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Sample records for community medicine

  1. 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

  2. Is there a discipline of community medicine?

    PubMed

    Brickner, P W

    1976-06-01

    Community Medicine is a distinct and definable discipline. Through Community Medicine Departments of medical schools and hospitals, patient care, teaching and research programs are conducted in an integrated fashion, concerned with a broad definition of health which is beyond the range of other clinical departments. Because Community Medicine is a developing field, and Departments of Community Medicine are not rigidly tied to traditional approaches, there exist unusual opportunities for new design and fresh insight. Community Medicine is in the fore of Medicine's ability to evolve with the society around us. Community Medicine both identifies the need for change, and acts as an agent for the change. There are obstacles. The most difficult challenges we face are obtaining curriculum time for a new discipline which, to those caught in "the vice-like irrational grip of tradition" (18), may not appear worthy; and ridding ourselves of the sterotype that the hospital can be the single unified source of health care for all community people. These problems are being resolved, however, and the inherent value of community medicine as a new body of theory and practice becomes increasingly clear.

  3. Community-Oriented Training in Family Medicine

    PubMed Central

    Ouchterlony, David P.

    1991-01-01

    Family medicine educators are challenged by the need to introduce community experiences into residency training programs. This paper describes one inner-city program's preliminary efforts to join with community-oriented health service agencies in the development of meaningful educational experiences and discusses problems and possible solutions. Imagesp1622-a PMID:21228976

  4. Bringing Precision Medicine to Community Oncologists.

    PubMed

    2017-01-01

    Quest Diagnostics has teamed up with Memorial Sloan Kettering Cancer Center and IBM Watson Health to offer IBM Watson Genomics to its network of community cancer centers and hospitals. This new service aims to advance precision medicine by combining genomic tumor sequencing with the power of cognitive computing.

  5. Human capital identification process: linkage for family medicine and community medicine to mobilize the community.

    PubMed

    Tanasugarn, Chanuantong; Thongbunjob, Krid

    2012-06-01

    Community diagnosis and approach has shifted from a professional focus to a community focus. The information system has also been developed to reflect socio-cultural information. This new system has been established throughout the country and is being recorded in the computer system. However these data still lack human capital information to promote community mobilization. The present study aims to develop a process which reflects human capital from the insider and outsider points of view and which builds on the existing work system of primary care service, family medicine, and community medicine. The present study applies the participatory action research design with mixed methods including community grand-tour, household survey socio-metric questionnaire and focus group discussion in order to gather insider view of human capital. A key instrument developed in the present study is the socio-metric questionnaire which was designed according to the community grand tour and household survey results. The findings indicate that the process is feasible and the insider point of view given a longer evidence based list of the human capital. The model enhanced a closer relationship between professional and community people and suggested the realistic community mobilizer name list. Human capital identification process is feasible and should be recommended to integrate in the existing work process of the health staff in family and community practice.

  6. Public health and community medicine instruction and physician practice location.

    PubMed

    Xierali, Imam M; Maeshiro, Rika; Johnson, Sherese; Arceneaux, Taniecea; Fair, Malika A

    2014-11-01

    Experts have historically recommended better integration of public health content into medical education. Whether this adoption is associated with physician practice location has not been studied. To examine the association between medical student perception of their public health and community medicine instruction and practice location in a Health Professional Shortage Area. Descriptive analysis and a regression model assessed the significance and strength of the association between medical student perception of their public health and community medicine instruction and practice location using data from the Medical School Graduation Questionnaire 1997-2004, 2013 American Medical Association Physician Masterfile, and 2013 Health Professional Shortage Areas. A higher proportion of medical students with an intent to practice in underserved areas reported inadequate instruction in public health and community medicine than those without such intentions. Students reporting adequate public health and community medicine instruction are slightly more likely to practice in a Health Professional Shortage Area, controlling for their intent to practice in underserved areas. Findings suggest an association between perceptions of public health and community medicine instruction and practice location. Improved public health and community medicine instruction may support medical students' preparation and ability to integrate public health skills into practices in underserved settings. More research is needed to ascertain factors enabling better incorporation of public health and community medicine in medical education. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Teaching Community Medicine to Undergraduates: The Role of Student Projects

    PubMed Central

    Kaufert, J. M.; Fish, D. G.; Hildes, J.; Krause, R.

    1981-01-01

    The community medicine primary care clerkship at the University of Manitoba integrates didactic elements, clinical placements and student projects in teaching community medicine. The clinical clerkship is undertaken in a variety of community settings and emphasizes ambulatory care. The rotation for each student is eight weeks, six of which are spent in the clinical clerkship, bracketed by two weeks of community medicine. Student research projects allow medical students to become familiar with the principles of population-based and community-oriented medicine as applied in clinical practice. Evaluation of 156 projects completed during the first two years of the program indicates that a wide range of community-based health problems were identified and a variety of methodological approaches applied. PMID:21289697

  8. Preventive and Community Medicine in Primary Care. Teaching of Preventive Medicine Vol. 5.

    ERIC Educational Resources Information Center

    Barker, William H., Ed.

