexus, a popular online network and website for medical doctors in November 2015.

  7. Frequently asked questions about family medicine in India

    PubMed Central

    Kumar, Raman

    2016-01-01

    Family medicine (FM) is an independent and distinct medical specialty in the developed countries such as USA, UK, Australia, and Canada since 1960s. FM teaching is imparted at undergraduate and postgraduate levels in countries such as Nepal, Pakistan, and Sri Lanka. Family practice is the practicing vocation of the majority doctors in India. The practitioners of FM include general practitioners, family physicians, FM specialists, and medical officers in the public sector. Medical students are largely unaware about FM career as this concept is not introduced at MBBS level. Faculty and senior doctors from other disciplines are also not able to answer the queries related to FM as they themselves also have gone through the same education system for last three decades, largely unexposed to the concept of academic family medicine. This article is a compilation of frequently asked questions, and their appropriate responses, presented here to dispel myths and misinformation about FM specialty. The answers are deliberated upon by Dr. Raman Kumar the founder president of the Academy of Family Physicians of India and the chief editor of the Journal of Family Medicine and Primary Care. This article was originally published as an interview in Docplexus, a popular online network and website for medical doctors in November 2015. PMID:27453835

  8. Frequently asked questions about family medicine in India.

    PubMed

    Kumar, Raman

    2016-01-01

    Family medicine (FM) is an independent and distinct medical specialty in the developed countries such as USA, UK, Australia, and Canada since 1960s. FM teaching is imparted at undergraduate and postgraduate levels in countries such as Nepal, Pakistan, and Sri Lanka. Family practice is the practicing vocation of the majority doctors in India. The practitioners of FM include general practitioners, family physicians, FM specialists, and medical officers in the public sector. Medical students are largely unaware about FM career as this concept is not introduced at MBBS level. Faculty and senior doctors from other disciplines are also not able to answer the queries related to FM as they themselves also have gone through the same education system for last three decades, largely unexposed to the concept of academic family medicine. This article is a compilation of frequently asked questions, and their appropriate responses, presented here to dispel myths and misinformation about FM specialty. The answers are deliberated upon by Dr. Raman Kumar the founder president of the Academy of Family Physicians of India and the chief editor of the Journal of Family Medicine and Primary Care. This article was originally published as an interview in Docplexus, a popular online network and website for medical doctors in November 2015. PMID:27453835

  9. Finding, keeping, and revitalizing the meaning in family medicine.

    PubMed

    Van Dyke, Anne; Seger, Amy M

    2013-01-01

    The culture of medicine is undergoing revolutionary change. Physicians are pulled in many directions involving the practice of medicine, the business of medicine, and the technology of medicine. Financial incentives and career promotions may be dependent upon such things as patient satisfaction scores, as well as adherence to guidelines for admissions and diagnostic testing. Of course, these metrics are monitored closely by hospitals, insurance companies, and the federal government. The resultant seemingly endless paperwork, deadlines, and multiple demands may result in a sense of time famine for physicians. Unfortunately, these expectations and demands can subsequently diminish the passion for medicine. Moreover, physicians are at high risk for significant physical and emotional exhaustion, often leading to a sense of demoralization. Physicians can ultimately lose sight of their reasons for choosing the field of medicine. Indeed, they can lose the inspiration and "meaning" derived from work in medicine all together. How, then, does one buffer oneself against such perils, and maintain the original passion and meaning in a chosen career of service to others? This article will describe one program's approach to promoting resilience and maintaining meaning during the residency training years through the establishment of a Meaning in Family Medicine Group. The conceptual background, approach to curriculum development, goals and objectives, resident feedback, and suggestions about how to carry this curriculum beyond the residency training years will be discussed. PMID:24261266

  10. Medicinal uses, phytochemistry and pharmacology of family Sterculiaceae: a review.

    PubMed

    Al Muqarrabun, L M R; Ahmat, N

    2015-03-01

    The family Sterculiaceae is one of the most important families among flowering plants. Many of its members demonstrate medicinal properties and have been used for the treatment of various ailments and wounds. A wide range of compounds including alkaloids, phenyl propanoids, flavonoids, terpenoids and other types of compounds including hydrocarbons, sugars, quinones, phenolic acids, lactones, lignans, amine and amides have been isolated from several species in this family. Few studies have reported that some extracts and single compounds isolated from this family exhibited several biological activities, such as antimicrobial, anti-inflammatory, antioxidant and cytotoxic activities. The present review is an effort to provide information about the traditional uses, phytochemistry and pharmacology of species from family Sterculiaceae, and to uncover the gaps and potentials requiring further research opportunities regarding the chemistry and pharmacy of this family.

  11. Morning Report in Family Medicine Residency Programs: A Descriptive Study.

    ERIC Educational Resources Information Center

    Kuncharapu, Indumathi; Cass, Alvah R.; Carlson, Carol A.; Scott, Jack R.

    Morning Report (MR) is a frequently held case conference in most Family Medicine (FM) residency programs among medical learners who discuss recent inpatient admissions before the day's care of patients. This study conducted a national survey of FM residency program directors to describe the roles of faculty and residents in facilitating MR.…

  12. ENT Experience in a Family Medicine Clerkship: Is There Enough?

    ERIC Educational Resources Information Center

    O'Hara, Brenda S.; Saywell, Robert M., Jr.; Zollinger, Terrell W.; Smith, Christopher P.; Burba, Jennifer L.; Stopperich, David M.

    2000-01-01

    Used patient encounter records completed by 445 medical students to determine whether a family medicine clerkship offered enough experience in ear, nose, and throat (ENT) conditions. Results, which were used for curriculum development, suggest that these students were receiving sufficient opportunities for some areas of ENT practice, but not for…

  13. Family Medicine Educators' Perceptions of the Future of Faculty Development.

    ERIC Educational Resources Information Center

    Quirk, Mark; Lasser, Daniel; Domino, Frank; Chuman, Alan; Devaney-O'Neil, Sarah

    2002-01-01

    Family medicine faculty participated in focus groups to gather their perceptions about faculty development. They emphasized that faculty development methods must be proven effective, woven into the fabric of clinical practice, and deal with increasing time and financial pressures. Much discussion was related to the need for national and regional…

  14. Depression and burnout symptoms among Air Force family medicine providers.

    PubMed

    Varner, Derrick F; Foutch, Brian K

    2014-05-01

    This study investigated the prevalence of depression and burnout symptoms among family medicine providers on active duty in the US Air Force. Results demonstrated that 84% of those surveyed scored positive for degrees of depression symptoms; only sex differences were significant. PMID:24758978

  15. 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

  16. 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.

  17. 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

  18. 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

  19. Folk medicinal uses of Verbenaceae family plants in Bangladesh.

    PubMed

    Rahmatullah, Mohammed; Jahan, Rownak; Azam, F M Safiul; Hossan, S; Mollik, M A H; Rahman, Taufiq

    2011-01-01

    Folk medicinal practitioners form the first tier of primary health-care providers to most of the rural population of Bangladesh. They are known locally as Kavirajes and rely almost solely on oral or topical administration of whole plants or plant parts for treatment of various ailments. Also about 2% of the total population of Bangladesh are scattered among more than twenty tribes residing within the country's borders. The various tribes have their own tribal practitioners, who use medicinal plants for treatment of diseases. The objective of the present survey was to conduct an ethnomedicinal survey among the Kavirajes and tribal practitioners to determine which species of plants belonging to the Verbenaceae family are used by the practitioners. The Verbenaceae family plants are well known for constituents having important bio-active properties. The present survey indicated that 13 species belonging to 8 genera are used by the folk and tribal medicinal practitioners of Bangladesh. A comparison of their folk medicinal uses along with published reports in the scientific literature suggests that the Verbenaceae family plants used in Bangladesh can potentially be important sources of lead compounds or novel drugs for treatment of difficult to cure debilitating diseases like malaria and rheumatoid arthritis.

  20. Folk medicinal uses of Verbenaceae family plants in Bangladesh.

    PubMed

    Rahmatullah, Mohammed; Jahan, Rownak; Azam, F M Safiul; Hossan, S; Mollik, M A H; Rahman, Taufiq

    2011-01-01

    Folk medicinal practitioners form the first tier of primary health-care providers to most of the rural population of Bangladesh. They are known locally as Kavirajes and rely almost solely on oral or topical administration of whole plants or plant parts for treatment of various ailments. Also about 2% of the total population of Bangladesh are scattered among more than twenty tribes residing within the country's borders. The various tribes have their own tribal practitioners, who use medicinal plants for treatment of diseases. The objective of the present survey was to conduct an ethnomedicinal survey among the Kavirajes and tribal practitioners to determine which species of plants belonging to the Verbenaceae family are used by the practitioners. The Verbenaceae family plants are well known for constituents having important bio-active properties. The present survey indicated that 13 species belonging to 8 genera are used by the folk and tribal medicinal practitioners of Bangladesh. A comparison of their folk medicinal uses along with published reports in the scientific literature suggests that the Verbenaceae family plants used in Bangladesh can potentially be important sources of lead compounds or novel drugs for treatment of difficult to cure debilitating diseases like malaria and rheumatoid arthritis. PMID:22754058

  1. E-Learning Readiness in Medicine: Turkish Family Medicine (FM) Physicians Case

    ERIC Educational Resources Information Center

    Parlakkiliç, Alaattin

    2015-01-01

    This research investigates e-learning readiness level of family medicine physicians (FM) in Turkey. The study measures the level of e-learning readiness of Turkish FM physicians by an online e-learning readiness survey. According to results five areas are ready at Turkish FM physicians but need a few improvements:…

  2. Balance of trade: export-import in family medicine.

    PubMed

    Pust, Ronald E

    2007-01-01

    North American family physicians leaving for less-developed countries (LDCs) may not be aware of internationally validated diagnostic and treatment technologies originating in LDCs. Thus they may bring with them inappropriate models and methods of medical care. More useful "exports" are based in sharing our collaborative vocational perspective with dedicated indigenous generalist clinicians who serve their communities. More specifically, Western doctors abroad can promote local reanalyses of international evidence-based medicine (EBM) studies, efficient deployment of scarce clinical resources, and a family medicine/generalist career ladder, ultimately reversing the "brain drain" from LDCs. Balancing these exports, we should import the growing number of EBM best practices originated in World Health Organization and other LDCs research that are applicable in developed nations. Many generalist colleagues, expatriate and indigenous, with long-term LDC experience stand ready to help us import these practices and perspectives. PMID:17987419

  3. Occupational Stress and Physical Symptoms among Family Medicine Residents

    PubMed Central

    Choi, So-Myung; Park, Yong Soon; Kim, Go-Young

    2013-01-01

    Background The purpose of this study was to examine the levels of occupational stress and physical symptoms among family medicine residents and investigate the effect of subscales of occupational stress on physical symptoms. Methods A self-administered questionnaire survey of 1,152 family medicine residents was carried out via e-mail from April 2010 to July 2010. The response rate was 13.1% and the R (ver. 2.9.1) was used for the analysis of completed data obtained from 150 subjects. The questionnaire included demographic factors, resident training related factors, 24-items of the Korean Occupational Stress Scales and Korean Versions of the Wahler Physical Symptom Inventory. Results The total score of occupational stress of family medicine residents was relatively low compared to that of average workers. The scores of 'high job demand', 'inadequate social support', 'organizational injustice', and 'discomfort in occupational climate' were within the top 50%. Parameters associated with higher occupational stress included level of training, on-duty time, daily patient load, critical patient assigned, total working days, night duty day, sleep duration, and sleep quality. The six subscales of occupational stress, except for 'Job insecurity', had a significant positive correlation with physical symptom scores after adjustment had been made for potential confounders (total score, r = 0.325 and P < 0.001; high job demand, r = 0.439 and P < 0.001). Conclusion After the adjustment had been made for potential confounders, the total score of occupational stress and six subscales in family medicine residents showed a significant positive correlation with physical symptom scores. PMID:23372906

  4. Patients' Perceived Quality of Family Physicians' Primary Care with or without 'Family Medicine' in the Clinic Name

    PubMed Central

    Kim, Ka Young; Lim, Kangjin; Choi, Eun Young; Cheong, Yoo Seock

    2016-01-01

    Background Patients' perspectives of family medicine according to the physician's identity and role as a primary-care specialist need to be investigated. This study was conducted to investigate the perceived quality of the primary care of family medicine clinics as assessed by patients in a community setting. Methods Patients (or their guardians) visiting nine community family medicine clinics were surveyed using the Korean Primary Care Assessment Tool from April 2014 to June 2014. The scores of the Korean Primary Care Assessment Tool domains were compared according to the clinics' designation (or not) as 'family medicine' and the patients' recognition (or not) of the physicians as board-certified family medicine specialists. Results A total of 196 subjects responded to the questionnaire. They assessed the community clinics' quality of primary care as moderate to high. Of the clinics, those that were not designated as family medicine scored higher than those that were designated as family medicine (P<0.05). The group of patients that recognized a clinic as that of a board-certified family medicine specialist awarded higher scores than the non-recognition group in the domains of coordination function and personalized care (P<0.05). Conclusion The moderate to high scores for the community family medicine clinics' quality of primary care are encouraging. It seems that patients' recognition of the family physician's role and of the physician-patient relationship has a significant influence on their assessment of the quality of primary care.

  5. Patients' Perceived Quality of Family Physicians' Primary Care with or without 'Family Medicine' in the Clinic Name

    PubMed Central

    Kim, Ka Young; Lim, Kangjin; Choi, Eun Young; Cheong, Yoo Seock

    2016-01-01

    Background Patients' perspectives of family medicine according to the physician's identity and role as a primary-care specialist need to be investigated. This study was conducted to investigate the perceived quality of the primary care of family medicine clinics as assessed by patients in a community setting. Methods Patients (or their guardians) visiting nine community family medicine clinics were surveyed using the Korean Primary Care Assessment Tool from April 2014 to June 2014. The scores of the Korean Primary Care Assessment Tool domains were compared according to the clinics' designation (or not) as 'family medicine' and the patients' recognition (or not) of the physicians as board-certified family medicine specialists. Results A total of 196 subjects responded to the questionnaire. They assessed the community clinics' quality of primary care as moderate to high. Of the clinics, those that were not designated as family medicine scored higher than those that were designated as family medicine (P<0.05). The group of patients that recognized a clinic as that of a board-certified family medicine specialist awarded higher scores than the non-recognition group in the domains of coordination function and personalized care (P<0.05). Conclusion The moderate to high scores for the community family medicine clinics' quality of primary care are encouraging. It seems that patients' recognition of the family physician's role and of the physician-patient relationship has a significant influence on their assessment of the quality of primary care. PMID:27688865

  6. The new Australian after-hours general practice incentive payment mechanism: equity for rural general practice?

    PubMed

    Neil, Amanda L; Nelson, Mark; Palmer, Andrew J

    2016-07-01

    In July 2015, a national scheme for after-hours incentive funding for general practices was re-introduced in Australia, 2-years after funding was transferred to regional primary health care organisations (Medicare Locals). The re-introduction was recommended in a 2014 review of after-hours primary care reflecting the "overwhelming desire" among general practice. Given the centrality of after-hours care provision in rural and remote practices identified in the review, we compare and contrast the current and historical after-hours incentive funding mechanisms focussing on fairness towards rural general practices. While there are similarities between the current and historical mechanisms, significant differences exist. The comparison is not straightforward. The major consistency is utilisation of practice standardised whole patient equivalents (SWPE) as the basis of funding, inherently favouring large urban general practices. This bias is expected to increase given a shift in focus from practices with no option but to provide 24/7 care to any practice providing 24/7 care; and an associated increased funding per SWPE. Differences primarily pertain to classification processes, in which the realities of rural service provision and recognition of regional support mechanisms are given minimal consideration. Rapid introduction of the new general practice after-hours incentive funding mechanism has led to inconsistencies and has exacerbated inherent biases, particularly inequity towards rural providers. Impact on morale and service provision in non-urban areas should be monitored.

  7. The new Australian after-hours general practice incentive payment mechanism: equity for rural general practice?

    PubMed

    Neil, Amanda L; Nelson, Mark; Palmer, Andrew J

    2016-07-01

    In July 2015, a national scheme for after-hours incentive funding for general practices was re-introduced in Australia, 2-years after funding was transferred to regional primary health care organisations (Medicare Locals). The re-introduction was recommended in a 2014 review of after-hours primary care reflecting the "overwhelming desire" among general practice. Given the centrality of after-hours care provision in rural and remote practices identified in the review, we compare and contrast the current and historical after-hours incentive funding mechanisms focussing on fairness towards rural general practices. While there are similarities between the current and historical mechanisms, significant differences exist. The comparison is not straightforward. The major consistency is utilisation of practice standardised whole patient equivalents (SWPE) as the basis of funding, inherently favouring large urban general practices. This bias is expected to increase given a shift in focus from practices with no option but to provide 24/7 care to any practice providing 24/7 care; and an associated increased funding per SWPE. Differences primarily pertain to classification processes, in which the realities of rural service provision and recognition of regional support mechanisms are given minimal consideration. Rapid introduction of the new general practice after-hours incentive funding mechanism has led to inconsistencies and has exacerbated inherent biases, particularly inequity towards rural providers. Impact on morale and service provision in non-urban areas should be monitored. PMID:27237945

  8. Designing and implementing a resiliency program for family medicine residents.

    PubMed

    Brennan, Julie; McGrady, Angele

    2015-01-01

    Family medicine residents are at risk for burnout due to extended work hours, lack of control over their work schedule, and challenging work situations and environments. Building resiliency can prevent burnout and may improve a resident's quality of life and health behavior. This report describes a program designed to build resiliency, the ability to bounce back from stress, in family medicine residents in a medium sized U.S. residency training program. Interactive sessions emphasized building self-awareness, coping skills, strengths and meaning in work, time management, self-care, and connections in and outside of medicine to support resident well-being. System changes which fostered wellness were also implemented. These changes included increasing the availability of fresh fruits in the conference and call room, purchasing an elliptical exercise machine for the on call room, and offering a few minutes of mindfulness meditation daily to the inpatient residents. Results to date show excellent acceptance of the program by trainees, increased consumption of nutritious foods, more personal exercise, and self-reported decreased overreactions to stress. Resiliency programs can effectively serve to meet accreditation requirements while fostering residents' abilities to balance personal and professional demands. PMID:26130769

  9. Mentorship perceptions and experiences among academic family medicine faculty

    PubMed Central

    Stubbs, Barbara; Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola

    2016-01-01

    Abstract Objective To collect information about the types, frequency, importance, and quality of mentorship received among academic family medicine faculty, and to identify variables associated with receiving high-quality mentorship. Design Web-based survey of all faculty members of an academic department of family medicine. Setting The Department of Family and Community Medicine of the University of Toronto in Ontario. Participants All 1029 faculty members were invited to complete the survey. Main outcome measures Receiving mentorship rated as very good or excellent in 1 or more of 6 content areas relevant to respondents’ professional lives, and information about demographic and practice characteristics, faculty ratings of their local departments and main practice settings, teaching activities, professional development, leadership, job satisfaction, and health. Bivariate and multivariate analyses identified variables associated with receiving high-quality mentorship. Results The response rate was 66.8%. Almost all (95.0%) respondents had received mentorship in several areas, with informal mentorship being the most prevalent mode. Approximately 60% of respondents rated at least 1 area of mentoring as very good or excellent. Multivariate logistic regression identified 5 factors associated with an increased likelihood of rating mentorship quality as very good or excellent: positive perceptions of their local department (odds ratio [OR] = 4.02, 95% CI 2.47 to 6.54, P < .001); positive ratings of practice infrastructure (OR = 1.86, 95% CI 1.23 to 2.80, P = .003); increased frequency of receiving mentorship (OR = 2.78, 95% CI 1.59 to 4.89, P < .001); fewer years in practice (OR = 1.93, 95% CI 1.19 to 3.12, P = .007); and practising in a family practice teaching unit (OR = 1.51, 95% CI 1.01 to 2.27, P = .040). Conclusion With increasing emphasis on distributed education and community-based teachers, family medicine faculties will need to develop strategies to support

  10. Context and trade-offs in family medicine.

    PubMed

    Seehusen, Dean A; Bowman, Marjorie A; Neale, Anne Victoria

    2014-01-01

    This issue contains several articles that highlight the effect of context and tradeoffs encountered in the practice of family medicine. Some articles demonstrate how context affects the implementation of the patient-centered medical home model, the community risk of a measles outbreak, the rate of complementary and alternative medicine among different generations, and the number of family physicians primarily providing urgent and emergent care in a region. Tradeoffs are explored in articles that look at how electronic medical record use has changed the composition of workload in primary care and how the burgeoning number of clinical guidelines affects the choices made by family physicians. A look at diabetic patients' perceptions of their risk of negative outcomes reveals an interesting pattern of underestimation of the risk of death. Patients with chronic mental disorders are at risk of having significant difficulties in the workplace, which may place a heavy cost on the individual and society. An interesting retrospective study found that it takes a surprising amount of replacement therapy to correct vitamin D deficiency.

  11. Why Family Medicine is a Good Career Choice for Indian Medical Graduates?

    PubMed Central

    Kumar, Raman

    2014-01-01

    Internationally family medicine has evolved as an independent academic discipline of medical science and speciality vocational training for community based primary care physicians. India has a long tradition of family practice however due to various regulatory barriers family medicine did not optimally develop in mainstream medical education system for many decades. Recently, there is growing interest in this concept in India and family medicine is emerging as a viable career option for medical graduates in India. PMID:24791226

  12. Why Family Medicine is a Good Career Choice for Indian Medical Graduates?

    PubMed

    Kumar, Raman

    2014-01-01

    Internationally family medicine has evolved as an independent academic discipline of medical science and speciality vocational training for community based primary care physicians. India has a long tradition of family practice however due to various regulatory barriers family medicine did not optimally develop in mainstream medical education system for many decades. Recently, there is growing interest in this concept in India and family medicine is emerging as a viable career option for medical graduates in India.

  13. Obstetrics anyone? How family medicine residents' interests changed.

    PubMed Central

    Ruderman, J.; Holzapfel, S. G.; Carroll, J. C.; Cummings, S.

    1999-01-01

    OBJECTIVE: To determine family medicine residents' attitudes and plans about practising obstetrics when they enter and when they graduate from their residency programs. DESIGN: Residents in each of 4 consecutive years, starting July 1991, were surveyed by questionnaire when they entered the program and again when they graduated (ending in June 1996). Only paired questionnaires were used for analysis. SETTING: Family medicine residency programs at the University of Toronto in Ontario. PARTICIPANTS: Of 358 family medicine residents who completed the University of Toronto program, 215 (60%) completed questionnaires at entry and exit. MAIN OUTCOME MEASURES: Changes in attitudes and plans during the residency program as ascertained from responses to entry and exit questionnaires. RESULTS: Analysis was based on 215 paired questionnaires. Women residents had more interest in obstetric practice at entry: 58% of women, but only 31% of men were interested. At graduation, fewer women (49%) and men (22%) were interested in practising obstetrics. The intent to undertake rural practice was strongly associated with the intent to practise obstetrics. By graduation, residents perceived lifestyle factors and compensation as very important negative factors in relation to obstetric practice. Initial interest and the eventual decision to practise obstetrics were strongly associated. CONCLUSIONS: Intent to practise obstetrics after graduation was most closely linked to being a woman, intending to practise in a rural area, and having an interest in obstetrics prior to residency. Building on the interest in obstetrics that residents already have could be a better strategy for producing more physicians willing to practise obstetrics than trying to change the minds of those uninterested in such practice. PMID:10099803

  14. Interdisciplinary, interinstitutional and international collaboration of family medicine researchers in Taiwan

    PubMed Central

    Lin, Yi-Hsuan; Tseng, Yen-Han; Chang, Hsiao-Ting; Lin, Ming-Hwai; Tseng, Yen-Chiang; Hwang, Shinn-Jang

    2015-01-01

    The family medicine researches flourished worldwide in the past decade. However, the collaborative patterns of family medicine publications had not been reported. Our study analyzed the collaborative activity of family medicine researchers in Taiwan. We focused on the types of collaboration among disciplines, institutions and countries. We searched “family medicine” AND “Taiwan” in address field from Web of Science and documented the disciplines, institutions and countries of all authors. We analyzed the collaborative patterns of family medicine researchers in Taiwan from 2010 to 2014. The journal’s impact factor of each article in the same publication year was also retrieved. Among 1,217 articles from 2010 to 2014, interdisciplinary collaboration existed in 1,185 (97.3%) articles, interinstitutional in 1,012 (83.2%) and international in 142 (11.7%). Public health was the most common collaborative discipline. All international researches were also interdisciplinary and interinstitutional. The United States (75 articles), the United Kingdom (21) and the People’s Republic of China (20) were the top three countries with which family medicine researchers in Taiwan had collaborated. We found a high degree of interdisciplinary and interinstitutional collaboration of family medicine researches in Taiwan. However, the collaboration of family medicine researchers in Taiwan with family medicine colleagues of other domestic or foreign institutions was insufficient. The future direction of family medicine studies could focus on the promotion of communication among family medicine researchers. PMID:26500827

  15. The Transplant Patient and Transplant Medicine in Family Practice

    PubMed Central

    Hughes, Lloyd D.

    2014-01-01

    Over the last two decades in particular there has been a remarkable increase in the number of solid organ transplants being performed worldwide alongside improvements in long-term survival rates. However, the infrastructure at transplant centres has been unable to keep pace with the current volume of the transplant patient work load. These pressures on transplant specialist centres has led to calls for an increased role of the general practitioner (GP) managing particular aspects of transplant patients’ medical care. Indeed, many aspects of follow-up care such as screening for malignancies, preventing infection through immunisation programmes, and managing cardiovascular risk factors are already important aspects of family practice medicine. This paper aims to review some of the aspects of transplant patient care that is important for healthcare workers in family practice to manage. PMID:25657941

  16. A Comparison of Students' Clinical Experience in Family Medicine and Traditional Clerkships.

    ERIC Educational Resources Information Center

    Parkerson, George R., Jr.; And Others

    1984-01-01

    Experience on the traditional internal medicine, surgery, pediatrics, obstetrics-gynecology, and psychiatry clerkships was compared with the experience on a family medicine clerkship. The family medicine clerkship offered the most experience with circulatory, respiratory, digestive, neurological, musculoskeletal, and skin problems and with…

  17. Holding Vulnerable Hands: Increasing Nontraditional Student Support and Retention through After-Hours eMentoring

    ERIC Educational Resources Information Center

    Carrier, Kristina K.

    2011-01-01

    This study investigated the use of online after-hours eMentoring as a nontraditional student support and retention strategy. The term eMentoring describes online support delivered to students electronically and through Learning Management Systems. An online university providing eMentors for student support was compared with a traditionally modeled…

  18. Commissioning for healthcare: a case study of the general practitioners After Hours Program.

    PubMed

    Carlisle, Karen; Fleming, Rhonda; Berrigan, Alison

    2016-01-01

    A strong primary healthcare system that is effective and efficient is a priority for health reform in Australia. Commissioning to support primary healthcare delivery has received increasing attention as part of healthcare reform in Australia and beyond. The aim of this paper is to present a case study of transitioning to an activity-based model for the provision of GP after-hours services in Australia. The GP After-Hours Program utilised a commissioning model that comprised of needs assessment, service development, provider engagement and evaluation. Evaluation of the new model showed a 17% increase in after-hours services, with service providers indicating that they were satisfied with the new process. Examination of the experience of implementation suggests that the commissioning model provided a useful framework for guiding activity-based funding for after-hours services. However, relational factors, such as engagement with the community, knowledge of the wider context and legitimacy of the commissioning body, can affect the implementation process. PMID:27469050

  19. After-Hours Access to the Cleveland Clinic Foundation Library Services Department: An Examination of Services.

    ERIC Educational Resources Information Center

    Bouria, Deanne Daniels

    This study was launched to address concerns about the needs of after-hours users going unmet at the Cleveland (Ohio) Clinic Foundation Library Services Department. The collection itself is available for use on the premises by clinic employees 24 hours a day, but employees do not remain on site to provide assistance, materials may not be signed out…

  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. Curriculum to enhance pharmacotherapeutic knowledge in family medicine

    PubMed Central

    Bordman, Risa; Bajcar, Jana; Kennie, Natalie; Fernandes, Lisa; Iglar, Karl

    2013-01-01

    Abstract Problem addressed Prescribing is an essential skill for physicians. Despite the fact that prescribing habits are still developing in residency, formal pharmacotherapy curricula are not commonplace in postgraduate programs. Objective of program To teach first-year and second-year family medicine residents a systematic prescribing process using a medication prescribing framework, which could be replicated and distributed. Program description A hybrid model of Web-based (www.rationalprescribing.com) and in-class seminar learning was used. Web-based modules, consisting of foundational pharmacotherapeutic content, were each followed by an in-class session, which involved applying content to case studies. A physician and a pharmacist were coteachers and they used simulated cases to enhance application of pharmacotherapeutic content and modeled interprofessional collaboration. Conclusion This systematic approach to prescribing was well received by family medicine residents. It might be important to introduce the process in the undergraduate curriculum—when learners are building their therapeutic foundational knowledge. Incorporating formal pharmacotherapeutic curriculum into residency teaching is challenging and requires further study to identify potential effects on prescribing habits. PMID:24235207

  2. [Family medicine and practice in the Mexican Social Security Institute].

    PubMed

    Casas Patiño, Donovan; Jarillo Soto, Edgar; Rodríguez Torres, Alejandra

    2014-06-26

    The central ideas of this research paper are related to the practice of family medicine as a specialty. It focuses in its origins, problems, unique characteristics, limitations, scope, management, and processes within the context of primary care of the Mexican Social Security System. This approach was based on a qualitative, hermeneutical study closely related to the Structural Functionalism Theory. Within this framework, medical practice is seen as an equation: Meaning = action + function/structure. This offers an approach to the understanding of reality through surveys and observations in five categories: identity, activity, purpose, values/norms, and power/relationship. The practice of family medicine is defined as a medical act in the Mexican Social Security Institute. This act is limited to a brief encounter and a prescription, which makes it a short, fleeting, medicalized interaction. The result is a negative social imaginary of the physician, the patient and the whole of society. Thus, individuals and society host a negative social imaginary bestowed on doctors and users of the health system.

  3. Interprofessional primary care in academic family medicine clinics

    PubMed Central

    Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz

    2012-01-01

    Abstract Objective To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Design Focus group interviews using a purposive sampling procedure. Setting Four academic family medicine clinics in Alberta. Participants Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Methods Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Main findings Our data supported the D’Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model’s main “factors” (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent “elements.” It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. Conclusion The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care. PMID:22893347

  4. Family medicine in post-communist Europe needs a boost. Exploring the position of family medicine in healthcare systems of Central and Eastern Europe and Russia

    PubMed Central

    2012-01-01

    Background The countries of Central and Eastern Europe have experienced a lot of changes at the end of the 20th century, including changes in the health care systems and especially in primary care. The aim of this paper is to systematically assess the position of family medicine in these countries, using the same methodology within all the countries. Methods A key informants survey in 11 Central and Eastern European countries and Russia using a questionnaire developed on the basis of systematic literature review. Results Formally, family medicine is accepted as a specialty in all the countries, although the levels of its implementation vary across the countries and the differences are important. In most countries, solo practice is the most predominant organisational form of family medicine. Family medicine is just one of many medical specialties (e.g. paediatrics and gynaecology) in primary health care. Full introduction of family medicine was successful only in Estonia. Conclusions Some of the unification of the systems may have been the result of the EU request for adequate training that has pushed the policies towards higher standards of training for family medicine. The initial enthusiasm of implementing family medicine has decreased because there was no initiative that would support this movement. Internal and external stimuli might be needed to continue transition process. PMID:22409775

  5. 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

  6. After hours availability of general practitioners in Canterbury/Westland: a survey.

    PubMed

    Musgrove, J P; Waghorne, M S

    1977-04-27

    The results of a postal questionnaire to 185 general practitioners in the Canterbury-Westland agea are discussed. The intention was to describe the after hours provision for patients made by general practitioners. The study indicates that about one half of doctors are on call on weekdays evenings and about a third on weekends. Only a handful of doctors provide no cover. The kind of cover provided is discussed and the patient load during such hours is analysed. Figures are presented which suggest that Canterbury practitioners are marginally younger than the national average; that most doctors (100 out of 106 responding) have formal cover arrangements; that 82% are on duty no more than one weekend a month (less often for group practitioners); that about two-thirds have a regular half-day free during the week; that about two-thirds of after hours call are judged to be justified. PMID:271815

  7. A vascular laboratory protocol for improving and managing after-hours suspected acute deep venous thrombosis.

    PubMed

    Martin, Angela H; Eckert, George; Lemmon, Gary W; Sawchuk, Alan; Dalsing, Michael C

    2014-04-01

    This study reviews the clinical and workforce impact of a suggested protocol designed for the management of suspected acute deep venous thrombosis (DVT) in patients seen after standard vascular laboratory business hours. The protocol included the use of Wells score, D-dimer and a single dose of therapeutic anticoagulant to defer venous duplex ultrasound (VDU) testing until routine business hours unless contraindicated. Information was collected on medical history, physical exam and the timing of any diagnostic studies and treatment provided. Over 15% of studies done after-hours were deemed unnecessary by our protocol and in every individual the results were negative for an acute DVT. There were no adverse events from a one-time dose of anticoagulant. Limiting emergency VDU coverage to evaluate for acute DVT based on a management protocol can eliminate unnecessary after-hours VDU testing without having a negative impact on patient care.

  8. Extending the boundaries of family medicine to perform manual procedures.

    PubMed

    Bitterman, Haim; Vinker, Shlomo

    2014-01-01

    A recent survey by Menahem and colleagues revealed that 65% of the surveyed primary care physicians reported that they performed any minor surgical procedures, and 46% reported performance of any musculoskeletal injections. Lack of allocated time and lack of training were the main reported barriers confronting higher performance rates. Healthcare systems are shifting large chunks of traditional hospital-centered activities to competent and comprehensive community-based structures. These changes are very well aligned with key trends in modern consumerism that prefer a close to home availability of medical services. Minor surgical procedures and musculoskeletal injections are good examples of medical activities that had been performed mainly by hospital and community based specialists. The syllabus of specialty training in Family Medicine in Israel includes these skills and trainees should acquire them during the residency program. We estimate that hundreds of family physicians obtain different levels of such training. Yet, only few family physicians have allocated protected time for performance of the procedures. For the skilled physician, performance of such relatively simple procedures extends his professional boundaries and the comprehensiveness of his service. For the healthcare system the "extra effort" and investment needed for performance of minor surgical procedures in primary care clinics is small. The results of the present study reflect on wider issues of care delivery. This study highlights the need for formalized and documented training of family physicians together with allocation of managerial and technical requirements needed to encourage these and similar medically and economically justified endeavors that seem to be perfectly aligned with the wishes of healthcare consumers. PMID:25383180

  9. Medical advertising: the Family Encyclopaedia of Medicine scandal of 1914.

    PubMed

    Jellinek, E H

    2008-12-01

    The past 100 years have seen a transition from a total ban in Britain on all advertising by doctors to the laity to almost total freedom of medical information, with probable benefit to public health but also a risk of loss of privacy. The Family Encyclopaedia of Medicine, written by Dr Hugh Howard Riddle and published by Lord Northcliffe's Daily Mail in 1914, started a flood of medical journalism in the press and the newer media. The lavishly advertised misattribution of its authorship to 'thirty eminent specialists', including Clifford Allbutt and William Osler, caused a major rumpus in the London Royal College of Physicians, but the fortnightly publication continued and became a four-volume book, popular with a public avid for more and more medical information.

  10. Reframing Balint: thoughts on family medicine departmental Balint groups.

    PubMed

    Stein, Howard F

    2003-04-01

    This paper explores recurrent processes and themes in the 1,300 family medicine faculty, resident, intern, and community Balint groups the author has facilitated/led. The frequent group "deviation" from the central Balint task of understanding difficult physician-patient relationships is reframed as less "resistance" or "obstacle" to work, as it is an expression of unmet developmental needs and organizational realities. When group members are carefully attended to (by facilitator and one another), the group often becomes emotionally capable of addressing a "case " in the conventional Balint understanding of the work the group has assembled to do. The group dynamics of such "hybrid" Balint groups thus become comprehensible as other than error.

  11. Medical advertising: the Family Encyclopaedia of Medicine scandal of 1914.

    PubMed

    Jellinek, E H

    2008-12-01

    The past 100 years have seen a transition from a total ban in Britain on all advertising by doctors to the laity to almost total freedom of medical information, with probable benefit to public health but also a risk of loss of privacy. The Family Encyclopaedia of Medicine, written by Dr Hugh Howard Riddle and published by Lord Northcliffe's Daily Mail in 1914, started a flood of medical journalism in the press and the newer media. The lavishly advertised misattribution of its authorship to 'thirty eminent specialists', including Clifford Allbutt and William Osler, caused a major rumpus in the London Royal College of Physicians, but the fortnightly publication continued and became a four-volume book, popular with a public avid for more and more medical information. PMID:19227968

  12. Teaching family medicine residents brief interventions for alcohol misuse.

    PubMed

    Rule, J Chris; Samuel, Pearl

    2015-01-01

    Across the lifespan, alcohol misuse affects a large percentage of patients seen in primary care clinics. It can lead to alcohol use disorders, ranging from risky use to alcohol dependence. Alcohol use disorders frequently complicate acute and chronic illnesses of patients seen in FM clinics. Screening patients for alcohol and substance use has become a standard of practice in most primary care settings. This report describes how a family medicine residency program solidified a residency curriculum in substance abuse screening, assessment, and brief intervention by merging three presentation-style didactics into a blended approach. The curriculum combines didactic teaching, motivational interviewing, and behavioral rehearsal of clinical practice skills. Qualitative feedback suggests that the curriculum has been successful in exposing residents to a variety of practical assessment methods and, through rehearsal, has improved resident confidence in addressing alcohol use and misuse in a primary care population. PMID:26130770

  13. Test ordering for preventive health care among family medicine residents

    PubMed Central

    Fung, Daisy; Schabort, Inge; MacLean, Catherine A.; Asrar, Farhan M.; Khory, Ayesha; Vandermeer, Ben; Allan, G. Michael

    2015-01-01

    Abstract Objective To determine which screening tests family medicine residents order as part of preventive health care. Design A cross-sectional survey. Setting Alberta and Ontario. Participants First- and second-year family medicine residents at the University of Alberta in Edmonton, the University of Calgary in Alberta, and McMaster University in Hamilton, Ont, during the 2011 to 2012 academic year. Main outcome measures Demographic information, Likert scale ratings assessing ordering attitudes, and selections from a list of 38 possible tests that could be ordered for preventive health care for sample 38-year-old and 55-year-old female and male patients. Descriptive and comparative statistics were calculated. Results A total of 318 of 482 residents (66%) completed the survey. Recommended or appropriate tests were ordered by 82% (for cervical cytology) to 95% (for fasting glucose measurement) of residents. Across the different sample patients, residents ordered an average of 3.3 to 5.7 inappropriate tests per patient, with 58% to 92% ordering at least 1 inappropriate test per patient. The estimated average excess costs varied from $38.39 for the 38-year-old man to $106.46 for the 55-year-old woman. More regular use of a periodic health examination screening template did not improve ordering (P = .88). Conclusion In general, residents ordered appropriate preventive health tests reasonably well but also ordered an average of 3.3 to 5.7 inappropriate tests for each patient. Training programs need to provide better education for trainees around inappropriate screening and work hard to establish good ordering behaviour in preparation for entering practice. PMID:25767171

  14. Effect of family medicine residents on use of diagnostic investigations

    PubMed Central

    Seong, Augene; Osmun, W.E.

    2014-01-01

    Abstract Objective To determine the effect of the presence of family medicine residents on the use of laboratory and imaging investigations in a rural emergency department (ED). Design A retrospective cross-sectional electronic chart audit was completed. Background characteristics, as well as type and number of ordered investigations, were compared between study groups. Setting Strathroy Middlesex General Hospital in Strathroy, Ont, a rural community hospital that sees approximately 20 000 ED visits per year. Participants A total of 2000 sequential ED visits, including adult and pediatric patients. The test group consisted of patients seen while a resident was present in the ED. The control group consisted of patients seen while no residents were present in the ED. Main outcome measures Twenty-two distinct categories of common ED investigations were studied. Results There was no statistically significant difference between study groups for 19 of the 22 categories of investigations. There were significant differences in 3 categories: an increased number of D-dimer assays for patients seen while there were no residents in the ED (1.7% of patients vs 0.5% of patients, P = .03) and increased computed tomography and ultrasound imaging for patients seen while a resident was in the ED (4.8% vs 1.8%, P = .0012, and 5.3% and 1.7%, P < .001, respectively). These differences are likely not owing to resident involvement but are explained by a difference in test availability between groups. Conclusion The study was underpowered for most categories of studied investigations. However, the trends demonstrated in this study suggest that the presence of family medicine residents in a rural community ED does not substantially affect the overall use of diagnostic investigations. PMID:25217692

  15. Students letters to patients as a part of education in family medicine.

    PubMed

    Mrduljaš-Đjujic, Nataša; Pavličević, Ivančica; Marušic, Ana; Marušic, Matko

    2012-01-01

    Family medicine fosters holistic approach to patient-centered practice. Current medical curriculum in Croatia does not have well-structured courses or tools to prepare medicals students for successful communication with the patient and for building lasting and beneficial doctor- patient relationship. We explored the value of students practice in writing letters to patients about their illness as a way of building personal and compassionate relationship with patients. Sixth year students at the School of Medicine in Split wrote letters to the patients from consultations under the supervision of the supervisor in a family medicine practice. Structured teaching of communication with the patient brings family medicine back to what has actually always been its main part- communication and doctor-patient relationship. Our future aim is to develop students letters to patients as a new tool in the family medicine course examination. Moreover, we will investigate how they can be used in everyday practice of family medicine.

  16. Interprofessional education in academic family medicine teaching units

    PubMed Central

    Price, David; Howard, Michelle; Hilts, Linda; Dolovich, Lisa; McCarthy, Lisa; Walsh, Allyn E.; Dykeman, Lynn

    2009-01-01

    ABSTRACT PROBLEM ADDRESSED The new family health teams (FHTs) in Ontario were designed to enable interprofessional collaborative practice in primary care; however, many health professionals have not been trained in an interprofessional environment. OBJECTIVE OF PROGRAM To provide health professional learners with an interprofessional practice experience in primary care that models teamwork and collaborative practice skills. PROGRAM DESCRIPTION The 2 academic teaching units of the FHT at McMaster University in Hamilton, Ont, employ 6 types of health professionals and provide learning environments for family medicine residents and students in a variety of health care professions. Learners engage in formal interprofessional education activities and mixed professional and learner clinical consultations. They are immersed in an established interprofessional practice environment, where all team members are valued and contribute collaboratively to patient care and clinic administration. Other contributors to the success of the program include the physical layout of the clinics, the electronic medical record communications system, and support from leadership for the additional clinical time commitment of delivering interprofessional education. CONCLUSION This academic FHT has developed a program of interprofessional education based partly on planned activities and logistic enablers, and largely on immersing learners in a culture of long-standing interprofessional collaboration. PMID:19752260

  17. Development and validation of a questionnaire for evaluation of students' attitudes towards family medicine.

    PubMed

    Šter, Marija Petek; Švab, Igor; Klemenc-Ketiš, Zalika; Kersnik, Janko

    2015-03-01

    The development of the EURACT (European Academy of Teachers in General Practice) Educational Agenda helped many family medicine departments in development of clerkship and the aims and objectives of family medicine teaching. Our aims were to develop and validate a tool for assessment of students' attitudes towards family medicine and to evaluate the impact of the clerkship on students' attitudes regarding the competences of family doctor. In the pilot study, experienced family doctors were asked to describe their attitudes towards family medicine by using the Educational Agenda as a template for brainstorming. The statements were paraphrased and developed into a 164-items questionnaire, which was administered to 176 final-year students in academic year 2007/08. The third phase consisted of development of a final tool using statistical analysis, which resulted in the 60-items questionnaire in six domains which was used for the evaluation of students' attitudes. At the beginning of the clerkship, person-centred care and holistic approach scored lower than the other competences. Students' attitudes regarding the competences at the end of 7 weeks clerkship in family medicine were more positive, with exception of the competence regarding primary care management. The students who named family medicine as his or her future career choice, found holistic approach as more important than the students who did not name it as their future career. With the decision tree, which included students' attitudes to the competences of family medicine, we can successfully predict the future career choice in family medicine in 93.5% of the students. This study reports on the first attempt to develop a valid and reliable tool for measuring attitudes towards family medicine based on EURACT Educational Agenda. The questionnaire could be used for evaluating changes of students' attitudes in undergraduate curricula and for prediction of students' preferences regarding their future professional

  18. Development and validation of a questionnaire for evaluation of students' attitudes towards family medicine.

    PubMed

    Šter, Marija Petek; Švab, Igor; Klemenc-Ketiš, Zalika; Kersnik, Janko

    2015-03-01

    The development of the EURACT (European Academy of Teachers in General Practice) Educational Agenda helped many family medicine departments in development of clerkship and the aims and objectives of family medicine teaching. Our aims were to develop and validate a tool for assessment of students' attitudes towards family medicine and to evaluate the impact of the clerkship on students' attitudes regarding the competences of family doctor. In the pilot study, experienced family doctors were asked to describe their attitudes towards family medicine by using the Educational Agenda as a template for brainstorming. The statements were paraphrased and developed into a 164-items questionnaire, which was administered to 176 final-year students in academic year 2007/08. The third phase consisted of development of a final tool using statistical analysis, which resulted in the 60-items questionnaire in six domains which was used for the evaluation of students' attitudes. At the beginning of the clerkship, person-centred care and holistic approach scored lower than the other competences. Students' attitudes regarding the competences at the end of 7 weeks clerkship in family medicine were more positive, with exception of the competence regarding primary care management. The students who named family medicine as his or her future career choice, found holistic approach as more important than the students who did not name it as their future career. With the decision tree, which included students' attitudes to the competences of family medicine, we can successfully predict the future career choice in family medicine in 93.5% of the students. This study reports on the first attempt to develop a valid and reliable tool for measuring attitudes towards family medicine based on EURACT Educational Agenda. The questionnaire could be used for evaluating changes of students' attitudes in undergraduate curricula and for prediction of students' preferences regarding their future professional

  19. Exploring Gaps of Family History Documentation in EHR for Precision Medicine -A Case Study of Familial Hypercholesterolemia Ascertainment.

    PubMed

    Mehrabi, Saeed; Wang, Yanshan; Ihrke, Donna; Liu, Hongfang

    2016-01-01

    In the era of precision medicine, accurately identifying familial conditions is crucial for providing target treatment. However, it is challenging to identify familial conditions without detailed family history information. In this work, we studied the documentation of family history of premature cardiovascular disease and hypercholesterolemia. The information on patients' family history of stroke within the Patient-provided information (PPI) forms was compared with the information gathered by clinicians in clinical notes. The agreement between PPI and clinical notes on absence of family history information in PPI was substantially higher compared to presence of family history. PMID:27570664

  20. Exploring Gaps of Family History Documentation in EHR for Precision Medicine -A Case Study of Familial Hypercholesterolemia Ascertainment

    PubMed Central

    Mehrabi, Saeed; Wang, Yanshan; Ihrke, Donna; Liu, Hongfang

    2016-01-01

    In the era of precision medicine, accurately identifying familial conditions is crucial for providing target treatment. However, it is challenging to identify familial conditions without detailed family history information. In this work, we studied the documentation of family history of premature cardiovascular disease and hypercholesterolemia. The information on patients’ family history of stroke within the Patient-provided information (PPI) forms was compared with the information gathered by clinicians in clinical notes. The agreement between PPI and clinical notes on absence of family history information in PPI was substantially higher compared to presence of family history. PMID:27570664

  1. Going Through Medical School and Considering the Choice of Family Medicine: Prescription or Antidote?

    ERIC Educational Resources Information Center

    Mauksch, Hans O.; And Others

    A study of the choice of specialty by medical students suggests that Family Medicine depends on students whose choice predates medical school; the number of those interested diminishes significantly over the four years. Interviews suggest several characteristics of the medical school that mitigate against the choice of family medicine and steer…

  2. 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

  3. 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

  4. Teaching adaptive leadership to family medicine residents: what? why? how?

    PubMed

    Eubank, Daniel; Geffken, Dominic; Orzano, John; Ricci, Rocco

    2012-09-01

    Health care reform calls for patient-centered medical homes built around whole person care and healing relationships. Efforts to transform primary care practices and deliver these qualities have been challenging. This study describes one Family Medicine residency's efforts to develop an adaptive leadership curriculum and use coaching as a teaching method to address this challenge. We review literature that describes a parallel between the skills underlying such care and those required for adaptive leadership. We address two questions: What is leadership? Why focus on adaptive leadership? We then present a synthesis of leadership theories as a set of process skills that lead to organization learning through effective work relationships and adaptive leadership. Four models of the learning process needed to acquire such skills are explored. Coaching is proposed as a teaching method useful for going beyond information transfer to create the experiential learning necessary to acquire the process skills. Evaluations of our efforts to date are summarized. We discuss key challenges to implementing such a curriculum and propose that teaching adaptive leadership is feasible but difficult in the current medical education and practice contexts.

  5. The economic impacts of Oklahoma's Family Medicine residency programs.

    PubMed

    Lapolla, Michael; Brandt, Edward N; Barker, Andréa; Ryan, Lori

    2004-06-01

    The enactment of Medicare and Medicaid created a new demand for medical services in Oklahoma, particularly in rural areas. The state of Oklahoma responded by creating The Oklahoma Physician Manpower Training Commission in 1975. The overall purpose of the Commission was to increase the number of primary care physicians and influence distribution into non-metro areas. This analysis concerns the public policy value of this ongoing program. The PMTC has provided resident stipend funding to each of Oklahoma's publicly funded Family Medicine residency programs. Since 1975, the PMTC has provided over 139 million dollars in resident stipend funding and support; and there have been 749 program graduates with 431 practicing in Oklahoma. This model calculates that the Oklahoma-based physicians have created a cumulative 3.7 billion dollars of economic impact on the state; and conservatively estimates that only 10% of the practice decisions/locations were influenced by the PMTC. This creates an estimated return of 370 million dollars on an "investment" of 139 million dollars. Additionally the model demonstrates that the current cohort of physicians is annually responsible for 15,530 jobs and an associated payroll of 428 million dollars. PMID:15346805

  6. [Family Medicine and university in Spain: initial reflections from a national research project].

    PubMed

    Martín Zurro, Amando; Villa, Josep Jiménez; Hijar, Antonio Monreal; Tuduri, Xavier Mundet; Puime, Angel Otero

    2011-04-01

    In 2006, a national research project was initially designed in Spain, with the basic aim of analysing the level of information on Primary Care that is available to medical students, their perception of the role of family medicine in the health system, and professional practice preferences, as well as the opinion expressed on the usefulness and need of specific teaching on primary care and family medicine during undergraduate studies. A questionnaire was prepared for each of the Spanish Faculties of Medicine to gather quantitative and qualitative data on the current situation on the teaching of primary care and family medicine. In this article, we give a short description of the characteristics of the project, the principle data obtained with this first questionnaire and, importantly, the first reflections on the academic situation of Family Medicine in Spain.

  7. Why does teaching research skills to family medicine trainees make sense?

    PubMed

    Kersnik, Janko; Ungan, Mehmet; Klemenc-Ketis, Zalika

    2015-01-01

    There are only a few countries in Europe that have incorporated research skills training in specialty training programmes. In the eyes of most practising family physicians, research traditionally is a field reserved for colleagues with academic ambitions; an activity that often is not associated with the clinical practice of family medicine. However, residents became aware that research is essential to improving healthcare provision. Research in family medicine has a long tradition. Performing or taking part in research projects opens new horizons to present and future family physicians and provides support to increase their self-esteem. Consequently, this could foster future family medicine development. The authors urge the whole family physician community to raise the awareness every single family physician towards teaching and learning research skills in specialty training and basic medical education as a generic subject. PMID:26414382

  8. Development and Validation of Search Filters to Identify Articles on Family Medicine in Online Medical Databases.

    PubMed

    Pols, David H J; Bramer, Wichor M; Bindels, Patrick J E; van de Laar, Floris A; Bohnen, Arthur M

    2015-01-01

    Physicians and researchers in the field of family medicine often need to find relevant articles in online medical databases for a variety of reasons. Because a search filter may help improve the efficiency and quality of such searches, we aimed to develop and validate search filters to identify research studies of relevance to family medicine. Using a new and objective method for search filter development, we developed and validated 2 search filters for family medicine. The sensitive filter had a sensitivity of 96.8% and a specificity of 74.9%. The specific filter had a specificity of 97.4% and a sensitivity of 90.3%. Our new filters should aid literature searches in the family medicine field. The sensitive filter may help researchers conducting systematic reviews, whereas the specific filter may help family physicians find answers to clinical questions at the point of care when time is limited.

  9. Violence against health workers in Family Medicine Centers

    PubMed Central

    Al-Turki, Nouf; Afify, Ayman AM; AlAteeq, Mohammed

    2016-01-01

    Background Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting. Objective To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia. Methods A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data. Results A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence. Conclusion Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers. PMID:27330300

  10. Personalised medicine in Canada: a survey of adoption and practice in oncology, cardiology and family medicine

    PubMed Central

    Bonter, Katherine; Currier, Nathan; Pun, Jason; Ashbury, Fredrick D

    2011-01-01

    Introduction In order to provide baseline data on genetic testing as a key element of personalised medicine (PM), Canadian physicians were surveyed to determine roles, perceptions and experiences in this area. The survey measured attitudes, practice, observed benefits and impacts, and barriers to adoption. Methods A self-administered survey was provided to Canadian oncologists, cardiologists and family physicians and responses were obtained online, by mail or by fax. The survey was designed to be exploratory. Data were compared across specialties and geography. Results The overall response rate was 8.3%. Of the respondents, 43%, 30% and 27% were family physicians, cardiologists and oncologists, respectively. A strong majority of respondents agreed that genetic testing and PM can have a positive impact on their practice; however, only 51% agreed that there is sufficient evidence to order such tests. A low percentage of respondents felt that they were sufficiently informed and confident practicing in this area, although many reported that genetic tests they have ordered have benefited their patients. Half of the respondents agreed that genetic tests that would be useful in their practice are not readily available. A lack of practice guidelines, limited provider knowledge and lack of evidence-based clinical information were cited as the main barriers to practice. Differences across provinces were observed for measures relating to access to testing and the state of practice. Differences across specialties were observed for the state of practice, reported benefits and access to testing. Conclusions Canadian physicians recognise the benefits of genetic testing and PM; however, they lack the education, information and support needed to practice effectively in this area. Variability in practice and access to testing across specialties and across Canada was observed. These results support a need for national strategies and resources to facilitate physician knowledge

  11. Exploring professional identification and reputation of family medicine among medical students: a Canadian case study.

    PubMed

    Rodríguez, Charo; Tellier, Pierre-Paul; Bélanger, Emmanuelle

    2012-05-01

    We aim to shed light on medical students' professional identification with family medicine by means of a qualitative case study examining the reputation of, and professional identification processes with, family medicine among students enrolled in a Canadian medical school, where a consistently low number of students choose family medicine as first choice for postgraduate training. Six focus groups, three for second year students and three for fourth year students, were conducted in 2007 and 2008. Transcripts from group discussions were submitted to a thematic analysis, while documentary sources supported contextualisation. All the students participating in the investigation had a clear idea about the traditional role of general practitioners (GPs). Those students who seemed to better identify with a family medicine career path were characterised by feeling comfortable with the broad scope of general medical knowledge, and with requesting a second opinion, by valuing the possibility of a diversified profile of practice, and holding strong humanistic values, as well as by being more concerned about lifestyle issues. This was observed despite an academic context that strongly encouraged medical specialisation, as students unanimously pointed out. In such circumstances, identification with family medicine by undecided medical students was hampered. In order to embed family medicine in the academic discourse of excellence, and therefore encourage students' identification with this profession, more attention should be paid to family physicians' identity formation in academic centres.

  12. Geriatric Core Competencies for Family Medicine Curriculum and Enhanced Skills: Care of Elderly

    PubMed Central

    Charles, Lesley; Triscott, Jean A.C.; Dobbs, Bonnie M.; McKay, Rhianne

    2014-01-01

    Background There is a growing mandate for Family Medicine residency programs to directly assess residents’ clinical competence in Care of the Elderly (COE). The objectives of this paper are to describe the development and implementation of incremental core competencies for Postgraduate Year (PGY)-I Integrated Geriatrics Family Medicine, PGY-II Geriatrics Rotation Family Medicine, and PGY-III Enhanced Skills COE for COE Diploma residents at a Canadian University. Methods Iterative expert panel process for the development of the core competencies, with a pre-defined process for implementation of the core competencies. Results Eighty-five core competencies were selected overall by the Working Group, with 57 core competencies selected for the PGY-I/II Family Medicine residents and an additional 28 selected for the PGY-III COE residents. The core competencies follow the CanMEDS Family Medicine roles. Both sets of core competencies are based on consensus. Conclusions Due to demographic changes, it is essential that Family Physicians have the required skills and knowledge to care for the frail elderly. The core competencies described were developed for PGY-I/II Family Medicine residents and PGY-III Enhanced Skills COE, with a focus on the development of geriatric expertise for those patients that would most benefit. PMID:24883163

  13. [Intensive care medicine from the viewpoint of patients, their family and nursing personnel].

    PubMed

    Wahl, W; Küchle, R; Schrapers, S; Junginger, T

    1998-01-01

    We wanted to know how our intensive care unit would be graded by the patients, their family members and the staff, as well as the impression that intensive care medicine made on them. A total of 82% of the patients and 90% of the family members were of the opinion that they owed their lives to intensive care medicine, and 100% of the patients and 96% of family members deemed intensive care medicine significant. The patients and their family members judged the medical and nursing care, the medical technology, the care of basic needs and their accommodation altogether positive. The nursing staff held a contrary opinion and were more critical. Competent explanation and transmission of information represented the most important factor in forming a positive opinion of intensive care medicine. PMID:9931723

  14. Assessment of the Federal Grant Program for the Establishment of Departments of Family Medicine.

    PubMed

    Lawler, F H; Davis, J A

    1990-01-01

    As part of an evaluation of the Federal Establishment of Departments of Family Medicine Grant Program, nine departments of family medicine were visited from March to May 1988 to assess their development in the academic setting and to evaluate the role of the federal program in that developmental process. The study found that grant support has been useful in enhancing the status of family medicine by aiding research and curriculum development, supporting administrative infrastructure, and fostering other topics specific to individual departments. The flexibility with which departments can seek funds for specific needs makes broad measures of success impractical; however, it appears that funds from this grant program have been reasonably effective in advancing the academic stature of departments of family medicine. It is concluded from the study that the program should be continued and that its inherent flexibility should be preserved.

  15. Family Medicine: A Solution for Career Inequalities among Doctors in India.

    PubMed

    Beswal, Gaurav

    2013-07-01

    Career in medicine is challenging. Medical education system is a ever evolving entity. Due to certain bottle necks in the medical education system, young medical graduates in India are facing difficulties in career progression. Author draws from the experience of Britain and explores how family medicine could be answer to many question which the Indian health system is challenged with. PMID:24479085

  16. After-hours Power Status of Office Equipment in the USA

    SciTech Connect

    Webber, Carrie A.; Roberson, Judy A.; McWhinney, Marla C.; Brown,Richard E.; Pinckard, Margaret J.; Busch, John F.

    2005-10-13

    Office equipment is expected to be the fastest-growingsegment of commercial energy use over the next 20 years, yet many aspectsof office equipment energy use are poorly understood. User behavior, suchas turning off devices at night or enabling power management, influencesenergy use to a great extent. The computing environment also plays a roleboth in influencing user behavior and in the success of power management.Information about turn-off rates and power management rates for officeequipment was collected through a series of after-hours audits incommercial buildings. Sixteen businesses were recruited, includingoffices (small, medium and large offices in a variety of industries),schools, and medical buildings in California, Georgia, and Pennsylvania.The types and power states of office equipment found in these buildingswere recorded and analyzed. This article presents these data forcomputers, monitors, printers, copiers, fax machines, scanners andmulti-function devices. These data can be used to improve estimates ofboth energy consumption for these devices and savings from energyconservation efforts.

  17. What can technology do to, and for, family medicine?

    PubMed

    Ebell, M H; Frame, P

    2001-04-01

    Medical technology can be divided into information technology, diagnostic technology, and therapeutic technology. These technologies can enhance the care of patients in a family practice; they also have the potential to diminish or fragment family practice when the technologies can only be provided by specialists. While some family physicians have an aversion to technological advances, we believe it is imperative that family physicians participate in the development of technologies that enhance family practice and improve patient outcomes in primary care practice. These include electronic medical records, decision support systems, tools for managing medical information, and others. Criteria are presented to help determine when these new technologies should be adopted into practice.

  18. Behavioral science in family medicine residencies: Part I. Teachers and curricula. The STFM Task Force on Behavioral Science.

    PubMed

    1985-01-01

    A survey was conducted of all members of the Society of Teachers of Family Medicine to describe teachers, curricula, and teacher satisfaction in family medicine residency behavioral science education. The response rate was approximately 60% of eligible individuals. Family medicine teachers divide themselves into behavioral scientists, family physicians, both, program directors, and other faculty members. Behavioral scientists are most often psychologists or social workers, have been teaching family medicine a relatively short time, and are more likely to be female than the other groups. Behavioral science curricula emphasize counseling, interviewing, and family dynamics. Satisfaction with behavioral curricula is high.

  19. Primary Care, Ambulatory Care, and Family Medicine: Overlapping But Not Synonymous

    ERIC Educational Resources Information Center

    Reynolds, Robert E.

    1975-01-01

    Defines and depicts graphically the relationships between primary, secondary, and tertiary care functions (from least to most intensified phases of medical care); ambulatory care (care of sick or well people not confined to bed); and family medicine (an emerging medical discipline focusing on complete and longterm care of the family). (JT)

  20. After-hours Power Status of Office Equipment and Inventory of Miscellaneous Plug-load Equipment

    SciTech Connect

    Roberson, Judy A.; Webber, Carrie A.; McWhinney, Marla C.; Brown, Richard E.; Pinckard, Margaret J.; Busch, John F.

    2004-01-22

    This research was conducted in support of two branches of the EPA ENERGY STAR program, whose overall goal is to reduce, through voluntary market-based means, the amount of carbon dioxide emitted in the U.S. The primary objective was to collect data for the ENERGY STAR Office Equipment program on the after-hours power state of computers, monitors, printers, copiers, scanners, fax machines, and multi-function devices. We also collected data for the ENERGY STAR Commercial Buildings branch on the types and amounts of ''miscellaneous'' plug-load equipment, a significant and growing end use that is not usually accounted for by building energy managers. This data set is the first of its kind that we know of, and is an important first step in characterizing miscellaneous plug loads in commercial buildings. The main purpose of this study is to supplement and update previous data we collected on the extent to which electronic office equipment is turned off or automatically enters a low power state when not in active use. In addition, it provides data on numbers and types of office equipment, and helps identify trends in office equipment usage patterns. These data improve our estimates of typical unit energy consumption and savings for each equipment type, and enables the ENERGY STAR Office Equipment program to focus future effort on products with the highest energy savings potential. This study expands our previous sample of office buildings in California and Washington DC to include education and health care facilities, and buildings in other states. We report data from twelve commercial buildings in California, Georgia, and Pennsylvania: two health care buildings, two large offices (> 500 employees each), three medium offices (50-500 employees), four education buildings, and one ''small office'' that is actually an aggregate of five small businesses. Two buildings are in the San Francisco Bay area of California, five are in Pittsburgh, Pennsylvania, and five are in Atlanta

  1. Acute asthma management by a pediatric after-hours call center.

    PubMed

    Nelson, Kyle A; Freiner, Donna; Garbutt, Jane; Trinkaus, Kathryn; Bruns, Julie; Sterkel, Randal; Smith, Sharon R; Strunk, Robert C

    2009-01-01

    To describe an asthma management protocol used in a nurse-staffed pediatric After-Hours Call Center (AHCC) that incorporates severity-based home treatment recommendations and follow-up call assessments. Call records for asthma advice from January 1, 2004 to June 30, 2004 were identified retrospectively and reviewed. Descriptive statistics were used to report patient demographics, frequencies of symptom severity zones (Red, Yellow, or Green) at initial calls, frequencies of call dispositions designating care advice provided (including home treatment recommendations and seeking emergency department [ED] care), and changes in severity zones between initial calls and follow-up calls when nurses reassessed patients after recommended home treatment. During the study period, 3,632 asthma calls (2,439 initial; 1,193 follow-up) were managed by AHCC nurses. Initial calls were classified mostly as Red (28%) or Yellow (42%) severity zones; 27% were Green zone and 3% could not be categorized. Fifty-two percent of initial calls with Red or Yellow severity zones involved home treatment recommendations; 50% of those Red zone and 63% of those Yellow zone calls had improved severity zones at follow-up call assessments. Twenty-eight percent of patients with home treatment recommendations were referred to the ED at the time of follow-up call nurse reassessment. This telephone-based nurse-staffed pediatric acute asthma management protocol includes provision of severity-based home treatment recommendations and follow-up assessments, and improved symptoms for many children with acute exacerbations. This protocol may also be successful in other locations and may improve outcomes, such as reduction in ED visits.

  2. 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

  3. [Experience and problems of implementation of family medicine in post-socialist countries].

    PubMed

    Chopey, I V

    2014-01-01

    The experience of medical-insurance organisations that provide medical services basing on family medicine principles (HMO-type organizations) shows huge potential opportunities for optimization of health care systems through family physicians operating as fundholders. The experience of training of health care specialists, in particular, family physicians at the Department of Post-Graduate Training calls for further improvement of the training in applied issues of legal, financial and economic nature that provide work of family medicine specialists under the conditions of market economy development and health insurance, in particular. In this article shows huge opportunities for optimization of financial and economic provisions of the system, as well as medical and report facility structure and network that are included in the plans of establishment of medical-insurance organizations working on the principles of family medicine and organized by family physicians. ln this regard, it is very important to provide personnel of such medical-insurance organizations with appropriate training in legal, financial and economic issues. Special attention should be paid to the training of facility administrators and managers of family medicine subunits in legal and economic issues. As this is one of the milestones of their work.

  4. 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…

  5. Family Medicine, the specialty of the future: the Portuguese situation within the European context

    PubMed Central

    2009-01-01

    General Practice/Family Medicine is a specialty focused on the provision of comprehensive, continuing, and community oriented, person-centred care. The lack of prestige and the difficulty in attracting trainees to the specialty have been longstanding problems in most countries around the world. In Europe, General Practice/Family Medicine is also hampered for not being recognized as a specialty throughout Europe. As for Portugal, General Practice/Family Medicine is undergoing a massive organizational reform, as well as unprecedented levels of popularity among trainees. General Practice/Family holds tremendous latent potential, and is thus a specialty with a bright future ahead. It could well establish itself as the specialty of the future if it is able to overcome the barriers that currently make of General Practice/Family Medicine an unpopular career choice. It is important to train confident, competent and polyvalent family physicians, but it is also necessary to overhaul payment schemes, to invest in primary care infra-structure and organization, and to continue to attract more and more bright and motivated trainees. PMID:19906299

  6. Children's psychosocial problems presenting in a family medicine practice.

    PubMed

    Wu, Yelena P; Messner, Brynne M; Roberts, Michael C

    2010-09-01

    Primary care physicians have an important role in identifying, treating, and referring children with psychosocial problems. However, there is a limited literature describing whether and how family physicians address psychosocial problems and why parents may not discuss children's problems with physicians. The current study examined how family physicians address psychosocial problems and reasons that parents do not discuss children's psychosocial problems with physicians. Results indicated that there are a variety of reasons involving parents, their perceptions of physicians, and the number of psychosocial problems reported, that may lead to fewer discussions of psychosocial problems. PMID:20508977

  7. Weaving public health education into the fabric of a family medicine residency.

    PubMed

    Potts, Stacy E; Deligiannidis, Konstantinos E; Cashman, Suzanne B; Caggiano, Marie E; Carter, Lisa H; Haley, Heather-Lyn; Ferguson, Warren J

    2011-10-01

    Policymakers and accrediting bodies have recognized the importance of integrating public health, population health, and prevention into graduate medical education programs. The high prevalence of chronic illness, coupled with the impact of behavioral and societal determinants of health, necessitate an urgent call for family medicine residencies to prepare future leaders to meet these challenges. The University of Massachusetts Worcester Family Medicine Residency recently developed an integrated curriculum that strives to develop a culture of incorporating fundamental public health principles into everyday practice. This public health curriculum was designed to integrate new topics within the current residency structure through longitudinal and concentrated experiences. This strategy has substantially improved public health and prevention education without substantial impact on the already strained residency curricular structure. This paper describes the integration of public health and prevention education into a family medicine residency to help residents acquire the fundamental skills necessary to improve a population's health.

  8. [USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE AMONG FAMILY MEDICINE PATIENTS--EXAMPLE OF THE TOWN OF ČAKOVEC].

    PubMed

    Vitale, Ksenija; Munđar, Roko; Sović, Slavica; Bergman-Marković, Biserka; Janev Holcer, Nataša

    2014-12-01

    The use of complementary and alternative medicine (CAM) is widespread around the world including Croatia. The number of studies that investigate both quantitative and qualitative use of CAM in Croatia is limited. The aim of this study was to investigate the use of CAM among family medicine patients in the town of Čakovec and the rate they report it to their family doctor. This was a cross-sectional study in a sample of 300 patients that visited primary health center for any reason. We used anonymous questionnaire already employed in a previous investigation (Čižmešija et al. 2008), which describes socioeconomic characteristics, modalities of CAM use, and reasons for use. We also added questions on the type of herbs used and use of over-the-counter vitamin and mineral supplements. On data analysis we used descriptive statistics, χ2-test and Fisher's exact test, while the level of statistical significance was set at p ≤ 0.05. The response rate was 76%. Out of the total number of patients, 82% used some modality of CAM. Women, patients with secondary school education, employed and retired persons used CAM more often. Students and pupils reported least use of CAM. The most commonly used were herbs (87%), bioenergy (29%), diet therapy (28%), chiropractics (22%), and homeopathy and acupuncture (11% each). Vitamin and mineral supplements were used by 77% of study subjects. CAM was most frequently used for respiratory, urinary and musculoskeletal problems, as well as to improve overall health condition. Of the respondents that reported CAM use, 55% believed it would help them, 43% used it because they wanted to try something new, while only 2% indicated dissatisfaction with their physician as the reason for using CAM. Statistically, there were more subjects that used CAM and did not notify their family doctor about it, which could indicate poor communication between family doctors and health care users. Our results are consistent with a previous quantitative study

  9. A Problem-Solving Oral Examination for Family Medicine

    ERIC Educational Resources Information Center

    Van Wart, Arthur D.

    1974-01-01

    The College of Family Physicians of Canada has used in its certification examination a new type of structured problem-solving examination called the Formal Oral. A series of preselected problem areas such as the complaint, relevant data base, investigation, and treatment are scored by two examiners. (Editor/PG)

  10. Cancer Risk Assessment by Rural and Appalachian Family Medicine Physicians

    ERIC Educational Resources Information Center

    Kelly, Kimberly M.; Love, Margaret M.; Pearce, Kevin A.; Porter, Kyle; Barron, Mary A.; Andrykowski, Michael

    2009-01-01

    Context: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region. Purpose: To examine primary care physicians' identification of hereditary cancers. Methods: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United…

  11. Osteoporosis guideline implementation in family medicine using electronic medical records

    PubMed Central

    Pritchard, Janet; Karampatos, Sarah; Ioannidis, George; Adachi, Jonathan; Thabane, Lehana; Nash, Lynn; Mehan, Upe; Kozak, Joseph; Feldman, Sid; Hirsch, Steve; Jovaisas, Algis V.; Cheung, Angela; Lohfeld, Lynne; Papaioannou, Alexandra

    2016-01-01

    Abstract Objective To identify family physicians’ learning needs related to osteoporosis care; determine family physicians’ preferred modes of learning; and identify barriers to using electronic medical records (EMRs) to implement osteoporosis guidelines in practice. Design Web-based survey. Setting Ontario. Participants Family physicians. Main outcome measures Quantitative and qualitative data about learning needs related to osteoporosis diagnosis and management; preferred mode of learning about guidelines; and barriers to using EMRs to implement guidelines. Results Of the 12 332 family physicians invited to participate in the survey, 8.5% and 7.0% provided partial or fully completed surveys, respectively. More than 80% of respondents agreed that the priority areas for education were as follows: selecting laboratory tests for secondary osteoporosis and interpreting the test results; interpreting bone mineral density results; determining appropriate circumstances for ordering anterior-posterior lumbar spine x-ray scans; and understanding duration, types, and adverse effects of pharmacotherapy. Qualitative analysis revealed that managing moderate-risk patients was a learning need. Continuing medical education was the preferred mode of learning. Approximately 80% of respondents agreed that the scarcity of EMR tools to aid in guideline implementation was a barrier to using guidelines, and 50% of respondents agreed that if EMR-embedded tools were available, time would limit their ability to use them. Conclusion This survey identified key diagnostic- and treatment-related topics in osteoporosis care that should be the focus of future continuing professional development for family physicians. Developers of EMR tools, physicians, and researchers aiming to implement guidelines to improve osteoporosis care should consider the potential barriers indicated in this study.

  12. Argentine folk medicine: genotoxic effects of Chenopodiaceae family.

    PubMed

    Gadano, A B; Gurni, A A; Carballo, M A

    2006-01-16

    Chenopodium ambrosioides L. and Chenopodium multifidum L. (Chenopodiaceae), common name: Paico, are medicinal plants. They are aromatic shrubs growing in South America. For centuries, they have been used due to its medicinal properties. However, there are few reports in literature about the genotoxic effects of these plants. There for, the aim of these work is the evaluation of genetic damage induced by decoction and infusion of this plants which were assayed in different concentrations (1, 10, 100, 1,000 microL extract/mL culture), by addition of the extract to human lymphocyte cell cultures, negative controls were included. The endpoints evaluated were chromosomal aberrations (CA), sister chromatid exchanges (SCE), cell proliferation kinetics (CPK) and mitotic index (MI). The repeated measure analysis of variance was used for statistic evaluation of the results. The results showed: (a) statistical increase in the percentage of cells with CA and in the frequency of SCE when cultures were exposed to both aromatic plants, (b) a decrease in MI of both Paicos assayed, although no modification in the CPK values was observed, (c) no effect was noticed in the analysis of Chenopodium album L., which was used as negative control of the essential oil. These results suggest a cyto and genotoxic effect of Chenopodium ambrosioides and Chenopodium multifidum aqueous extracts related to the essential oil of the plant (as Chenopodium album did not perform).

  13. Argentine folk medicine: genotoxic effects of Chenopodiaceae family.

    PubMed

    Gadano, A B; Gurni, A A; Carballo, M A

    2006-01-16

    Chenopodium ambrosioides L. and Chenopodium multifidum L. (Chenopodiaceae), common name: Paico, are medicinal plants. They are aromatic shrubs growing in South America. For centuries, they have been used due to its medicinal properties. However, there are few reports in literature about the genotoxic effects of these plants. There for, the aim of these work is the evaluation of genetic damage induced by decoction and infusion of this plants which were assayed in different concentrations (1, 10, 100, 1,000 microL extract/mL culture), by addition of the extract to human lymphocyte cell cultures, negative controls were included. The endpoints evaluated were chromosomal aberrations (CA), sister chromatid exchanges (SCE), cell proliferation kinetics (CPK) and mitotic index (MI). The repeated measure analysis of variance was used for statistic evaluation of the results. The results showed: (a) statistical increase in the percentage of cells with CA and in the frequency of SCE when cultures were exposed to both aromatic plants, (b) a decrease in MI of both Paicos assayed, although no modification in the CPK values was observed, (c) no effect was noticed in the analysis of Chenopodium album L., which was used as negative control of the essential oil. These results suggest a cyto and genotoxic effect of Chenopodium ambrosioides and Chenopodium multifidum aqueous extracts related to the essential oil of the plant (as Chenopodium album did not perform). PMID:16219440

  14. The development of academic family medicine in central and eastern Europe since 1990

    PubMed Central

    2013-01-01

    Background Since the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries. Methods A key informants study, using a questionnaire developed on the basis of a systematic literature review and panel discussions, conducted in 11 central and eastern European countries and Russia. Results Family medicine in CEE countries is now formally recognized as a medical specialty and successfully introduced into medical training at undergraduate and postgraduate levels. Almost all universities have FM/GP departments, but only a few of them are led by general practitioners. The specialist training programmes in all countries except Russia fulfil the recommendations of the European Parliament. Structured support for research in FM/GP is not always available. However specific scientific organisations function in almost all countries except Russia. Scientific conferences are regularly organised in all the countries, but peer-reviewed journals are published in only half of them. Conclusions Family medicine has a relatively strong position in medical education in central and eastern Europe, but research in family practice is less developed. Although the position of the discipline at the universities is not very strong, most of the CEE countries can serve as an example of successful academic development for countries southern Europe, where family medicine is still not fully recognised. PMID:23510461

  15. Practising family medicine for adults with intellectual disabilities

    PubMed Central

    Baumbusch, Jennifer; Phinney, Alison; Baumbusch, Sarah

    2014-01-01

    Abstract Objective To explore the perspectives of adults with intellectual disabilities (IDs) on helpful interactions with their family physicians. Design Exploratory, qualitative study. Setting Vancouver, BC. Participants Purposive sample of 11 community-dwelling adults with IDs. Methods In-depth, semistructured interviews were conducted face to face with participants. Interviews were audiorecorded and transcribed verbatim. Research team members read the transcripts, which were then coded into categories and subcategories and discussed at collective analysis meetings. The main study themes were generated through this iterative, collective process. Main findings Two themes about helpful interactions were identified: helping patients understand and helping patients navigate the health care system. The first theme reflected helpful ways of communicating with patients with IDs. These approaches focused on plain-language communication and other strategies developed jointly by the patients and their physicians. The second theme reflected ways in which the family physicians helped adults with IDs manage their health needs despite the complex constraints of their socioeconomic situations. Conclusion Adults with IDs want to play an active role in managing their health as they age, and helpful interactions with family physicians make this possible. PMID:25022654

  16. A Significant Number of Charter Diplomates Participate in American Board of Family Medicine (ABFM) Maintenance of Certification.

    PubMed

    Puffer, James C

    2015-01-01

    Considerable controversy about the value of participating in Maintenance of Certification has recently arisen within the medical community. Despite this controversy, large numbers of family physicians certified by the American Board of Family Medicine participate in Maintenance of Certification for Family Physicians. Surprisingly, a small but significant number of charter diplomats--those initially certified by the American Board of Family Medicine at its founding--are engaged in the process.

  17. 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

  18. Family medicine in Denmark: Are there lessons for Botswana and Africa?

    PubMed Central

    2016-01-01

    Family medicine is a new specialty in Botswana and many African countries and its definition and scope are still evolving. In this region, healthcare is constrained by resource limitation and inefficiencies in resource utilisation. Experiences in countries with good health indicators can help inform discussions on the future of family medicine in Africa. Observations made during a visit to family physicians (FPs) in Denmark showed that the training of FPs, the practice of family medicine and the role of support staff in a family practice were often different and sometimes unimaginable by African standards. Danish family practices were friendly and enmeshed in an egalitarian and efficient health system, which is supported by an effective information technology network. There was a lot of task shifting and nurses and clerical staff attended to simple or uncomplicated aspects of patient care whilst FPs attended to more complicated patient problems. Higher taxation and higher health expenditure seemed to undergird the effective health system. An egalitarian relationship amongst patients and healthcare workers (HCW) may help improve patient care in Botswana. Task shifting should be formalised, and all sectors of primary healthcare should have fast and effective information technology systems. HCW training and roles should be revised. Higher health expenditure is necessary to achieve good health indicators. PMID:27247159

  19. [The use of medicines storaged in the household in a population assisted by Family Health Program].

    PubMed

    Lima, Geandra Batista; Nunes, Lívio César Cunha; de Barros, José Augusto Cabral

    2010-11-01

    To approach the epidemiological use of medicines is necessary to recognize that such practice is not strictly limited to pharmacotherapy. The appropriate storage and the preservation of medicines are fundamental factors for effectiveness. This study was aimed at verifying the storage form/use of medicines in a community assisted by the Family Health Program in the district of Cristino Castro (PI, Brazil), as well as the level of the people's knowledge regarding drugs storage at home. The data were obtained visiting 52 families, starting with observations and applying a questionnaire. It was observed a low income and education levels, a fact that contributes in the effective therapeutic orientation. High percentage of the stored medicines is acquired without prescription. It is worth of mention the presence of a big amount of antimicrobial, reinforcing the danger of the self medication. 62% of those who take care of drugs have no information about their rational use, and 66% are not conscious of the toxicity. 54.10% of the medicines were at children's and domestic animals reach and 15.92% didn't possess label or any identification. Some families maintain in stock, basic medications, another accumulate a "therapeutic arsenal".

  20. Back to the future: reflections on the history of the future of family medicine.

    PubMed

    Doohan, Noemi C; Endres, Jill; Koehn, Nerissa; Miller, John; Scherger, Joseph E; Martin, James; Devoe, Jennifer E

    2014-01-01

    These are historic times for family medicine. The profession is moving beyond the visionary blueprint of the Future of Family Medicine (FFM) report while working to harness the momentum created by the FFM movement. Preparing for, and leading through, the next transformative wave of change (FFM version 2.0) will require the engagement of multigenerational and multidisciplinary visionaries who bring wisdom from diverse experiences. Active group reflection on the past will potentiate the collective work being done to best chart the future. Historical competency is critically important for family medicine's future. This article describes the historical context of the development and launch of the FFM report, emphasizing the professional activism that preceded and followed it. This article is intended to spark intergenerational dialog by providing a multigenerational reflection on the history of FFM and the evolution that has occurred in family medicine over the past decade. Such intergenerational conversations enable our elders to share wisdom with our youth, while allowing our discipline to visualize history through the eyes of future generations. PMID:25381082

  1. Multi-Source Evaluation of Interpersonal and Communication Skills of Family Medicine Residents

    ERIC Educational Resources Information Center

    Leung, Kai-Kuen; Wang, Wei-Dan; Chen, Yen-Yuan

    2012-01-01

    There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and…

  2. Acting as Standardized Patients Enhances Family Medicine Residents' Self-Reported Skills in Palliative Care

    ERIC Educational Resources Information Center

    Sittikariyakul, Pat; Jaturapatporn, Darin; Kirshen, A. J.

    2015-01-01

    Recent publications have confirmed the use of standardized patients (SPs) in improving clinical skills and enhancing competency. Little research has studied the benefits residents may themselves gain in palliative care playing the role of SPs. Nineteen Family Medicine residents were recruited as standardized patients (FMR-SPs) for a mandatory…

  3. Clinical Poems and Clinical Conversations: Some Thoughts on Working with Family Medicine Residents

    ERIC Educational Resources Information Center

    Stein, Howard F.

    2006-01-01

    This paper describes an experiment in which Family Medicine residents composed, read, and discussed their poems as a way of bringing to life their often complex relationships with patients. It argues that this approach mobilizes the physicians' own creativity in the service of reflective practice and improved doctor-patient relationships. This…

  4. Health Literacy Teaching in U.S. Family Medicine Residency Programs: A National Survey.

    PubMed

    Coleman, Clifford A; Nguyen, Nancy T; Garvin, Roger; Sou, Channbunmorl; Carney, Patricia A

    2016-01-01

    Health care providers, including medical residents, often lack adequate knowledge and skills to work effectively with patients who have limited health literacy. Little is known about the degree to which medical residents are trained to communicate effectively with people who have limited health literacy. This study aimed to assess the status of health literacy training for physicians in U.S. family medicine residency programs. We conducted an online survey of residency directors at 444 U.S. family medicine residencies. Among 138 respondents (31% response rate), 58 programs (42%) reported teaching residents about health literacy as part of the required curriculum. Most instruction occurred during the 1st year of training. Hours of instruction ranged from 2 to 5 during Years 1 through 3. Skills-based training (e.g., plain language techniques) was taught by most programs. Not having access to a faculty authority on health literacy was strongly associated with lack of a required health literacy curriculum. Respondents overwhelmingly agreed that increasing health literacy training for medical students and residents would help improve residents' clinical skills. This study provides a baseline snapshot of health literacy curricula in U.S. family medicine residencies and likely overestimates the prevalence of such curricula. Additional studies are needed to determine the quality of health literacy instruction in U.S. family medicine residencies and the most effective methods for teaching residents about health literacy. PMID:27043758

  5. Monetary Value of a Prescription Assistance Program Service in a Rural Family Medicine Clinic

    ERIC Educational Resources Information Center

    Whitley, Heather P.

    2011-01-01

    Purpose: To quantify the monetary value of medications provided to rural Alabamians through provision of pharmaceutical manufacturer-sponsored prescription assistance programs (PAPs) provided by a clinical pharmacist in a private Black Belt family medicine clinic during 2007 and 2008. Methods: Patients struggling to afford prescription medications…

  6. Development of a Competency Framework for Quality Improvement in Family Medicine: A Qualitative Study

    ERIC Educational Resources Information Center

    Czabanowska, Katarzyna; Klemenc-Ketis, Zalika; Potter, Amanda; Rochfort, Andree; Tomasik, Tomasz; Csiszar, Judit; Van den Bussche, Piet

    2012-01-01

    Objective: The aim of this study was to develop a comprehensive framework of quality improvement competencies for use in continuing professional development (CPD) and continuing medical education (CME) for European general practice/family medicine physicians (GPs/FDs). Methods: The study was carried out in three phases: literature review,…

  7. Chinese herbal medicine and acupuncture. How do patients who consult family physicians use these therapies?

    PubMed Central

    Wong, L. K.; Jue, P.; Lam, A.; Yeung, W.; Cham-Wah, Y.; Birtwhistle, R.