    This monograph is the result of a conference on the role of preventive and community medicine in primary medical care and education. The following six papers were presented at the conference: (1) Roles of Departments of Preventive Medicine; (2) Competency-Based Objectives in Preventive Medicine for the Family Physician; (3) Preventive Medicine…

  9. Medicine shortages--a study of community pharmacies in Finland.

    PubMed

    Heiskanen, K; Ahonen, R; Karttunen, P; Kanerva, R; Timonen, J

    2015-02-01

    To explore the frequency, the reasons behind, and the consequences of medicine shortages in Finnish community pharmacies. During the 27-day study period in the autumn of 2013, randomly selected pharmacies reported on medicines that were in short supply from orders made to wholesalers. Altogether 129 (66%, n=195) pharmacies participated in the study, and the study material consisted of 3311 report forms. Of the study pharmacies, 79.8% had medicine shortages daily or almost daily. Medicines in short supply were most commonly medicines that affect the nervous system (30.8%) and the cardiovascular system (17.5%). The reason behind the shortage was reported to the pharmacies in 11.2% of the shortage cases. The medicine shortages caused problems for the pharmacies in 33.0% of the cases. In most cases (67.0%) the medicine shortages did not cause problems for the pharmacies, usually because a substitutable product was available (48.5%). Medicine shortages are common in Finnish community pharmacies. Medicines in short supply were commonly used medicines. The reason behind the shortage was rarely told to the pharmacies. Medicine shortages caused problems for the pharmacies in one-third of all the shortage cases. These shortages may be significant for the customers or the pharmacies, as they cause customer dissatisfaction and increase the workload of the pharmacy staff. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Community Medicine in India — Which Way Forward?

    PubMed Central

    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

  11. Opportunities for the Cardiovascular Community in the Precision Medicine Initiative.

    PubMed

    Shah, Svati H; Arnett, Donna; Houser, Steven R; Ginsburg, Geoffrey S; MacRae, Calum; Mital, Seema; Loscalzo, Joseph; Hall, Jennifer L

    2016-01-12

    The Precision Medicine Initiative recently announced by President Barack Obama seeks to move the field of precision medicine more rapidly into clinical care. Precision medicine revolves around the concept of integrating individual-level data including genomics, biomarkers, lifestyle and other environmental factors, wearable device physiological data, and information from electronic health records to ultimately provide better clinical care to individual patients. The Precision Medicine Initiative as currently structured will primarily fund efforts in cancer genomics with longer-term goals of advancing precision medicine to all areas of health, and will be supported through creation of a 1 million person cohort study across the United States. This focused effort on precision medicine provides scientists, clinicians, and patients within the cardiovascular community an opportunity to work together boldly to advance clinical care; the community needs to be aware and engaged in the process as it progresses. This article provides a framework for potential involvement of the cardiovascular community in the Precision Medicine Initiative, while highlighting significant challenges for its successful implementation. © 2016 American Heart Association, Inc.

  12. [Pharmacists in community medicine: especially in cancer treatment].

    PubMed

    Takagi, Masakazu

    2011-01-01

    It is important for clinics and hospitals to cooperate in treating cancer patients in the community health. We are treating cancer patients in cooperation with five general hospitals in Shizuoka and about 100 clinics in the same community. In this system, it is required that pharmacists in the community should have knowledge about beneficial effects and adverse events of anticancer drugs as do hospital pharmacists, and furthermore they should have good communication with cancer patients. The expectation for pharmacists is great in community medicine especially in the treatment of cancer patients.

  13. Community medicine teaching and evaluation: scope of betterment.

    PubMed

    Gopalakrishnan, S; Kumar, P Ganesh

    2015-01-01

    There have been rapid and extensive changes in the way assessment is conducted in medical education. Assessment brings about standardization of the manner in which the syllabus is to be implemented and also gives guidelines regarding the teaching pattern, especially when the student is going to rotate through various departments in a medical college. Community Medicine is an important branch of medicine concerned with the health of populations. Existing forms of assessment of community medicine education mainly consists of internal [formative] assessment and final (summative) examination. Advantages of the present system is the similarity of the methods used for internal assessments and final examinations and is relatively easily done since only the knowledge application and recall ability of the student in theory and practical are assessed. Disadvantages in the current evaluation system are neglecting the assessment of psychomotor, affective and communication skills. Evaluation systems can be improved by implementing techniques to assess psychomotor skills, presentation and communication skills, organizational skills and the student's ability to work in a team. Regular feedback from students should be taken periodically for the betterment of Community Medicine education. This article is meant to sensitise the academic experts in medical education to plan better need based methods of assessment in the subject of Community Medicine, in relation to the new MCI 2012 Regulations, in order to make it a better learning experience for the students.