    1998-01-01

    OBJECTIVE: To determine how a population of Chinese patients consulting family physicians in Vancouver use traditional Chinese medicine (TCM), specifically Chinese herbal medicine and acupuncture. DESIGN: Bilingual survey (English and Chinese). SETTING: Four family practices with predominantly Chinese patients in metropolitan Vancouver. PARTICIPANTS: The 932 patients or family members who visited one of the practices. MAIN OUTCOME MEASURES: Demographic characteristics; frequency and reason for visiting a family physician, Chinese herbalist, or acupuncturist; choice of practitioner if affected by one of 16 common conditions. RESULTS: The study population was mostly Chinese and immigrant to Canada. Chinese herbal medicine was currently used by 28% (262/930) of respondents (more than one visit in the last year), and another 18% (172/930) were past users. Acupuncture was currently used by 7% (64/927) and had been used in the past by another 8% (71/927). Use of Chinese herbal medicine varied significantly (P < .01) according to age, sex, immigrant status, and ethnicity. Acupuncture use varied significantly only by age. The main reasons for consulting Chinese herbalists were infection (41%, 157/382), respiratory problems (11%, 42/382), and rheumatologic problems (10%, 38/382), whereas acupuncturists were consulted almost exclusively for rheumatologic problems (80%, 45/56). CONCLUSIONS: Using TCM in conjunction with visiting family physicians was very popular among this predominantly Chinese study population. Patients with acute conditions, such as influenza, consulted both their family physicians and Chinese herbalists in quick succession. On the other hand, those suffering from more chronic conditions, such as rheumatologic diseases, were more likely to start using TCM after repeated visits to their family physicians. Images p1011-a PMID:9612586

  8. [Trends in family medicine--how to sort the wheat from the chaff].

    PubMed

    Djalali, Sima; Senn, Oliver

    2015-11-11

    Considering the trends in medicine, time just seems to move at a slower pace in general practice/family medicine than in the medical specialties. Novel medical drugs and therapeutic modalities appear to take longer to become well-established, and sometimes it never happens. There are obvious gaps between the requirements of the guidelines issued by scientific medical societies and the practical implementation of these guidelines by primary care physicians. In health services research this is known as the «evidence-performance gap». The aim of this narrative review is to outline the nature and the dynamics of trends in general practice/family medicine on the one hand and in the medical specialties on the other hand, and to elucidate the potential causes leading to the evidence-performance gaps observed.

  9. Family medicine in Denmark: Are there lessons for Botswana and Africa?

    PubMed

    Setlhare, Vincent

    2016-01-01

    Family medicine is a new specialty in Botswana and many African countries and its definitionand scope are still evolving. In this region, healthcare is constrained by resource limitation andinefficiencies in resource utilisation. Experiences in countries with good health indicators canhelp inform discussions on the future of family medicine in Africa. Observations made duringa visit to family physicians (FPs) in Denmark showed that the training of FPs, the practice offamily medicine and the role of support staff in a family practice were often different andsometimes unimaginable by African standards. Danish family practices were friendly andenmeshed in an egalitarian and efficient health system, which is supported by an effectiveinformation technology network. There was a lot of task shifting and nurses and clerical staffattended to simple or uncomplicated aspects of patient care whilst FPs attended to morecomplicated patient problems. Higher taxation and higher health expenditure seemed toundergird the effective health system. An egalitarian relationship amongst patients andhealthcare workers (HCW) may help improve patient care in Botswana. Task shifting shouldbe formalised, and all sectors of primary healthcare should have fast and effective informationtechnology systems. HCW training and roles should be revised. Higher health expenditure isnecessary to achieve good health indicators. PMID:27247159

  10. The practice of travel medicine by family practitioners.

    PubMed

    Ross, M; Pinto, I; Sparks, B

    1995-06-01

    This study sought to determine the prevalence of family practitioners (FPs) in Johannesburg, South Africa, who are consulted by travelers. The study quantified the extent of medical activity of FPs and determined sources of physicians' updating information. Data were obtained from a random sample of 180 of the 576 nonspecialists listed as private medical practitioners in 1992-93 in the Johannesburg telephone directory. Interviews were obtained from 109 practitioners, of whom 105 were consulted by travelers. The average rate of consultations was an estimated 30/FP. Over 90% of FPs were asked about malaria prevention and/or immunization. 98% provided advice on malaria, and over 80% administered immunizations. The most common vaccine was Hepatitis B (63%), followed by gamma globulin for Hepatitis A (58%), and tetanus toxoid (50%). It was common for FPs to recommend antidiarrheal medications. Clients did not generally ask about diarrhea prevention. 47% gave preventive advice alone on diarrhea or recommendations for medication. FPs kept up to date on medical affairs by reading professional journals and following local experts or colleagues. In 1992, an estimated 100,000 travelers visited FPs in Johannesburg. PMID:12178510

  11. [Diet as a cardiovascular risk factor in family medicine].

    PubMed

    Bergman Marković, Biserka; Katić, Milica; Vrdoljak, Davorka; Kranjcević, Ksenija; Jasna, Vucak; Ivezić Lalić, Dragica

    2010-05-01

    Although Mediterranean country by its geographic position, according to cardiovascular mortality (CVM) rate, Croatia belongs to Central-East European countries with high CV mortality. Prevention by changing nutritional habits is population (public health programmes) or individually targeted. General practitioner (GP) provides care for whole person in its environment and GP's team plays a key role in achieving lifestyle changes. GPs intervention is individually/group/family targeted by counselling or using printed leaflets (individual manner, organized programmes). Adherence to lifestyle changes is not an easy task; it is higher when recommendations are simple and part of individually tailored programme with follow- ups included. Motivation is essential, but obstacles to implementation (by patient and GPs) are also important. Nutritional intervention influences most important CV risk factors: cholesterol level, blood pressure (BP), diabetes. Restriction in total energy intake with additional nutritional interventions is recommended. Lower animal fat intake causes CVM reduction by 12%, taking additional serving of fruit/day by 7% and vegetables by 4%. Restriction of dietary salt intake (3 g/day) lowers BP by 2-8 mm Hg, CVM by 16%. Nutritional intervention gains CHD and stroke redact in healthy adults (12%, 11% respectively). Respecting individual lifestyle and nutrition, GP should suggest both home cooking and careful food declaration reading and discourage salt adding. Recommended daily salt intake is < or =6 g. In BP lowering, salt intake restriction (10-12 to 5-6 g/day) is as efficient as taking one antihypertensive drug. Lifestyle intervention targeting nutritional habits and pharmacotherapy is the most efficient combination in CV risk factors control.

  12. The Future of Family Medicine version 2.0: reflections from Pisacano scholars.

    PubMed

    Doohan, Noemi C; Duane, Marguerite; Harrison, Bridget; Lesko, Sarah; DeVoe, Jennifer E

    2014-01-01

    The Future of Family Medicine (FFM) project has helped shape and direct the evolution of primary care medicine over the past decade. Pisacano Scholars, a group of leaders in family medicine supported by the American Board of Family Medicine, gathered for a 2-day symposium in April 2013 to explore the history of the FFM project and outline a vision for the next phase of this work-FFM version 2.0 (v2.0). After learning about the original FFM project (FFM v1.0), the group held interactive discussions using the World Café approach to conversational leadership. This commentary summarizes the discussions and highlights major themes relevant to FFM v2.0 identified by the group. The group endorsed the FFM v1.0 recommendations as still relevant and marvelled at the progress made toward achieving many of those goals. Most elements of FFM v1.0 have moved forward, and some have been incorporated into policy blueprints for reform. Now is the time to refocus attention on facets of FFM v1.0 not yet realized and to identify key aspects missing from FFM v1.0. The Pisacano Scholars are committed to moving the FFM goals forward and hope that this expression of the group's vision will help to do so. PMID:24390896

  13. The Future of Family Medicine version 2.0: reflections from Pisacano scholars.

    PubMed

    Doohan, Noemi C; Duane, Marguerite; Harrison, Bridget; Lesko, Sarah; DeVoe, Jennifer E

    2014-01-01

    The Future of Family Medicine (FFM) project has helped shape and direct the evolution of primary care medicine over the past decade. Pisacano Scholars, a group of leaders in family medicine supported by the American Board of Family Medicine, gathered for a 2-day symposium in April 2013 to explore the history of the FFM project and outline a vision for the next phase of this work-FFM version 2.0 (v2.0). After learning about the original FFM project (FFM v1.0), the group held interactive discussions using the World Café approach to conversational leadership. This commentary summarizes the discussions and highlights major themes relevant to FFM v2.0 identified by the group. The group endorsed the FFM v1.0 recommendations as still relevant and marvelled at the progress made toward achieving many of those goals. Most elements of FFM v1.0 have moved forward, and some have been incorporated into policy blueprints for reform. Now is the time to refocus attention on facets of FFM v1.0 not yet realized and to identify key aspects missing from FFM v1.0. The Pisacano Scholars are committed to moving the FFM goals forward and hope that this expression of the group's vision will help to do so.

  14. Family medicine's search for manpower: the American Osteopathic Association accreditation option.

    PubMed

    Cummings, Mark; Kunkle, Judith L; Doane, Cheryl

    2006-03-01

    In recent years, family medicine has encountered problems recruiting and filling its Accreditation Council for Graduate Medical Education (ACGME)-accredited residencies. In addressing these reverses, one increasingly popular strategy has been to acquire American Osteopathic Association (AOA) accreditation as a way to tap into the growing number of osteopathic graduates. This stratagem is founded on assumptions that parallel-accredited postdoctoral programs are attractive to doctor of osteopathy (DO) graduates, that collaboration with sponsoring colleges of osteopathic medicine (COMs) provides direct access to osteopathic students, and that DOs can play an important role in replacing the increasing scarcity of United States medical graduates who are selecting specialty residencies. Within the past 5 years, nearly 10% of all ACGME family medicine residency programs have voluntarily obtained a second level of accreditation to also qualify as AOA-accredited family medicine residency programs. This strategy has produced mixed outcomes, as noted from the results of the osteopathic matching program. The flood of osteopathic graduates into these parallel-accredited programs has not occurred. In addition, recent AOA policy changes now require ACGME-accredited programs to make a deeper educational commitment to osteopathic postdoctoral education. The most successful ACGME/AOA-accredited programs have been those that are closely affiliated with and in near proximity of a COM and also train osteopathic students in required clerkship rotations. PMID:16518739

  15. Family Physicians with a Certificate of Added Qualifications (CAQs) in Sports Medicine Spend the Majority of Their Time Practicing Sports Medicine.

    PubMed

    Rankin, Wade M; Cochrane, Anneli; Puffer, James C

    2015-01-01

    While family physicians holding certificates of added qualifications in sports medicine practice in multiple settings, little is currently known about the proportion of their time devoted exclusively to the practice of sports medicine. We found that most spend a majority of their time doing so, and this number has been increasing over the past decade.

  16. African leaders’ views on critical human resource issues for the implementation of family medicine in Africa

    PubMed Central

    2014-01-01

    Background The World Health Organisation has advocated for comprehensive primary care teams, which include family physicians. However, despite (or because of) severe doctor shortages in Africa, there is insufficient clarity on the role of the family physician in the primary health care team. Instead there is a trend towards task shifting without thought for teamwork, which runs the risk of dangerous oversimplification. It is not clear how African leaders understand the challenges of implementing family medicine, especially in human resource terms. This study, therefore, sought to explore the views of academic and government leaders on critical human resource issues for implementation of family medicine in Africa. Method In this qualitative study, key academic and government leaders were purposively selected from sixteen African countries. In-depth interviews were conducted using an interview guide. All interviews were audio-recorded, transcribed and thematically analysed. Results There were 27 interviews conducted with 16 government and 11 academic leaders in nine Sub-Saharan African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Malawi, Nigeria, Rwanda, South Africa and Uganda. Respondents spoke about: educating doctors in family medicine suited to Africa, including procedural skills and holistic care, to address the difficulty of recruiting and retaining doctors in rural and underserved areas; planning for primary health care teams, including family physicians; new supervisory models in primary health care; and general human resource management issues. Conclusions Important milestones in African health care fail to specifically address the human resource issues of integrated primary health care teamwork that includes family physicians. Leaders interviewed in this study, however, proposed organising the district health system with a strong embrace of family medicine in Africa, especially with regard to providing clinical leadership in team

  17. Profile of Diseases Prevalent in a Tribal Locality in Jharkhand, India: A Family Medicine Practitioner's Perspective

    PubMed Central

    Kumar, Sumit

    2015-01-01

    Background: Majority of Indian population is dependent on general practitioners (GPs) for medical services at primary care level in India. They are most preferred and considered to be first contact person for medical services at primary care level. But advances in medical science has put more emphasis on specialist culture and average Bachelor of Medicine and Bachelor of Surgery (MBBS) graduates who are working as general physician are gradually feeling themselves less competent because they are less exposed to latest advances in treatment of diseases. Amidst such scenario, Christian Medical College (CMC) has come up with an idea: “The refer less and resolve more initiative”. It has started a decentralized 2-year family medicine distance diploma course (Postgraduate Diploma in Family Medicine (PGDFM)) now accredited by Dr. MGR Medical University, Chennai, Tamil Nadu, that trains the GPs to become family medicine specialist. Materials and Methods: As component of PGDFM course, this study was conducted to provide better understanding of prevalent ailments and common treatment provided by the GPs in the community at present giving key insight of current practice in rural area by a registered family medicine practitioner. Results: As part of study, among 500 patients evaluated, three most common diagnosis were upper respiratory infections (URIs; 18%), acute gastroenteritis including water-borne diseases (15.8%), and anemia (10.4%). Treatment given to these patients comprised of mostly of antipyretic, analgesic, and antimicrobial agents. Most common drug prescribed was paracetamol for fever. Other common drugs prescribed were amoxicillin/clavulanic acid, chloroquine, artemisin derivative, doxycycline, co-trimoxazole, miltefosine, cephalexin, ceftriaxone sodium, cefixime, oral rehydration salts, ranitidine, omeprazole, pantoprazole, metronidazole, albendazole, ondansetron, diclofenac sodium, piroxicam, ibuprofen, diphenhydramine, codeine-sulfate, amlodipine, ramipril

  18. 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

  19. Reform in the United States: its impact on medicine and education for family practice.

    PubMed

    Stephens, G G

    1976-10-01

    The historical concept of reform is useful as an aid to understand the modern rise of family practice education. Beginning about 1890, historians have identified several themes of reform in the United States which have been expressed culturally, politically, and socially. Each of these themes, agrarianism, bureaucratization of the professions, and utopianism, has influenced medicine and medical education--first at the turn of the century in the activities of the AMA in promoting public health and in establishing the natural sciences as a basis for medical education and practice. Since the end of World War II, additional reform themes have become visible which are also influencing medicine. Among these are humanism, consumerism, and the women's movement. It is the author's thesis that the present vitality and future development of family practice as a discipline is more dependent on its capacity and willingness to be identified with these expressions of reform than on its negotiations and compromises within the medical education establishment.

  20. Federal Research Funding for Family Medicine: Highly Concentrated, with Decreasing New Investigator Awards.

    PubMed

    Cameron, Brianna J; Bazemore, Andrew W; Morley, Christopher P

    2016-01-01

    A small proportion of National Institutes of Health and other federal research funding is received by university departments of family medicine, the largest primary care specialty. That limited funding is also concentrated, with roughly a quarter of all National Institutes of Health, Centers for Disease Control and Prevention, and Agency for Healthcare Research and Quality funding awarded to 3 departments, almost half of that funding coming from 3 agencies, and a recent trend away from funding for new investigators.

  1. Federal Research Funding for Family Medicine: Highly Concentrated, with Decreasing New Investigator Awards.

    PubMed

    Cameron, Brianna J; Bazemore, Andrew W; Morley, Christopher P

    2016-01-01

    A small proportion of National Institutes of Health and other federal research funding is received by university departments of family medicine, the largest primary care specialty. That limited funding is also concentrated, with roughly a quarter of all National Institutes of Health, Centers for Disease Control and Prevention, and Agency for Healthcare Research and Quality funding awarded to 3 departments, almost half of that funding coming from 3 agencies, and a recent trend away from funding for new investigators. PMID:27613785

  2. Social Justice as the Moral Core of Family Medicine: A Perspective from the Keystone IV Conference.

    PubMed

    Schroeder, Steven A

    2016-01-01

    A recurring conference theme was the essential place of social justice within family medicine, especially the need to focus on denominator populations, exalt the personal and caring qualities of doctoring, and address social determinants of health. Many expressed solidarity with "community," but it is not always easy to define community in our large and diverse nation. Exhortations for health advocacy were frequently voiced, but putting these into meaningful action agendas is a challenge. There was general agreement that medicine is in flux and that the many expressions of "commodity-centered consumerism" have altered organization and financing. The increasing demands by "consumers", who want low cost, instant availability, and shared decision-making, and yet change doctors when health plans alter coverage also differentially impact high-volume, low-margin specialties such as family medicine. Additional challenges were the electronic health record and calibrating an appropriate work/life balance. Five action steps are recommended: 1) speak out on the important social and moral issues; 2) be the experts on personal care; 3) make common cause with potential allies; 4) help institutions perceive the value of generalism; and 5) help find ways to enrich generalist disciplines to increase the joy of medicine and decrease the threat of burn out.

  3. Social Justice as the Moral Core of Family Medicine: A Perspective from the Keystone IV Conference.

    PubMed

    Schroeder, Steven A

    2016-01-01

    A recurring conference theme was the essential place of social justice within family medicine, especially the need to focus on denominator populations, exalt the personal and caring qualities of doctoring, and address social determinants of health. Many expressed solidarity with "community," but it is not always easy to define community in our large and diverse nation. Exhortations for health advocacy were frequently voiced, but putting these into meaningful action agendas is a challenge. There was general agreement that medicine is in flux and that the many expressions of "commodity-centered consumerism" have altered organization and financing. The increasing demands by "consumers", who want low cost, instant availability, and shared decision-making, and yet change doctors when health plans alter coverage also differentially impact high-volume, low-margin specialties such as family medicine. Additional challenges were the electronic health record and calibrating an appropriate work/life balance. Five action steps are recommended: 1) speak out on the important social and moral issues; 2) be the experts on personal care; 3) make common cause with potential allies; 4) help institutions perceive the value of generalism; and 5) help find ways to enrich generalist disciplines to increase the joy of medicine and decrease the threat of burn out. PMID:27387169

  4. 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

  5. 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.

  6. Behavioral science in family medicine residencies: Part II. Teacher roles, relationships, and rewards. The STFM Task Force on Behavioral Science.

    PubMed

    1985-01-01

    A survey of members of the Society of Teachers of Family Medicine provided information about roles, relationships, and rewards for teachers involved in family medicine residency behavioral science education. Family physicians and behavioral scientists perceive their own roles in behavioral teaching and patient care as greater than is perceived by the other group. All groups of respondents see a continued need for collaborative behavioral teaching, patient care, and research. Interpersonal rewards reported emphasize family physicians learning from behavioral scientists. Frustrations reflect personal style, use of jargon, and a sense that the other group does not understand important aspects of one's work. Income is markedly greater for family physicians than behavioral scientists. Most behavioral scientists responding plan to remain in family medicine teaching.

  7. Improving Health Care Globally: A Critical Review of the Necessity of Family Medicine Research and Recommendations to Build Research Capacity

    PubMed Central

    van Weel, Chris; Rosser, Walter W.

    2004-01-01

    An invitational conference led by the World Organization of Family Doctors (Wonca) involving selected delegates from 34 countries was held in Kingston, Ontario, Canada, March 8 to12, 2003. The conference theme was “Improving Health Globally: The Necessity of Family Medicine Research.” Guiding conference discussions was the value that to improve health care worldwide, strong, evidence-based primary care is indispensable. Eight papers reviewed before the meeting formed the basic material from which the conference developed 9 recommendations. Wonca, as an international body of family medicine, was regarded as particularly suited to pursue these conference recommendations: Research achievements in family medicine should be displayed to policy makers, health (insurance) authorities, and academic leaders in a systematic way. In all countries, sentinel practice systems should be developed to provide surveillance reports on illness and diseases that have the greatest impact on the population’s health and wellness in the community. A clearinghouse should be organized to provide a central repository of knowledge about family medicine research expertise, training, and mentoring. National research institutes and university departments of family medicine with a research mission should be developed. Practice-based research networks should be developed around the world. Family medicine research journals, conferences, and Web sites should be strengthened to disseminate research findings internationally, and their use coordinated. Improved representation of family medicine research journals in databases, such as Index Medicus, should be pursued. Funding of international collaborative research in family medicine should be facilitated. International ethical guidelines, with an international ethical review process, should be developed in particular for participatory (action) research, where researchers work in partnership with communities. When implementing these recommendations

  8. Public Health Aspects of the Family Medicine Concepts in South Eastern Europe

    PubMed Central

    Masic, Izet; Hadziahmetovic, Miran; Donev, Doncho; Pollhozani, Azis; Ramadani, Naser; Skopljak, Amira; Pasagic, Almir; Roshi, Enver; Zunic, Lejla; Zildzic, Muharem

    2014-01-01

    Introduction: Family medicine as a part of the primary health care is devoted to provide continuous and comprehensive health care to the individuals and families regardless of age, gender, types of diseases and affected system or part of the body. Special emphasis in such holistic approach is given to the prevention of diseases and health promotion. Family Medicine is the first step/link between doctors and patients within patients care as well as regular inspections/examinations and follow-up of the health status of healthy people. Most countries aspire to join the European Union and therefore adopting new regulations that are applied in the European Union. Aim: The aim of this study is to present the role and importance of family medicine, or where family medicine is today in 21 Century from the beginning of development in these countries. The study is designed as a descriptive epidemiological study with data from 10 countries of the former Communist bloc, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, Bulgaria, Romania, Czech Republic, Slovakia and Hungary, just about half of them are members of the EU. We examined the following variables: socio-organizational indicators, health and educational indicators and health indicators. The data used refer to 2002 and as a source of data are used official data from reference WebPages of family medicine doctors associations, WONCA website (EURACT, EQuiP, EGPRN), WebPages of Bureau of Statistics of the countries where the research was conducted as well as the Ministries of Health. Results: Results indicates that the failures and shortcomings of health care organizations in Southeast Europe. Lack of money hinders the implementation of health care reform in all mentioned countries, the most of them that is more oriented to Bismarck financing system. Problems in the political, legal and economic levels are obstacles for efficient a problem reconstructing health care system toward

  9. Teaching team membership to family medicine residents: what does it take?

    PubMed

    Eubank, Daniel; Orzano, John; Geffken, Dominic; Ricci, Rocco

    2011-03-01

    Primary care reform proponents advocate for patient-centered medical homes built on interdisciplinary teamwork. Recent efforts document the difficulty achieving reform, which requires personal transformation by doctors. Currently no widely accepted curriculum to teach team membership in Family Medicine residencies exists. Organizational Development (OD) has 40 years of experience assessing and teaching the skills underlying teamwork. We present a curriculum that adapts OD insights to articulate a framework describing effective teamwork; define and teach specific team membership skills; reframe residents' perception of medicine to make relationships relevant; and transform training experiences to provide practice in interdisciplinary teamwork. Curriculum details include a rotation to introduce the new framework, six workshops, experiential learning in the practice, and coaching as a teaching method. We review program evaluations. We discuss challenges, including institutional resources and support, incorporation of a new language and culture into residency training, recruitment "for fit," and faculty/staff development. We conclude that teaching the relationship skills of effective team membership is feasible, but hard. Succeeding has transformative implications for patient relationships, residency training and the practice of family medicine. PMID:21417522

  10. Developing a funding model for an after-hours primary medical care service in a rural town.

    PubMed

    O'Meara, P; Hall, R H; Strasser, R; Speck, V

    1998-01-01

    The study described in this paper aimed to determine a funding model for an after-hours primary medical care service in the rural town of Moe, a socioeconomically disadvantaged area of Victoria suffering the rigours of industry restructuring and privatisation. It has 12.5 equivalent full-time general practitioners servicing 21,966 persons. A break-even analysis of the financial viability compared the expected costs of providing the service with the anticipated income. A mixed funding model is recommended. This would incorporate a general practitioner incentive scheme and State Government underwriting of infrastructure and basic non-medical staffing costs during the business development phase to supplement the income from the Health Insurance Commission. PMID:10185679

  11. The views of key leaders in South Africa on implementation of family medicine: critical role in the district health system

    PubMed Central

    2014-01-01

    Background Integrated team-based primary care is an international imperative. This is required more so in Africa, where fragmented verticalised care dominates. South Africa is trying to address this with health reforms, including Primary Health Care Re-engineering. Family physicians are already contributing to primary care despite family medicine being only fully registered as a full specialty in South Africa in 2008. However the views of leaders on family medicine and the role of family physicians is not clear, especially with recent health reforms. The aim of this study was to understand the views of key government and academic leaders in South Africa on family medicine, roles of family physicians and human resource issues. Methods This was a qualitative study with academic and government leaders across South Africa. In-depth interviews were conducted with sixteen purposively selected leaders using an interview guide. Thematic content analysis was based on the framework method. Results Whilst family physicians were seen as critical to the district health system there was ambivalence on their leadership role and ‘specialist’ status. National health reforms were creating both threats and opportunities for family medicine. Three key roles for family physicians emerged: supporting referrals; clinical governance/quality improvement; and providing support to community-oriented care. Respondents’ urged family physicians to consolidate the development and training of family physicians, and shape human resource policy to include family physicians. Conclusions Family physicians were seen as critical to the district health system in South Africa despite difficulties around their precise role. Whilst their role was dominated by filling gaps at district hospitals to reduce referrals it extended to clinical governance and developing community-oriented primary care - a tall order, requiring strong teamwork. Innovative team-based service delivery is possible despite human

  12. The Application of Entrustable Professional Activities to Inform Competency Decisions in a Family Medicine Residency Program.

    PubMed

    Schultz, Karen; Griffiths, Jane; Lacasse, Miriam

    2015-07-01

    Assessing entrustable professional activities (EPAs), or carefully chosen units of work that define a profession and are entrusted to a resident to complete unsupervised once she or he has obtained adequate competence, is a novel and innovative approach to competency-based assessment (CBA). What is currently not well described in the literature is the application of EPAs within a CBA system. In this article, the authors describe the development of 35 EPAs for a Canadian family medicine residency program, including the work by an expert panel of family physician and medical education experts from four universities in three Canadian provinces to identify the relevant EPAs for family medicine in nine curriculum domains. The authors outline how they used these EPAs and the corresponding templates that describe competence at different levels of supervision to create electronic EPA field notes, which has allowed educators to use the EPAs as a formative tool to structure day-to-day assessment and feedback and a summative tool to ground competency declarations about residents. They then describe the system to compile, collate, and use the EPA field notes to make competency declarations and how this system aligns with van der Vleuten's utility index for assessment (valid, reliable, of educational value, acceptable, cost-effective). Early outcomes indicate that preceptors are using the EPA field notes more often than they used the generic field notes. EPAs enable educators to evaluate multiple objectives and important but unwieldy competencies by providing practical, manageable, measurable activities that can be used to assess competency development.

  13. Walking the Walk in Team-Based Education: The Crimson Care Collaborative Clinic in Family Medicine.

    PubMed

    Meisinger, Kirsten; Wohler, Diana

    2016-01-01

    Effective implementation of robust team-based care in the United States requires significant training for all team members. This education is integral to creating a culture of collaboration and respect among interprofessional members of the health care team. The lack of interprofessional clinical educational experiences contributes to a "hidden curriculum" that reinforces the problematic view that medicine is at the top of a hierarchy among health professions. However, learners themselves have started resisting this view by integrating cross-disciplinary team-based training into their own education. One example of learner-based leadership in interprofessional team care is the Crimson Care Collaborative at Cambridge Health Alliance, a student-faculty collaborative family medicine clinic. This successful clinic demonstrates that high-quality interprofessional clinical education can be accomplished through partnerships between educational institutions and existing patient-centered medical homes. PMID:27669136

  14. Effect of debt on U.S. medical school graduates' preferences for family medicine, general internal medicine, and general pediatrics.

    PubMed

    Colquitt, W L; Zeh, M C; Killian, C D; Cultice, J M

    1996-04-01

    The authors assess the importance of educational debt in graduates' primary care specialty choices, and the variety of mechanisms through which debt may influence career decisions. Logistic regression models were used to identify significant predictors of the primary care specialty choices made by the 1991 and 1992 graduates of U.S. medical schools. These predictors were debt itself; other financial indicators; certain medical school characteristics; certain practice location plans; certain demographic factors; aspects of academic performance; and students' predisposition to a primary care specialty. Data for this study were gathered from a variety of sources at the Association of American Medical Colleges and from the Health Education Assistance Loans program. Both direct and indirect effects of debt were identified under specific conditions. The study revealed complex relationships between debt and the other predictors identified. For example, debt operated in relation to the levels of the graduates' expected incomes; debt from subsidized loan sources was significant for women who chose general internal medicine; debt was important in choices of family practice; and debt by itself was significant for those planning to practice in the West and who chose general internal medicine. Also, seemingly opposing effects of debt occurred. For example, in the family practice model used in this study, the threshold effect of debt was positive, while the linear effect of debt above the threshold was negative. Such vriations help explain the conflicting findings of some past research. These and other findings prompt the authors to state that when investigating the effects of debt, it is not fruitful to ask what the effect of the debt is on all three primary care fields as a group. It is more appropriate to ask several questions, such as: under what conditions does debt influence specialty plans? Among which groups of students does debt have an impact on specialty plans? Are

  15. 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

  16. Behavioral interventions for office-based care: interventions in the family medicine setting.

    PubMed

    Larzelere, Michele McCarthy

    2014-03-01

    The practice of family medicine includes the care of many patients with mental health or behavior change needs. Patients in mild to moderate distress may benefit from brief interventions performed in the family physician's office. Patients in more extreme distress may be helped by referral to behavioral health clinicians for short-term or open-ended therapies. Electronic therapy programs and bibliotherapy are also useful resources. The transition to the patient-centered medical home model may allow for more widespread integration of behavioral health care clinicians into primary care, in person and through telemental health care. Integrated care holds the promise of improved access, greater effectiveness of behavioral health service provision, and enhanced efficiency of primary care for patients with behavioral health care needs.

  17. Appraisal of the communication skills of residents in the Family Medicine Program in Central Saudi Arabia

    PubMed Central

    Alsaad, Saad M.; Alshammari, Sulaiman A.; Almogbel, Turki A.

    2016-01-01

    Objectives: To assess patients’ perceptions of the communication skills of family medicine residents. Methods: This is a cross-sectional study. Data were collected from patients, seeing 23 residents from 4 family medicine residency programs in Riyadh, Kingdom of Saudi Arabia namely, King Khalid University Hospital, Riyadh Military Hospital, Security Forces Hospital, and King Abdul-Aziz Medical City. The translated version of the Communication Assessment Tool (CAT) was used. Data were collected during January and February 2013. Results: A total of 350 patients completed the CAT, with an 87.5% response rate. Patients rated each resident differently, but the mean percentage of items, which residents rated as excellent was 71%. In general, male residents were rated higher 72.8 ± 27.2 than female residents 67.8 ± 32.2 with a significant difference; (p<0.005). Also, significant differences were found based on the gender of the residents, when each item of the CAT was compared. Comparing training centers, there were no significant differences found in the overall percentage of items rated as excellent or among items of the CAT. Conclusion: The study identified areas of strength and weaknesses that need to be addressed to improve communication skills of physicians. PMID:27381544

  18. Learning to See Beneath the Surface: A Qualitative Analysis of Family Medicine Residents' Reflections About Communication.

    PubMed

    Duggan, Ashley P; Vicini, Andrea; Allen, Lucas; Shaughnessy, Allen F

    2015-01-01

    Patients share straightforward statements with physicians such as describing their fears about their diagnosis. Physicians need to also understanding implicit, indirect, subtle communication cues that give broader context to patients' illness experiences. This project examines physicians' written reflections that offer insight into their interpretation of both the stated and the tacit aspects of their observations about communication, their resulting responses, and their intended actions. Tufts University Family Medicine residents (N = 33) of the Tufts Family Medicine Cambridge Health Alliance completed three reflective exercises each week over the course of 1 year (756 reflective entries). An interdisciplinary research team identified communication-related concepts within the reflections. Identified themes include (a) physicians recognizing and discovering mutual interplay of their communication with and patient disclosure, (b) physicians paying attention to subtleties of patient behavior as indicative of a fuller picture of patients' lives and their coping with illness, and (c) physician images of growth and awareness about communication indicative of their potential for growth and improvement. The project extends the literature in communication and medical education by examining explicit and tacit points of reflection about communication. The project (a) allows for unpacking the multifaceted aspects of reflection and (b) bridges reflective theory and medical education with communication foundations.

  19. Learning to See Beneath the Surface: A Qualitative Analysis of Family Medicine Residents' Reflections About Communication.

    PubMed

    Duggan, Ashley P; Vicini, Andrea; Allen, Lucas; Shaughnessy, Allen F

    2015-01-01

    Patients share straightforward statements with physicians such as describing their fears about their diagnosis. Physicians need to also understanding implicit, indirect, subtle communication cues that give broader context to patients' illness experiences. This project examines physicians' written reflections that offer insight into their interpretation of both the stated and the tacit aspects of their observations about communication, their resulting responses, and their intended actions. Tufts University Family Medicine residents (N = 33) of the Tufts Family Medicine Cambridge Health Alliance completed three reflective exercises each week over the course of 1 year (756 reflective entries). An interdisciplinary research team identified communication-related concepts within the reflections. Identified themes include (a) physicians recognizing and discovering mutual interplay of their communication with and patient disclosure, (b) physicians paying attention to subtleties of patient behavior as indicative of a fuller picture of patients' lives and their coping with illness, and (c) physician images of growth and awareness about communication indicative of their potential for growth and improvement. The project extends the literature in communication and medical education by examining explicit and tacit points of reflection about communication. The project (a) allows for unpacking the multifaceted aspects of reflection and (b) bridges reflective theory and medical education with communication foundations. PMID:26147857

  20. Impact of a family medicine resident wellness curriculum: a feasibility study

    PubMed Central

    Runyan, Christine; Savageau, Judith A.; Potts, Stacy; Weinreb, Linda

    2016-01-01

    Background Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction. PMID:27282276

  1. Evaluation of Four Commonly Used DNA Barcoding Loci for Chinese Medicinal Plants of the Family Schisandraceae

    PubMed Central

    Lin, Ruozhu; Fan, Jianhua; Chen, Zhiduan

    2015-01-01

    Many species of Schisandraceae are used in traditional Chinese medicine and are faced with contamination and substitution risks due to inaccurate identification. Here, we investigated the discriminatory power of four commonly used DNA barcoding loci (ITS, trnH-psbA, matK, and rbcL) and corresponding multi-locus combinations for 135 individuals from 33 species of Schisandraceae, using distance-, tree-, similarity-, and character-based methods, at both the family level and the genus level. Our results showed that the two spacer regions (ITS and trnH-psbA) possess higher species-resolving power than the two coding regions (matK and rbcL). The degree of species resolution increased with most of the multi-locus combinations. Furthermore, our results implied that the best DNA barcode for the species discrimination at the family level might not always be the most suitable one at the genus level. Here we propose the combination of ITS+trnH-psbA+matK+rbcL as the most ideal DNA barcode for discriminating the medicinal plants of Schisandra and Kadsura, and the combination of ITS+trnH-psbA as the most suitable barcode for Illicium species. In addition, the closely related species Schisandra rubriflora Rehder & E. H. Wilson and Schisandra grandiflora Hook.f. & Thomson, were paraphyletic with each other on phylogenetic trees, suggesting that they should not be distinct species. Furthermore, the samples of these two species from the southern Hengduan Mountains region formed a distinct cluster that was separated from the samples of other regions, implying the presence of cryptic diversity. The feasibility of DNA barcodes for identification of geographical authenticity was also verified here. The database and paradigm that we provide in this study could be used as reference for the authentication of traditional Chinese medicinal plants utilizing DNA barcoding. PMID:25938480

  2. Master's and doctoral theses in family medicine and their publication output, Suez Canal University, Egypt

    PubMed Central

    Nour-Eldein, Hebatallah; Mansour, Nadia M.; Abdulmajeed, Abdulmajeed A.

    2015-01-01

    Background: The completion of a thesis is a significant requirement for both a Master's and a doctorate degree in general practice/family medicine (GP/FM). A postgraduate thesis is a well-planned, time-intensive activity carried out over several years. The quality of the theses can be judged by the proportion of published papers. Objective: This study aimed to describe Master's and doctoral theses in family medicine and their publications between 1982 and 2014. Materials and Methods: GP/FM degree theses were reviewed at the Faculty of Medicine and central Suez Canal libraries. Several characteristics were extracted from each thesis relating to the main researcher, supervisors, themes, and study methods according to predefined criteria. Publications from the theses were described. Results: Over 33 years, 208 theses were completed by 173 GP/FM researchers. The majority of the theses were for Master's degrees (84.1%). Regarding the study design, most of the degree theses were cross-sectional studies (76.9%). The adult population was targeted in 33.7% of research theses. Nonprobability sampling was used in 51%. Rural communities were the setting of research in 43.8%, and primary health center (PHC)-based studies in 59.1%. The “Patient” category exceeded the other categories (28.4%). Publication from theses started in the second decade of research production. Of the degree theses, 21.6% original articles were published. Only 13.3% of articles from theses were published in PubMed-indexed journals. The researcher was first author in 62.2% of published articles. Conclusion: The production of GP/FM theses and their publications are going to increase. Continuous assessment and planning for GP/FM studies are recommended. PMID:25949959

  3. Evidence-based medicine in primary care: qualitative study of family physicians

    PubMed Central

    Tracy, C Shawn; Dantas, Guilherme Coelho; Upshur, Ross EG

    2003-01-01

    Background The objectives of this study were: a) to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM) in primary care; b) to investigate the influence of patient preferences on clinical decision-making; and c) to explore the role of intuition in family practice. Method Qualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians. Results Participants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician. Discussion Primary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour. PMID:12740025

  4. Relevance of Hypersexual Disorder to Family Medicine and Primary Care as a Complex Multidimensional Chronic Disease Construct

    PubMed Central

    Vrijhoef, Bert; De Maeseneer, Jan; Vansintejan, Johan; Devroey, Dirk

    2013-01-01

    Hypersexual disorder (HD) is not defined in a uniform way in the psychiatric literature. In the absence of solid evidence on prevalence, causes, empirically validated diagnostic criteria, instruments for diagnosis, consistent guidelines on treatment options, medical and psychosocial consequences, and type of caregivers that need to be involved, HD remains a controversial and relatively poorly understood chronic disease construct. The role of family medicine in the detection, treatment, and followup of HD is not well studied. The purpose of this paper is to describe the complexity of HD as a multidimensional chronic disease construct and its relevance to family medicine and primary care. PMID:24066230

  5. How can we help family carers manage pain medicines for patients with advanced cancer? A systematic review of intervention studies

    PubMed Central

    Latter, Sue; Hopkinson, Jane B; Richardson, Alison; Hughes, Jane A; Lowson, Elizabeth; Edwards, Deborah

    2016-01-01

    Background Family carers play a significant role in managing pain and associated medicines for people with advanced cancer. Research indicates that carers often feel inadequately prepared for the tasks involved, which may impact on carers’ and patients’ emotional state as well as the achievement of optimal pain control. However, little is known about effective methods of supporting family carers with cancer pain medicines. Aims To systematically identify and review studies of interventions to help carers manage medicines for pain in advanced cancer. To identify implications for practice and research. Method A systematic literature search of databases (MEDLINE, CINAHL, PsycINFO and AMED) was carried out to identify studies of pain medication management interventions that involved family carers of patients with advanced cancer, and reported specific outcomes for family carers. Patient pain outcomes were also sought. Studies were quality appraised; key aspects of study design, interventions and outcomes were compared and a narrative synthesis of findings developed. Results 8 studies were included; all had significant methodological limitations. The majority reported improvements in family carer knowledge and/or self-efficacy for managing pain medicines; no effect on patient pain outcomes; and no adverse effects. It was not possible to discern any association between particular intervention characteristics and family carer outcomes. Conclusions Current evidence is limited, but overall suggests face-to-face educational interventions supported by written and/or other resources have potential to improve carers’ knowledge and self-efficacy for pain management. Further research is needed to identify how best to help family carers manage pain medicines for patients with advanced cancer. PMID:27150294

  6. Family medicine model in Turkey: a qualitative assessment from the perspectives of primary care workers

    PubMed Central

    2014-01-01

    Background A person-list-based family medicine model was introduced in Turkey during health care reforms. This study aimed to explore from primary care workers’ perspectives whether this model could achieve the cardinal functions of primary care and have an integrative position in the health care system. Methods Four groups of primary care workers were included in this exploratory-descriptive study. The first two groups were family physicians (FP) (n = 51) and their ancillary personnel (n = 22). The other two groups were physicians (n = 44) and midwives/nurses (n = 11) working in community health centres. Participants were selected for maximum variation and 102 in-depth interviews and six focus groups were conducted using a semi-structured form. Results Data analysis yielded five themes: accessibility, first-contact care, longitudinality, comprehensiveness, and coordination. Most participants stated that many people are not registered with any FP and that the majority of these belong to the most disadvantaged groups in society. FPs reported that 40-60% of patients on their lists have never received a service from them and the majority of those who use their services do not use FPs as the first point of contact. According to most participants, the list-based system improved the longitudinality of the relationship between FPs and patients. However, based on other statements, this improvement only applies to one quarter of the population. Whereas there was an improvement limited to a quantitative increase in services (immunisation, monitoring of pregnant women and infants) included in the performance-based contracting system, participants stated that services not among the performance targets, such as family planning, postpartum follow-ups, and chronic disease management, could be neglected. FPs admitted not being able to keep informed of services their patients had received at other health institutions. Half of the participants stated that the list

  7. Lost in Translation: NIH Funding for Family Medicine Research Remains Limited.

    PubMed

    Cameron, Brianna J; Bazemore, Andrew W; Morley, Christopher P

    2016-01-01

    Departments of Family Medicine (DFMs) in the United States consistently received around 0.2% of total research funding dollars and 0.3% of all awards awarded by the National Institutes of Health (NIH) across the years 2002 to 2014. We used the NIH Reporter tool to quantify the amount of funding and the number of grants received by DFMs from the NIH from 2002 to 2014, using criteria similar to those applied by previous researchers. NIH funding to DFMs as remained fairly consistent across the time period, at roughly 0.2% of total NIH funding and 0.3% of total grants awarded. Changing these proportions will likely require considerable effort to build research capacity within DFMs and their frontline practice research networks, and to shift policymaker and funder perceptions of the value of the FM research enterprise. PMID:27613784

  8. Teaching and addressing health disparities through the family medicine social and community context of care project.

    PubMed

    White, Jordan; Heney, Jessica; Esquibel, Angela Y; Dimock, Camia; Goldman, Roberta; Anthony, David

    2014-09-01

    By training future physicians to care for patients with backgrounds different from their own, medical schools can help reduce health disparities. To address the need for education in this area, the leaders of the Family Medicine Clerkship at the Warren Alpert Medical School of Brown University developed the Social and Community Context of Care project, required of all medical students rotating through this clerkship. Students develop a hypothetical intervention addressing a health issue seen at their preceptor site, and are assessed on their grasp of the social and contextual issues affecting that health issue in their particular community. Some interventions are actualized in later clerkships or independent study projects; one example, a health class for pregnant and parenting teens at Central Falls High School, is described here. If made a routine part of medical education, projects such as these may help medical students address the health disparities they will encounter in future practice.

  9. 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.

  10. Assessing prescribing of NSAIDs, antiplatelets, and anticoagulants in Canadian family medicine using chart review.

    PubMed

    Hamilton, Kevin; Davis, Christine; Falk, Jamie; Singer, Alex; Bugden, Shawn

    2016-10-01

    Background Drug-related problems have been identified as a major contributor to emergency room visits, hospitalizations, and death. The most commonly implicated medications are nonsteroidal anti-inflammatory drugs (NSAIDs), antiplatelets, and anticoagulants. Considering a significant proportion of these harms are preventable, indicators to identify risky prescribing before they lead to harm have been developed. Objective To examine the prevalence and patterns of potentially inappropriate prescriptions (PIPs) in a primary care population who are using high-risk medications. Setting This study was performed within two multi-disciplinary family medicine teaching clinics in Winnipeg, Canada. Method A cross-sectional electronic/paper chart audit was conducted within two multi-disciplinary family medicine teaching clinics to evaluate the prevalence of 13 evidence-based high-risk prescriptions. Patients were included if they were prescribed an oral NSAID, antiplatelet, or an anticoagulant within the 12 month period between June 2012 and June 2013. Main outcome measure The proportion of PIPs associated with an increased bleeding risk for NSAIDs, antiplatelets, and anticoagulants. Results Of the 567 patients included in the review, 198 (35 %) patients had received at least 1 PIP in the past year. The most common PIP was the use of an oral NSAID with one or more GI risk factors without adequate gastro-protection. Only 34 (6 %) of these patients received a full medication review performed by a pharmacist. Although not statistically significant, patients who received a medication review had fewer inappropriate prescriptions (27 % with review, 35 % without). Conclusion Over one-third of the patients who were using high-risk medications were using them potentially inappropriately. Although pharmacists have been shown to reduce the amount of inappropriate prescribing, very few patients using these medications were referred to the pharmacist for a full medication review

  11. Drug sample management in University of Montreal family medicine teaching units

    PubMed Central

    Lussier, Marie-Thérèse; Vanier, Marie-Claude; Authier, Marie; Diallo, Fatoumata Binta; Gagnon, Justin

    2015-01-01

    Abstract Objective To describe the management and distribution of drug samples in family medicine teaching units (FMUs). Design Cross-sectional descriptive study. Setting All 16 FMUs affiliated with the Department of Family Medicine and Emergency Medicine at the University of Montreal in Quebec. Participants Health care professionals (physicians, residents, pharmacists, and nurses) who manage (n = 22) and dispense (n = 294) drug samples in the FMUs. Methods Data were collected between February and March 2013 using 2 self-administered questionnaires completed by health care professionals who manage or dispense drug samples. The data were subjected to descriptive and bivariate analyses. Results The participation rate was 100.0% for staff who manage drug samples and 72.5% for those who dispense them. Of the 16 participating FMUs, 12 have drug sample cabinets. Eight of the FMUs have a written institutional policy governing the management of drug samples. Of the 76.2% of respondents who said they distributed samples, more than half did not know whether their institution had a policy. In 7 of 12 FMUs with drug sample cabinets, access to samples is not restricted to those authorized to prescribe medications. Cabinets are most often managed by nurses (9 of 12 FMUs). Only 4 of 12 FMUs take regular inventory of cabinet contents. The main reasons cited for dispensing samples were to help a patient financially and to test for tolerance and efficacy when initiating or modifying a treatment for a patient. Three-quarters (78.2%) of dispensers reported that sometimes they were unable to find the drug they wanted in the cabinet; half of those consequently gave patients drugs that were not their first choice. More than half the dispensers reported they never or only occasionally referred patients to their community pharmacists. Conclusion A portrait of drug sample management and dispensation in the academic FMUs emerged from this study. This study provides insight into current

  12. After-hours power status of office equipment and energy use of miscellaneous plug-load equipment

    SciTech Connect

    Roberson, Judy A.; Webber, Carrie A.; McWhinney, Marla C.; Brown, Richard E.; Pinckard, Marageret J.; Busch, John F.

    2004-05-27

    This research was conducted in support of two branches of the EPA ENERGY STAR program, whose overall goal is to reduce, through voluntary market-based means, the amount of carbon dioxide emitted in the U.S. The primary objective was to collect data for the ENERGY STAR Office Equipment program on the after-hours power state of computers, monitors, printers, copiers, scanners, fax machines, and multi-function devices. We also collected data for the ENERGY STAR Commercial Buildings branch on the types and amounts of miscellaneous plug-load equipment, a significant and growing end use that is not usually accounted for by building energy managers. For most types of miscellaneous equipment, we also estimated typical unit energy consumption in order to estimate total energy consumption of the miscellaneous devices within our sample. This data set is the first of its kind that we know of, and is an important first step in characterizing miscellaneous plug loads in commercial buildings. The main purpose of this study is to supplement and update previous data we collected on the extent to which electronic office equipment is turned off or automatically enters a low power state when not in active use. In addition, it provides data on numbers and types of office equipment, and helps identify trends in office equipment usage patterns. These data improve our estimates of typical unit energy consumption and savings for each equipment type, and enables the ENERGY STAR Office Equipment program to focus future effort on products with the highest energy savings potential. This study expands our previous sample of office buildings in California and Washington DC to include education and health care facilities, and buildings in other states. We report data from sixteen commercial buildings in California, Georgia, and Pennsylvania: four education buildings, two medical buildings, two large offices (> 500 employees each), three medium offices (50-500 employees each), and five small

  13. “Negotiorum Gestio” in Family Medicine, Informed Consent Obtainment, and Disciplinary Responsibility

    PubMed Central

    Birkeland, Søren

    2016-01-01

    Introduction. Negotiorum gestio (NG) denotes an action where a person well intendedly acts on behalf of another without obtaining the latter's prior consent. In broad terms, NG-like actions have played a considerable role in health care provision. In some settings, health care delivery with only little or presumed patients' consent has been the rule rather than the exception. However, bioethical principles regarding patient autonomy and obtainment of the patient's informed consent (IC) before intervention are now increasingly materialized in the law of many countries. Aim. To study legal consequences of NG in family medicine and IC handling options. Methods. Case law examination. Results. A disciplinary board case is described concerning a family doctor conducting unlawful NG by not coming up to legal IC requirements. Discussion and Conclusion. The practical and legal implications of IC and possible role of novel Shared Decision-Making approaches in coming up to regulation and bioethical demands are discussed. It is concluded that a doctor may run an unnecessary legal risk when conducting NG in decision-competent patients and furthermore it is suggested that novel Shared Decision-Making approaches could help in obtaining a rightful and practicable IC. PMID:27110401

  14. 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

  15. 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 ...

  16. 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…

  17. Impact of family medicine clerkships in undergraduate medical education: a systematic review

    PubMed Central

    Turkeshi, Eralda; Michels, Nele R; Hendrickx, Kristin; Remmen, Roy

    2015-01-01

    Objective Synthesise evidence about the impact of family medicine/general practice (FM) clerkships on undergraduate medical students, teaching general/family practitioners (FPs) and/or their patients. Data sources Medline, ERIC, PsycINFO, EMBASE and Web of Knowledge searched from 21 November to 17 December 2013. Primary, empirical, quantitative or qualitative studies, since 1990, with abstracts included. No country restrictions. Full text languages: English, French, Spanish, German, Dutch or Italian. Review methods Independent selection and data extraction by two authors using predefined data extraction fields, including Kirkpatrick’s levels for educational intervention outcomes, study quality indicators and Best Evidence Medical Education (BEME) strength of findings’ grades. Descriptive narrative synthesis applied. Results Sixty-four included articles: impact on students (48), teaching FPs (12) and patients (8). Sample sizes: 16-1095 students, 3-146 FPs and 94-2550 patients. Twenty-six studies evaluated at Kirkpatrick level 1, 26 at level 2 and 6 at level 3. Only one study achieved BEME’s grade 5. The majority was assessed as grade 4 (27) and 3 (33). Students reported satisfaction with content and process of teaching as well as learning in FM clerkships. They enhanced previous learning, and provided unique learning on dealing with common acute and chronic conditions, health maintenance, disease prevention, communication and problem-solving skills. Students’ attitudes towards FM were improved, but new or enhanced interest in FM careers did not persist without change after graduation. Teaching FPs reported increased job satisfaction and stimulation for professional development, but also increased workload and less productivity, depending on the setting. Overall, student’s presence and participation did not have a negative impact on patients. Conclusions Research quality on the impact of FM clerkships is still limited, yet across different settings and

  18. Integration of Complementary and Alternative Medicine into Family Practices in Germany: Results of a National Survey

    PubMed Central

    Joos, Stefanie; Musselmann, Berthold; Szecsenyi, Joachim

    2011-01-01

    More than two-thirds of patients in Germany use complementary and alternative medicine (CAM) provided either by physicians or non-medical practitioners (“Heilpraktiker”). There is little information about the number of family physicians (FPs) providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-particpation in the survey) was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34%) returned the questionnaire and 444 (15%) returned the postcard. Altogether, 886 of the 1471 responding FPs (60%) reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%), a rather negative attitude by 127 FPs (14%). Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned. PMID:19293252

  19. 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.

  20. 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.

  1. Patient perception and knowledge of acetaminophen in a large family medicine service.

    PubMed

    Herndon, Christopher M; Dankenbring, Dawn M

    2014-06-01

    The use of acetaminophen is currently under increased scrutiny by the US Food and Drug Administration (FDA) due to the risk of intentional and more concerning, unintentional overdose-related hepatotoxicity. Acetaminophen is responsible for an estimated 48% of all acute liver failure diagnoses. The purpose of this study is to evaluate patient perception and knowledge of the safe use and potential toxicity of acetaminophen-containing products. The authors conducted a descriptive, 2-week study using a convenience sample from a large family medicine clinic waiting room. Survey questions assessed ability to identify acetaminophen, knowledge of the current recommended maximum daily dose, respondent acetaminophen use patterns, common adverse effects associated with acetaminophen, and respondent self-reported alcohol consumption. Acetaminophen safety information was provided to all persons regardless of participation in the study. Of the 102 patients who chose to participate, 79% recognized acetaminophen as a synonym of Tylenol, whereas only 9% identified APAP as a frequently used abbreviation. One third of respondents thought acetaminophen was synonymous with ibuprofen and naproxen. Approximately one fourth of patients correctly identified the then maximum recommended daily acetaminophen dose of 4 g. Seventy-eight percent of patients correctly identified hepatotoxicity as the most common serious adverse effect. We conclude that patient deficiencies in knowledge of acetaminophen recognition, dosing, and toxicity warrant public education by health professionals at all levels of interaction. Current initiatives are promising; however, further efforts are required.

  2. A computerized faculty time-management system in an academic family medicine department.

    PubMed

    Daugird, Allen J; Arndt, Jane E; Olson, P Richard

    2003-02-01

    The authors describe the development, implementation, and evaluation of a computerized faculty time-management system (FTMS) in the Department of Family Medicine at the University of North Carolina-Chapel Hill. The FTMS is presented as an integrated set of computerized spreadsheets used annually to allocate faculty time across all mission activities of the department. It was first implemented in 1996 and has been continuously developed since then. An iterative approach has been used to gain consensus among faculty about time resources needed for various tasks of all missions of the department. These time-resource assumptions are used in the computerized system. Faculty time is allocated annually by the department vice chair in negotiation with individual faculty, making sure that the activities planned do not exceed the work time each faculty member has available for the year. During this process, faculty preferences are balanced against department aggregate needs to meet mission commitments and obligations. The authors describe how the computerized FTMS is used for faculty time management and career development, department planning, budget planning, clinical scheduling, and mission cost accounting. They also describe barriers and potential abuses and the challenge of building an organizational culture willing to discuss faculty time openly and committed to developing a system perceived as fair and accurate. The spreadsheet file is available free from the authors for use in other departments.

  3. 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

  4. Family medicine residents' beliefs, attitudes and performance with problem drinkers: a survey and simulated patient study.

    PubMed

    Kahan, Meldon; Wilson, Lynn; Liu, Eleanor; Borsoi, Diane; Brewster, Joan M; Sobell, Linda C; Sobell, Mark B

    2004-03-01

    Fifty-six second-year family medicine residents completed a survey on their knowledge and beliefs about problem drinkers. Most residents felt responsible for screening and counseling, were confident in their clinical skills in these areas, and scored well on related knowledge questions. However, only 18% felt that problem drinkers would often respond to brief counseling sessions with physicians while 36% felt that moderate drinking was a reasonable goal for patients with severe alcohol dependence. Residents were then visited by unannounced simulated patients (SPs) presenting with alcohol-induced hypertension or insomnia. Residents detected the SP in 45 out of 104 visits. In the 59 undetected SP visits, residents asked about alcohol consumption in 47 visits (80%), discussed the relationship between alcohol use and the presenting complaint in 37 visits (63%), and recommended a specific weekly consumption in 35 visits (59%). Only 31% offered reduced drinking strategies, and most did not ask about features of alcohol dependence. These results suggest that residents have the fundamental clinical skills required to manage the problem drinker who gives a clear history and is receptive to advice. Educational efforts with residents should focus on the importance of systematic screening, taking an alcohol history under more challenging conditions, identifying the subtler presentations of alcohol problems, counselling the less receptive patient at an earlier stage of change, distinguishing the problem drinker from the alcohol-dependent patient, and offering specific behavioral strategies for the problem drinker.

  5. Task Force 1. Report of the Task Force on Patient Expectations, Core Values, Reintegration, and the New Model of Family Medicine

    PubMed Central

    Green, Larry A.; Graham, Robert; Bagley, Bruce; Kilo, Charles M.; Spann, Stephen J.; Bogdewic, Stephen P.; Swanson, John

    2004-01-01

    BACKGROUND To lay the groundwork for the development of a comprehensive strategy to transform and renew the specialty of family medicine, this Future of Family Medicine task force was charged with identifying the core values of family medicine, developing proposals to reform family medicine to meet consumer expectations, and determining systems of care to be delivered by family medicine in the future. METHODS A diverse, multidisciplinary task force representing a broad spectrum of perspectives and expertise analyzed and discussed published literature; findings from surveys, interviews, and focus groups compiled by research firms contracted to the Future of Family Medicine project; and analyses from The Robert Graham Center, professional societies in the United States and abroad, and others. Through meetings, conference calls, and writing, and revision of a series of subcommittee reports, the entire task force reached consensus on its conclusions and recommendations. These were reviewed by an external panel of experts and revisions were made accordingly. MAJOR FINDINGS After delivering on its promise to reverse the decline of general practice in the United States, family medicine and the nation face additional challenges to assure all people receive care that is safe, effective, patient-centered, timely, efficient, and equitable. Challenges the discipline needs to address to improve family physicians’ ability to make important further contributions include developing a broader, more accurate understanding of the specialty among the public and other health professionals, addressing the wide scope and variance in practice types within family medicine, winning respect for the specialty in academic circles, making family medicine a more attractive career option, and dealing with the perception that family medicine is not solidly grounded in science and technology. The task force set forth a proposed identity statement for family medicine, a basket of services that

  6. [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

  7. Relevance of chronic lyme disease to family medicine as a complex multidimensional chronic disease construct: a systematic review.

    PubMed

    Borgermans, Liesbeth; Goderis, Geert; Vandevoorde, Jan; Devroey, Dirk

    2014-01-01

    Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review.

  8. Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review

    PubMed Central

    Goderis, Geert

    2014-01-01

    Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review. PMID:25506429

  9. Relevance of chronic lyme disease to family medicine as a complex multidimensional chronic disease construct: a systematic review.

    PubMed

    Borgermans, Liesbeth; Goderis, Geert; Vandevoorde, Jan; Devroey, Dirk

    2014-01-01

    Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review. PMID:25506429

  10. Experience of complementary and alternative medicine in patients with amyotrophic lateral sclerosis and their families: A qualitative study.

    PubMed

    Kim, Sungha; Chung, Seung Eun; Lee, Sanghun; Park, Jeonghwan; Choi, Sunmi; Kim, Sungchul

    2016-01-01

    The purpose of this study was to explore the life experience related to complementary and alternative medicine (CAM) use among patients with amyotrophic lateral sclerosis (ALS). Data were collected though semi-structured interviews of nine patients with ALS and seven family members, who have used CAM. Audio recordings of the interviews were transcribed verbatim and checked for accuracy. The Giorgi's method of phenomenology was used for data analysis. Five constituents forming the units of meaning were: facing the limits of conventional medicine; getting to know CAM; recognizing the ineffectiveness of CAM; using CAM for symptomatic treatment; and seeking new CAM endlessly for complete cure. The study results provide an in-depth understanding of experience with CAM among patients with ALS and their family members. Healthcare providers must give accurate information about the efficacy of CAM as well as its safety and possible adverse effects and should offer patient-centred treatment through active communication throughout the process of diagnosis and treatment.

  11. Split-Session Focus Group Interviews in the Naturalistic Setting of Family Medicine Offices

    PubMed Central

    Fetters, Michael D.; Guetterman, Timothy C.; Power, Debra; Nease, Donald E.

    2016-01-01

    PURPOSE When recruiting health care professionals to focus group interviews, investigators encounter challenges such as busy clinic schedules, recruitment, and a desire to get candid responses from diverse participants. We sought to overcome these challenges using an innovative, office-based, split-session focus group procedure in a project that elicited feedback from family medicine practices regarding a new preventive services model. This procedure entails allocating a portion of time to the entire group and the remaining time to individual subgroups. We discuss the methodologic procedure and the implications of using this approach for data collection. METHODS We conducted split-session focus groups with physicians and staff in 4 primary care practices. The procedure entailed 3 sessions, each lasting 30 minutes: the moderator interviewed physicians and staff together, physicians alone, and staff alone. As part of the focus group interview, we elicited and analyzed participant comments about the split-session format and collected observational field notes. RESULTS The split-session focus group interviews leveraged the naturalistic setting of the office for context-relevant discussion. We tested alternate formats that began in the morning and at lunchtime, to parallel each practice’s workflow. The split-session approach facilitated discussion of topics primarily relevant to staff among staff, topics primarily relevant to physicians among physicians, and topics common to all among all. Qualitative feedback on this approach was uniformly positive. CONCLUSION A split-session focus group interview provides an efficient, effective way to elicit candid qualitative information from all members of a primary care practice in the naturalistic setting where they work. PMID:26755786

  12. Multi-source evaluation of interpersonal and communication skills of family medicine residents.

    PubMed

    Leung, Kai-Kuen; Wang, Wei-Dan; Chen, Yen-Yuan

    2012-12-01

    There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and teaching staffs and to compare the ratings with the objective structured clinical examination (OSCE). Our results revealed instruments used by staffs, peers, nurses, and self-evaluation have good internal consistency reliability (α > 0.90), except for the behavioral checklist (α = 0.57). Staffs', peers', and nurses' evaluations were highly correlated with one another (r = 0.722 for staff- and peer-rating, r = 0.734 for staff- and nurse-rating, r = 0.634 for peer- and nurse-rating). However, residents' self-rating and patients-rating were not correlated to ratings by any other raters. OSCE evaluation was correlated to peer-rating (r = 0.533) and staff-rating (r = 0.642), but not correlated to self- or patient-rating. The generalizability study revealed the major sources of variance came from the types of rater and the interaction of residents and types of rater. This study found self-rating and patient-rating were not consistent with other sources of rating on residents' interpersonal and communication skills. Whether variations among different types of rater in a multi-source evaluation should be regarded as measurement errors or complementary information is worth further study.

  13. Medical student attitudes towards family medicine in Spain: a statewide analysis

    PubMed Central

    2012-01-01

    Background Family and community medicine (FM) became a recognized specialty in Spain in 1978; however, most medical schools in Spain still lack mandatory core courses in FM. In order to explore the perceptions, expectations and level of information amongst medical students in Spain in relation to FM and PC, and the training in these areas in the curriculum of the Medical Schools, a survey was developed to be administered in medical schools every two years. This article presents data from the first questionnaire administration. Methods The study population was all first-, third-, and fifth-year students (2009–2010) in 22 participating medical schools in Spain (of 27 total). The 83-item survey had three sections: personal data, FM training, professional practice expectations, and preferences). Chi-squared test or analyses of variance were used, as appropriate. Results We had a 41.8% response rate (n = 5299/12924); 89.8% considered the social role of FM to be essential, while only 20% believed the specialty was well respected within the medical profession. The appeal of FM increased with years of study, independent of student characteristics or medical school attended. Among third and fifth-year students, 54.6% said their specialty preferences had changed during medical school; 73.6% felt that FM specialists should teach FM courses, and 83.3% thought that FM rotations in primary care centres were useful. Conclusions Students valued the social role of FM more highly than its scientific standing. The vast majority believe that FM training should be mandatory. Only 25% of first-year students have clear preferences for a specialization. Interest in FM increases moderately over their years of study. Working conditions in FM have decisive influence in choosing a specialty. PMID:22642617

  14. 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

  15. Parents Studying Medicine – the dichotomy of studying with a family

    PubMed Central

    Iden, Kirstin; Nürnberger, Frank; Sader, Robert; Dittrich, Winand

    2012-01-01

    Introduction: In this article the personal study and life situation of parents who are also medical students at the Medical School of the Goethe University Frankfurt am Main is discussed. There is a special focus on the topics “studying with children” and “family-friendly university”, which have been present in discussions about university development and in the daily life of academics, especially during the last decade. The workgroup “Individual Student Services” at the medical faculty at the Goethe University tries to meet the necessities of the individual study courses and to support the study success with a new counselling and student service concept. Methods: The experience of parents studying medicine was recorded in semi-structured interviews (Date: April 2010), which were held as part of the sponsored pilot project on part-time medical studies (“Pilot Project Part-time Medical Studies”). Additionally, study results from the Medical School of the Goethe University Frankfurt am Main were integrated as well as a literature analysis. Results: It was found that the teaching demands and support services, which have been suggested and needed for years now, have been partially implemented and are without sufficient support at the faculty level to date. Thus the current situation of medical students with children is still difficult and seems a big challenge for everyone involved. Solution: As part of the “Individual Student Services” a new pilot project on part-time medical studies was established in November 2009. Only the use of new, unconventional and innovative ideas allows universities to adequately support the changing and heterogeneous student population and support them to successfully completing their medical studies. PMID:22558026

  16. Undergraduate medical education in general practice/family medicine throughout Europe – a descriptive study

    PubMed Central

    2013-01-01

    Background It is increasingly becoming evident that a strong primary health care system is more likely to provide better population health, more equity in health throughout the population, and better use of economic resources, compared to systems that are oriented towards specialty care. Developing and maintaining a strong and sustainable primary health care requires that a substantial part of graduating doctors go into primary care. This in turn requires that general practice/family medicine (GP/FM) strongly influences the curricula in medical schools. In the present paper we aim at describing the extent of GP/FM teaching in medical schools throughout Europe, checking for the presence of GP/FM curricula and clinical teaching in GP offices. Methods A brief questionnaire was e-mailed to GP/FM or other professors at European medical universities. Results 259 out of 400 existing universities in 39 European countries responded to our questionnaire. Out of these, 35 (13.5%) reported to have no GP/FM curriculum. These 35 medical faculties were located in 12 different European countries. In addition, 15 of the medical schools where a GP/FM curriculum did exist, reported that this curriculum did not include any clinical component (n = 5), or that the clinical part of the course was very brief - less than one week, mostly only a few hours (n = 10). In total, 50 universities (19%) thus had no or a very brief GP/FM curriculum. These were mainly located in the Eastern or Southern European regions. Conclusion It is still possible to graduate from European medical universities without having been exposed to a GP/FM curriculum. The European Academy of Teachers in General Practice (EURACT) will launch efforts to change this situation. PMID:24289459

  17. Comparative Review of Education Programs of Family Medicine (FM) in Bosnia and Herzegovina and Several Transition Countries.

    PubMed

    Masic, Izet; Skopljak, Amira; Jatic, Zaim

    2014-12-01

    Family Medicine as an independent medical discipline is relatively young in the countries of Southeast Europe. Still are used the old models of all forms of education in this module, although most countries accepted Bologna undergraduate teaching concept and already implement it with greater or lesser success. Measuring the effects of the qualities of these concepts and models is not done systematically nor in uniform manner, so it could not be compared by the unique variables measuring the quality of education curricula, and especially the quality of education level of the graduates at the first, second and third degree courses and other forms of education. This paper provides a comparative overview of the state of education in the area of family medicine in the region. It creates comparison according to the study duration for undergraduate and postgraduate studies, doctoral studies and specialized studies in specified areas. What stand out are the proposals to improve education in the field of family medicine in the region.

  18. 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.

  19. 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

  20. Telemedicine and E-Learning in a Primary Care Setting in Sudan: The Experience of the Gezira Family Medicine Project.

    PubMed

    Mohamed, K G; Hunskaar, S; Abdelrahman, S H; Malik, E M

    2015-01-01

    Information and communication technology (ICT) is progressively used in the health sector (e-health), to provide health care in a distance (telemedicine), facilitate medical education (e-learning), and manage patients' information (electronic medical records, EMRs). Gezira Family Medicine Project (GFMP) in Sudan provides a 2-year master's degree in family medicine, with ICT fully integrated in the project. This cross-sectional study describes ICT implementation and utilization at the GFMP for the years 2011-2012. Administrative data was used to describe ICT implementation, while questionnaire-based data was used to assess candidates' perceptions and satisfaction. In the period from April 2011 to December 2012, 3808 telemedicine online consultations were recorded and over 165000 new patients' EMRs were established by the study subjects (125 candidates enrolled in the program). Almost all respondents confirmed the importance of telemedicine. The majority appreciated also the importance of using EMRs. Online lectures were highly rated by candidates in spite of the few challenges encountered by combining service provision with learning activity. Physicians highlighted some patients' concerns about the use of telemedicine and EMRs during clinical consultations. Results from this study confirmed the suitability of ICT use in postgraduate training in family medicine and in service provision. PMID:26839704

  1. 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

  2. Experience with using second life for medical education in a family and community medicine education unit

    PubMed Central

    2012-01-01

    Background The application of new technologies to the education of health professionals is both a challenge and a necessity. Virtual worlds are increasingly being explored as a support for education. Aim: The aim of this work is to study the suitability of Second Life (SL) as an educational tool for primary healthcare professionals. Methods Design: Qualitative study of accredited clinical sessions in SL included in a continuing professional development (CPD) programme for primary healthcare professionals. Location: Zaragoza I Zone Family and Community Medicine Education Unit (EU) and 9 health centres operated by the Aragonese Health Service, Aragon, Spain. Method: The EU held two training workshops in SL for 16 healthcare professionals from 9 health centres by means of two workshops, and requested them to facilitate clinical sessions in SL. Attendance was open to all personnel from the EU and the 9 health centres. After a trail period of clinical sessions held at 5 health centres between May and November 2010, the CPD-accredited clinical sessions were held at 9 health centres between February and April 2011. Participants: 76 healthcare professionals attended the CPD-accredited clinical sessions in SL. Main measurements: Questionnaire on completion of the clinical sessions. Results Response rate: 42-100%. Questionnaire completed by each health centre on completion of the CPD-accredited clinical sessions: Access to SL: 2 centres were unable to gain access. Sound problems: 0% (0/9). Image problems: 0% (0/9). Voice/text chat: used in 100% (10/9); 0 incidents. Questionnaire completed by participants in the CPD-accredited clinical sessions: Preference for SL as a tool: 100% (76/76). Strengths of this method: 74% (56/76) considered it eliminated the need to travel; 68% (52/76) believed it made more effective use of educational resources; and 47% (36/76) considered it improved accessibility. Weaknesses: 91% (69/76) experienced technical problems, while; 9% (7/76) thought

  3. Admission Factors Predicting Family Medicine Specialty Choice: A Literature Review and Exploratory Study among Students in the Rural Medical Scholars Program

    ERIC Educational Resources Information Center

    Avery, Daniel M., Jr.; Wheat, John R.; Leeper, James D.; McKnight, Jerry T.; Ballard, Brent G.; Chen, Jia

    2012-01-01

    Purpose: The Rural Medical Scholars Program (RMSP) was created to increase production of rural family physicians in Alabama. Literature review reveals reasons medical students choose careers in family medicine, and these reasons can be categorized into domains that medical schools can address through admission, curriculum, and structural…

  4. 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.

  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. Starting a family during medical studies? Results of a pilot study on family friendliness in the study of medicine at the University of Ulm

    PubMed Central

    Liebhardt, Hubert; Stolz, Katrin; Mörtl, Kathrin; Prospero, Katrin; Niehues, Johanna; Fegert, Jörg

    2011-01-01

    Objective: The Ulm pilot study aimed to explore factors for a successful combination of medical education and starting a family. The empirical data derived from this study constitutes the foundation for an evidence-based reform of the medical curriculum in Ulm. Methods: In 2009, qualitative interviews with 37 of the 79 medical students with children at University of Ulm were conducted and analyzed using content analysis. The detected problem areas were used to develop a quantitative questionnaire for studying parents and academic teaching members in medical education in Ulm. Results: The parents were older, more often married and more likely to already have obtained a first training. One third of the students thought there was no ideal time to start a family during the years of medical education or specialist training. However, the majority of the students (61%) were convinced that parenthood is more compatible with medical studies than with specialist training. The interview data suggests that the end of medical school (4th to 6th year of studies), preferably during semester break, is especially suitable for child birth since it allows students to continue their studies without ‘losing time’. Conclusion: The biography and career of studying parents in medicine have specific characteristics. Universities and teaching hospitals are required to no longer leave the compatibility of family and study responsibilities to the students themselves. Rather, flexible structures need to be implemented that enable students to start a family while continuing their education. This means providing more childcare and greater support regarding academic counselling and career development. PMID:21818229

  8. A Countercultural Heritage: Rediscovering the Relationship-Centered and Social Justice Roots of Family Medicine-A Perspective from the Keystone IV Conference.

    PubMed

    Waters, Richard C; Stoltenberg, Mark; Hughes, Lauren S

    2016-01-01

    The 2015 G. Gayle Stephens Keystone conference convened a cohort of primary care professionals to discuss what promises personal physicians will make to their patients going forward. New physicians were prompted to rediscover the foundational values of and historic context for family medicine. At the heart of this rediscovery was learning of the writings and teachings of Dr. G. Gayle Stephens, a founder of family medicine who emphasized the essentiality of relationship-centered care and social justice to the new specialty. Dr. Stephens viewed family medicine as being in a countercultural relationship to mainstream medicine, as family medicine fought for justice and equity in an inequitable and fragmented health care system. Here we argue that by reaffirming and renewing this countercultural heritage the new generation of family physicians will have better clarity in approaching the many challenges in health care today. Particularly for trainees and new physicians, the historic lens offered by Dr. Stephens's writing and other foundational documents allows us to better see ourselves in a trajectory of ongoing health care reform. PMID:27387164

  9. A Countercultural Heritage: Rediscovering the Relationship-Centered and Social Justice Roots of Family Medicine-A Perspective from the Keystone IV Conference.

    PubMed

    Waters, Richard C; Stoltenberg, Mark; Hughes, Lauren S

    2016-01-01

    The 2015 G. Gayle Stephens Keystone conference convened a cohort of primary care professionals to discuss what promises personal physicians will make to their patients going forward. New physicians were prompted to rediscover the foundational values of and historic context for family medicine. At the heart of this rediscovery was learning of the writings and teachings of Dr. G. Gayle Stephens, a founder of family medicine who emphasized the essentiality of relationship-centered care and social justice to the new specialty. Dr. Stephens viewed family medicine as being in a countercultural relationship to mainstream medicine, as family medicine fought for justice and equity in an inequitable and fragmented health care system. Here we argue that by reaffirming and renewing this countercultural heritage the new generation of family physicians will have better clarity in approaching the many challenges in health care today. Particularly for trainees and new physicians, the historic lens offered by Dr. Stephens's writing and other foundational documents allows us to better see ourselves in a trajectory of ongoing health care reform.

  10. Academic promotion and tenure in U.S. family medicine units.

    PubMed

    Holloway, R L; Hale, K L; Rakel, R E

    1989-05-01

    The authors interviewed by telephone the heads (or their representatives) of 101 of the 120 family practice units in U.S. medical schools in 1987. Each respondent was asked for his or her personal perceptions of the relative importances of research, teaching, patient care, and administrative activities in the academic promotion process. Respondents were also asked for their views of their units' and institutions' perceptions of the importances of the same four activities in the promotion process, as well as other related questions about promotion and tenure. The findings indicate that there is still a significant incongruence between the value structure of most family practice units and that of their institutions but that many family practice units are beginning to achieve parity of promotion and tenure with other departments in their institutions. PMID:2713010

  11. A National Survey on the Current Status of Family Practice Residency Education in Geriatric Medicine.

    ERIC Educational Resources Information Center

    Li, Ina; Arenson, Christine; Warshaw, Gregg; Bragg, Elizabeth; Shaull, Ruth; Counsell, Steven R.

    2003-01-01

    A survey of family practice residency directors found that 92 percent have a required geriatrics curriculum; nursing homes, assisted living facilities, and home care are the predominant training sites; the mean number of geriatrics faculty is 2.6 per program; and conflicting time demands with other curricula was ranked as the most significant…

  12. Acetylcholinesterase inhibitory, antioxidant and phytochemical properties of selected medicinal plants of the Lamiaceae family.

    PubMed

    Vladimir-Knežević, Sanda; Blažeković, Biljana; Kindl, Marija; Vladić, Jelena; Lower-Nedza, Agnieszka D; Brantner, Adelheid H

    2014-01-09

    The present study aimed to evaluate acetylcholinesterase (AChE) inhibitory and antioxidant activities of Lamiaceae medicinal plants growing wild in Croatia. Using Ellman's colorimetric assay all tested ethanolic extracts and their hydroxycinnamic acid constituents demonstrated in vitro AChE inhibitory properties in a dose dependent manner. The extracts of Mentha x piperita, M. longifolia, Salvia officinalis, Satureja montana, Teucrium arduini, T. chamaedrys, T. montanum, T. polium and Thymus vulgaris at 1 mg/mL showed strong inhibitory activity against AChE. The antioxidant potential of the investigated Lamiaceae species was assessed by DPPH• scavenging activity and total antioxidant capacity assays, in comparison with hydroxycinnamic acids and trolox. The extracts differed greatly in their total hydroxycinnamic derivatives content, determined spectrophotometrically. Rosmarinic acid was found to be the predominant constituent in most of the investigated medicinal plants (by RP-HPLC) and had a substantial influence on their AChE inhibitory and antioxidant properties, with the exception of Teucrium species. These findings indicate that Lamiaceae species are a rich source of various natural AChE inhibitors and antioxidants that could be useful in the prevention and treatment of Alzheimer's and other related diseases.

  13. [Learning concepts of diagnosis in family medicine: the "mark robinson sign" - the traces that should not be there].

    PubMed

    Turabián, José Luis; Samarín-Ocampos, Elena; Minier, Luis; Pérez-Franco, Benjamín

    2015-11-01

    We review the mechanisms of the mental operation to identify the disease in family medicine, using five cases where the diagnosis process began in "the trace that should not be there" or "Robinson sign" as happened to Robinson Crusoe when he saw a human footprint on the beach of the "desert island". How could it be there?; It was a mystery, and based on metaphors, we framed the mechanism of "the trace that should not be there" mainly in the first phase of clinical or intuitive reasoning, but this intuition of the doctor should be accompanied by the diagnostic process, like the "basso continuo" of Baroque music, allowing improvisation and personal style, and in this way, eventually observing the footprint "that should not have been there" that may arise in the analytical, as well as in the verification phase of the assumptions made. PMID:25959290

  14. [Learning concepts of diagnosis in family medicine: the "mark robinson sign" - the traces that should not be there].

    PubMed

    Turabián, José Luis; Samarín-Ocampos, Elena; Minier, Luis; Pérez-Franco, Benjamín

    2015-11-01

    We review the mechanisms of the mental operation to identify the disease in family medicine, using five cases where the diagnosis process began in "the trace that should not be there" or "Robinson sign" as happened to Robinson Crusoe when he saw a human footprint on the beach of the "desert island". How could it be there?; It was a mystery, and based on metaphors, we framed the mechanism of "the trace that should not be there" mainly in the first phase of clinical or intuitive reasoning, but this intuition of the doctor should be accompanied by the diagnostic process, like the "basso continuo" of Baroque music, allowing improvisation and personal style, and in this way, eventually observing the footprint "that should not have been there" that may arise in the analytical, as well as in the verification phase of the assumptions made.

  15. Medical liability insurance as a barrier to the provision of abortion services in family medicine.

    PubMed

    Dehlendorf, Christine E; Grumbach, Kevin

    2008-10-01

    Family physicians who wish to provide abortions have been subject to both denial of coverage by medical liability insurers and the imposition of large premium increases. These policy decisions by insurance companies raise questions about the role of family physicians in abortion care and about the autonomy of medical specialties in defining their scope of practice. We review the issues specific to abortion services in the primary care setting and examine the broader implications for the medical profession. Finally, we review how advocacy and improved regulation of the insurance industry could help to ensure that clinicians who are trained and willing to provide services to their patients are not limited by the decisions of medical liability insurers.

  16. Attitudes and perceptions of medical students about family medicine in Spain: protocol for a cross-sectional survey

    PubMed Central

    Alonso-Coello, Pablo; Villa, Josep Jiménez; Hijar, Antonio Monreal; Tuduri, Xavier Mundet; Puime, Ángel Otero

    2011-01-01

    Background Despite the fact that family medicine (FM) has become established as a specialty in the past 25 years, this has not been reflected in the inclusion of the specialty in the majority of medical schools in Spain. Almost 40% of the students will work in primary care but, in spite of this, most universities do not have an assessed placement as such. There are only specific practice periods in health centres or some student-selected components with little weight in the overall curricula. Objectives To evaluate the attitudes and perceptions of medical students about FM in the health system and their perception about the need for specific training in FM at the undergraduate level. To explore change over time of these attitudes and perceptions and to examine potential predictive factors for change. Finally, we will review what teaching activity in FM is offered across the Spanish schools of medicine. Methods Descriptive cross-sectional survey. Each one of the different analyses will consist of two surveys: one for all the students in the first, third and fifth year of medical school in all the Spanish schools of medicine asking about their knowledge, perceptions and attitudes in relation to primary care and FM. There will be an additional survey for the coordinating faculty of the study in each university about the educational activities related to FM that are carried out in their centres. The repetition of the study every 2 years will allow for an analysis of the evolution of the cohort of students until they receive their degree and the potential predictive factors. Discussion This study will provide useful information for strategic planning decisions, content and educational methodology in medical schools in Spain and elsewhere. It will also help to evaluate the influence of the ongoing changes in FM, locally and at the European level, on the attitudes and perceptions of the students towards FM in Spain. PMID:22189348

  17. 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

  18. Bending the cost curve and increasing revenue: a family medicine model that works!

    PubMed

    Katz, Bernard J; Needham, Mark R

    2012-12-01

    This article attempts to illustrate ways in which family physician practices are able to demonstrate high value, enhanced quality, and streamlined costs, essential components of practice sustainability. Specific examples are provided to assist practices to consider questions and information that allow for skillful engagement during contract negotiations, consider increasing practice revenues by adopting practice enhancements that make sense for the location of the practice and community needs, develop workflow analyses, and review opportunities for expense reduction.

  19. VARIABLE SELECTION FOR QUALITATIVE INTERACTIONS IN PERSONALIZED MEDICINE WHILE CONTROLLING THE FAMILY-WISE ERROR RATE

    PubMed Central

    Gunter, Lacey; Zhu, Ji; Murphy, Susan

    2012-01-01

    For many years, subset analysis has been a popular topic for the biostatistics and clinical trials literature. In more recent years, the discussion has focused on finding subsets of genomes which play a role in the effect of treatment, often referred to as stratified or personalized medicine. Though highly sought after, methods for detecting subsets with altering treatment effects are limited and lacking in power. In this article we discuss variable selection for qualitative interactions with the aim to discover these critical patient subsets. We propose a new technique designed specifically to find these interaction variables among a large set of variables while still controlling for the number of false discoveries. We compare this new method against standard qualitative interaction tests using simulations and give an example of its use on data from a randomized controlled trial for the treatment of depression. PMID:22023676

  20. Family consent and the pursuit of better medicines through genetic research.

    PubMed

    Renegar, G; Rieser, P; Manasco, P

    2001-01-01

    Rapid changes in the science and technology related to genetic research are challenging scientists, health care providers, ethicists, regulators, patient groups, and the pharmaceutical industry to keep pace with ethically grounded, workable guidelines for both the research and clinical applications of human genetics. We describe the genetic research being conducted by one pharmaceutical company (GlaxoSmithKline) and how the company is addressing the ethical, legal, and social issues surrounding this research; discuss an industry working group's attempt to advance pharmacogenetic research by openly addressing and disseminating information on related ethical, legal, and regulatory issues; identify scientific and ethical differences among various types of genetic research; discuss potential implications of family consent on subject privacy and autonomy, data collection, and study conduct; and suggest points to consider when study sponsors, investigators, and ethics committees evaluate research proposals. Public and expert opinion regarding informed consent in genetic research is evolving as a result of increased education, discussion, and understanding of the relevant issues. Five years ago, there was strong support for anonymity in genetic research as a privacy safeguard. Now, an increasingly popular school of thought advocates against anonymity to preserve an individual's ability to withdraw and, if desired, access research results. It is important to recognize this evolution and address consent issues in a reasoned, practical, and consistent way, including input from patients and their families, health care providers, ethicists, scientists, regulatory bodies, research sponsors, and the lay community. Responsibility for assessing issues related to family consent for research should remain with local investigators, ethics boards, and study sponsors. A "one-size-fits-all" perspective in the form of new regulations, for example, would likely be a disservice to all.

  1. Early Signs of Atherogenesis in Adolescents in a Havana Family Medicine Catchment Area.

    PubMed

    Valdés, Wendy; Díaz-Perera, Georgia; Espinosa, Tania M

    2015-10-01

    INTRODUCTION Atherosclerosis is the common underlying cause of cardiovascular diseases; the leading cause of morbidity and mortality globally. It is a major contributor to disability and poorer quality of life and is costly to health systems, individuals, families and society. Early signs of atherogenesis are manifestations of atherosclerosis and known atherogenic risk factors occurring at young ages and detectable by health professionals. Early detection of such signs in children and adolescents enables actions to prevent short- and long-term complications. OBJECTIVE Detect early signs of atherogenesis in adolescents in Family Doctor-and-Nurse Office No. 13 of the Raúl Gómez García Polyclinic in Havana's 10 de Octubre Municipality. METHODS An observational, cross-sectional descriptive study was conducted: the universe consisted of 110 adolescents and, once exclusion criteria were applied, the sample was made up of 96 adolescents in the office's geographical catchment area. Variables included sociodemographic data; measurements from physical and anthropometric examinations (weight, height, body mass index, waist circumference, blood pressure, presence of acanthosis nigricans); maternal history of diabetes mellitus and hypertension, smoking during pregnancy; birth weight and duration of exclusive breastfeeding; lifestyle (physical activity, dietary habits by frequency of consumption of fruits and vegetables, salt intake, and smoking); and a history of atherogenic risk factors and atherosclerotic diseases (hypertension, diabetes mellitus, heart disease, cerebrovascular disease, peripheral arterial disease and chronic kidney disease) in adolescents and their families. The number of early signs of atherogenesis was determined. Descriptive statistics and a chi-square test, with significance threshold set at p = 0.05, were used to examine differences by sex and age. RESULTS A total of 62.5% of participating adolescents were female and the same percent of the total

  2. GP clinic and community health centre approach to after hours and the role of Medicare Locals in educating and raising awareness.

    PubMed

    Rinehart, Natalie E; Smorgon, Samantha; Holman, Jessica

    2014-01-01

    This article reviews a Quality Improvement Project concerning how GP clinics approach after hours (AH) primary care information for themselves and their patients. Medicare Locals have been given the responsibility of coordinating AH services in their catchments and supporting health systems and patients in accessing care appropriate to their needs. The AH project conducted by Inner North West Melbourne Medicare Local (INWMML) sought to explore how a range of GP clinics approached AH information before an educational forum, evaluation of its developed resources for increasing awareness of AH options and how clinics would choose to change their approach to AH following this process. The findings suggested that 46 participating clinic staff had a strong focus on hospitals and locum services as the main AH options despite telephone advice line options being available. Additionally, there was a lack of awareness for some clinic staff concerning services for mental health, dental health and residential aged care. The educational forum and the AH resources developed (i.e. brochures, posters and service directory) by INWMML were rated as valuable and would be used and shared with other health care providers and patients. Confidence that patients would be able to find appropriate care in the AH period after clinics had finished implementing planned changes, rose significantly in key areas after participating in the AH project.

  3. GP clinic and community health centre approach to after hours and the role of Medicare Locals in educating and raising awareness.

    PubMed

    Rinehart, Natalie E; Smorgon, Samantha; Holman, Jessica

    2014-01-01

    This article reviews a Quality Improvement Project concerning how GP clinics approach after hours (AH) primary care information for themselves and their patients. Medicare Locals have been given the responsibility of coordinating AH services in their catchments and supporting health systems and patients in accessing care appropriate to their needs. The AH project conducted by Inner North West Melbourne Medicare Local (INWMML) sought to explore how a range of GP clinics approached AH information before an educational forum, evaluation of its developed resources for increasing awareness of AH options and how clinics would choose to change their approach to AH following this process. The findings suggested that 46 participating clinic staff had a strong focus on hospitals and locum services as the main AH options despite telephone advice line options being available. Additionally, there was a lack of awareness for some clinic staff concerning services for mental health, dental health and residential aged care. The educational forum and the AH resources developed (i.e. brochures, posters and service directory) by INWMML were rated as valuable and would be used and shared with other health care providers and patients. Confidence that patients would be able to find appropriate care in the AH period after clinics had finished implementing planned changes, rose significantly in key areas after participating in the AH project. PMID:23480857

  4. [Experience and problems of the primary health care centers' specialists in the implementation of the integrated health system based on family medicine in Ukraine].

    PubMed

    Hrytsko, R Iu; Furtak, I I; Parobets'ka, I M

    2014-01-01

    The experience of the primary health care' centers in Lviv, Mykolaiv, Kherson regions on the basis of family medicine, integrated medical space, modern governance mechanisms, market technology, promotion trasmural' approach, intersectoral coordination and collaboration and preventative health care population allows to get the maximum effectiveness of the provision of public health in relation to a particular administrative area with limited resources.

  5. CHEMICAL COMPOSITION AND ANTIBACTERIAL ACTIVITY OF SOME MEDICINAL PLANTS FROM LAMIACEAE FAMILY.

    PubMed

    Kozłowska, Mariola; Laudy, Agnieszka E; Przybył, Jarosław; Ziarno, Małgorzata; Majewska, Ewa

    2015-01-01

    Chemical composition and antibacterial activity of aqueous (ethanolic and methanolic) extracts from herbs often used in Polish cuisine and traditional herbal medicine including thyme (Thymus vulgaris L.), rosemary (Rosmarinus officinalis L.), oregano (Origanum vulgare L.), peppermint (Mentha piperita L.) and sage (Salvia officinalis L.) were compared. The aqueous ethanolic extracts contained slightly higher levels of phenolics compared to the aqueous methanolic extracts. In turn, GC-MS analysis showed that the aqueous methanolic extracts of thyme, rosemary and sage contained several additional compounds such as eugenol or ledol. The present studies also indicated that the bacterial species applied in the experiment exhibited different sensitivities towards tested extracts. Staphylococcus aureus strains were found to be the most sensitive bacteria to aqueous (ethanolic and methanolic) rosemary and sage extracts and aqueous methanolic thyme extract. Klebsiella pneumoniae ATCC 13883 and Proteus vulgaris NCTC 4635 were more susceptible to the aqueous methanolic thyme extract. However, Listeria monocytogenes 1043S was the most sensitive to the aqueous ethanolic rosemary extract. Gram-positive bacteria were generally more sensitive to the tested extracts than Gram-negative ones. PMID:26647633

  6. [The evaluation of maternal-child care at 5 family medicine units].

    PubMed

    Vega-Vega, G

    1993-01-01

    In 1991 five of the 38 Family Practice Units of a Social Security Institute in Mexico City were evaluated regarding the care provided to pregnant women and to children under the age of one. The clinical records were reviewed looking for the following indicators: a) weeks of pregnancy at first prenatal visit, b) total number of prenatal visits, c) total number of times the arterial tension was recorded during the prenatal visits, d) total number of urine exams during the prenatal visits, e) total number of visits by the first year of age, f) weight, and g) number and type of vaccines. The five units had a variable compliance with the standards. The measurement of the indicators permits the identification of deviations and to focus future efforts to improve the care provided at the Units.

  7. Career preferences and the work-family balance in medicine: gender differences among medical specialists.

    PubMed

    Heiliger, P J; Hingstman, L

    2000-05-01

    In this article career preferences of medical specialists in the Netherlands are analysed, based on a survey among the members of medical associations of five specialties. Four different career preferences were offered, each of which implied a possible variation in working hours. A questionnaire was sent to a random selected group of working specialists in general practice, internal medicine, anaesthesiology, ophthalmology and psychiatry. Logistic regressions were used to predict career preferences. Besides individual characteristics, work and home domain characteristics were taken into the analysis. Not surprisingly, the preference for career change in respect of working hours is higher among full-time MDs, especially women, than among part-time workers. In contradiction to what was expected, home domain characteristics did not predict a part-time preference for female, but for male MDs. One home domain characteristic, children's age, did predict the male part-time preference. Further gender differences were found in respect of the fit between actual and preferred working hours (A/P-fit). The majority of male MDs with a full-time preference had achieved an A/P-fit, whereas significantly less female MDs achieved their preferences. It was found that hospital-bound specialists are less positive towards part-time careers than other specialists. Furthermore, the change of working hours would imply a reduction in FTE for all specialties, if all preferences were met. Especially in hospital-bound specialisms it was not confirmed that the reduction in FTE would be low; this was found only in respect of interns. It may be concluded that individual preferences in career paths are very diverse. Personnel policy in medical specialties, especially in hospitals, will have to cope with changes in traditional vertical and age-related career paths. Flexible careers related to home domain determinants or other activities will reinforce a life cycle approach, in which the centrality

  8. Family.

    ERIC Educational Resources Information Center

    Hurst, Hunter, Ed.; And Others

    1985-01-01

    This document contains the fourth volume of "Today's Delinquent," an annual publication of the National Center for Juvenile Justice. This volume deals with the issue of the family and delinquency. "The Family and Delinquency" (LaMar T. Empey) systematically reviews and weighs the evidence to support prominent theories on the origins of…

  9. Barriers to Screening and Possibilities for Active Detection of Family Medicine Attendees Exposed to Intimate Partner Violence

    PubMed Central

    KOPČAVAR GUČEK, Nena; PETEK, Davorina; ŠVAB, Igor; SELIČ, Polona

    2016-01-01

    Introduction In 1996 the World Health Organization declared intimate partner violence (IPV) the most important public health problem. Meta-analyses in 2013 showed every third female globally had been a victim of violence. Experts find screening controversial; family medicine is the preferred environment for identifying victims of violence, but barriers on both sides prevent patients from discussing it with doctors. Methods In July 2014, a qualitative study was performed through semi-structured interviews with ten family doctors of different ages and gender, working in rural or urban environments. Sound recordings of the interviews were transcribed, and the record verified. The data were interpreted using content analysis. A coding scheme was developed and later verified and analysed by two independent researchers. The text of the interviews was analysed according to the coding scheme. Results Two coding schemes were developed: one for screening, and the other for the active detection of IPV. The main themes emerging as barriers to screening were lack of time, staff turnover, inadequate finance, ignorance of a clear definition, poor commitment to screening, obligatory follow-up, risk of deterioration of the doctor-patient relationship, and insincerity on the part of the patient. Additionally, cultural aspects of violence, uncertainty/ helplessness, fear, lack of competence and qualifications, autonomy/negative experience, and passive role/stigma/ fear on the part of the patients were barriers to active detection. Conclusion All the participating doctors had had previous experience with active detection of IPV and were aware of its importance. Due to several barriers to screening for violence they preferred active detection. PMID:27647084

  10. The value of an ENT specialist outreach service in a Family Medicine Unit for the urban poor in India

    PubMed Central

    John, Mary; Parsons, Alicia; Abraham, Sunil

    2016-01-01

    Objectives: To assess the function of an otolaryngology (ENT) specialist outreach service in a Family Medicine (FM) Unit for the urban poor attached to a Tertiary Teaching Hospital in India. Materials and Methods: The study investigated the pattern of ENT diseases in patients who came to the FM Unit and the proportion of these patients who were referred to the ENT specialist clinic at the unit. The study also analyzed the ENT problems that were managed by the ENT specialist at the unit and the conditions, which needed referral to the Tertiary Hospital. Data was collected by chart review. Setting: Weekly ENT specialist outreach service in an FM Unit for the urban poor in India attached to a Tertiary Teaching Hospital. Results: Among the outpatients who attended the unit in 12 months, 12.89% had ENT-related problems, of which 23.9% were referred to the visiting ENT specialist, 88.30% of these patients were managed in the FM Unit with basic ENT facilities. Conclusion: This study demonstrated that majority of the patients with ENT-related problems who presented to an FM Unit could be managed by the FM specialists. Of those patients who required the expertise of a specialist in ENT, the majority could be managed in the FM Unit, with basic ENT examination and treatment facilities. Triage and management by the family physician and the visiting ENT surgeon in the FM Unit is a prudent use of resources and will improve the quality of care people receive for their ENT problems. PMID:27453846

  11. Evaluation of the quality of antenatal care using electronic health record information in family medicine clinics of Mexico City

    PubMed Central

    2014-01-01

    Background Evaluation of the quality of antenatal care (ANC) using indicators should be part of the efforts to improve primary care services in developing countries. The growing use of the electronic health record (EHR) has the potential of making the evaluation more efficient. The objectives of this study were: (a) to develop quality indicators for ANC and (b) to evaluate the quality of ANC using EHR information in family medicine clinics (FMCs) of Mexico City. Methods We used a mixed methods approach including: (a) in-depth interviews with health professionals; (b) development of indicators following the RAND-UCLA method; (c) a retrospective cohort study of quality of care provided to 5342 women aged 12–49 years who had completed their pregnancy in 2009 and attended to at least one ANC visit with their family doctor. The study took place in four FMCs located in Mexico City. The source of information was the EHR. SAS statistical package served for programing and performing the descriptive statistical analysis. Results 14 ANC quality indicators were developed. The evaluation showed that 40.6% of women began ANC in the first trimester; 63.5% with low-risk pregnancy attended four or more ANC visits; 4.4% were referred for routine obstetric ultrasound, and 41.1% with vaginal infection were prescribed metronidazole. On average, the percentage of recommended care that women received was 32.7%. Conclusions It is feasible to develop quality indicators suitable for evaluating the quality of ANC using routine EHR data. The study identified the ANC areas that require improvement; which can guide future strategies aimed at improving ANC quality. PMID:24885103

  12. Setting priorities for teaching and learning: an innovative needs assessment for a new family medicine program in Lao PDR.

    PubMed

    Kanashiro, Jeanie; Hollaar, Gwen; Wright, Bruce; Nammavongmixay, Khamphong; Roff, Sue

    2007-03-01

    Lao People's Democratic Republic (Lao PDR) is a small, tropical, landlocked country in southeast Asia. It is one of the least developed countries in the region, and its socioeconomic indicators are among the lowest 25% in the world. The World Health Organization has long called for increased equity in primary health care access around the world. To meet this need in Lao PDR, the Family Medicine Specialist Program was developed, a Lao-generated postgraduate training program designed to produce community-oriented primary care practitioners to serve the rural, remote areas of Lao PDR, where 80% of the population lives. An innovative method of needs assessment was required to determine the health care priorities to be met by this new program. Through the use of a modified Delphi technique, local key leaders in medical education, clinical specialists, and teachers were consulted to develop prioritized objectives for the hospital-based curriculum of the program. By setting priorities for teaching and learning in the unique and needy circumstances of Lao PDR, a novel approach to curriculum planning in a low-income country was explored and ultimately formed the foundation of the new curriculum. This process served to direct the allocation of scarce resources during implementation of this groundbreaking program. More importantly, this model of needs assessment could potentially be used to customize medical curricula in other low-income countries facing challenges similar to those in Lao PDR.

  13. Constructing and Communicating Privacy Boundaries: How Family Medicine Physicians Manage Patient Requests for Religious Disclosure in the Clinical Interaction.

    PubMed

    Canzona, Mollie Rose; Peterson, Emily Bylund; Villagran, Melinda M; Seehusen, Dean A

    2015-01-01

    Religion/spirituality (R/S) is an important component of some patients' psychosocial framework when facing illness. While many patients report an increased desire for R/S dialogue in clinical interaction, especially when facing a frightening diagnosis, some physicians report discomfort talking about R/S and hold various beliefs regarding the appropriateness of such discussions. Not only do physicians manage conversations centering on patient disclosures in the clinical visit, they must also navigate requests to share their own personal information. Farber et al. (2000) found that over a 12-month period nearly 40% of physicians reported that patients asked questions that transgressed professional boundaries. This article uses Petronio's communication privacy management theory as a lens through which to situate our understanding of how family medicine physicians construct and communicate privacy boundaries in response to patient requests for religious disclosure. Results provide an in-depth theoretical understanding of issues surrounding religious disclosure in the medical visit and expand the discussion on health care providers' personal and professional privacy boundaries as documented by Petronio and Sargent (2011). Implications for health care training and practice are discussed.

  14. Genome-wide analysis of auxin response factor gene family members in medicinal model plant Salvia miltiorrhiza

    PubMed Central

    Xu, Zhichao; Ji, Aijia; Chen, Shilin

    2016-01-01

    ABSTRACT Auxin response factors (ARFs) can function as transcriptional activators or repressors to regulate the expression of auxin response genes by specifically binding to auxin response elements (AuxREs) during plant development. Based on a genome-wide strategy using the medicinal model plant Salvia miltiorrhiza, 25 S. miltiorrhiza ARF (SmARF) gene family members in four classes (class Ia, IIa, IIb and III) were comprehensively analyzed to identify characteristics including gene structures, conserved domains, phylogenetic relationships and expression patterns. In a hybrid analysis of the phylogenetic tree, microRNA targets, and expression patterns of SmARFs in different organs, root tissues, and methyl jasmonate or indole-3-acetic acid treatment conditions, we screened for candidate SmARFs involved in various developmental processes of S. miltiorrhiza. Based on this analysis, we predicted that SmARF25, SmARF7, SmARF16 and SmARF20 are involved in flower, leaf, stem and root development, respectively. With the further insight into the targets of miR160 and miR167, specific SmARF genes in S. miltiorrhiza might encode products that participate in biological processes as described for ARF genes in Arabidopsis. Our results provide a foundation for understanding the molecular basis and regulatory mechanisms of SmARFs in S. miltiorrhiza. PMID:27230647

  15. Genome-wide analysis of auxin response factor gene family members in medicinal model plant Salvia miltiorrhiza.

    PubMed

    Xu, Zhichao; Ji, Aijia; Song, Jingyuan; Chen, Shilin

    2016-01-01

    Auxin response factors (ARFs) can function as transcriptional activators or repressors to regulate the expression of auxin response genes by specifically binding to auxin response elements (AuxREs) during plant development. Based on a genome-wide strategy using the medicinal model plant Salvia miltiorrhiza, 25 S. miltiorrhiza ARF (SmARF) gene family members in four classes (class Ia, IIa, IIb and III) were comprehensively analyzed to identify characteristics including gene structures, conserved domains, phylogenetic relationships and expression patterns. In a hybrid analysis of the phylogenetic tree, microRNA targets, and expression patterns of SmARFs in different organs, root tissues, and methyl jasmonate or indole-3-acetic acid treatment conditions, we screened for candidate SmARFs involved in various developmental processes of S. miltiorrhiza Based on this analysis, we predicted that SmARF25, SmARF7, SmARF16 and SmARF20 are involved in flower, leaf, stem and root development, respectively. With the further insight into the targets of miR160 and miR167, specific SmARF genes in S. miltiorrhiza might encode products that participate in biological processes as described for ARF genes in Arabidopsis Our results provide a foundation for understanding the molecular basis and regulatory mechanisms of SmARFs in S. miltiorrhiza. PMID:27230647

  16. Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists

    PubMed Central

    2014-01-01

    Background Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. Methods A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Results Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on ‘as needed’ basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS’ perceived 4 important ‘needs’ in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family

  17. Journal of the American Board of Family Medicine Sixth Annual Practice-based Research Network theme issue--They just keep getting better and better.

    PubMed

    Bowman, Marjorie A; Neale, Anne Victoria

    2011-01-01

    We have quite a rich issue this month related to practice-based research networks (PBRNs)--reflections on where they have been, where they should go, how they should happen; lessons learned about recruiting physicians and patients and new research methods; and several clinical studies from existing PBRNs. We had an amazing number of manuscripts submitted this year for the PBRN issue; as a result, this is a powerful issue. Some are under revision for future issues of the Journal of the American Board of Family Medicine, just as we have some articles from PBRNs appearing in most issues. PBRNs have deepened the family medicine research tradition. The importance of primary care research to build the evidence base of our clinical practice, plus the useful work building the methods of primary care research, distinguishes the pioneers in PBRNs. PBRNs are Health Improvement Networks and national treasures to be nurtured.

  18. 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

  19. A nationwide survey of public healthcare providers’ impressions of family medicine specialists in Malaysia: a qualitative analysis of written comments

    PubMed Central

    Cheong, Ai-Theng; Ismail, Mastura; Hamzah, Zuhra; A-Rashid, Mohd-Radzniwan; Md-Yasin, Mazapuspavina; Ali, Norsiah; Mohd-Salleh, Noridah; Bashah, Baizury

    2016-01-01

    Objective To examine impressions of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics. Design Cross-sectional study. Setting This study is part of a larger national study on the perception of Malaysian public healthcare professionals on FMSs (PERMFAMS). Participants PHCPs from three categories of health facility: hospitals, health clinics and health offices. Main outcome measures Qualitative analyses of written comments of respondents’ general impression of FMSs. Results The participants’ response rate was 58.0% (780/1345), with almost equal proportions from each public healthcare facility. A total of 23 categories for each of the 648 impression comments were identified. The six emerging themes were: (1) importance of FMSs; (2) roles of FMSs; (3) clinical performance of FMSs; (4) attributes of FMSs; (5) FMS practice challenges; (6) misconception of FMS roles. Overall, FMS practice was perceived to be safe and able to provide effective treatments in a challenging medical discipline that was in line with the current standards of medical care and ethical and professional values. The areas of concern were in clinical performance expressed by PHCPs from some hospitals and the lack of personal attributes and professionalism among FMSs mentioned by PHCPs from health clinics and offices. Conclusions FMSs were perceived to be capable of providing effective treatment and were considered to be important primary care physicians. There were a few negative impressions in some areas of FMS practice, which demanded attention by the FMSs themselves and the relevant authorities in order to improve efficiency and safeguard the fraternity's reputation. PMID:26743703

  20. Developing and successfully implementing a competency-based portfolio assessment system in a postgraduate family medicine residency program.

    PubMed

    McEwen, Laura A; Griffiths, Jane; Schultz, Karen

    2015-11-01

    The use of portfolios in postgraduate medical residency education to support competency development is increasing; however, the processes by which these assessment systems are designed, implemented, and maintained are emergent. The authors describe the needs assessment, development, implementation, and continuing quality improvement processes that have shaped the Portfolio Assessment Support System (PASS) used by the postgraduate family medicine program at Queen's University since 2009. Their description includes the impetus for change and contextual realities that guided the effort, plus the processes used for selecting assessment components and developing strategic supports. The authors discuss the identification of impact measures at the individual, programmatic, and institutional levels and the ways the department uses these to monitor how PASS supports competency development, scaffolds residents' self-regulated learning skills, and promotes professional identity formation. They describe the "academic advisor" role and provide an appendix covering the portfolio elements. Reflection elements include learning plans, clinical question logs, confidence surveys, and reflections about continuity of care and significant incidents. Learning module elements cover the required, online bioethics, global health, and consult-request modules. Assessment elements cover each resident's research project, clinical audits, presentations, objective structured clinical exam and simulated office oral exam results, field notes, entrustable professional activities, multisource feedback, and in-training evaluation reports. Document elements are the resident's continuing medical education activities including procedures log, attendance log, and patient demographic summaries.The authors wish to support others who are engaged in the systematic portfolio-design process or who may adapt aspects of PASS for their local programs.

  1. Internal Medicine Trainee Self-Assessments of End-of-Life Communication Skills Do Not Predict Assessments of Patients, Families, or Clinician-Evaluators

    PubMed Central

    Dickson, Robert P.; Engelberg, Ruth A.; Back, Anthony L.; Ford, Dee W.

    2012-01-01

    Abstract Purpose To investigate the strength of association between trainees' self-assessments of the quality of their end-of-life communication skills and the assessments of their patients, patients' families, and clinician-evaluators. Methods As part of a randomized trial, pre-intervention survey data were collected at two sites from internal medicine trainees and their patients, patients' families, and clinician-evaluators. In this observational analysis, comparisons using regression analysis were made between (1) trainees' scores on a scale of perceived competence at communication about end-of-life care and (2) patients', families', and clinician-evaluators' scores on a questionnaire on the quality of end-of-life communication (QOC). Secondary analyses were performed using topic-focused subscales of these measures. Results Internal medicine trainees (143) were studied with both self-assessment and external assessments. No significant associations were found between trainee perceived competence scores and primary outcome measures (p>0.05). Of the 12 secondary subscale analyses, trainees' self-ratings were significantly associated with external assessments for only one comparison, but the association was in the opposite direction with increased trainee ratings being significantly associated with decreased family ratings on “treatment discussions.” We also examined the correlation between ratings by patients, family, and clinician-evaluators, which showed significant correlations (p<0.05) for 7 of 18 comparisons (38.9%). Conclusions Trainee self-evaluations do not predict assessments by their patients, patients' families, or their clinician-evaluators regarding the quality of end-of-life communication. Although these results should be confirmed using the same measures across all raters, in the meantime efforts to improve communication about end-of-life care should consider outcomes other than physician self-assessment to determine intervention success. PMID

  2. A Brief Boot Camp for 4th-Year Medical Students Entering into Pediatric and Family Medicine Residencies

    PubMed Central

    Adler, Mark; Mangold, Karen; Trainor, Jennifer

    2016-01-01

    The transition from medical student to intern is a challenging process characterized by a steep learning curve. Focused courses targeting skills necessary for success as a resident have increased self-perceived preparedness, confidence, and medical knowledge. Our aim was to create a brief educational intervention for 4th-year medical students entering pediatric, family practice, and medicine/pediatric residencies to target skills necessary for an internship. The curriculum used a combination of didactic presentations, small group discussions, role-playing, facilitated debriefing, and simulation-based education. Participants completed an objective structured clinical exam requiring synthesis and application of multiple boot camp elements before and after the elective. Participants completed anonymous surveys assessing self-perceived preparedness for an internship, overall and in regards to specific skills, before the elective and after the course. Participants were asked to provide feedback about the course. Using checklists to assess performance, students showed an improvement in performing infant lumbar punctures (47.2% vs 77.0%; p < 0.01, 95% CI for the difference 0.2, 0.4%) and providing signout (2.5 vs. 3.9 (5-point scale) p < 0.01, 95% CI for the difference 0.6, 2.3). They did not show an improvement in communication with a parent. Participants demonstrated an increase in self-reported preparedness for all targeted skills, except for obtaining consults and interprofessional communication. There was no increase in reported overall preparedness. All participants agreed with the statements, “The facilitators presented the material in an effective manner,” “I took away ideas I plan to implement in internship,” and “I think all students should participate in a similar experience.” When asked to assess the usefulness of individual modules, all except order writing received a mean Likert score > 4. A focused boot camp addressing key knowledge and skills

  3. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 2. Results: Primary care management and community orientation.

    PubMed

    Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

    2010-03-01

    At the WONCA Europe conference 2009 the recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' was presented. It is a background paper and reference manual, providing advocacy of general practice/family medicine (GP/FM) in Europe. The Research Agenda summarizes the evidence relating to the core competencies and characteristics of the WONCA Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In this second article, the results for the core competencies 'primary care management' and 'community orientation' are presented. Though there is a large body of research on various aspects of 'primary care management', it represents a very scattered rather than a meta view. Many studies focus on care for specific diseases, the primary/secondary care interface, or the implications of electronic patient records. Cost efficiency or process indicators of quality are current outcomes. Current literature on community orientation is mainly descriptive, and focuses on either care for specific diseases, or specific patient populations, or on the uptake of preventive services. Most papers correspond poorly to the WONCA concept. For both core competencies, there is a lack of research with a longitudinal perspective and/or relevant health or quality of life outcomes as well as research on patients' preferences and education for organizational aspects of GP/FM.

  4. Residents’ and preceptors’ perceptions of the use of the iPad for clinical teaching in a family medicine residency program

    PubMed Central

    2014-01-01

    Background As Family Medicine programs across Canada are transitioning into a competency-based curriculum, medical students and clinical teachers are increasingly incorporating tablet computers in their work and educational activities. The purpose of this pilot study was to identify how preceptors and residents use tablet computers to implement and adopt a new family medicine curriculum and to evaluate how they access applications (apps) through their tablet in an effort to support and enhance effective teaching and learning. Methods Residents and preceptors (n = 25) from the Family Medicine program working at the Pembroke Regional Hospital in Ontario, Canada, were given iPads and training on how to use the device in clinical teaching and learning activities and how to access the online curriculum. Data regarding the use and perceived contribution of the iPads were collected through surveys and focus groups. This mixed methods research used analysis of survey responses to support the selection of questions for focus groups. Results Reported results were categorized into: curriculum and assessment; ease of use; portability; apps and resources; and perceptions about the use of the iPad in teaching/learning setting. Most participants agreed on the importance of accessing curriculum resources through the iPad but recognized that these required enhancements to facilitate use. The iPad was considered to be more useful for activities involving output of information than for input. Participants’ responses regarding the ease of use of mobile technology were heterogeneous due to the diversity of computer proficiency across users. Residents had a slightly more favorable opinion regarding the iPad’s contribution to teaching/learning compared to preceptors. Conclusions iPad’s interface should be fully enhanced to allow easy access to online curriculum and its built-in resources. The differences in computer proficiency level among users should be reduced by sharing

  5. A chemical family-based strategy for uncovering hidden bioactive molecules and multicomponent interactions in herbal medicines

    PubMed Central

    Song, Hui-Peng; Wu, Si-Qi; Hao, Haiping; Chen, Jun; Lu, Jun; Xu, Xiaojun; Li, Ping; Yang, Hua

    2016-01-01

    Two concepts involving natural products were proposed and demonstrated in this paper. (1) Natural product libraries (e.g. herbal extract) are not perfect for bioactivity screening because of the vast complexity of compound compositions, and thus a library reconstruction procedure is necessary before screening. (2) The traditional mode of “screening single compound” could be improved to “screening single compound, drug combination and multicomponent interaction” due to the fact that herbal medicines work by integrative effects of multi-components rather than single effective constituents. Based on the two concepts, we established a novel strategy aiming to make screening easier and deeper. Using thrombin as the model enzyme, we firstly uncovered the minor lead compounds, potential drug combinations and multicomponent interactions in an herbal medicine of Dan-Qi pair, showing a significant advantage over previous methods. This strategy was expected to be a new and promising mode for investigation of herbal medicines. PMID:27025397

  6. Training family physicians and residents in family medicine in shared decision making to improve clinical decisions regarding the use of antibiotics for acute respiratory infections: protocol for a clustered randomized controlled trial

    PubMed Central

    2011-01-01

    Background To explore ways to reduce the overuse of antibiotics for acute respiratory infections (ARIs), we conducted a pilot clustered randomized controlled trial (RCT) to evaluate DECISION+, a training program in shared decision making (SDM) for family physicians (FPs). This pilot project demonstrated the feasibility of conducting a large clustered RCT and showed that DECISION+ reduced the proportion of patients who decided to use antibiotics immediately after consulting their physician. Consequently, the objective of this study is to evaluate, in patients consulting for ARIs, if exposure of physicians to a modified version of DECISION+, DECISION+2, would reduce the proportion of patients who decide to use antibiotics immediately after consulting their physician. Methods/design The study is a multi-center, two-arm, parallel clustered RCT. The 12 family practice teaching units (FPTUs) in the network of the Department of Family Medicine and Emergency Medicine of Université Laval will be randomized to a DECISION+2 intervention group (experimental group) or to a no-intervention control group. These FPTUs will recruit patients consulting family physicians and residents in family medicine enrolled in the study. There will be two data collection periods: pre-intervention (baseline) including 175 patients with ARIs in each study arm, and post-intervention including 175 patients with ARIs in each study arm (total n = 700). The primary outcome will be the proportion of patients reporting a decision to use antibiotics immediately after consulting their physician. Secondary outcome measures include: 1) physicians and patients' decisional conflict; 2) the agreement between the parties' decisional conflict scores; and 3) perception of patients and physicians that SDM occurred. Also in patients, at 2 weeks follow-up, adherence to the decision, consultation for the same reason, decisional regret, and quality of life will be assessed. Finally, in both patients and physicians

  7. A nationwide survey on the expectation of public healthcare providers on family medicine specialists in Malaysia—a qualitative analysis of 623 written comments

    PubMed Central

    Chew, Boon-How; Cheong, Ai-Theng; Ismail, Mastura; Hamzah, Zuhra; A-Rashid, Mohd-Radzniwan; Md-Yasin, Mazapuspavina; Ali, Norsiah

    2014-01-01

    Objective To examine the expectation of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics. Design Cross-sectional study. Setting This study is part of a larger national study on the perception of the Malaysian public healthcare professionals on FMSs. Participants PHCPs from three categories of health facilities, namely hospitals, health clinics and health offices. Main outcome measures Qualitative analysis of written comments of respondents’ expectation of FMSs. Results The participants’ response rate was 58% (780/1345) with an almost equal proportion from each public healthcare facility. We identified 21 subthemes for the 623 expectation comments. The six emerging themes are (1) need for more FMSs, (2) clinical roles and functions of FMSs, (3) administrative roles of FMSs, (4) contribution to community and public health, (5) attributes improvement and (6) research and audits. FMSs were expected to give attention to clinical duty. Delivering this responsibility with competence included having the latest medical knowledge in their own and others’ medical disciplines, practising evidence-based medicine in prehospital and posthospital care, better supervision of staff and doctors under their care, fostering effective teamwork, communicating more often with hospital specialists and making appropriate referral. Expectations ranged from definite and strong for more FMSs at the health clinics to low expectation for FMSs’ involvement in research; to mal-expectation on FMSs’ involvement in community and public health programmes. Conclusions There were some remarkable differences in expectations on FMSs from the three different PHCPs. These ranged from being clinically competent and administratively available for patients and staff at the health clinics, to mal-expectations on FMSs to engage in public health affairs. Relevant parties, including FMSs themselves, could take

  8. Did past economic prosperity affect the health related quality of life predictors? A longitudinal study on a representative sample of Slovenian family medicine patients

    PubMed Central

    2013-01-01

    Background Health related quality of life (HRQOL) as an important measure of medical outcomes has been shown to be associated with demographic factors and the most common mental and chronic somatic diseases. This study’s aim was to identify factors predicting changes in HRQOL over a follow-up period in a representative sample of Slovenian family medicine patients. Methods In a longitudinal multi-centred study between 2003 and 2005, data were collected from 1118 consecutive attendees from 60 family medicine practices in Slovenia on quality of life, socio-demographic factors and the presence of mental disorders, with follow-up after 6 and 24 months. Retrospective information on chronic diseases was obtained from patients` health records. In three time-sequential multiple linear regression models, data on 601 patients (53.8%) was analysed to determine factors associated with each component score of quality of life. Results At baseline the patients were 48.58 (SE = 0.58) years of age, over half were women (386 (64.2%)) and most were Slovenian (548 (91.2%)). Quality of life was seen to improve over the two-year period. Factors significantly and consistently associated with a better mental component score of quality of life were social support, satisfactory circumstances in patients` household and absence of anxiety. Major life events in the past year and depression were shown to be risk factors for mental and physical components, while level of education, absence of long-term disability and chronic pain were identified as predictors of the physical component. Conclusions Detection and successful treatment of depression and anxiety has a potential to lead to improved quality of life in family medicine attendees; family physicians should be alert for the early onset of these conditions, knowing that symptoms of chronic pain, depression and anxiety often overlap in patients. Poorly educated patients and those lacking social support and/or satisfactory household

  9. Family medicine, 'La Herencia' and breast cancer; understanding the (dis)continuities of predictive genetics in Cuba.

    PubMed

    Gibbon, Sahra

    2011-06-01

    Building on social science research examining the relationship between genetic knowledge, identity and the family this paper takes the cultural context of Cuba as a site for critical ethnographic engagement. The paper makes use of research working with a range of Cuban public and genetic professionals as part of a collaborative research project exploring the social and cultural context of health beliefs about breast cancer. It illuminates the contrasting ways in which genomic knowledge linked to an increased risk of breast cancer is perceived, communicated, and acted upon. It is argued that the particular meaning and significance of genetic risk linked to breast cancer in this context must be examined in relation to long standing institutional practices relating to public health care provision. The focus on 'the family' in the provision of Cuban health provides a particularly viable foundation for the expansion of what is described as 'community genetics', including the collation of family history details for common complex diseases such as breast cancer. Nevertheless specific public perceptions of risk related to breast cancer and the difficulties of discussing a diagnosis of cancer openly in the family point to the very specific challenges for the translation and application of predictive interventions in Cuba. In summary the dynamic interrelationship between public health, perceptions of risk or health beliefs about the causes of the disease and attitudes towards cancer diagnosis within the family point to both continuities and discontinuities in the way that genomic interventions linked to breast cancer are unfolding as part of a dynamic yet still ostensibly socialist project of health care in Cuba.

  10. After-Hours Science: Gee, A Dome!

    ERIC Educational Resources Information Center

    Santos, John G.

    1984-01-01

    Nature's Classroom (Southbridge, MA), which provides field experiences, academic classes, and activities in the natural sciences, has been recognized as an outstanding program by the National Science Teachers Association's Search for Excellence in Science Education project. Various program activities (including building a geodesic dome) are…

  11. Quality of care and health-related quality of life of climacteric stage women cared for in family medicine clinics in Mexico

    PubMed Central

    2010-01-01

    Objectives 1) To design and validate indicators to measure the quality of the process of care that climacteric stage women receive in family medicine clinics (FMC). 2) To assess the quality of care that climacteric stage women receive in FMC. 3) To determine the association between quality of care and health-related quality of life (HR-QoL) among climacteric stage women. Methods The study had two phases: I. Design and validation of indicators to measure the quality of care process by using the RAND/UCLA Appropriateness Method. II. Evaluation of the quality of care and its association with HR-QoL through a cross-sectional study conducted in two FMC located in Mexico City that included 410 climacteric stage women. The quality of care was measured by estimating the percentage of recommended care received (PRCR) by climacteric stage women in three process components: health promotion, screening, and treatment. The HR-QoL was measured using the Cervantes scale (0-155). The association between quality of care and HR-QoL was estimated through multiple linear regression analysis. Results The lowest mean of PRCR was for the health promotion component (24.1%) and the highest for the treatment component (86.6%). The mean of HR-QoL was 50.1 points. The regression analysis showed that in the treatment component, for every 10 additional points of the PRCR, the global HR-QoL improved 2.8 points on the Cervantes scale (coefficient -0.28, P < 0.0001). Conclusion The indicators to measure quality of care for climacteric stage women are applicable and feasible in family medicine settings. There is a positive association between the quality of the treatment component and HR-QoL; this would encourage interventions to improve quality of care for climacteric stage women. PMID:20144238

  12. Family medicine, ‘La Herencia’ and breast cancer; understanding the (dis)continuities of predictive genetics in Cuba

    PubMed Central

    Gibbon, Sahra

    2011-01-01

    Building on social science research examining the relationship between genetic knowledge, identity and the family this paper takes the cultural context of Cuba as a site for critical ethnographic engagement. The paper makes use of research working with a range of Cuban publics and genetic professionals as part of a collaborative research project exploring the social and cultural context of health beliefs about breast cancer. It illuminates the contrasting ways in which genomic knowledge linked to an increased risk of breast cancer is perceived, communicated, and acted upon. It is argued that the particular meaning and significance of genetic risk linked to breast cancer in this context must be examined in relation to long standing institutional practices relating to public health care provision. The focus on ‘the family’ in the provision of Cuban health provides a particularly viable foundation for the expansion of what is described as ‘community genetics’, including the collation of family history details for common complex diseases such as breast cancer. Nevertheless specific public perceptions of risk related to breast cancer and the difficulties of discussing a diagnosis of cancer openly in the family point to the very specific challenges for the translation and application of predictive interventions in Cuba. In summary the dynamic interrelationship between public health, perceptions of risk or health beliefs about the causes of the disease and attitudes towards cancer diagnosis within the family point to both continuities and discontinuities in the way that genomic interventions linked to breast cancer are unfolding as part of a dynamic yet still ostensibly socialist project of health care in Cuba. PMID:21239101

  13. Paradigms of family medicine: bridging traditions with new concepts; meeting the challenge of being the good doctor from 2011

    PubMed Central

    2011-01-01

    This is the paper for the Wes Fabb Oration for the WONCA Asia Pacific Regional Conference 2011. This paper will review the case for the important role of the family physician/general practitioner in worldwide health care as determined by the WHO. The importance of continuing care is highlighted. The features of a good doctor will be defined and the process of meeting this challenge for excellence of care is presented. PMID:21762524

  14. 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

  15. The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: person centred care, comprehensive and holistic approach.

    PubMed

    Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri E J H; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, Eva

    2010-06-01

    The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies 'primary care management' and 'community orientation' were presented. This article reflects on the three core competencies, which deal with person related aspects of GP/FM, i.e. 'person centred care', 'comprehensive approach' and 'holistic approach'. Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defined and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.

  16. High use of complementary and alternative medicine among a large cohort of women with a family history of breast cancer: the Sister Study.

    PubMed

    Greenlee, Heather; Sardo Molmenti, Christine L; Falci, Laura; Ulmer, Ross; Deming-Halverson, Sandra; DeRoo, Lisa A; Sandler, Dale P

    2016-04-01

    Use of complementary and alternative medicine (CAM) is high among U.S. women, yet information is limited on use among women at increased breast cancer risk. We analyzed CAM use among women with a family history of breast cancer. CAM use was analyzed among women enrolled 2003-2009 in the Sister Study cohort. Eligible women were aged 35-74, U.S. or Puerto Rican residents, no personal history of breast cancer, and had ≥1 sister with breast cancer. Baseline data on CAM use in the past year were available for 49,734 women. Logistic regression models examined the association between CAM use and Gail Model breast cancer risk score. Results were compared to female participants in the 2007 National Health Interview Survey (n = 7965). Among Sister Study participants, there was high use of vitamin/mineral supplements (79 %), mind-body practices (41 %), manipulative/body-based practices (32 %), and botanicals (23 %). Overall use was higher than the U.S. female population. No association was observed between familial breast cancer risk and CAM use. Black women were more likely to use spirituality/meditation-based CAM modalities, while non-Hispanic white and Asian women were high users of dietary supplements. In a cohort of women with increased breast cancer risk due to family history, CAM use is higher than women in the general U.S. population and is associated with race/ethnicity. Use was not associated with breast cancer risk. Given the high prevalence of CAM use among women at risk for breast caner, research on the effectiveness of CAM use for disease prevention is needed.

  17. High use of complementary and alternative medicine among a large cohort of women with a family history of breast cancer: the Sister Study.

    PubMed

    Greenlee, Heather; Sardo Molmenti, Christine L; Falci, Laura; Ulmer, Ross; Deming-Halverson, Sandra; DeRoo, Lisa A; Sandler, Dale P

    2016-04-01

    Use of complementary and alternative medicine (CAM) is high among U.S. women, yet information is limited on use among women at increased breast cancer risk. We analyzed CAM use among women with a family history of breast cancer. CAM use was analyzed among women enrolled 2003-2009 in the Sister Study cohort. Eligible women were aged 35-74, U.S. or Puerto Rican residents, no personal history of breast cancer, and had ≥1 sister with breast cancer. Baseline data on CAM use in the past year were available for 49,734 women. Logistic regression models examined the association between CAM use and Gail Model breast cancer risk score. Results were compared to female participants in the 2007 National Health Interview Survey (n = 7965). Among Sister Study participants, there was high use of vitamin/mineral supplements (79 %), mind-body practices (41 %), manipulative/body-based practices (32 %), and botanicals (23 %). Overall use was higher than the U.S. female population. No association was observed between familial breast cancer risk and CAM use. Black women were more likely to use spirituality/meditation-based CAM modalities, while non-Hispanic white and Asian women were high users of dietary supplements. In a cohort of women with increased breast cancer risk due to family history, CAM use is higher than women in the general U.S. population and is associated with race/ethnicity. Use was not associated with breast cancer risk. Given the high prevalence of CAM use among women at risk for breast caner, research on the effectiveness of CAM use for disease prevention is needed. PMID:27017506

  18. Why do – or don’t – patients with urinary tract infection participate in a clinical trial? A qualitative study in German family medicine

    PubMed Central

    Bleidorn, Jutta; Bucak, Sermin; Gágyor, Ildikó; Hummers-Pradier, Eva; Dierks, Marie-Luise

    2015-01-01

    family medicine, the following key issues should be considered: emphasizing patients’ personal benefit, featuring patient relevant trial topics, providing a maximum of safety, keeping effort by trial procedures comfortable. PMID:26512232

  19. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 4. Results: specific problem solving skills.

    PubMed

    Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

    2010-09-01

    The 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. The previous articles presented background, objectives, and methodology, as well results on 'primary care management' and 'community orientation' and the person-related core competencies of GP/FM. This article reflects on the general practitioner's 'specific problem solving skills'. These include decision making on diagnosis and therapy of specific diseases, accounting for the properties of primary care, but also research questions related to quality management and resource use, shared decision making, or professional education and development. Clinical research covers most specific diseases, but often lacks pragmatism and primary care relevance. Quality management is a stronghold of GP/FM research. Educational interventions can be effective when well designed for a specific setting and situation. However, their message that 'usual care' by general practitioners is insufficient may be problematic. GP and their patients need more research into diagnostic reasoning with a step-wise approach to increase predictive values in a setting characterized by uncertainty and low prevalence of specific diseases. Pragmatic comparative effectiveness studies of new and established drugs or non-pharmaceutical therapy are needed. Multi-morbidity and complexity should be addressed. Studies on therapy, communication strategies and educational interventions should consider impact on health and sustainability of effects.

  20. No-scalpel vasectomy: review of the first 1,000 cases in a family medicine unit.

    PubMed

    Arellano Lara, S; Gonzalez Barrera, J L; Hernandez Ono, A; Moreno Alcazar, O; Espinosa Perez, J

    1997-01-01

    In Mexico, the Mexican Institute of Social Security (IMSS) had adopted the no-scalpel vasectomy technique by the end of 1989. The technique was described by Dr. Li Shunquiang in 1974, and more than 60 million no-scalpel vasectomies have been performed in 26 countries. Among the advantages with no-scalpel vasectomy is that it has fewer complications (0.4%) compared to the traditional technique (3.1%). We studied 1,000 clinical charts of the subjects operated on between January, 1990 and January, 1993, with the objective of reporting our experiences as well as analyzing whether there existed a correlation between the subject's social and demographic characteristics and the number of control spermatic counts he attended postoperatively. In 97.9% of the cases, subjects had no postoperative hemorrhage or hematoma. None of the subjects had a surgical wound infection. In addition, 54.4% of the subjects came to the first control spermatic count, 39.7% came to the second, and only 18.4% came to all three controls. In an attempt to find a characteristic which defined the subject who attends his postoperative control spermatic counts, we found an association using chi2 between the attendance at two controls with the subjects who had been married from 6 - 10 years (p = 0.059), and with the subjects who had an income of three minimum wages. Regarding the attendance at all three controls, we found an association with subjects who had an income of two minimum wages (p = 0.037). We also found a weak correlation between the attendance at all three controls and the reason reported for not having more children (the couple did not want more children) (r = 0.07; p = 0.025) and with the manner in which the subjects were referred to the clinic (came on their own initiative) (r = 0.09; p = 0.006). Finally, we consider that no-scalpel vasectomy can be implemented as an adequate family planning method in Mexico's primary care centers. The lack of adequate attendance at postoperative control

  1. The European General Practice Research Network Presents the Translations of Its Comprehensive Definition of Multimorbidity in Family Medicine in Ten European Languages

    PubMed Central

    Le Reste, Jean Yves; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Slawomir; Lingner, Heidrun; Argyriadou, Stella; Lazic, Djurdjica; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel Angel; Thulesius, Hans; Le Floch, Bernard; Derriennic, Jeremy; Sowinska, Agnieska; Van Marwijk, Harm; Lietard, Claire; Van Royen, Paul

    2015-01-01

    Background Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. Objective To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Method Forward translation of the EGPRN’s definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached Results 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. Conclusion A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care. PMID:25607642

  2. Nuclear Medicine

    MedlinePlus

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  3. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. Methods/design This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain and disability. Secondary outcomes include general and functional health status, symptom bothersomeness, expectations for treatment effectiveness and improvement, fear avoidance behaviors, depression, anxiety, satisfaction, medication use and health care utilization. Treatment safety and adverse events also are monitored. Participant-rated outcome measures are collected via self-reported questionnaires and computer-assisted telephone interviews at baseline, and at 4, 8, 12, 24, 36 and 52 weeks post-randomization. Provider-rated expectations for treatment effectiveness and participant improvement also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits of progress notes and content

  4. Statistical methods and errors in family medicine articles between 2010 and 2014-Suez Canal University, Egypt: A cross-sectional study

    PubMed Central

    Nour-Eldein, Hebatallah

    2016-01-01

    Background: With limited statistical knowledge of most physicians it is not uncommon to find statistical errors in research articles. Objectives: To determine the statistical methods and to assess the statistical errors in family medicine (FM) research articles that were published between 2010 and 2014. Methods: This was a cross-sectional study. All 66 FM research articles that were published over 5 years by FM authors with affiliation to Suez Canal University were screened by the researcher between May and August 2015. Types and frequencies of statistical methods were reviewed in all 66 FM articles. All 60 articles with identified inferential statistics were examined for statistical errors and deficiencies. A comprehensive 58-item checklist based on statistical guidelines was used to evaluate the statistical quality of FM articles. Results: Inferential methods were recorded in 62/66 (93.9%) of FM articles. Advanced analyses were used in 29/66 (43.9%). Contingency tables 38/66 (57.6%), regression (logistic, linear) 26/66 (39.4%), and t-test 17/66 (25.8%) were the most commonly used inferential tests. Within 60 FM articles with identified inferential statistics, no prior sample size 19/60 (31.7%), application of wrong statistical tests 17/60 (28.3%), incomplete documentation of statistics 59/60 (98.3%), reporting P value without test statistics 32/60 (53.3%), no reporting confidence interval with effect size measures 12/60 (20.0%), use of mean (standard deviation) to describe ordinal/nonnormal data 8/60 (13.3%), and errors related to interpretation were mainly for conclusions without support by the study data 5/60 (8.3%). Conclusion: Inferential statistics were used in the majority of FM articles. Data analysis and reporting statistics are areas for improvement in FM research articles. PMID:27453839

  5. A nationwide postal survey on the perception of Malaysian public healthcare providers on family medicine specialists' (PERMFAMS) clinical performance, professional attitudes and research visibility.

    PubMed

    Chew, Boon-How; Yasin, Mazapuspavina Md; Cheong, Ai-Theng; Rashid, Mohd-Radzniwan A; Hamzah, Zuhra; Ismail, Mastura; Ali, Norsiah; Bashah, Baizury; Mohd-Salleh, Noridah

    2015-01-01

    Perception of healthcare providers who worked with family medicine specialists (FMSs) could translate into the effectiveness of primary healthcare delivery in daily practices. This study examined perceptions of public healthcare providers/professionals (PHCPs) on FMSs at public health clinics throughout Malaysia. This was a cross-sectional study in 2012-2013 using postal method targeting PHCPs from three categories of health facilities, namely health clinics, health offices and hospitals. A structured questionnaire was developed to assess PHCP's perception of FMS's clinical competency, safety practice, ethical and professional values, and research involvement. It consists of 37 items with Likert scale of strongly disagree (a score of 1) to strongly agree (a score of 5). Interaction and independent effect of the independent variables were tested and adjusted means score were reported. The participants' response rate was 58.0% (780/1345) with almost equal proportion from each of the three public healthcare facilities. There were more positive perceptions than negative among the PHCPs. FMSs were perceived to provide effective and safe treatment to their patients equally disregards of patient's social background. However, there were some concerns of FMSs not doing home visits, not seeing walk-in patients, had long appointment time, not active in scientific research, writing and publication. There were significant differences in perception based on a respondent's health care facility (p < 0.0001) and frequency of encounter (p < 0.0001). PHCPs had overall positive perceptions on FMSs across all the domains investigated. PHCPs from different health care facilities and frequency of encounter with FMSs had different perception. Practicing FMSs could improve on the critical service areas that were perceived to be important but lacking. FMSs might need further support in conducting research and writing for publication.

  6. Diabetes Medicines

    MedlinePlus

    ... Financial Help for Diabetes Care Diabetes Statistics Diabetes Medicines What do diabetes medicines do? Over time, high levels of blood glucose, ... your diabetes medicines, food choices, and physical activity. Medicines for My Diabetes Ask your doctor what type ...

  7. Family practice clinics. Survey of family practice residents' attitudes.

    PubMed Central

    Rubenstein, H.; Levitt, C.

    1993-01-01

    All residents of McGill University's Department of Family Medicine were surveyed by mail about their family practice clinic experience. Residents were generally satisfied with their training site and their supervision, but noted problems with volume and diversity of patients, learning certain procedures, and knowledge of community resources. They did not want more family medicine clinic time. PMID:8219838

  8. [Concepts of anthropological medicine].

    PubMed

    Petzold, E R; Petzold, U

    2001-01-01

    Medical anthropology is the teaching of the ill human being, of being ill; anthropological medicine is the realization of this teaching in practice. This concept was first developed and assessed in the "Gestaltkreis" and in the Pathosophy (44), in Medicine in Motion (39), and in the Bipersonality (10). The four most important concepts are represented, which have their origin and aim in anthropological medicine: anthropological medicine, Balint-work, family-oriented medicine, and salutogenesis. These concepts are exemplified in the Aachen psychosomatic liaison model, the Aachen Balint cooperation model, and the Aachen model of psychosomatic care. We wish to portray the meaning of these resources for the medicine of the future, since they have proven to be effective, cost-saving, and easy to be handled. In the latter part of our presentation, we will document this point with a pilot study conducted in Israel and in our own clinic in Aachen. PMID:11603206

  9. Aerospace Medicine

    NASA Technical Reports Server (NTRS)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  10. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  11. Heart failure - medicines

    MedlinePlus

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  12. Medicine safety: Filling your prescription

    MedlinePlus

    Institute for Safe Medication Practices. Purchasing medications. ConsumerMedSafety.org. www.consumermedsafety.org/medication-safety-articles/purchasing-medications . Accessed June 28, 2016. American Academy of Family Medicine. How ...

  13. [Market oriented occupational medicine].

    PubMed

    Rurik, Imre; Cseh, Károly

    2012-09-01

    The history and the recent state of occupational medicine in Hungary, and its relation with governmental labor organizations are analyzed. In the past 20 years, large "socialist" factories were replaced by smaller companies employing fewer workers. They have been forced to establish contract with occupational health providers. Many of them offer primary care services, whereas family physicians having a board examination in occupational medicine are allowed to work in this field as well. The market of occupational medicine is less regulated, and ethical rules are not always considered. Undercutting prices is a common practice. The recent system could be improved by some regulations which should be respected. There is no reason to make rough changes establishing a new market for profit oriented insurance companies, and to allow employees and employers to work without specification neglecting international agreements. Occupational medicine should be supervised again by the health authorities instead of economists who have quite different, short-term priorities. PMID:22951411

  14. Diabetes Medicines

    MedlinePlus

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  15. [SPORT MEDICINE].

    PubMed

    Constantini, Naama; Mann, Gideon

    2016-06-01

    Sports Medicine is a relatively new subject in medicine and includes a variety of medical and paramedical fields. Although sports medicine is mistakenly thought to be mainly for sports professionals/athletes, it actually encompasses the entire population, including the active and non-active healthy populations, as well as the sick. Sports medicine also engages amateur sportsmen and strives to promote physical activity and quality of life in the general population. Hence, the field involves all ages from childhood to old age, aiming to preserve and support every person at every age. Sports medicine, which started developing in the 19th century, is today a specialty, primary or secondary, in many countries, while in others it is a fellowship or under the jurisdiction of local or sports authorities. In Israel, the field exists since the 1950's and is advanced. The Sports Medicine Society founded a 3-year course of continued education in sport medicine as part of the Tel-Aviv University Faculty of Medicine. Later on, a fellowship in general Sports Medicine and in Orthopedic Sports Medicine were developed within the Israel Medical Association. A year ago, Israel formally became a member of the global "Exercise is Medicine" foundation, and under this title promotes education for health care providers on exercise prescription. The understanding of the importance of physical activity and fitness as part of a healthy lifestyle is increasing in Israel, as well as the number of amateur athletes, and the profession of sports medicine takes a big part in this process.

  16. Medicine Women.

    ERIC Educational Resources Information Center

    Beiswenger, James N., Ed.; Jeanotte, Holly, Ed.

    Described as a survival manual for Indian women in medicine, this collected work contains diverse pieces offering inspiration and practical advice for Indian women pursuing or considering careers in medicine. Introductory material includes two legends symbolizing the Medicine or Spirit Woman's role in Indian culture and an overview of Indians Into…

  17. Independent associations of childhood and current socioeconomic status with risk of self-reported doctor-diagnosed arthritis in a family-medicine cohort of North-Carolinians

    PubMed Central

    2013-01-01

    Background Associations of socioeconomic status (SES) with the prevalence of various forms of arthritis are well documented. Increasing evidence suggests that SES during childhood is a lasting determinant of health, but its association with the onset of arthritis remains unclear. Methods Cross-sectional data on 1276 participants originated from 22 family practices in North-Carolina, USA. We created 4-level (high, medium, low, lowest) current SES and childhood SES summary scores based on parental and participant education, occupation and homeownership. We investigated associations of individual SES characteristics, summary scores and SES trajectories (e.g. high/low) with self-reported arthritis in logistic regression models progressively adjusted for race and gender, age, then BMI, and clustered by family practice. Results We found evidence for independent associations of both childhood and current SES with the reporting of arthritis across our models. In covariate-adjusted models simultaneously including current and childhood SES, compared with high SES participants in the lowest childhood SES category (OR = 1.39 [95% CI = 1.04, 1.85]) and those in the low (OR = 1.66 [95% CI = 1.14, 2.42]) and lowest (OR = 2.08 [95% CI = 1.16, 3.74]) categories of current SES had significantly greater odds of having self-reported arthritis. Conclusions Current SES and childhood SES are both associated with the odds of reporting arthritis within this primary-care population, although the possibly superseding influence of existing circumstances must be noted. BMI was a likely mechanism in the association of childhood SES with arthritis onset, and research is needed to elucidate further pathways linking the socioeconomic environment across life-stages and the development of rheumatic diseases. PMID:24256740

  18. [SPORT MEDICINE].

    PubMed

    Constantini, Naama; Mann, Gideon

    2016-06-01

    Sports Medicine is a relatively new subject in medicine and includes a variety of medical and paramedical fields. Although sports medicine is mistakenly thought to be mainly for sports professionals/athletes, it actually encompasses the entire population, including the active and non-active healthy populations, as well as the sick. Sports medicine also engages amateur sportsmen and strives to promote physical activity and quality of life in the general population. Hence, the field involves all ages from childhood to old age, aiming to preserve and support every person at every age. Sports medicine, which started developing in the 19th century, is today a specialty, primary or secondary, in many countries, while in others it is a fellowship or under the jurisdiction of local or sports authorities. In Israel, the field exists since the 1950's and is advanced. The Sports Medicine Society founded a 3-year course of continued education in sport medicine as part of the Tel-Aviv University Faculty of Medicine. Later on, a fellowship in general Sports Medicine and in Orthopedic Sports Medicine were developed within the Israel Medical Association. A year ago, Israel formally became a member of the global "Exercise is Medicine" foundation, and under this title promotes education for health care providers on exercise prescription. The understanding of the importance of physical activity and fitness as part of a healthy lifestyle is increasing in Israel, as well as the number of amateur athletes, and the profession of sports medicine takes a big part in this process. PMID:27544982

  19. Immunoinformatics in personalized medicine.

    PubMed

    Gulukota, Kamalakar

    2003-01-01

    Diagnosis of human disease has been undergoing steady improvement over the past few centuries. Many ailments that were once considered a single entity have been classified into finer categories on the basis of response to therapy (e.g. type I and type II diabetes), inheritance (e.g. familial and non-familial polyposis coli), histology (e.g. small cell and adenocarcinoma of lung) and most recently transcriptional profiling (e.g. leukaemia, lymphoma). The next dimension in this finer categorization appears to be the typing of the patient rather than the disease i.e. disease X in person of type Y. The problem of personalized medicine is to devise tests which predict the type of individual, especially where the type is correlated with response to therapy. Immunology has been at the forefront of personalized medicine for quite a while, even though the term is not often used in this connection. Blood grouping and cross-matching (for blood transfusion), and anaphylaxis test (for penicillin) are just two examples. In this paper I will argue that immunological tests have an important place in the future of personalized medicine. I will describe methods we developed for personalizing vaccines based on MHC allele frequencies in human populations and methods for predicting peptide binding to class I MHC molecules. In conclusion, I will argue that immunological tests, and consequently immunoinformatics, will play a big role in making personalized medicine a reality. PMID:14712931

  20. Use Medicines Safely

    MedlinePlus

    ... Medicines Safely Print This Topic En español Use Medicines Safely Browse Sections The Basics Overview Prescription Medicines ... Medicines 1 of 7 sections The Basics: Prescription Medicines There are different types of medicine. The 2 ...

  1. Mentoring in Medicine Program Encourages Careers in Health | NIH MedlinePlus the Magazine

    MedlinePlus

    ... professor of clinical emergency medicine at the Albert Einstein College of Medicine in New York City, and ... Kingsley’ Nwabuobi, a second-year medical student at Einstein College of Medicine. “My MIM family believed in ...

  2. After School Astronomy Clubs: Exploring the universe after hours

    NASA Astrophysics Data System (ADS)

    Mayo, L.; Janney, D.

    2011-10-01

    After School Astronomy clubs are unique in focusing on children in the K-12 grades as opposed to the numerous Amateur Astronomy Clubs within the US and abroad whose membership is largely adult focused. Over the last 12 years, we have identified over 140 clubs that were previously running in isolation, provided them with science and education resources and a means to communicate, created an online community of after School Astronomy Clubs, and facilitated the development of new clubs. Over this time, our model for developing and running these clubs has changed as we gained experience with various target populations, educational settings, and external partners and as best practices have emerged regarding engagement, impact, pedagogy, and sustainability. This talk will highlight these experiences and practices and discuss implications for future development of the After School Astronomy Club program.

  3. After-Hours Science: Teaching Science with a Club.

    ERIC Educational Resources Information Center

    Dyreng, Ivan

    1984-01-01

    Describes Salt Lake City's (Utah) East High School science club, recognized by the National Science Teachers Association's Search for Excellence in Science Education project as an outstanding science program. Unique aspects of the club's activities, instructional strategies, and other areas are discussed. (BC)

  4. Open All Night: After-Hours Technical Support for Networks.

    ERIC Educational Resources Information Center

    Weiter, Steve

    1996-01-01

    Describes how a library automation system administrator developed a computer support network for the Finger Lakes Library System's (New York) evening and weekend hours. Discusses support options and decision-making factors--hiring extra staff, utilizing vendors, pagers, cellular phones, or contracting for third-party support. After employing staff…

  5. After-Hours Science: Microchips and Onion Dip.

    ERIC Educational Resources Information Center

    Brugger, Steve

    1984-01-01

    Computer programs were developed for a science center nutrition exhibit. The exhibit was recognized by the National Science Teachers Association Search for Excellence in Science Education as an outstanding science program. The computer programs (Apple II) and their use in the exhibit are described. (BC)

  6. Vulnerable Medicine

    ERIC Educational Resources Information Center

    Bochner, Arthur P.

    2009-01-01

    In "Narrative Medicine: Honoring the Stories of Illness," Rita Charon paints an original and humane portrait of what it can mean to be a doctor, to live a life immersed in sickness and dedicated to wellness. Charon drops the veil, inviting readers to look at the secret, subjective, emotional face of medicine, a zone of self-censored feelings and…

  7. Aerospace Medicine

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2006-01-01

    This abstract describes the content of a presentation for ground rounds at Mt. Sinai School of Medicine. The presentation contains three sections. The first describes the history of aerospace medicine beginning with early flights with animals. The second section of the presentation describes current programs and planning for future missions. The third section describes the medical challenges of exploration missions.

  8. Behavioral Medicine.

    ERIC Educational Resources Information Center

    Garfield, Sol L., Ed.

    1982-01-01

    Contains 18 articles discussing the uses of behavioral medicine in such areas as obesity, smoking, hypertension, and headache. Reviews include discussions of behavioral medicine and insomnia, chronic pain, asthma, peripheral vascular disease, and coronary-prone behavior. Newly emerging topics include gastrointestinal disorders, arthritis,…

  9. [Sport medicine].

    PubMed

    Epstein, Yoram

    2012-02-01

    It is only since the late 20th century that Sport and Exercise Medicine has emerged as a distinct entity in health care. In Israel, sports medicine is regulated by a State Law and a sport physician is certified after graduating a structured program. In the past, sports medicine was related to the diagnosis and treatment of injuries encountered by top athletes. In recent years, the scope of sport medicine has broadened to reflect the awareness of modern society of the dangers of physical inactivity. In this perspective the American College of Sport Medicine (ACSM) recently launched a program--"Exercise is Medicine", to promote physical activity in order to improve health and well-being and prevention of diseases through physical activity prescriptions. This program is from doctors and healthcare providers, adjusted to the patient or trainee. The sport physician does not replace a medical specialist, but having a thorough understanding about the etiology of a sport-related injury enables him to better focus on treatment and prevention. Therefore, Team Physicians in Elite Sport often play a role regarding not only the medical care of athletes, but also in the physiological monitoring of the athlete and correcting aberrations, to achieve peak physical performance. The broad spectrum of issues in sport and exercise medicine cannot be completely covered in one issue of the Journal. Therefore, the few reports that are presented to enhance interest and understanding in the broad spectrum of issues in sports and exercise medicine are only the tip of the iceberg.

  10. [Rational use of medicines].

    PubMed

    Helali, A

    2006-12-01

    Every body speaks about inappropriate use of medicines and each one gives his own explanation. Politicians are telling about the waste of medicines and the money of their national budget. Citizens are saying that the physicians prescribe more than necessary for treatment and blame them as one part of the financial burden weighting on their family budget. Physicians give different explanation and think that the rational use of medicines is a sort of pressure to limit their freedom to prescribe what it seems to them necessary and better for their patients. Pharmacists dispensing medicines consider the prescription as a physician's prerogative and prefer to stay neutral in this debate. Within this large range of opinions, it is difficult to find general consensus, so that every body take care to not declare his proper opinion about the subject, the causes and the adequate solutions. Finally no changes take place in this issue. However, neither the government as responsible for the citizen's health, nor the health professionals and international organisations, are facing their complete obligations toward the populations by ensuring to them that the medicines are administered according to the health need of the patients, efficacious and safe , in doses that meet their own individual requirements, for an adequate period of time, and at the lower cost, and be secured against misuse by the pharmacist before the delivery to the patients. This is a worthwhile programme, but unfortunately without designate takers or promoters until now.

  11. 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

  12. Complementary medicine.

    PubMed Central

    Spiegel, D; Stroud, P; Fyfe, A

    1998-01-01

    The widespread use of complementary and alternative medicine techniques, often explored by patients without discussion with their primary care physician, is seen as a request from patients for care as well as cure. In this article, we discuss the reasons for the growth of and interest in complementary and alternative medicine in an era of rapidly advancing medical technology. There is, for instance, evidence of the efficacy of supportive techniques such as group psychotherapy in improving adjustment and increasing survival time of cancer patients. We describe current and developing complementary medicine programs as well as opportunities for integration of some complementary techniques into standard medical care. PMID:9584661

  13. Genomic medicine implementation: learning by example.

    PubMed

    Williams, Marc S

    2014-03-01

    Genomic Medicine is beginning to emerge into clinical practice. The National Human Genome Research Institute's Genomic Medicine Working Group consists of organizations that have begun to implement some aspect of genomic medicine (e.g., family history, systematic implementation of Mendelian disease program, pharmacogenomics, whole exome/genome sequencing). This article concisely reviews the working group and provides a broader context for the articles in the special issue including an assessment of anticipated provider needs and ethical, legal, and social issues relevant to the implementation of genomic medicine. The challenges of implementation of innovation in clinical practice and the potential value of genomic medicine are discussed.

  14. Herbal Medicine

    MedlinePlus

    An herb is a plant or plant part used for its scent, flavor, or therapeutic properties. Herbal medicines are ... go through the testing that drugs do. Some herbs, such as comfrey and ephedra, can cause serious ...

  15. Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban Underserved.

    PubMed

    Berz, Jonathan P B; Gergen Barnett, Katherine A; Gardiner, Paula; Saper, Robert B

    2015-11-01

    The Preventive Medicine Residency Program collaborated with the Department of Family Medicine's Program for Integrative Medicine and Health Disparities at Boston Medical Center to create a new rotation for preventive medicine residents starting in autumn 2012. Residents participated in integrative medicine group visits and consults, completed an online curriculum in dietary supplements, and participated in seminars all in the context of an urban safety net hospital. This collaboration was made possible by a federal Health Resources and Services Administration grant for integrative medicine in preventive medicine residencies and helped meet a need of the program to increase residents' exposure to clinical preventive medicine and integrative health clinical skills and principles. The collaboration has resulted in a required rotation for all residents that continues after the grant period and has fostered additional collaborations related to integrative medicine across the programs.

  16. Academic Medicine Meets Traditional African Healing

    ERIC Educational Resources Information Center

    Lindow, Megan

    2008-01-01

    Cyril Naidoo, who directs the department of family medicine at the University of KwaZulu-Natal's Nelson R. Mandela School of Medicine, conducts workshops to traditional healers on how to help patients with AIDS and HIV. In Dr. Naidoo's workshop, the group discusses how to counsel patients about HIV and AIDS, how to refer them for testing, and then…

  17. Women in academic medicine.

    PubMed

    Bickel, J

    2000-01-01

    Women now constitute 43% of US medical students, 37% of residents, and 27% of full-time medical school faculty. Less than 11% of women faculty are full professors, however, compared to 31% of men, and these proportions haven't changed in more than 15 years. Since the proportion of women reaching the top ranks remains relatively low, the pool of women available for leadership positions in academic medicine is still small. This review article first summarizes recent data on women's representation in academic medicine and then discusses why they are not succeeding at the same pace as men. Reasons include a complex combination of women's choices, sexism, cultural stereotypes, constraints in combining family responsibilities with professional opportunities, and lack of effective mentoring. Multiple approaches are required to overcome these "cumulative disadvantages," among them improving the gender climate at academic medical centers; the mentoring of women faculty, residents, and students; and skill-building opportunities for women.

  18. Mesopotamian medicine.

    PubMed

    Retief, F P; Cilliers, L

    2007-01-01

    Although the Mesopotamian civilisation is as old as that of Egypt and might even have predated it, we know much less about Mesopotamian medicine, mainly because the cuneiform source material is less well researched. Medical healers existed from the middle of the 3rd millennium. In line with the strong theocratic state culture, healers were closely integrated with the powerful priestly fraternity, and were essentially of three main kinds: barû (seers) who were experts in divination, âshipu (exorcists), and asû (healing priests) who tended directly to the sick. All illness was accepted as sent by gods, demons and other evil spirits, either as retribution for sins or as malevolent visitations. Treatment revolved around identification of the offending supernatural power, appeasement of the angry gods, for example by offering amulets or incantations, exorcism of evil spirits, as well as a measure of empirical therapy aimed against certain recognised symptom complexes. Medical practice was rigidly codified, starting with Hammurabi's Code in the 18th century BC and persisting to the late 1st millennium BC. Works like the so-called Diagnostic Handbook, the Assyrian Herbal and Prescription Texts describe the rationale of Mesopotamian medicine, based predominantly on supernatural concepts, although rudimentary traces of empirical medicine are discernible. There is evidence that Egyptian medicine might have been influenced by Mesopotamian practices, but Greek rational medicine as it evolved in the 5th/4th centuries BC almost certainly had no significant Mesopotamian roots. PMID:17378276

  19. Travel medicine

    PubMed Central

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

  20. Evaluation and validation of biochip multi-array technology for the screening of six families of antibiotics in honey according to the European guideline for the validation of screening methods for residues of veterinary medicines.

    PubMed

    Gaudin, Valérie; Hedou, Celine; Soumet, Christophe; Verdon, Eric

    2014-01-01

    The main chemicals used against varoa are acaricides, and the antibiotics used for the control of bee bacterial diseases are mainly tetracyclines, streptomycins, sulfonamides and chloramphenicol. No maximum residue limits (MRLs) have been set for any antibiotics in honey. Therefore, in the European Union, minimum recommended concentrations (RC) for the analytical performance of methods to control a certain set of these non-authorised chemicals in honey were published by the European Union Reference Laboratory (EU-RL) in 2007. Concerning the strategy for the control for antibiotic residues in honey, there is still a great need for a cheap and single multi-residue method. Biochip array technology is an innovative assay technology for the multi-analyte screening of biological samples in a rapid and easy-to-use format. A multi-array system, called Evidence Investigator™ (Randox, Crumlin, Co., Antrim, UK), was evaluated in our laboratory. It is a semi-automated biochip system designed for research, clinical applications and veterinary use. A competitive chemiluminescent immunoassay is employed for the detection of antimicrobials. The MicroArray II kit (AM II) dedicated to the screening of six different families of antibiotic residues was validated according to the European guideline for the validation of screening methods for residues of veterinary medicines. The specificity was proven to be very satisfactory, and applicability to different kinds of honey was demonstrated. The detection capabilities (CCβ) of six antibiotic residues were determined and were below the RCs when exist. The AM II kit could detect at least six quinolones, four tetracyclines and three epimers, three aminoglycosides, three macrolides, thiamphenicol, florfenicol and ceftiofur along with one of its stabilised metabolites, the desfuroylceftiofurcysteine disulfide (DCCD).

  1. Evaluation and validation of biochip multi-array technology for the screening of six families of antibiotics in honey according to the European guideline for the validation of screening methods for residues of veterinary medicines.

    PubMed

    Gaudin, Valérie; Hedou, Celine; Soumet, Christophe; Verdon, Eric

    2014-01-01

    The main chemicals used against varoa are acaricides, and the antibiotics used for the control of bee bacterial diseases are mainly tetracyclines, streptomycins, sulfonamides and chloramphenicol. No maximum residue limits (MRLs) have been set for any antibiotics in honey. Therefore, in the European Union, minimum recommended concentrations (RC) for the analytical performance of methods to control a certain set of these non-authorised chemicals in honey were published by the European Union Reference Laboratory (EU-RL) in 2007. Concerning the strategy for the control for antibiotic residues in honey, there is still a great need for a cheap and single multi-residue method. Biochip array technology is an innovative assay technology for the multi-analyte screening of biological samples in a rapid and easy-to-use format. A multi-array system, called Evidence Investigator™ (Randox, Crumlin, Co., Antrim, UK), was evaluated in our laboratory. It is a semi-automated biochip system designed for research, clinical applications and veterinary use. A competitive chemiluminescent immunoassay is employed for the detection of antimicrobials. The MicroArray II kit (AM II) dedicated to the screening of six different families of antibiotic residues was validated according to the European guideline for the validation of screening methods for residues of veterinary medicines. The specificity was proven to be very satisfactory, and applicability to different kinds of honey was demonstrated. The detection capabilities (CCβ) of six antibiotic residues were determined and were below the RCs when exist. The AM II kit could detect at least six quinolones, four tetracyclines and three epimers, three aminoglycosides, three macrolides, thiamphenicol, florfenicol and ceftiofur along with one of its stabilised metabolites, the desfuroylceftiofurcysteine disulfide (DCCD). PMID:25186037

  2. [Alternative medicine].

    PubMed

    Mitello, L

    2001-01-01

    In a critical situation of world official medicine, we can find different alternatives therapies: natural therapy traditional and complementary, survival sometimes, of antique stiles and conditions of life. New sciences presented for them empiricism to the margin of official science. Doctors and sorcerer do the best to defeat the horrible virus that contribute to build symbols categories of sick. The alternatives put dangerously in game the scientific myth of experiment and exhume, if they got lost, antique remedy, almost preserved like cultural wreck very efficient where the medicine is impotent. Besides alternatives and complementary therapies, that are remedies not recognized conventional from official medicine, there are the homeopathic, phytotherapy, pranotherapy, nutritional therapy, the ayurveda, the yoga, ecc. Italians and internationals research show a composite picture of persons that apply that therapies. Object of this work is to understand and know the way that sick lighten their sufferings and role that have o that can assume the nurses to assist this sick. PMID:12146072

  3. [Traightened on Chinese endemic seed plant species of medicine plants used in Tibetan medicine].

    PubMed

    Zhou, Hua-rong; Mu, Ze-jing; Du, Xiao-lang; He, Jun-wei; Cao, Lan; Zhong, Guo-yue

    2015-09-01

    This paper is in order to discussion with the composition and characteristics of Tibetan medicine plant resources, and promote the reasonable protection and utilization of the resources of Tibetan materia medica. Statistical analysis of species, distributions, and others of Chinese endemic seed plant from Tibetan medicine plants and usually used in the clinic of Tibetan medicine. The results showed that there are 523 species (25%) of Chinese endemic seed plant, belonging to 65 families and 162 genera, in about 2 000 varieties of Tibetan medicine plants recorded in relevant literatures. There are 180 Chinese endemic seed plant species (28%) belonging to 42 families and 72 genera from 625 medicine plants usually used in the clinic of Tibetan medicine. Specifically, the most of these Chinese endemic seed plant species are characteristic crude drug used in Tibetan medicine, and mainly or only distributed in Qinghai-Tibet Plateau. And a few species of them were intersected with traditional Chinese medicines (TCM) and other ethnic medicines. In addition, about 10% are listed in China Species Red List. The Qinghai-Tibet Plateau is the most abundant areas of Areal-types of the Chinese endemic seed plant. This is the biological and ecological reason formation the characteristics of Tibetan medicine plant resources. Therefore, strengthen the research of Chinese endemic seed plants used in Tibetan medicine is great significance for the reasonable protection and utilization of Tibetan medicine plant resources. PMID:26978990

  4. [Traightened on Chinese endemic seed plant species of medicine plants used in Tibetan medicine].

    PubMed

    Zhou, Hua-rong; Mu, Ze-jing; Du, Xiao-lang; He, Jun-wei; Cao, Lan; Zhong, Guo-yue

    2015-09-01

    This paper is in order to discussion with the composition and characteristics of Tibetan medicine plant resources, and promote the reasonable protection and utilization of the resources of Tibetan materia medica. Statistical analysis of species, distributions, and others of Chinese endemic seed plant from Tibetan medicine plants and usually used in the clinic of Tibetan medicine. The results showed that there are 523 species (25%) of Chinese endemic seed plant, belonging to 65 families and 162 genera, in about 2 000 varieties of Tibetan medicine plants recorded in relevant literatures. There are 180 Chinese endemic seed plant species (28%) belonging to 42 families and 72 genera from 625 medicine plants usually used in the clinic of Tibetan medicine. Specifically, the most of these Chinese endemic seed plant species are characteristic crude drug used in Tibetan medicine, and mainly or only distributed in Qinghai-Tibet Plateau. And a few species of them were intersected with traditional Chinese medicines (TCM) and other ethnic medicines. In addition, about 10% are listed in China Species Red List. The Qinghai-Tibet Plateau is the most abundant areas of Areal-types of the Chinese endemic seed plant. This is the biological and ecological reason formation the characteristics of Tibetan medicine plant resources. Therefore, strengthen the research of Chinese endemic seed plants used in Tibetan medicine is great significance for the reasonable protection and utilization of Tibetan medicine plant resources.

  5. Complementary medicine.

    PubMed

    Schimpff, S C

    1997-07-01

    Complementary medicine can be described as additional approaches to care outside of mainstream medical practice but frequently based on traditional practices of nonwestern cultures. These include acupuncture, meditation, massage, diet manipulation, and many others. Recent reviews demonstrate wide and frequent use of these measures, often without concurrent discussion with the patient's physician. One estimate is that more than $13 billion is spent annually on complementary techniques in the United States alone. Many patients with cancer turn to these techniques. Care givers need to recognize this trend, learn about complementary medicine, and guide patients in their proper application when appropriate.

  6. 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.

  7. 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

  8. A Rhinitis Primer for Family Medicine

    PubMed Central

    Macy, Eric

    2012-01-01

    Rhinitis and related problems such as facial pressure and nasal congestion are a very common reason people seek medical care. There are four, often overlapping, syndromes or conditions that account for most of what patients perceive as “nose” problems or rhinitis. These conditions are irritant rhinitis, the anterior nasal valve effect, migraine with vasomotor symptoms, and allergic rhinitis. Virtually all patients with allergic rhinitis have some concomitant irritant or nonallergic rhinitis. Many migraine sufferers with vasomotor nasal symptoms will have their nasal congestion, headaches, and runny noses exacerbated by irritant rhinitis, allergic rhinitis, and/or a preexisting nasal valve effect. Failure to consider all of the causes for the symptoms will result in poor clinical outcomes. The work-up and management of these common conditions is discussed in this article. PMID:23251121

  9. [Teacher's perfomance assessment in Family Medicine specialization].

    PubMed

    Martínez-González, Adrián; Gómez-Clavelina, Francisco J; Hernández-Torres, Isaías; Flores-Hernández, Fernando; Sánchez-Mendiola, Melchor

    2016-01-01

    Introducción: en México no hay una evaluación sistemática del desempeño docente en las especializaciones médicas, lo que reduce la posibilidad de identificación de prácticas educativas adecuadas, su mejora y reconocimiento. El estudio pretende analizar la opinión de los residentes acerca de las actividades docentes de los profesores-tutores responsables del curso de especialización en medicina familiar, y valorar la fiabilidad y validez del instrumento aplicado en línea. Método: estudio observacional y transversal, la población de estudio fueron setenta y ocho profesores titulares de medicina familiar de la residencia médica de la Facultad de Medicina de la Universidad Nacional Autónoma de México evaluados por 734 residentes. Se utilizó un cuestionario anónimo de evaluación del desempeño docente por opinión del residente, integrado por 37 enunciados y 5 dimensiones con una escala de respuesta tipo Likert. Se utilizó estadística descriptiva e inferencial (t de Student, ANOVA de un factor y análisis factorial). Resultados: los residentes opinaron que el desempeño docente en general es aceptable, con una media de 4.25 ± 0.93, la dimensión con mayor puntaje fue la de metodología con 4.34 ± 0.92 en contraste con la dimensión de evaluación con la menor media de 4.16 ± 1.04. Conclusiones: los profesores de la especialización tienen un desempeño aceptable según la opinión de los residentes. El instrumento de evaluación en línea reúne los criterios de validez y confiabilidad.

  10. Insurance Medicine: Introduction for the Family Physician

    PubMed Central

    Williamson, Elliot A.

    1983-01-01

    Insurance companies request reports on patients' health to corroborate and clarify information on insurance application forms. Illegible or vague reports, or one that varies from the patient's understanding of his health, can result in patients being offered substandard policies at increased premiums. Reports, even if brief, must include known risk factors, disease history, and information on stability of medical conditions. PMID:21283404

  11. Is old medicine new medicine?

    PubMed

    Montaocean, K

    1991-07-01

    By the year 2000, over 90% of cases of acquired immunodeficiency syndrome (AIDS) are expected in Third World countries where Western medicine is often unavailable, unaffordable, or culturally unacceptable. Thus, there is a need for greater attention to the potential role of traditional medicine and healers in the prevention and treatment of AIDS. A US-based nongovernmental organization, Green Cross Inc, is examining cross-cultural healing traditions and seeking areas of convergence between scientific bio-medicine and indigenous traditional healing systems. At a street clinic operated by Green Cross in Washington DC, both Western medicine and traditional Chinese practices such as acupuncture, herbal remedies, and meditation are offered to AIDS patients at those at risk of infection. Although the individualized nature of Chinese medicine makes it difficult to evaluate through use of Western research methods, there is anecdotal evidence that it reduces the stress, anxiety, depression, and fatigue that accompany AIDS. Health care systems in all parts of the world could benefit from the concept that illness cannot be treated in isolation from individuals and communities.

  12. [Osteopathic medicine].

    PubMed

    Klein, P; Lepers, Y; Salem, W

    2011-09-01

    Osteopathy is originated in the 19th century in the United States. Andrew Taylor Still seek for an alternative medical system to the orthodox medicine largely empirical and advocating bloodletting, calomel, etc., all of which was resumed with terms like" heroic medicine". Osteopathy as other alternative medical practices (homeopathy, eclecticism, etc.) based on rational and metaphysical postulates as vitalism or the fact that man is a divinely ordained machine. Still's approach was essentially manual and based on manipulation of the joints. Today osteopaths challenge these dogmas and seek to agree their practice within scientific biomedical standards. Even if strong randomized clinical trials are lacking, several surveys report how osteopathy gained public notoriety. Several recent meta-analyses pinpoint the benefit of the spinal manipulative treatment and even if there is no evidence that such an approach is superior to other advocated therapies there is no evidence that these therapies are more effective than the first one. The major indications for such a treatment are cervical and low back pain, either chronic or acute. The quality of the relationship between the practitioner and patient together with the placebo effect are important components of a treatment effect. Osteopathic education is an important aspect and only higher education institutions, i.e. universities can achieve and maintain adequate standards. Materia medica and surgery represent the two major therapeutic mainstreams in medicine; osteopathy considered as manual medicine could be the third one. PMID:22034767

  13. Nuclear medicine

    SciTech Connect

    Wagner, H.N. Jr.

    1986-10-17

    In 1985 and 1986 nuclear medicine became more and more oriented toward in vov chemistry, chiefly as a result of advances in positron emission tomography (PET). The most important trend was the extension of PET technology into the care of patients with brain tumors, epilepsy, and heart disease. A second trend was the increasing use of single-photon emission computed tomography (SPECT).

  14. Medicine Handbook.

    ERIC Educational Resources Information Center

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

    New York State education law, rules, and regulations concerning the practice of medicine are presented, along with requirements and procedures for obtaining licensure and first registration as a physician. State statutory provisions cover: duration and registration of a license, practice and regulation of the profession, supervision by the Board…

  15. 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…

  16. Medicinal Plants.

    ERIC Educational Resources Information Center

    Phillipson, J. David

    1997-01-01

    Highlights the demand for medicinal plants as pharmaceuticals and the demand for health care treatments worldwide and the issues that arise from this. Discusses new drugs from plants, anticancer drugs, antiviral drugs, antimalarial drugs, herbal remedies, quality, safety, efficacy, and conservation of plants. Contains 30 references. (JRH)

  17. Medicines for sleep

    MedlinePlus

    Benzodiazepines; Sedatives; Hypnotics; Sleeping pills; Insomnia - medicines; Sleep disorder - medicines ... the-counter (OTC) sleeping pills contain antihistamines. These medicines are commonly used to treat allergies. While these ...

  18. Chronic Pain Medicines

    MedlinePlus

    ... Treatment of chronic pain usually involves medicines and therapy. Medicines used for chronic pain include pain relievers, antidepressants and anticonvulsants. Different types of medicines help ...

  19. Primary Care Sports Medicine: A Part-Timer's Perspective.

    ERIC Educational Resources Information Center

    Howe, Warren B.

    1988-01-01

    A family practice physician describes his part-time sports medicine experience, including the multiple roles he plays as team physician, the way sports medicine is integrated into his family practice, and how it affects his professional life and peer relationships. (Author/MT)

  20. 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…

  1. Complementary and Alternative Medicine

    MedlinePlus

    ... Help a Friend Who Cuts? Complementary and Alternative Medicine KidsHealth > For Teens > Complementary and Alternative Medicine Print ... replacement. continue How Is CAM Different From Conventional Medicine? Conventional medicine is based on scientific knowledge of ...

  2. ADHD Medicines (for Kids)

    MedlinePlus

    ... Homework? Here's Help White House Lunch Recipes ADHD Medicines KidsHealth > For Kids > ADHD Medicines Print A A ... doctor can decide if ADHD medicine is needed. Medicine and the Mind There are a lot of ...

  3. Pregnancy and Medicines

    MedlinePlus

    ... Pregnancy and medicines fact sheet ePublications Pregnancy and medicines fact sheet Print this fact sheet Pregnancy and ... pregnancy and medicines Is it safe to use medicine while I am pregnant? There is no clear- ...

  4. Medicine safety and children

    MedlinePlus

    ... medicine is made to look and taste like candy. Children are curious and attracted to medicine. Most ... like you. DO NOT call medicine or vitamins candy. Children like candy and will get into medicine ...

  5. Medicines by Design

    MedlinePlus

    ... Education > Medicines By Design Medicines By Design Spotlight Nature's Medicine Cabinet A Medicine's Life Inside the Body ... CYP 450 enzymes » more Chapter 3: Drugs from Nature, Then and Now Drugs from plants, oceans and ...

  6. The Fairfax County Family Literacy Curriculum.

    ERIC Educational Resources Information Center

    Wong, Betsy Lindeman

    The Fairfax County Family Literacy Curriculum is designed to be used in a multi-level adult English for Speakers of Other Languages (ESOL) family literacy class. There are four modules to choose from: Introductory (self, family, and community); Government (schools and community); Health (medicine and stress); and Consumerism (shopping and making a…

  7. Community Medicine in India - Which Way Forward?

    PubMed

    Krishnan, Anand

    2016-01-01

    Today, the Community Medicine professionals in India feel both "confused" and "threatened" by the mushrooming of schools of public health and departments of family medicine. The phenomenon of identity crisis and low-self esteem is not a recent one, nor is it restricted to India. The disciplines of community medicine and public health have evolved differently and despite some overlaps have differences especially in the need for clinical training. The core of the issue is that while the community medicine fraternity is keen to retain its clinical tag, what differentiates it from clinicians is the use of public health approach. I believe the strength of community medicine is that it bridges the gap between traditional fields of public health and clinical medicine and brings community perspective into health. The perceived threat from non-medical persons led public health is largely a result of us undervaluing our strength and our inability to foster partnership on equal footing with non-clinicians. While departments of community medicine have a fully functional rural or urban field practice area used for training at primary level care, these can serve as an excellent platform for training in secondary level care required for family medicine. National needs dictate that all three disciplines are required for improvement of population health, whether these are housed together or separately can be left to individual institutions to decide as long as they enable collaborations between them. We need to strengthen community medicine and market it appropriately to ministries of health. PMID:26917866

  8. Space Medicine

    NASA Technical Reports Server (NTRS)

    Pool, Sam L.

    2000-01-01

    The National Academy of Sciences Committee on Space Biology and Medicine points out that space medicine is unique among space sciences, because in addition to addressing questions of fundamental scientific interest, it must address clinical or human health and safety issues as well. Efforts to identify how microgravity affects human physiology began in earnest by the United States in 1960 with the establishment of the National Aeronautics and Space Administration (NASA's) Life Sciences program. Before the first human space missions, prediction about the physiological effects of microgravity in space ranged from extremely severe to none at all. The understanding that has developed from our experiences in space to date allows us to be guardedly optimistic about the ultimate accommodations of humans to space flight. Only by our travels into the microgravity environment of space have we begun to unravel the mysteries associated with gravity's role in shaping human physiology. Space medicine is still at its very earliest stages. Development of this field has been slow for several reasons, including the limited number of space flights, the small number of research subjects, and the competition within the life sciences community and other disciplines for flight opportunities. The physiological changes incurred during space flight may have a dramatic effect on the course of an injury or illness. These physiological changes present an exciting challenge for the field of space medicine: how to best preserve human health and safety while simultaneously deciphering the effects of microgravity on human performance. As the United States considers the future of humans in long-term space travel, it is essential that the many mysteries as to how microgravity affects human systems be addressed with vigor. Based on the current state of our knowledge, the justification is excellent indeed compelling- for NASA to develop a sophisticated capability in space medicine. Teams of physicians

  9. FORENSIC MEDICINE: AN AID TO CRIMINAL INVESTIGATION.

    PubMed

    DEADMAN, W J

    1965-03-27

    Forensic medicine is medicine as applied to the problems of the law. The origins of both are hidden in the mists of antiquity, dating from the beginnings of family and tribal life. Recorded human history goes back for 6000 years. Sumeria, Babylon and Egypt all contributed to the development of forensic medicine. Imhotep was probably the first real medicolegal expert. Hippocrates, the Greek physician, and Galen, the Roman, made considerable contributions. Little advance was made during the millenium of the Dark Ages. But Renaissance medicine gave this branch of medicine an impetus in the seventeenth, eighteenth and nineteenth centuries, and in the twentieth, interest in forensic medicine is worldwide. The physician, the coroner, the pathologist, the medical specialist and the forensic laboratory contribute to the investigation of crimes against the person, and to the solution of such problems as identification, untoward deaths, apparent drowning and many others.

  10. Family Meals

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy Family Meals KidsHealth > For Parents > Family Meals Print A ... even more important as kids get older. Making Family Meals Happen It can be a big challenge ...

  11. Family Arguments

    MedlinePlus

    ... Spread the Word Shop AAP Find a Pediatrician Family Life Medical Home Family Dynamics Adoption & Foster Care ... Life Listen Español Text Size Email Print Share Family Arguments Page Content Article Body We seem to ...

  12. Family History

    MedlinePlus

    Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, ... as heart disease, stroke, and cancer. Having a family member with a disease raises your risk, but ...

  13. Why sports medicine is not medicine.

    PubMed

    Edwards, Steven D; McNamee, Mike

    2006-06-01

    Sports Medicine as an apparent sub-class of medicine has developed apace over the past 30 years. Its recent trajectory has been evidenced by the emergence of specialist international research journals, standard texts, annual conferences, academic appointments and postgraduate courses. Although this field of enquiry and practice lays claim to the title 'sports medicine' this paper queries the legitimacy of that claim. Depending upon how 'sports medicine' and 'medicine' are defined, a plausible-sounding case can be made to show that sports medicine is not in fact a branch of medicine. Rather, it is sometimes closer to practices such as non-therapeutic cosmetic surgery. The argument of the paper is as follows. It begins with a brief statement concerning methodology. We then identify and subscribe to a plausible defining goal of medicine taken from a recognised authority in the field. Then two representative, authoritative, definitions of sports medicine are discussed. It is then shown that acceptance of these definitions of sports medicine generates a problem in that if they are accepted, no necessary commitment to the defining goal of medicine is present within sports medicine. It seems to follow that sports medicine is not medicine. In the final part of the paper a critical response to that conclusion is presented and rebutted. The response is one which rejects the identification of the defining goal of medicine upon which our argument rests.

  14. Evolutionary medicine.

    PubMed

    Swynghedauw, B

    2004-04-01

    Nothing in biology makes sense except in the light of evolution. Evolutionary, or darwinian, medicine takes the view that contemporary diseases result from incompatibility between the conditions under which the evolutionary pressure had modified our genetic endowment and the lifestyle and dietary habits in which we are currently living, including the enhanced lifespan, the changes in dietary habits and the lack of physical activity. An evolutionary trait express a genetic polymorphism which finally improve fitness, it needs million years to become functional. A limited genetic diversity is a necessary prerequisite for evolutionary medicine. Nevertheless, search for a genetic endowment would become nearly impossible if the human races were genetically different. From a genetic point of view, homo sapiens, is homogeneous, and the so-called human races have only a socio-economic definition. Historically, Heart Failure, HF, had an infectious origin and resulted from mechanical overload which triggered mechanoconversion by using phylogenically ancient pleiotropic pathways. Adaptation was mainly caused by negative inotropism. Recently, HF was caused by a complex remodelling caused by the trophic effects of mechanics, ischemia, senescence, diabetes and, neurohormones. The generally admitted hypothesis is that cancers were largely caused by a combination of modern reproductive and dietary lifestyles mismatched with genotypic traits, plus the longer time available for a confrontation. Such a concept is illustrated for skin and breast cancers, and also for the link between cancer risk and dietary habits.

  15. Interpretive Medicine

    PubMed Central

    Reeve, Joanne

    2010-01-01

    Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the

  16. Medicinal cannabis.

    PubMed

    Murnion, Bridin

    2015-12-01

    A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations. Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy. However, evidence is limited, may reflect subjective rather than objective outcomes, and is not conclusive. Controversies lie in how to produce, supply and administer cannabinoid products. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community. The Regulator of Medicinal Cannabis Bill 2014 is under consideration in Australia to address this. Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion in Schedule 4. PMID:26843715

  17. Plasma Medicine

    NASA Astrophysics Data System (ADS)

    Laroussi, M.; Kong, M. G.; Morfill, G.; Stolz, W.

    2012-05-01

    Foreword R. Satava and R. J. Barker; Part I. Introduction to Non-equilibrium Plasma, Cell Biology, and Contamination: 1. Introduction M. Laroussi; 2. Fundamentals of non-equilibrium plasmas M. Kushner and M. Kong; 3. Non-equilibrium plasma sources M. Laroussi and M. Kong; 4. Basic cell biology L. Greene and G. Shama; 5. Contamination G. Shama and B. Ahlfeld; Part II. Plasma Biology and Plasma Medicine: 6. Common healthcare challenges G. Isbary and W. Stolz; 7. Plasma decontamination of surfaces M. Kong and M. Laroussi; 8. Plasma decontamination of gases and liquids A. Fridman; 9. Plasma-cell interaction: prokaryotes M. Laroussi and M. Kong; 10. Plasma-cell interaction: eukaryotes G. Isbary, G. Morfill and W. Stolz; 11. Plasma based wound healing G. Isbary, G. Morfill and W. Stolz; 12. Plasma ablation, surgery, and dental applications K. Stalder, J. Woloszko, S. Kalghatgi, G. McCombs, M. Darby and M. Laroussi; Index.

  18. Medicinal cannabis

    PubMed Central

    Murnion, Bridin

    2015-01-01

    Summary A number of therapeutic uses of cannabis and its derivatives have been postulated from preclinical investigations. Possible clinical indications include spasticity and pain in multiple sclerosis, cancer-associated nausea and vomiting, cancer pain and HIV neuropathy. However, evidence is limited, may reflect subjective rather than objective outcomes, and is not conclusive. Controversies lie in how to produce, supply and administer cannabinoid products. Introduction of cannabinoids therapeutically should be supported by a regulatory and educational framework that minimises the risk of harm to patients and the community. The Regulator of Medicinal Cannabis Bill 2014 is under consideration in Australia to address this. Nabiximols is the only cannabinoid on the Australian Register of Therapeutic Goods at present, although cannabidiol has been recommended for inclusion in Schedule 4. PMID:26843715

  19. Diving medicine.

    PubMed

    Benton, P J; Glover, M A

    2006-01-01

    Recreational diving developed in the late 1940s when self-contained underwater breathing apparatus (SCUBA) first became available for civilian use. At the same time the development of the commercial airliner, in particular the jet airliner, made possible the concept of international travel for pleasure as opposed to business. Over the past 50 years the number of international tourists has increased by over 2500% from a mere 25 million in 1950 to over 700 million in 2002 (Treadwell TL. Trends in travel. In: Zuckerman JN, editor. Principles and practice of travel medicine, 2001; p. 2-6). The popularity of recreational diving has also increased over the same period from an activity experienced by a small number of individuals in the early 1950s to an activity today enjoyed by many millions. The combination of increased international travel and the means by which to enter and explore the underwater world has led to diving becoming increasingly popular as a tourist activity.

  20. Family Privilege

    ERIC Educational Resources Information Center

    Seita, John R.

    2014-01-01

    Family privilege is defined as "strengths and supports gained through primary caring relationships." A generation ago, the typical family included two parents and a bevy of kids living under one roof. Now, every variation of blended caregiving qualifies as family. But over the long arc of human history, a real family was a…

  1. Family Literacy.

    ERIC Educational Resources Information Center

    Washington, Charles W., Ed.

    1996-01-01

    This newsletter theme issue focuses on the impact of learning disabilities within families, specifically families with low literacy skills. It explores the effectiveness of family literacy programs, examines the connection between the field of family literacy and learning disabilities (LD), and offers suggestions on how to work with students with…

  2. Asteroid families

    NASA Technical Reports Server (NTRS)

    Williams, James G.

    1991-01-01

    More than 100 asteroid families are presented in Williams. Several examples of cratering events are known including family numbers 150, 162, 169, and 189. These are recognizable as many small fragments adjacent to and to one side (in three dimensions) of a much larger cratered body. Family numbers 138 and 140 are adjacent in proper element space. In population they are an intermediate step between the long recognizable families and the more frequent less populated families. Family number 164 is the fifth most populous family in the belt. All members are faint and nothing is known of the physical properties.

  3. Native American medicine.

    PubMed

    Cohen, K

    1998-11-01

    This article summarizes common principles, practices, and ethics of Native American healing, the traditional medicine of North America. Native American healing, spirituality, culture, and, in modern times, political, social, and economic concerns are closely intertwined. Intuition and spiritual awareness are a healer's most essential diagnostic tools. Therapeutic methods include prayer, music, ritual purification, herbalism, massage, ceremony, and personal innovations of individual healers. A community of friends, family, and helpers often participate in the healing intervention and help to alleviate the alienation caused by disease. A healthy patient has a healthy relationship with his or her community and, ultimately, with the greater community of nature known as "All Relations." The goal of Native American healing is to find wholeness, balance, harmony, beauty, and meaning. "Healing," making whole, is as important as curing disease; at times they are identical.

  4. Emergency medicine ultrasonography

    PubMed Central

    Woo, Michael Y.; Nussbaum, Chris; Lee, A. Curtis

    2009-01-01

    ABSTRACT OBJECTIVE To survey program directors of family medicine–emergency medicine (CCFP[EM]) training programs regarding current and future emergency medicine ultrasonography (EMUS) training. DESIGN A Web-based survey using a modified Dillman method. Two academic emergency physicians reviewed the validity and reliability of the survey. SETTING Canada. PARTICIPANTS Program directors of all 17 Canadian CCFP(EM) residency training programs in 2006. MAIN OUTCOME MEASURES Characteristics of EMUS training currently offered and program directors’ perceptions of needs for future EMUS training. RESULTS The survey, performed in 2006, had a response rate of 100% (17/17), although not all respondents answered all questions. At the time of the study, 82.4% of respondents’ programs used EMUS. Although all program directors recommended that residents attend introductory EMUS courses, only 71.4% (10/14) of programs offered such courses; 60.0% (9/15) of those were mandatory. In one-third of the programs, more than 75% of the attending staff used EMUS. A total of 76.5% of program directors thought that introductory courses in EMUS should be mandatory; 62.5% (10/16) believed that residents were able to acquire sufficient experience to use EMUS independently to make practice decisions before completion of their residency; and 88.2% believed that EMUS should be a part of the scope of practice for emergency medicine physicians. Only 58.8% believed that there should be questions about EMUS on the CCFP(EM) Certification examination. Open responses indicated that funding, resources, and standardization were issues that needed to be addressed. CONCLUSION Formal EMUS training for CCFP(EM) programs is being introduced in Canada. Quality assurance needs to be strengthened. Most program directors thought that an introductory course in EMUS should be mandatory. Fewer directors, however, believed EMUS should be on the CCFP(EM) Certification examination until further funding, resources

  5. Medicinal applications of fullerenes

    PubMed Central

    Bakry, Rania; Vallant, Rainer M; Najam-ul-Haq, Muhammad; Rainer, Matthias; Szabo, Zoltan; Huck, Christian W; Bonn, Günther K

    2007-01-01

    Fullerenes have attracted considerable attention in different fields of science since their discovery in 1985. Investigations of physical, chemical and biological properties of fullerenes have yielded promising information. It is inferred that size, hydrophobicity, three-dimensionality and electronic configurations make them an appealing subject in medicinal chemistry. Their unique carbon cage structure coupled with immense scope for derivatization make them a potential therapeutic agent. The study of biological applications has attracted increasing attention despite the low solubility of carbon spheres in physiological media. The fullerene family, and especially C60, has appealing photo, electrochemical and physical properties, which can be exploited in various medical fields. Fullerene is able to fit inside the hydrophobic cavity of HIV proteases, inhibiting the access of substrates to the catalytic site of enzyme. It can be used as radical scavenger and antioxidant. At the same time, if exposed to light, fullerene can produce singlet oxygen in high quantum yields. This action, together with direct electron transfer from excited state of fullerene and DNA bases, can be used to cleave DNA. In addition, fullerenes have been used as a carrier for gene and drug delivery systems. Also they are used for serum protein profiling as MELDI material for biomarker discovery. In this review we report the aspects of medicinal applications of fullerenes. PMID:18203430

  6. Medicinal applications of fullerenes.

    PubMed

    Bakry, Rania; Vallant, Rainer M; Najam-ul-Haq, Muhammad; Rainer, Matthias; Szabo, Zoltan; Huck, Christian W; Bonn, Günther K

    2007-01-01

    Fullerenes have attracted considerable attention in different fields of science since their discovery in 1985. Investigations of physical, chemical and biological properties of fullerenes have yielded promising information. It is inferred that size, hydrophobicity, three-dimensionality and electronic configurations make them an appealing subject in medicinal chemistry. Their unique carbon cage structure coupled with immense scope for derivatization make them a potential therapeutic agent. The study of biological applications has attracted increasing attention despite the low solubility of carbon spheres in physiological media. The fullerene family, and especially C60, has appealing photo, electrochemical and physical properties, which can be exploited in various medical fields. Fullerene is able to fit inside the hydrophobic cavity of HIV proteases, inhibiting the access of substrates to the catalytic site of enzyme. It can be used as radical scavenger and antioxidant. At the same time, if exposed to light, fullerene can produce singlet oxygen in high quantum yields. This action, together with direct electron transfer from excited state of fullerene and DNA bases, can be used to cleave DNA. In addition, fullerenes have been used as a carrier for gene and drug delivery systems. Also they are used for serum protein profiling as MELDI material for biomarker discovery. In this review we report the aspects of medicinal applications of fullerenes.

  7. Preventing HIV with Medicine

    MedlinePlus

    ... information in Spanish ( en español ) Preventing HIV with medicine Get medicine right after you are exposed to ... to top More information on Preventing HIV with medicine Explore other publications and websites National HIV and ...

  8. Managing Your Medicines

    MedlinePlus

    ... Blood Pressure Tools & Resources Stroke More Managing Your Medicines Updated:Sep 2,2016 If you have heart ... Weight • Tools & Resources Heart Insight Supplement: Know Your Medicines Keeping track of your medicines can be overwhelming. ...

  9. Cough & Cold Medicine Abuse

    MedlinePlus

    ... I Help a Friend Who Cuts? Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold Medicine Abuse ... DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  10. Storing your medicines

    MedlinePlus

    ... your medicine out of reach and out of sight of children. Store your medicine in a cabinet ... Your Medicines Up and Away and Out of Sight. December 12, 2011. www.cdc.gov/Features/MedicationStorage . ...

  11. High blood pressure medicines

    MedlinePlus

    Hypertension - medicines ... blood vessel diseases. You may need to take medicines to lower your blood pressure if lifestyle changes ... blood pressure to the target level. WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED Most of the ...

  12. Complementary and Integrative Medicine

    MedlinePlus

    ... medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine. Complementary medicine is used together with mainstream medical ...

  13. Muslim Families and Family Therapy.

    ERIC Educational Resources Information Center

    Daneshpour, Manijeh

    1998-01-01

    Examines the applicability of the Anglo-American models of family therapy to Muslim immigrant families. The differences in value systems are the Muslim families' preferences for greater connectedness, a less flexible and more hierarchical family structure, and an implicit communication style. Suggests that directions for change for Muslims need to…

  14. Cancer, Families, and Family Counselors.

    ERIC Educational Resources Information Center

    Duffy, Maureen; Gillig, Scott

    2003-01-01

    Examines the role of the family counselor in working with cancer patients and their families. Suggests ways in which the family counselor can work proactively with families in the area of cancer prevention and helping them cope more effectively with its impact on their lives. Uses a clinical case example to illustrate intervention with cancer…

  15. Medicines for osteoporosis

    MedlinePlus

    ... Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines ... when: A bone density test shows you have osteoporosis, even if you have not had a fracture ...

  16. Family Violence and Family Physicians

    PubMed Central

    Herbert, Carol P.

    1991-01-01

    The acronym IDEALS summarizes family physicians' obligations when violence is suspected: to identify family violence; document injuries; educate families and ensure safety for victims; access resources and coordinate care; co-operate in the legal process; and provide support for families. Failure to respond reflects personal and professional experience and attitudes, fear of legal involvement, and lack of knowledge. Risks of intervention include physician burnout, physician overfunctioning, escalation of violence, and family disruption. PMID:21228987

  17. Medicine organizer

    NASA Astrophysics Data System (ADS)

    Martins, Ricardo; Belchior, Ismael

    2015-04-01

    In the last year of secondary school, students studying physics and chemistry are incentivized to do a project where they must put in practice their improvement of scientific knowledge and skills, like observation of phenomena and analysis of data with scientific knowledge. In this project a group of students, tutored by the teacher, wanted to build an instrument that helps people to take their medical drugs at the right time. This instrument must have some compartments with an alarm and an LED light where the people can put their medical drugs. The instrument must be easily programed using an android program that also registers if the medicine has been taken. The students needed to simulate the hardware and software, draw the electronic system and build the final product. At the end of the school year, a public oral presentation was prepared by each group of students and presented to the school community. They are also encouraged to participate in national and international scientific shows and competitions.

  18. [Disaster medicine].

    PubMed

    Carli, Pierre; Telionri, Caroline

    2015-01-01

    For over 30 years, the French hospital and pre-hospital medical teams are trained in disaster medicine. In fact, they are regularly confronted with the management of multiple casualties in accidents or even terrorist attacks, and more rarely to large-scale disasters. The intervention of physicians of the EMS system (SAMU-SMUR) in the field allows an original healthcare organization: in an advanced medical post, the victims are triaged according to their severity and benefit if needed of initial resuscitation. SAMU medical regulating center then organize their transport and repartition in several hospitals put on alert. To cope with a mass casualty situation, the hospital also has a specific organization, the White Plan. This plan, initiated by the director, assisted by a medico-administrative cell crisis can mobilize all the resources of the institution. Personnel are recalled and the ability of emergency units is increased. Care, less urgent, other patients are postponed. There are many plans for responding to disasters. ORSEC plans of the ministry of Interior articulate with the ORSAN plans of the ministry of Health. This complementarity allows a global mobilization of public services in disasters or exceptional medical situations.

  19. [Medicinal leeches].

    PubMed

    Massart, D; Sohawon, S; Noordally, O

    2009-01-01

    Leeches are hermaphroditic and hematophagous annelids. One important medical species, Hirudo medicinalis, comes from hirudiniculture of fresh water pools. Thanks to their three mandibles with some 300 teeth on their anterior muscular sucker, they easily grab to tissues and by secreting their saliva containing numerous powerful enzymes, such as hyaluronidase, collagenase and inhibitors of platelet aggregation and coagulation, like hirudin, allow blood sucking. Once they are full of blood (up to 15 g of blood), they detach themselves from their prey. Used ever since the 18th Egyptian Dynasty, leeches became famous during the first part of the XIXth century, thanks to a French physician, François Joseph Victor Broussais, known to his adversaries as the "vampire of medicine" for treating various conditions such as phlebotomy, laryngitis, ocular problems, obesity, mental disorders, etc. Overfishing, therapeutic failures and most particularly, the emergence of hygiene, brought the decline of living leeches. In 1884, an extract of leeches was obtained--hirudin and henceforth used. Nowadays, leeches are still used in microsurgery to enhance the venous circulation in finger reimplantation or skin flap transposition. Hirudin is synthesized through recombinant DNA technology and molecules such as lepirudin and desirudin are available on the market as anticoagulant.

  20. Palliative medicine review: prognostication.

    PubMed

    Glare, Paul A; Sinclair, Christian T

    2008-01-01

    Prognostication, along with diagnosis and treatment, is a traditional core clinical skill of the physician. Many patients and families receiving palliative care want information about life expectancy to help plan realistically for their futures. Although underappreciated, prognosis is, or at least should be, part of every clinical decision. Despite this crucial role, expertise in the art and science of prognostication diminished during the twentieth century, due largely to the ascendancy of accurate diagnostic tests and effective therapies. Consequently, "Doctor, how long do I have?" is a question most physicians find unprepared to answer effectively. As we focus on palliative care in the twenty-first century, prognostication will need to be restored as a core clinical proficiency. The discipline of palliative medicine can provide leadership in this direction. This paper begins by discussing a framework for understanding prognosis and how its different domains might be applied to all patients with life limiting illness, although the main focus of the paper is predicting survival in patients with cancer. Examples of prognostic tools are provided, although the subjective assessment of prognosis remains important in the terminally ill. Other issues addressed include: the importance of prognostication in terms of clinical decision-making, discharge planning, and care planning; the impact of prognosis on hospice referrals and patient/family satisfaction; and physicians' willingness to prognosticate. PMID:18370898

  1. Familial gigantism.

    PubMed

    Herder, Wouter W de

    2012-01-01

    Familial GH-secreting tumors are seen in association with three separate hereditary clinical syndromes: multiple endocrine neoplasia type 1, Carney complex, and familial isolated pituitary adenomas. PMID:22584702

  2. Family Support.

    ERIC Educational Resources Information Center

    Wieck, Colleen, Ed.; McBride, Marijo, Ed.

    1990-01-01

    This "Feature Issue" of the quarterly journal "Impact" presents 19 brief articles on family support systems in the United States for persons with developmental disabilities and their families. Emphasis is on provisions of Public Law 99-457. Articles include: "Family Support in the United States: Setting a Course for the 1990s" (James Knoll);…

  3. Rural Families.

    ERIC Educational Resources Information Center

    Goetz, Kathy, Ed.

    1992-01-01

    This "special focus" journal issue consists of 13 individual articles on the theme of rural family programs relating to school, health services, church, and other institutions. It includes: (1) "Towards a Rural Family Policy" (Judith K. Chynoweth and Michael D. Campbell); (2) "Montana: Council for Families Collaborates for Prevention (Jean…

  4. Being the Family's Therapist: An Integrative Approach.

    ERIC Educational Resources Information Center

    Zimmerman, James K.; La Sorsa, Valerie A.

    There is strong justification in the counseling literature for bridging individual and family perspectives. The Adolescent Depression and Suicide Program at Montefiore Center/Albert Einstein College of Medicine (New York) is a brief treatment, outpatient clinic designed to provide mental health services for suicidal adolescents and their families.…

  5. 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

  6. SACRED TULSI (OCIMUM SANCTUM L.) IN TRADITIONAL MEDICINE AND PHARMACOLOGY

    PubMed Central

    Khosla, M.K.

    1995-01-01

    Scared Tulasi (Ocimum sanctum L.) of family Lamiaceae is a wonder ayurvedic herb which is known for its tremendous medicinal properties both in traditional folklore as well as pharmacological system of medicines. Every part of the plant finds its use in one form or the other. Keeping in view the importance of the plant, an attempt has been made to review the various studies carried out in traditional system of medicine as well as modern pharmacological investigations. PMID:22556721

  7. Medicinal Plants with Antiplatelet Activity.

    PubMed

    El Haouari, Mohammed; Rosado, Juan A

    2016-07-01

    Blood platelets play an essential role in the hemostasis and wound-healing processes. However, platelet hyperactivity is associated to the development and the complications of several cardiovascular diseases. In this sense, the search for potent and safer antiplatelet agents is of great interest. This article provides an overview of experimental studies performed on medicinal plants with antiplatelet activity available through literature with particular emphasis on the bioactive constituents, the parts used, and the various platelet signaling pathways modulated by medicinal plants. From this review, it was suggested that medicinal plants with antiplatelet activity mainly belong to the family of Asteraceae, Rutaceae, Fabaceae, Lamiaceae, Zygophyllaceae, Rhamnaceae, Liliaceae, and Zingiberaceae. The antiplatelet effect is attributed to the presence of bioactive compounds such as polyphenols, flavonoids, coumarins, terpenoids, and other substances which correct platelet abnormalities by interfering with different platelet signalization pathways including inhibition of the ADP pathway, suppression of TXA2 formation, reduction of intracellular Ca(2+) mobilization, and phosphoinositide breakdown, among others. The identification and/or structure modification of the plant constituents and the understanding of their action mechanisms will be helpful in the development of new antiplatelet agents based on medicinal plants which could contribute to the prevention of thromboembolic-related disorders by inhibiting platelet aggregation. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27062716

  8. Veterinary herbal medicines in India

    PubMed Central

    Rastogi, Shruti; Pandey, Manoj Kumar; Prakash, Jai; Sharma, Alok; Singh, Gyanendra Nath

    2015-01-01

    India has a rich and diversified flora. It is seen that synthetic drugs could pose serious problems, are toxic and costly. In contrast to this, herbal medicines are relatively nontoxic, cheaper and are eco-friendly. Moreover, the people have used them for generations. They have also been used in day-to-day problems of healthcare in animals. 25% of the drugs prescribed worldwide come from plants. Almost 75% of the medicinal plants grow naturally in different states of India. These plants are known to cure many ailments in animals like poisoning, cough, constipation, foot and mouth disease, dermatitis, cataract, burning, pneumonia, bone fractures, snake bites, abdominal pains, skin diseases etc. There is scarce review of such information (veterinary herbals) in the literature. The electronic and manual search was made using various key words such as veterinary herbal, ethno-veterinary medicines etc. and the content systematically arranged. This article deals with the comprehensive review of 45 medicinal plant species that are official in Indian Pharmacopoeia (IP) 2014. The botanical names, family, habitat, plant part used and pharmacological actions, status in British Pharmacopoeia 2014, USP 36 are mentioned. Also, a relationship between animal and human dose, standardization and regulatory aspects of these selected veterinary herbals are provided. PMID:26392714

  9. Natural medicine: the genus Angelica.

    PubMed

    Sarker, S D; Nahar, L

    2004-06-01

    More than 60 species of medicinal plants belong to the genus Angelica (Family: Apiaceae). Many of these species have long been used in ancient traditional medicine systems, especially in the far-east. Various herbal preparations containing Angelica species are available over-the-counter, not only in the far-eastern countries, but also in the western countries like USA, UK, Germany, etc. For centuries, many species of this genus, e.g. A. acutiloba, A. archangelica, A. atropupurea, A. dahurica, A. japonica, A. glauca, A. gigas, A. koreana, A. sinensis, A. sylvestris, etc., have been used traditionally as anti-inflammatory, diuretic, expectorant and diaphoretic, and remedy for colds, flu, influenza, hepatitis, arthritis, indigestion, coughs, chronic bronchitis, pleurisy, typhoid, headaches, wind, fever, colic, travel sickness, rheumatism, bacterial and fungal infections and diseases of the urinary organs. Active principles isolated from these plants mainly include various types of coumarins, acetylenic compounds, chalcones, sesquiterpenes and polysaccharides. This review evaluates the importance of the genus Angelica in relation to its traditional medicinal uses, alternative medicinal uses in the modern society and potential for drug development, and summarises results of various scientific studies on Angelica species or Angelica-containing preparations for their bioactivities including, antimicrobial, anticancer, antitumour, analgesic, anti-inflammatory, hepatoprotective, nephroprotective, etc. PMID:15180579

  10. [Internal medicine and public health].

    PubMed

    2009-08-01

    A special Committee on Internal Medicine and Public Health was established by Sociedad Médica de Santiago (Chilean Society of Internal Medicine) in April 2007 with the duty to write a Consensus Paper on the interaction between both branches of medical profession. The main objective was to find the common grounds on which to construct a positive approach to regain space for Internal Medicine, based on prevalent epidemiológical features related to adult health issues. The authors describe the reasons to explain the gap between clinical medicine and population health and identify the nature and evolution of chronic diseases as the point of encounter between both. With Chilean health surveys data, they state that chronic diseases explain the high proportion of burden of disease, mortality and disability, and stress that by the year 2025 one in every five inhabitants will be over 65 years of age, with ageing as another main problem for the health care sector. Population with multiple risks and multimorbidity is the most important challenge for the Chilean Health Care System. A new model of care is needed to tackle this scenario with new skills regarding psychosocial determinants of health. The leading role of internists and ideally geriatricians, will be crucial in this process and will help the implementation of sound population based interventions. Both individual and community level interventions will help to improve quality of life of Chilean families.

  11. IN PURSUIT OF NEW HERBAL SOURCES FOR INDIAN MEDICINE

    PubMed Central

    Sivarajan, V. V.; Balachandran, Indu

    1987-01-01

    Due to destruction of forest wealth and natural flora the sources of herbal medicine are becoming increasingly rare. So, it is high time to discover alternative sources of such drugs among plant species that are already available in large numbers. As a first installment of the series the medicinal properties of a few members of the family Phytolaccaceae are discussed here. PMID:22557586

  12. Familial hypertriglyceridemia

    MedlinePlus

    ... avoiding excess calories and foods high in saturated fats and carbohydrates . You may need to take medicine if your triglyceride levels stay high even after making diet changes. Nicotinic acid, gemfibrozil, and fenofibrate have been ...

  13. Mozart and medicine in the eighteenth century.

    PubMed

    Jenkins, J S

    1995-07-01

    Over the years the medical history and death of Mozart have been the subject of many studies, but in spite of all this attention much remains controversial. In an attempt to resolve some of the difficulty it is useful to see his life, and that of his family as recorded in their letters, in the context of medicine in eighteenth-century Europe.

  14. From basic research to personalized medicine

    PubMed Central

    Thibaut, Florence

    2016-01-01

    In the future, precision medicine will enable every clinician to tailor treatment and even prevention strategies to an individual's unique characteristics. In order to reach this goal, we need to collect and analyze many different types of data, from many different sources, including symptoms, genomics, and brain circuitry, as well as family dynamics, environmental exposures, and cultural background. PMID:27757058

  15. HERBAL FOLK MEDICINES OF JALGAON DISTRICT (MAHARASHTRA)

    PubMed Central

    Fawar, Shubhangi; Patil, D.A.

    2001-01-01

    Fifty plants belonging to 33 angiospermic families used by aborigines and rurals for different human ailments hitherto unreported from Jalgaon district. Maharashtra, India are communicated. Further scientific evaluation on pharmacological and clinical lines is needed for these widely employed herbal medicines. PMID:22557036

  16. [ETHICS, MORALS AND SOCIETY IN PERSONALIZED MEDICINE].

    PubMed

    Flugelman, Anath

    2015-09-01

    Following the completion of the human genome project, genomic medicine including personalized medicine, widely based on pharmacogenetics and pharmacogenomics, is rapidly developing. This breakthrough should benefit humankind thanks to tailoring the most appropriate prevention, interventions and therapies to each individual, minimizing adverse side effects, based on inter-personal genetic variety and polymorphism. Yet wide spectrum ethical, legal and social issues carry significant implications regarding individuals, families, society and public health. The main issues concern genomic information and autonomy, justice and equity, resources allocation and solidarity, challenging the traditional role of medicine and dealing with unlimited boundaries of knowledge. Those issues are not new nor exceptional to genomic medicine, yet their wide unlimited scope and implications on many aspects of life renders them crucial. These aspects will be discussed in light of Beauchamp and Childress' four principles: non-maleficence, beneficence, autonomy and justice, and main moral philosophies, Kant's autonomy, Utilitarianism which promotes the common good, and Rawls' Theory of Justice. PMID:26665754

  17. [ETHICS, MORALS AND SOCIETY IN PERSONALIZED MEDICINE].

    PubMed

    Flugelman, Anath

    2015-09-01

    Following the completion of the human genome project, genomic medicine including personalized medicine, widely based on pharmacogenetics and pharmacogenomics, is rapidly developing. This breakthrough should benefit humankind thanks to tailoring the most appropriate prevention, interventions and therapies to each individual, minimizing adverse side effects, based on inter-personal genetic variety and polymorphism. Yet wide spectrum ethical, legal and social issues carry significant implications regarding individuals, families, society and public health. The main issues concern genomic information and autonomy, justice and equity, resources allocation and solidarity, challenging the traditional role of medicine and dealing with unlimited boundaries of knowledge. Those issues are not new nor exceptional to genomic medicine, yet their wide unlimited scope and implications on many aspects of life renders them crucial. These aspects will be discussed in light of Beauchamp and Childress' four principles: non-maleficence, beneficence, autonomy and justice, and main moral philosophies, Kant's autonomy, Utilitarianism which promotes the common good, and Rawls' Theory of Justice.

  18. Cinnamon: A Multifaceted Medicinal Plant

    PubMed Central

    Rao, Pasupuleti Visweswara; Gan, Siew Hua

    2014-01-01

    Cinnamon (Cinnamomum zeylanicum, and Cinnamon cassia), the eternal tree of tropical medicine, belongs to the Lauraceae family. Cinnamon is one of the most important spices used daily by people all over the world. Cinnamon primarily contains vital oils and other derivatives, such as cinnamaldehyde, cinnamic acid, and cinnamate. In addition to being an antioxidant, anti-inflammatory, antidiabetic, antimicrobial, anticancer, lipid-lowering, and cardiovascular-disease-lowering compound, cinnamon has also been reported to have activities against neurological disorders, such as Parkinson's and Alzheimer's diseases. This review illustrates the pharmacological prospective of cinnamon and its use in daily life. PMID:24817901

  19. Herbal medicine in healthcare--an overview.

    PubMed

    Mosihuzzaman, Mohammed

    2012-06-01

    It is generally accepted by all concerned that modern pharmaceuticals will remain out of reach of many people and 'health for all' may only be realized by the use of adequately assessed herbal products. Mankind has been using herbal medicine for healing right from the beginning of human civilization. With the advent of 'modern medicine' herbal products have been looked down upon, especially by western societies. Yet, in recent times, use of herbal medicine for heathcare has increased steadily all over the world. However, serious concerns are being realized regarding the safety, claimed efficacy and quality of herbal products used as herbal medicine, nutraceuticals, health food and cosmetics. Although herbal products are generally considered safe due to their age-old usage, significant side effects have been reported for many herbal products, including herbal medicine. Accidental contamination and intentional adulteration are considered as primary reasons for the side effects. The historical perspective and the philosophy of herbal medical practice along with its present status in the light of present day science have been reviewed and included in the present article. Assurance of safety by identification of contaminants and assessment of toxicity has been outlined. Assessment of claimed efficacy of herbal medicine is difficult due to its holistic approach. Practical ways of assessing efficacy of herbal medicine by adapting the methodologies used for modern pharmaceutical are described. The maintenance of standard of herbal medicine has been stressed and pragmatic approaches of assuring quality of herbal medicine by using modern tools of fingerprinting the chemical profile of herbal medicine are discussed. As much of the traditional herbal medical knowledge is scattered around the world at the family and community levels, and more so in the indigeneous people, the knowledge base is continuously being lost and so needs immediate documentation. Difficulties in

  20. Some Less Known Medicinal Plants Traditionally Used In Dharmapuri District – Tamilnadu

    PubMed Central

    Singh, R. Suthar; Arani, M. U. V; Mohanmarugaraja, M.K.; Kumar, K. Suresh; Kumar, K.K. Shiva

    2005-01-01

    A medicinal plants survey was done in various parts of Dharmapuri district, about 260 medicinal plants were identified and collected. Amongst them, few of the plants were less known but had remarkable medicinal properties, they were grouped together and are enumerated by the botanical name, family name, local name, locality and ethnomedical properties. PMID:22557179

  1. Family Life.

    ERIC Educational Resources Information Center

    Naturescope, 1986

    1986-01-01

    Focuses on various aspects of mammal family life ranging from ways different species are born to how different mammals are raised. Learning activities include making butter from cream, creating birth announcements for mammals, and playing a password game on family life. (ML)

  2. Family Workshops

    ERIC Educational Resources Information Center

    Bennett, Dave; Rees-Jones, Tanny

    1978-01-01

    A Family Workshop is an informal, multidisciplined educational program for adults and children, organized by a team of teachers. This article discusses the Lavender Hill Family Workshop, one of many, which attempts to provide education in various subject areas for adults and for children while also integrating both objectives in order to educate…

  3. Family Empowerment.

    ERIC Educational Resources Information Center

    Sinclair, Mary F., Ed.; And Others

    1992-01-01

    This feature issue of IMPACT focuses on the empowerment of families with a member who has a developmental disability. It presents strategies and models for a collaborative, respectful approach to service provision, and presents the experiences of families in seeking support and assistance. Feature articles include "Two Generations of Disability: A…

  4. Family, Extended

    ERIC Educational Resources Information Center

    Patton, Jessica Rae

    2006-01-01

    Parents are a child's first and most influential teacher. People hear this truism often, yet nowhere has the author seen it more taken to heart than at Tower Street Elementary School. The school's efforts to form a true partnership with students' families--from involving families in the first day of school, to the principal making home visits, to…

  5. Family Potyviridae

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The International Committee on the Taxonomy of Viruses potyvirus study group has revised the description of the family Potyviridae for inclusion in the ICTV 9th report. Characteristic features of each genus within the family is presented. Revised criteria for demarcation and nomenclature of viral sp...

  6. FAMILY EMPIDIDAE.

    PubMed

    Rafael, José Albertino; Câmara, Josenir Teixeira

    2016-01-01

    Empididae is one of the biggest families of Diptera with around 3,000 known species. The family is poorly known in Colombia, with only six species reported and this work provides information on their distribution. No endemic genera or species have been recorded to date from Colombia. PMID:27395282

  7. Training Patient and Family Storytellers and Patient and Family Faculty

    PubMed Central

    Morrise, Lisa; Stevens, Katy Jo

    2013-01-01

    Narrative medicine has become a prominent method of developing more empathetic relationships between medical clinicians and patients, on the basis of a deeper understanding of the patient experience. Beyond its usefulness during clinical encounters, patient storytelling can inform processes and procedures in Advisory Councils, Committee Meetings, and Family as Faculty settings, leading to improved quality and safety in health care. Armed with a better understanding of the patient experience, clinicians and administrators can make decisions, hopefully in collaboration with patients, that will enrich the patient experience and increase satisfaction among patients, families, and staff. Patient and family storytelling is a key component of the collaboration that is ideal when an organization seeks to deliver patient- and family-centered care. Providing patients and families with training will make the narratives they share more powerful. Health care organizations will find that purposeful storytelling can be an invaluable aspect of a patient- and family-centered culture. Well-delivered storytelling will support quality- and safety-improvement efforts and contribute to improved patient satisfaction. This article provides instruction for teaching patients and families how to tell stories with purpose and offers advice about how to support patients, families, and clinicians participating in this effort. PMID:24355906

  8. Using Medicines Wisely

    MedlinePlus

    ... Consumers Consumer Information by Audience For Women Use Medicines Wisely Share Tweet Linkedin Pin it More sharing ... or foods should I avoid? 2. Keep a Medicine List Write down the important facts about each ...

  9. Depression - stopping your medicines

    MedlinePlus

    ... gov/ency/patientinstructions/000570.htm Depression - stopping your medicines To use the sharing features on this page, ... Why Do You Want to Stop Taking This Medicine? Write down all of the reasons you want ...

  10. Medicines for ADHD

    MedlinePlus

    ... stomach. DO NOT reduce your dose to save money. If you are having problems paying for medicine, talk with your provider. There may be programs that provide medicines for free or at a lower cost. SAFETY TIPS FOR ...

  11. Cold and Cough Medicines

    MedlinePlus

    ... What can you do for your cold or cough symptoms? Besides drinking lots of fluids and getting ... medicines. There are lots of different cold and cough medicines, and they do different things. Nasal decongestants - ...

  12. Sports Medicine Today

    ERIC Educational Resources Information Center

    Ryan, Allan J.

    1978-01-01

    Includes a general discussion of sports medicine including exercise and conditioning techniques, prevention of illness and injury, treatment of and rehabilitation after sports injury, and the future of sports medicine. (BB)

  13. Taking multiple medicines safely

    MedlinePlus

    ... falls . You are at higher risk for drug interactions. An interaction is when one medicine affects how another medicine ... interact with alcohol and even some foods. Some interactions can be serious, even life threatening. You may ...

  14. Physical medicine and rehabilitation

    MedlinePlus

    Rehabilitation; Physical rehab; Physiatry ... or developmental disorders Speech disorders and language problems Physical medicine and rehabilitation services also include sports medicine and injury prevention. WHERE REHABILITATION IS DONE People can have ...

  15. HIV/AIDS Medicines

    MedlinePlus

    ... few years. But today, there are many effective medicines to fight the infection, and people with HIV ... healthier lives. There are five major types of medicines: Reverse transcriptase (RT) inhibitors - interfere with a critical ...

  16. Individualized medicine, health medicine, and constitutional theory in Chinese medicine.

    PubMed

    Wang, Qi

    2012-03-01

    The patterns of modern science and changes in the medical model can result in the transformation of the current state of individualized and health medicines into being the primary trend in medical development. Chinese and Western medical systems are dissimilar in terms of value orientations, thinking style, and research directions because of their different historical and cultural backgrounds. Individualized treatment in modern medicine is mainly established based on individual genome information and the differences in mononucleotide polymorphisms. However, such treatment method is expensive, creates an uncertain genetic marker, and leads to different result interpretations, among other problems. The Chinese constitutional theory developed in the 1970s expresses the principle behind Chinese health medicine and individual treatment and provides the corresponding methods. The Chinese constitutional theory divides the constitution of the Chinese population into nine categories based on established classification criteria. It promotes the study of the relationship of each constitution to diseases and Chinese medicine preparation toward adjusting the constitution and preventing diseases. The theory also provides methods and tools for individualized treatment. Constitution identification shows the direction and provides the core technology for the evaluation of the health status. By combining the developments in modern biotechnology, new diagnostic techniques and treatment models of constitution-differentiation, disease-differentiation, and syndrome-differentiation can be established for the development of individualized Chinese medicine treatment and health medicine for the international medical community.

  17. Radicalism, Marxism, and medicine.

    PubMed

    Navarro, V

    1983-01-01

    This article presents a critique of recent radical interpretations of medicine and provides an alternative explanation of such interpretations. It analyzes 1) the articulation of medical practices, knowledge, and institutions within specific modes of production and social formations; 2) the dual functions of medicine within capitalist relations of production; 3) the reproduction of power within medicine; and 4) the meaning of capitalist, socialist, and communist medicine. The political practice derived from these analyses is also elaborated.

  18. Acaroid mites (Acari: Astigmata) in Chinese traditional medicines.

    PubMed

    Cui, Y-B; Li, C-P; Wang, J; Yang, Q-G; Tian, Y

    2003-12-01

    Almost 2000 samples of the dried plants and animals used in Chinese traditional medicine were collected from a storehouse in Huainan city, Anhui province, China, where they had been kept for at least 6 months. When examined, every sample was found to contain acaroid mites. The mites included representatives of 44 species belonging to 22 genera and seven families. It seems that samples of Chinese traditional medicine frequently become severely infested with mites while in storage. More importance should be attached to protecting the medicines against mite infestation and to protecting against acariasis those who ingest or simply handle the medicines.

  19. Family Theory and Family Health Research

    PubMed Central

    Doherty, William J.

    1991-01-01

    Different family theories can be applied to different aspects of how families experience health and illness. The family health and illness cycle describes the phases of a family's experience, beginning with health promotion and risk reduction, then family vulnerability and disease onset or relapse, family illness appraisal, family acute response, and finally family adaptation to illness and recovery. For each phase, specific family theories that are most appropriate for guiding family and health research are discussed. PMID:21229056

  20. Is Marijuana Medicine?

    MedlinePlus

    ... Publications » DrugFacts » Is Marijuana Medicine? DrugFacts: Is Marijuana Medicine? Email Facebook Twitter Revised July 2015 What is ... isn’t the marijuana plant an FDA-approved medicine? The FDA requires carefully conducted studies (clinical trials) ...

  1. Performing Narrative Medicine

    ERIC Educational Resources Information Center

    Langellier, Kristin M.

    2009-01-01

    In this article, the author weaves narrative medicine and performance together to consider what might it mean to call narrative medicine a performance. To name narrative medicine as performance is to recognize the texts and bodies, the stories and selves, that participate in its practice--patients' and physicians' embodied stories as well as the…

  2. Medicines By Design

    ERIC Educational Resources Information Center

    Davis, Alison

    2006-01-01

    This publication discusses the many different ways medicines work in the body and how this information guides the hunt for drugs of the future. The science of pharmacology--understanding the basics of how our bodies react to medicines and how medicines affect our bodies--is already a vital part of 21st-century research. Pharmacology is a broad…

  3. Nuclear medicine annual, 1984

    SciTech Connect

    Freeman, L.M.; Weissmann, H.S.

    1984-01-01

    The following topics are reviewed in this work: nuclear physicians role in planning for and handling radiation accidents; the role of nuclear medicine in evaluating the hypertensive patient; studies of the heart with radionuclides; role of radionuclide imaging in the patient undergoing chemotherapy; hematologic nuclear medicine; the role of nuclear medicine in sports related injuries; radionuclide evaluation of hepatic function with emphasis on cholestatis.

  4. A Picrinine N-Methyltransferase Belongs to a New Family of γ-Tocopherol-Like Methyltransferases Found in Medicinal Plants That Make Biologically Active Monoterpenoid Indole Alkaloids1[OPEN

    PubMed Central

    Levac, Dylan; Cázares, Paulo; Yu, Fang

    2016-01-01

    Members of the Apocynaceae plant family produce a large number of monoterpenoid indole alkaloids (MIAs) with different substitution patterns that are responsible for their various biological activities. A novel N-methyltransferase involved in the vindoline pathway in Catharanthus roseus showing distinct similarity to γ-tocopherol C-methyltransferases was used in a bioinformatic screen of transcriptomes from Vinca minor, Rauvolfia serpentina, and C. roseus to identify 10 γ-tocopherol-like N-methyltransferases from a large annotated transcriptome database of different MIA-producing plant species (www.phytometasyn.ca). The biochemical function of two members of this group cloned from V. minor (VmPiNMT) and R. serpentina (RsPiNMT) have been characterized by screening their biochemical activities against potential MIA substrates harvested from the leaf surfaces of MIA-accumulating plants. The approach was validated by identifying the MIA picrinine from leaf surfaces of Amsonia hubrichtii as a substrate of VmPiNMT and RsPiNMT. Recombinant proteins were shown to have high substrate specificity and affinity for picrinine, converting it to N-methylpicrinine (ervincine). Developmental studies with V. minor and R. serpentina showed that RsPiNMT and VmPiNMT gene expression and biochemical activities were highest in younger leaf tissues. The assembly of at least 150 known N-methylated MIAs within members of the Apocynaceae family may have occurred as a result of the evolution of the γ-tocopherol-like N-methyltransferase family from γ-tocopherol methyltransferases. PMID:26848097

  5. The biology of family psychotherapy.

    PubMed

    Kramer, D A

    2001-07-01

    This article has presented a view of biologic psychiatry consistent with that described by Bowlby, discussed hypotheses concerning the biologic purpose of the primate brain and the human brain, and challenged standard beliefs about the identity of the patient entity in a true biologically based psychiatry. Ideas developed by Whitaker, Malone, and their colleagues almost 50 years ago are consistent with a modern biologic basis of family psychotherapy. The treatment of an anorexic family was used to illustrate possible mechanisms of psychotherapeutic treatment requiring the presence of the whole family. The role of the psychiatrist who treats a family is to understand the biologic or medical importance of treating the family as a whole, communicate this to the family, continually work toward that level of participation, suggest relevant topics for discussion, and catalyze interactions within the family. Psychotherapy with families as a whole is effective because of the power of kin selection and inclusive fitness, biologic processes not usually considered in the practice of medicine or psychiatry.

  6. Family Health and Family Planning.

    ERIC Educational Resources Information Center

    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    This document is made up of a selection of some of the papers distributed to participants in courses on "Family Health and Family Planning" which have been organized each year since 1973 by the International Children's Center and the World Health Organization Regional Office for Europe. Six courses, held between 1973 and 1978, brought together a…

  7. Cough and Cold Medicine Abuse

    MedlinePlus

    ... and Cold Medicine Abuse DrugFacts: Cough and Cold Medicine Abuse Email Facebook Twitter Revised May 2014 Some ... diverted for abuse. How Are Cough and Cold Medicines Abused? Cough and cold medicines are usually consumed ...

  8. 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 ( ...

  9. Internet resources for family physicians.

    PubMed Central

    Anthes, D. L.; Berry, R. E.; Lanning, A.

    1997-01-01

    PROBLEM BEING ADDRESSED: The internet has experienced tremendous growth over the past few years and has many resources in the field of family medicine. However, many family physicians remain unaware of how the Internet can be used to enhance their practice and of how to gain access to this powerful tool. OBJECTIVE OF PROGRAM: To characterize components of the Internet, to explore how family physicians can use the Internet to enhance practice, and to increase awareness of how to gain access to Internet sites relevant to family medicine. MAIN COMPONENTS OF THE PROGRAM: An on-line search through the World Wide Web was conducted using multiple search engines including Lycos, WebCrawler, OpenText, and Yahoo as well as a conventional MEDLINE search of Internet publications for the past 5 years. A website containing an evolving selection of resources can be found at http:@dfcm 18.med.utoronto.ca/anthes/hpgdfcm1.htm. CONCLUSION: The Internet has useful applications and resources for family physicians including rapid communication between physicians, access to medical literature, continuing medical education programs, and lists of patient support and discussion groups. PMID:9189299

  10. The Genomic Medicine Game.

    PubMed

    Tran, Elvis; de Andrés-Galiana, Enrique J; Benitez, Sonia; Martin-Sanchez, Fernando; Lopez-Campos, Guillermo H

    2016-01-01

    With advancements in genomics technology, health care has been improving and new paradigms of medicine such as genomic medicine have evolved. The education of clinicians, researchers and students to face the challenges posed by these new approaches, however, has been often lagging behind. From this the Genomic Medicine Game, an educational tool, was created for the purpose of conceptualizing the key components of Genomic Medicine. A number of phenotype-genotype associations were found through a literature review, which was used to be a base for the concepts the Genomic Medicine Game would focus on. Built in Java, the game was successfully tested with promising results. PMID:27577486

  11. Medicinal plants: conception / contraception.

    PubMed

    Chaing, H S; Merino-chavez, G; Yang, L L; Wang, F N; Hafez, E S

    1994-01-01

    Researchers have conducted considerable experiments on the effectiveness and therapeutic values of Chinese herbs and parts of plants. We should not ignore the significance of natural medicine. The Chinese have been perfecting medicinal therapy based on the raw ingredients of plants/herbs and their derivatives for thousands of years. Chinese practitioners of traditional medicine prescribe medicines based on yin and yang. Traditional medicine is communicated in a verb or written form. Natural resources used in traditional medicine to treat diseases are not limited to just medicinal plants but also include animals, shell fish, and minerals. Parts of plants used in traditional medicine are leaves, stems, flowers, bark, and root. Chinese medicine is the world's oldest continuous surviving tradition. The Chinese experimented with local plants, often resulting in mild to violent reactions. This process allowed them to become familiar with poisonous plants and those that could relieve pain or successfully treat illness. Current allopathic medicines are composed of synthetic compounds copied from natural chemical derivatives, which tend to be more potent than the original compound. Some medicinal plants used to effect conception/contraception include Striga astiatica (contraceptive); Eurycoma longifolia (male virility); and a mixture of lengkuas, mengkudu masak, black pepper seeds, ginger, salt, and 2 eggs (increase libido). Women in Malaysia take jamu to preserve their body shape and to provide nutrition during pregnancy. Praneem causes local cell-mediated immunity in the uterus. Clinical trials of Praneem with or without the hCG vaccine are planned.

  12. Family Issues

    MedlinePlus

    ... not mean that everyone gets along all the time. Conflicts are a part of family life. Many things can lead to conflict, such as illness, disability, addiction, job loss, school problems, and marital issues. Listening to ...

  13. Unusual families.

    PubMed

    Golombok, Susan

    2005-03-01

    The introduction of assisted reproduction has led to unusual forms of procreation. This article describes the social consequences of lesbian motherhood and of families headed by single heterosexual mothers. PMID:15819999

  14. Familial hypercholesterolemia

    MedlinePlus

    A diet low in cholesterol and saturated fat and rich in unsaturated fat may help to control your LDL level. People with a family history of this condition, particularly if both parents carry the defective ...

  15. Tomorrow's Family

    ERIC Educational Resources Information Center

    Pickett, Robert S.

    1977-01-01

    Author states that "...the traditional form of family which has been the norm in recent times in the West will persist, but will be forced to "move over" to accommodate other forms of domestic life." (Author)

  16. FAMILY PIOPHILIDAE.

    PubMed

    Wolff, Marta; Pérez, Sandra; Grisales, Diana

    2016-01-01

    Piophilidae is a little family poorly known in Colombia, with only Piophila casei (L.) and Stearibia nigriceps Meigen reported so far. This catalogue expands the distribution of these species to other localities in the country. PMID:27395294

  17. FAMILY BIBIONIDAE.

    PubMed

    Falaschi, Rafaela Lopes; Oliveira, Sarah Siqueira; Amorim, Dalton De Souza

    2016-06-14

    The Bibionidae are a family belonging to the suborder Bibionomorpha with four genera and 17 species known from Colombia. This work expands the distribution of these species to other localities in the country.

  18. FAMILY RHAGIONIDAE.

    PubMed

    Santos, Charles Morphy D; Carmo, Daniel D D

    2016-01-01

    The family Rhagionidae is one of the oldest Brachyeran lineages. Its monophyly is still uncertain. There are four rhagionid genera distributed in Neotropical Region but only three species of Chrysopilus are found in Colombia. PMID:27395270

  19. [Resources and application of She's nationality wild medicinal plants].

    PubMed

    Lei, Hou-Xing; Li, Jian-Liang; Zheng, Song-Ming; Fan, Li-Hua; Li, Shui-Fu; Cheng, Wen-Liang; Hua, Jin-Wei; Yu, Hua-Li; Dai, De-Xiong; Xie, Yuan-Wei

    2014-08-01

    To make a thorough investigation of the common She's nationality wild medicinal plants resources in our country, including the species, the distribution, the folk application and the endemic medicinal plant species, Field surveyed was conducted with 25 She people mainly lived area (county, district or city) throughout the country, the folk prescription and treatment cases provided by She's medical personnel, the drug usage and dosage, the commonly used traditional She's medicine and drug samples were collected. And the distribution, growing environment of these plants were investigated, their characteristics, photographs, GPS data and track were record , and the fresh wax leaf or plants specimens were collected. In total 1 600 varieties of folk medicine of She's nationality, 450 disease names and 1 016 prescriptions were collected. 520 kinds of these medicinal plants were commonly used, growing mainly distributed in the southeastern China, about 200 meters above sea level to 1 500 meters. There are 5 First-Grade State protection wild plants (medicinal), 15 second-Grade State protection wild plants (medicinal), and 11 She characteristic medicinal plants in our study, they belong to 144 families, 312 genera 494 species, 2 subspecies, 17 varieties, 3 forms and 1 cultivated varieties of She's nationality. Folk medicine usage is different from the traditional Chinese medicine and ethnic medicine. This survey finds out the common She's nationality wild medicinal plants resources in China, including the species, the distribution, the folk application and commonly used drugs, and found the rare and endangered medicinal plants and the She's nationality endemic medicinal plants, which provides a basis for further development and use the traditional She's medicine resources.

  20. FAMILY PLATYSTOMATIDAE.

    PubMed

    Wendt, Lisiane Dilli

    2016-01-01

    Platystomatidae (Signal Flies) are one of the largest families of Tephritoidea, with about 1200 species and four subfamilies, worldwide distributed. However, Platystomatidae are not well represented in the New World, and in the Neotropical Region only four genera and 26 species, belonging to Platystomatinae, are recorded. The family is a group understudied in Colombia and only one species is recorded to the country. PMID:27395295

  1. [Interaction between medicines and medicinal plants].

    PubMed

    Tres, J C

    2006-01-01

    In recent years there has been a notable increase in the consumption of medicinal plants in Spanish society. This might be due to the fact that in some cases they have shown themselves to be efficient in treating certain pathologies and to the erroneous perception that these products are innocuous. Medicinal plants behave as authentic medicines since the chemical substances of which they are formed can have a biological activity in humans. For this reason, their joint administration with "conventional medicines" can produce variations in the magnitude of the effect. This type of interaction, just like those produced between two or more medicines, can produce pharmacokinetic mechanisms if they affect the processes of absorption, distribution, metabolism and excretion, or pharmacodynamic mechanisms if they affect the result of the pharmacological action. In the medical literature there are few articles and notifications of cases concerning the adverse effects and interactions that affect medicinal plants, which probably reflects an under-notification of these phenomena. If we add to this the lack of experimental data and controlled studies, perception of their prevalence is difficult or nearly impossible. This article sets out, in an order that will be explained later, the findings of an exhaustive review of the medical literature with the aim of making its existence known to the reader, without going into other considerations, such as the degree of evidence for example, which will be the subject of forthcoming articles.

  2. Books, children, dogs, artists: library programs for the entire family.

    PubMed

    Haver, Mary Katherine

    2014-01-01

    The promotion of library resources and services is a continuous process for all libraries, especially hospital family resource center libraries. Like public libraries, a family resource center can utilize programs as a pathway for connecting with and developing awareness of library resources and services available to patient families. This column describes the programs currently offered for All Children's Hospital Johns Hopkins Medicine patient families, marketing initiatives to promote these programs, and utilization of grant funding to supplement a program.

  3. Books, children, dogs, artists: library programs for the entire family.

    PubMed

    Haver, Mary Katherine

    2014-01-01

    The promotion of library resources and services is a continuous process for all libraries, especially hospital family resource center libraries. Like public libraries, a family resource center can utilize programs as a pathway for connecting with and developing awareness of library resources and services available to patient families. This column describes the programs currently offered for All Children's Hospital Johns Hopkins Medicine patient families, marketing initiatives to promote these programs, and utilization of grant funding to supplement a program. PMID:24735270

  4. Dulce Wireless Tijuana: A Randomized Control Trial Evaluating the Impact of Project Dulce and Short-Term Mobile Technology on Glycemic Control in a Family Medicine Clinic in Northern Mexico

    PubMed Central

    Contreras, Sonia; Vargas-Ojeda, Adriana; Menchaca-Díaz, Rufino; Fortmann, Addie; Philis-Tsimikas, Athena

    2016-01-01

    Abstract Background: The global epidemic of diabetes calls for innovative interventions. This study evaluated the effectiveness of the Project Dulce model, with and without wireless technology, on glycemic control and other clinical and self-reported outcomes in patients with poorly controlled type 2 diabetes in Mexico. Subjects and Methods: Adults with type 2 diabetes and a glycated hemoglobin A1c (HbA1c) level of ≥8% were recruited from Family Medical Unit #27 of the Instituto Mexicano del Seguro Social (IMSS) in Tijuana, México, and randomly assigned to one of three groups: Project Dulce–only (PD); Project Dulce technology-enhanced with mobile tools (PD-TE); or IMSS standard of care/control group (CG). Clinical and self-reported outcomes were assessed at baseline, Month 4, and Month 10. Time-by-group interactions and within-group changes were analyzed. Results: HbA1c reductions from baseline to Month 10 were significantly greater in PD-TE (−3.0% [−33 mmol/mol]) and PD (−2.6% [−28.7 mmol/mol]) compared with CG (−1.3% [−14.2 mmol/mol]) (P = 0.009 and 0.001, respectively). PD-TE and PD also exhibited significant improvement in diabetes knowledge when compared with CG (P < 0.05 for both). No statistically significant differences were detected between PD and PD-TE on these indicators (P = 0.54 and 0.86, respectively). Several within-group improvements were observed on other clinical and self-report indicators but did not vary significantly across groups. Conclusions: Project Dulce with and without wireless technology substantially improved glycemic control and diabetes knowledge in high-risk patients with type 2 diabetes in a Mexican family medical unit, suggesting that integrating peer-led education, nurse coordination, and 3G wireless technology is an effective approach for improving diabetes outcomes in high-risk populations. PMID:26914371

  5. Ethics in sports medicine.

    PubMed

    Dunn, Warren R; George, Michael S; Churchill, Larry; Spindler, Kurt P

    2007-05-01

    Physicians have struggled with the medical ramifications of athletic competition since ancient Greece, where rational medicine and organized athletics originated. Historically, the relationship between sport and medicine was adversarial because of conflicts between health and sport. However, modern sports medicine has emerged with the goal of improving performance and preventing injury, and the concept of the "team physician" has become an integral part of athletic culture. With this distinction come unique ethical challenges because the customary ethical norms for most forms of clinical practice, such as confidentiality and patient autonomy, cannot be translated easily into sports medicine. The particular areas of medical ethics that present unique challenges in sports medicine are informed consent, third parties, advertising, confidentiality, drug use, and innovative technology. Unfortunately, there is no widely accepted code of sports medicine ethics that adequately addresses these issues.

  6. Clinical Space Medicine Panel

    NASA Technical Reports Server (NTRS)

    Baisden, Denise L.; Billica, Roger (Technical Monitor)

    2000-01-01

    The practice of space medicine is diverse. It includes routine preventive medical care of astronauts and pilots, the development of inflight medical capability and training of flight crews as well as the preflight, inflight, and postflight medical assessment and monitoring. The Johnson Space Center Medical Operations Branch is a leader in the practice of space medicine. The papers presented in this panel will demonstrate some of the unique aspects of space medicine.

  7. Preparing injectable medicines safely.

    PubMed

    Beaney, Alison M; Black, Anne

    Risks to patients are greater when injectable medicines are prepared in clinical areas (wards, theatres, clinics or even patients' homes), rather than provided in ready-to-use form. This article describes the risks involved in preparing injectable medicines in such areas and outlines key principles to ensure they are prepared safely. It also suggests that high-risk injectable medicines be provided in ready-to-use form, either in house, by pharmacy or by pharmaceutical companies. PMID:22359855

  8. FAMILY HYBOTIDAE.

    PubMed

    Ale-Rocha, Rosaly; De Freitas-Silva, Rafael Augusto Pinheiro

    2016-01-01

    Hybotidae is a diverse family of the order Diptera, suborder Brachycera, superfamily Empidoidea. Hybotid flies are generally yellow to black, are morphologically diverse, and are distributed worldwide. The monophyly of the family is based on: palpifer and fore tibial gland present, laterotergite bare and R4+5 unbranched. Hybotids are mainly predators and are usually found on the vegetation, logs and other surfaces, or in flight during displacement and forage. This catalogue, based on the study of specimens and available literature records, summarizes and updates the information on the Colombian fauna of Hybotidae, which includes 19 species distributed in six genera. PMID:27395283

  9. [Italy's Slow Medicine: a new paradigm in medicine].

    PubMed

    Bonaldi, Antonio; Vernero, Sandra

    2015-02-01

    Italy's Slow Medicine was founded in 2011 as a movement aimed to promote processes of care based on appropriateness, but within a relation of listening, dialogue and decision sharing with the patient. The mission of Slow Medicine is synthetized by three key words: measured, because it acts with moderation, gradually and without waste; respectful, because it is careful in preserving the dignity and values of each person; and equitable, because it is committed to ensuring access to appropriate care for all. In a short time, the association spreads at national and international level, gathering the needs of change of a growing number of health professionals, patients and citizens, committed to manage health problems with a new cultural and methodological paradigm. Medicine is soaked with inappropriateness, wastes, conflicts of interest, and many clichés induce professionals and patients to consume more and more healthcare services in the illusion that it is always better doing more for improving health. Moreover, the dominant reductionist cultural model, on which the concept of health and disease is based today, considers man as a machine, investigated by a growing number of specialists, particularly interested in the pathophysiological mechanisms of diseases. The interest is mainly focused on technologies, while the person along with the relations with his/her family and the social environment are completely neglected. The systemic approach adopted by Slow Medicine, on the contrary, teaches us that health and disease are complex phenomena and the life of a person is more than the sum of the chemical reactions that occur in its cells. At different levels of complexity, in fact, new and unexpected properties appear, such as thinking, emotions, pleasure, health. These properties are not detectable in the individual elements and can only be studied using methods of analysis and knowledge belonging to other domains of knowledge, such as humanity sciences: philosophy

  10. [Italy's Slow Medicine: a new paradigm in medicine].

    PubMed

    Bonaldi, Antonio; Vernero, Sandra

    2015-02-01

    Italy's Slow Medicine was founded in 2011 as a movement aimed to promote processes of care based on appropriateness, but within a relation of listening, dialogue and decision sharing with the patient. The mission of Slow Medicine is synthetized by three key words: measured, because it acts with moderation, gradually and without waste; respectful, because it is careful in preserving the dignity and values of each person; and equitable, because it is committed to ensuring access to appropriate care for all. In a short time, the association spreads at national and international level, gathering the needs of change of a growing number of health professionals, patients and citizens, committed to manage health problems with a new cultural and methodological paradigm. Medicine is soaked with inappropriateness, wastes, conflicts of interest, and many clichés induce professionals and patients to consume more and more healthcare services in the illusion that it is always better doing more for improving health. Moreover, the dominant reductionist cultural model, on which the concept of health and disease is based today, considers man as a machine, investigated by a growing number of specialists, particularly interested in the pathophysiological mechanisms of diseases. The interest is mainly focused on technologies, while the person along with the relations with his/her family and the social environment are completely neglected. The systemic approach adopted by Slow Medicine, on the contrary, teaches us that health and disease are complex phenomena and the life of a person is more than the sum of the chemical reactions that occur in its cells. At different levels of complexity, in fact, new and unexpected properties appear, such as thinking, emotions, pleasure, health. These properties are not detectable in the individual elements and can only be studied using methods of analysis and knowledge belonging to other domains of knowledge, such as humanity sciences: philosophy

  11. Fluorine in medicinal chemistry.

    PubMed

    Swallow, Steven

    2015-01-01

    Since its first use in the steroid field in the late 1950s, the use of fluorine in medicinal chemistry has become commonplace, with the small electronegative fluorine atom being a key part of the medicinal chemist's repertoire of substitutions used to modulate all aspects of molecular properties including potency, physical chemistry and pharmacokinetics. This review will highlight the special nature of fluorine, drawing from a survey of marketed fluorinated pharmaceuticals and the medicinal chemistry literature, to illustrate key concepts exploited by medicinal chemists in their attempts to optimize drug molecules. Some of the potential pitfalls in the use of fluorine will also be highlighted.

  12. Palliative medicine in Britain.

    PubMed

    Doyle, Derek

    In Britain, Palliative Medicine was recognized as a subspecialty of Internal Medicine exactly 20 years after Cicely Saunders founded St Christopher's, at exactly the same time that government was at last recognizing the worth and the needs of general practice. Both had far-reaching effects and implications for patients, doctors, and the future of medicine. For Palliative Medicine it meant units wishing to train specialists going through a rigorous selection process; the development of an equally rigorous training program for the doctors who had already gained a higher qualification before starting Palliative Medicine, demonstrating the need for and benefits of palliative medicine to the sceptics in the profession and, now, continuing to recruit the staff for the steadily increasing number of new services. Today there are more Palliative Medicine consultants/specialists than there are oncologists and neurologists combined, with Hospital Palliative Care Teams in every major hospital and cancer center. With nine Chairs in Palliative Medicine, there is now a drive for research and professional education. The specialty faces major challenges, however, ranging from training to care for patients with non-malignant disease to enabling patients to die in the place of their choice-something that rarely happens today; from defining what is distinctive or unique about palliative medicine to clarifying the respective place of general practice and the specialty. Most would agree that the biggest challenge for the young, thriving specialty is how to share its principles with other doctors wherever they work. PMID:18051021

  13. Glimpses of Islamic medicine.

    PubMed

    Majumdar, S K

    1997-07-01

    The fall of the Roman Empire during the fifth century A.D. Ushered in the beginning of the Dark Ages. After this, in Europe further progress of Greco-Roman medicine originated from Hippocrates was halted. The ideas about medicine and hygiene were kept alive in monasteries only. The Arabs made advances in medicine at a time when the rest of Europe was in the Dark Ages. Islamic system or the rulers of the day actively encouraged scholarship and growth of knowledge. The Islamic gift of the day to the world of medicine was simply unique. PMID:12572570

  14. Technologists for Nuclear Medicine

    ERIC Educational Resources Information Center

    Barnett, Huey D.

    1974-01-01

    Physicians need support personnel for work with radioisotopes in diagnosing dangerous diseases. The Nuclear Medicine Technology (NMT) Program at Hillsborough Community College in Tampa, Florida, is described. (MW)

  15. Work-Family Balance and Academic Advancement in Medical Schools

    ERIC Educational Resources Information Center

    Fox, Geri; Schwartz, Alan; Hart, Katherine M.

    2006-01-01

    Objective: This study examines various options that a faculty member might exercise to achieve work-family balance in academic medicine and their consequences for academic advancement. Method: Three data sets were analyzed: an anonymous web-administered survey of part-time tenure track-eligible University of Illinois College of Medicine (UI-COM)…

  16. Mozart and medicine in the eighteenth century.

    PubMed Central

    Jenkins, J S

    1995-01-01

    Over the years the medical history and death of Mozart have been the subject of many studies, but in spite of all this attention much remains controversial. In an attempt to resolve some of the difficulty it is useful to see his life, and that of his family as recorded in their letters, in the context of medicine in eighteenth-century Europe. PMID:7562811

  17. Palliative care: an evolving field in medicine.

    PubMed

    Eti, Serife

    2011-06-01

    Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems: physical, psychosocial, and spiritual. This article discusses illness trajectories and prognostic estimates, prognostic tools, educating physicians and nurses in palliative care, research in palliative medicine, and palliative care in hospitals and the community. PMID:21628032

  18. [Herbal medicines alternative to synthetical medicines].

    PubMed

    Beer, A M; Schilcher, H; Loew, D

    2013-12-16

    Herbal pharmaceuticals in medical practice are similarly used as chemically well defined drugs. Like other synthetical drugs, they are subject to pharmaceutical legislature (AMG) and EU directives. It is to differentiate between phytopharmaceuticals with effectiveness of proven indications and traditional registered herbal medicine. Through the Health Reform Act January 2004 and the policy of the Common Federal Committee (G-BA)on the contractual medical care from March 2009--with four exceptions--Non-prescription Phytopharmaka of the legal Health insurance is no longer (SHI) refundable and must be paid by the patients. The result is that more and more well-established preparations disappear from the market. This article gives an overview of practical relevant indications for herbal medicines, which according to its licensing status, the scientific assessment by the Cochrane Collaboration and the Institute for Quality and Efficiency in Health Care (IQWiG) and evidence-based Medicine (EBM)/ meta-analyzes as an alternative to synthetics can be used.

  19. Familial leukemias.

    PubMed

    Wiernik, Peter H

    2015-02-01

    Familial leukemia has been described for more than 50 years but only recently have modern genetic techniques allowed for the investigation of the genome. Genome-wide association studies have identified a number of genetic sites that appear to relate to susceptibility to leukemia in certain families and occasionally to susceptibility to a specific leukemia in general. Many questions remain, including susceptibility to what? An oncogenic virus? An environmental chemical? Mutation of another gene induced by a heritable mutation-promoting gene?.Clinically important facts have been learned. Chronic lymphocytic leukemia (CLL) is by far the most common familial leukemia. Patients with CLL have approximately a 10% chance of a first-degree relative developing CLL, and even a greater chance of one developing monoclonal B-cell lymphocytosis which may be an asymptomatic forme fruste of the neoplasm. Furthermore, there may be an increased incidence of breast cancer in familial CLL pedigrees which raises the question of a common etiology for neoplasms in general, or at least a previously unrecognized relationship among them.

  20. Family Hypnotherapy.

    ERIC Educational Resources Information Center

    Araoz, Daniel L.; Negley-Parker, Esther

    1985-01-01

    A therapeutic model to help families activate experiential and right hemispheric functioning through hypnosis is presented in detail, together with a clinical illustration. Different situations in which this model is effective are mentioned and one such set of circumstances is described. (Author)

  1. FAMILY SCIARIDAE.

    PubMed

    Carvalho-Fernandes, Sheila Patrícia

    2016-01-01

    Sciaridae are a widely distributed family with high number of species. They are known as black fungus gnats due to their dark color and feeding activity. This catalogue presents 17 species from Colombia distributed in eight genera, and for each species the geographical distribution is provided.

  2. FAMILY CECIDOMYIIDAE.

    PubMed

    Maia, Valéria Cid

    2016-01-01

    This large family is poorly known in Colombia, where only 44 species have been recorded in 20 genera. All of them are included in Cecidomyiinae, which is the most diverse subfamily of gall midges in number of species and feeding habits, including phytophagous, predaceous and fungivorous species. Most of them are galler. The other subfamilies have never been recorded in this country.

  3. FAMILY SCATHOPHAGIDAE.

    PubMed

    Wolff, Marta; Grisales, Diana; Nihei, Silvio S

    2016-01-01

    Scathophagidae (Diptera, Calyptratae) is an uncommon group of flies. In Colombia there was no scientific record of this family until now. In this paper we report for the first time the genus Scatogera and the species S. primogenita Albuquerque, collected over 3000m. and previously collected in Ecuador. PMID:27395319

  4. Family Caregivers.

    ERIC Educational Resources Information Center

    Frazier, Billie H.

    This document contains a brief bibliography of peer-reviewed literature, with abstracts, on family caregiving. It is one of 12 bibliographies on aging prepared by the National Agricultural Library for its "Pathfinders" series of publications. Topics covered by the other 11 bibliographies include aging parents, adult children, dementia and…

  5. FAMILY SCIARIDAE.

    PubMed

    Carvalho-Fernandes, Sheila Patrícia

    2016-01-01

    Sciaridae are a widely distributed family with high number of species. They are known as black fungus gnats due to their dark color and feeding activity. This catalogue presents 17 species from Colombia distributed in eight genera, and for each species the geographical distribution is provided. PMID:27395255

  6. FAMILY CECIDOMYIIDAE.

    PubMed

    Maia, Valéria Cid

    2016-01-01

    This large family is poorly known in Colombia, where only 44 species have been recorded in 20 genera. All of them are included in Cecidomyiinae, which is the most diverse subfamily of gall midges in number of species and feeding habits, including phytophagous, predaceous and fungivorous species. Most of them are galler. The other subfamilies have never been recorded in this country. PMID:27395254

  7. FAMILY ROPALOMERIDAE.

    PubMed

    Ale-Rocha, Rosaly

    2016-01-01

    Ropalomeridae is a small family with most species distributed in the Neotropical Region, from Mexico to Argentina, and only one Nearctic species. In Colombia, eight species distributed in four genera have been found. This catalogue, based on the study of specimens and available literature records, summarizes and updates the information on the Colombian fauna. PMID:27395300

  8. FAMILY RICHARDIIDAE.

    PubMed

    Wendt, Lisiane Dilli; Ale-Rocha, Rosaly

    2016-01-01

    Richardiidae are a family of "acalyptrate" Diptera represented by ca. 180 species distributed in the New World, mostly in the Neotropical region. The species that occur in Colombia have received little attention from taxonomists, and the great majority of them are known only from their type localities. Currently, 14 genera and 23 species are known to occur in the country. PMID:27395297

  9. Family Disruptions

    MedlinePlus

    ... and Returns Do you or your spouse frequently travel on business? These can be disruptive times for your child and for the family as ... these out-of-town trips. Spend as much time as it takes to explain where you are ... before and during your travels. You need to acknowledge and accept her feelings: " ...

  10. Implementation of an Integrative Medicine Curriculum for Preventive Medicine Residents.

    PubMed

    Chiaramonte, Delia R; D'Adamo, Christopher; Amr, Sania

    2015-11-01

    The University of Maryland Department of Epidemiology and Public Health collaborated with the Center for Integrative Medicine at the same institution to develop and implement a unique integrative medicine curriculum within a preventive medicine residency program. Between October 2012 and July 2014, Center for Integrative Medicine faculty provided preventive medicine residents and faculty, and occasionally other Department of Epidemiology and Public Health faculty, with comprehensive exposure to the field of integrative medicine, including topics such as mind-body medicine, nutrition and nutritional supplements, Traditional Chinese Medicine, massage, biofield therapies, manual medicine, stress management, creative arts, and the use of integrative medicine in the inpatient setting. Preventive medicine residents, under the supervision of Department of Epidemiology and Public Health faculty, led integrative medicine-themed journal clubs. Resident assessments included a case-based knowledge evaluation, the Integrative Medicine Attitudes Questionnaire, and a qualitative evaluation of the program. Residents received more than 60 hours of integrative medicine instruction, including didactic sessions, experiential workshops, and wellness retreats in addition to clinical experiences and individual wellness mentoring. Residents rated the program positively and recommended that integrative medicine be included in preventive medicine residency curricula. The inclusion of a wellness-focused didactic, experiential, and skill-based integrative medicine program within a preventive medicine residency was feasible and well received by all six preventive medicine residents.

  11. HIV Medicines and Side Effects

    MedlinePlus

    Side Effects of HIV Medicines HIV Medicines and Side Effects (Last updated 1/7/2016; last reviewed 1/7/2016) Key Points HIV medicines help people with ... will depend on a person’s individual needs. Can HIV medicines cause side effects? HIV medicines help people ...

  12. MEDICINAL PLANTS OF RAJASTHAN IN INDIAN SYSTEM OF MEDICINE

    PubMed Central

    Tripathi, Y.C.; Prabhu, V.V.; Pal, R.S.; Mishra, R.N.

    1996-01-01

    Medicinal plants used in Indian system of medicine from Rajasthan state have been surveyed and catagorised systematically. The paper deals with 205 medicinal plants, thoroughly indexed along with their important traditional application for the cure of various ailments. PMID:22556743

  13. Textbook of respiratory medicine

    SciTech Connect

    Murray, J.F.; Nadel, J.

    1987-01-01

    This book presents a clinical reference of respiratory medicine. It also details basic science aspects of pulmonary physiology and describes recently developed, sophisticated diagnostic tools and therapeutic methods. It also covers anatomy, physiology, pharmacology, and pathology; microbiologic, radiologic, nuclear medicine, and biopsy methods for diagnosis.

  14. Wilderness Medicine Newsletter, 1995.

    ERIC Educational Resources Information Center

    Weber, Holly, Ed.; Thompson, Ken, Ed.

    1995-01-01

    This document consists of the six issues of the "Wilderness Medicine Newsletter" issued during 1995. The newsletter addresses issues related to the treatment and prevention of medical emergencies in the wilderness. Issues typically include feature articles, interviews with doctors in the field of wilderness medicine, product reviews, notices of…

  15. Medicines from Marine Invertebrates

    ERIC Educational Resources Information Center

    Davies-Coleman, Mike

    2011-01-01

    Few of us realise that the oceans of the world are a relatively untapped reservoir of new natural product-derived medicines to combat the many diseases that plague humanity. We explore the role that an unremarkable sea snail and sea squirt are playing in providing us with new medicines for the alleviation of chronic pain and cancer respectively.…

  16. Veterinary medicines update.

    PubMed

    2016-07-01

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:27365238

  17. Veterinary medicines update.

    PubMed

    2016-06-11

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:27288166

  18. Medicines to Treat Allergies

    MedlinePlus

    ... every day, shop around to find the best price. There can be a big difference in price for these medicines from store to store, even ... drugs/ antihistamine. htm How to Get the Best Price for Your Medicines  Ask for a generic: Tell ...

  19. Veterinary medicines update.

    PubMed

    2016-08-01

    The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:27493045

  20. Children's Knowledge about Medicines.

    ERIC Educational Resources Information Center

    Almarsdottir, Anna B.; Zimmer, Catherine

    1998-01-01

    Examined knowledge about medicines and perceived benefit among 101 children, ages 7 and 10. Found that medicine knowledge was explained using age, educational environment, and degree of internal locus of control as significant predictors. The negative effect of internal locus of control predicted perceived benefit. Retention of drug advertising…