  14. Reading Communities and Hippocratism in Hellenistic Medicine.

    PubMed

    Berrey, Marquis

    2015-09-01

    The sect of ancient Greek physicians who believed that medical knowledge came from personal experience also read the Hippocratic Corpus intensively. While previous scholarship has concentrated on the contributions of individual physicians to ancient scholarship on Hippocrates, this article seeks to identify those characteristics of Empiricist reading methodology that drove an entire medical community to credit Hippocrates with medical authority. To explain why these physicians appealed to Hippocrates' authority, I deploy surviving testimonia and fragments to describe the skills, practices, and ideologies of the reading community of ancient Empiricist physicians over the one-hundred year period 175 to 75 BCE. The Empiricist conception of testimony taken on trust operative within that reading community elided the modern distinction between personal and institutional targets of trust by treating Hippocratic writings as revelatory of the moral character of Hippocrates as an author. Hippocrates' moral character as an honest witness who accurately observed empirical phenomena aligned with the epistemic virtues of an empirical medical community who believed that medical knowledge came from personal experience. So I argue that Empiricist reading culture constructed a moral authority of honesty and accuracy from Hippocratic writings, enlarged the personal authority of Hippocrates among medical readers, and contributed to the development of Hippocratism.

  15. Attitudes towards community medicine: a comparison of students from traditional and community-oriented medical schools.

    PubMed

    Rolfe, I E; Pearson, S A; Cleary, E G; Gannon, C

    1999-08-01

    To compare the attitudes towards community medicine of first and final year students from two Australian medical schools. In 1995, medical students from Newcastle University (a problem-based, community-oriented curriculum) and Adelaide University (a more traditional lecture-based curriculum) were asked to complete the Attitudes to Community Medicine questionnaire. This is a valid and reliable 35 item survey assessing six key domains of community medicine. The two medical schools differ in their methods of selection and curriculum delivery, and also in curriculum content. Response rates averaged 95% for first year and 81% for final year students. Students selected into both medical schools were found to have positive attitudes with respect to most aspects of community medicine. However, those entering Newcastle had more positive attitudes toward community medicine overall than their Adelaide counterparts. They also scored more positively on subscales relating to holistic care and evaluation of health care interventions. Students who were older and female scored more positively on some subscales, but correction for age and gender did not change the conclusions about medical school differences. This study suggests that selection criteria, and probably curriculum style and emphasis, have an influence on the attitudes that medical students possess and later develop toward community medicine.

  16. Emergency medicine systems advancement through community-based development.

    PubMed

    Bloem, Martha M; Bloem, Christina M; Rosentsveyg, Juliana; Arquilla, Bonnie

    2014-02-01

    Humanitarian health programs frequently focus on immediate relief and are supply side oriented or donor driven. More emphasis should be placed on long-term development projects that engage local community leaders to ensure sustainable change in health care systems. With the Emergency Medicine Educational Exchange (EMEDEX) International Rescue, Recover, Rebuild initiative in Northeast Haiti as a model, this paper discusses the opportunities and challenges in using community-based development to establish emergency medical systems in resource-limited settings.

  17. A Community Medicine Clerkship on the Navajo Indian Reservation.

    ERIC Educational Resources Information Center

    Rogers, Kenneth D.; Coulehan, John L.

    1984-01-01

    An important part of a clerkship in community medicine on the Navajo Indian reservation is a project in which students select a health problem which they investigate using epidemiological methods of assessment and for which they seek a solution. (Author/MLW)

  18. Narrative Medicine: Community Poetry Heals Young and Old

    ERIC Educational Resources Information Center

    Walker, Allison S.

    2016-01-01

    This is a snapshot of a service learning course founded on narrative medicine, a clinical practice designed to replace impersonal care with empathic listening. By utilizing poetry therapy techniques among nursing home populations, a program called "HPU LifeLines" promotes a community literacy of illness and provides psychological and…

  19. A New Integrated Course in Preventive and Community Medicine

    ERIC Educational Resources Information Center

    Schwartz, K.

    1977-01-01

    Details of the fourth, fifth, and sixth clinical years' course in preventive and community medicine, introduced at New Zealand's Christchurch Clinical School in 1974, are presented. Topic studies, rotating attachments, preventive medical examinations and ward rounds, simulated disabilities, and conferences are discussed. (LBH)

  20. Perceptions and attitudes of community pharmacists towards generic medicines.

    PubMed

    Dunne, Suzanne S; Shannon, Bill; Cullen, Walter; Dunne, Colum P

    2014-11-01

    Following the enactment of legislation in June 2013, generic substitution and reference pricing of medicines has been introduced, for the first time, in Ireland. This novel study is the first assessment of the perceptions of community pharmacists in Ireland towards generic medicines completed in the period immediately prior to the introduction of generic substitution and reference pricing.  To determine the perceptions towards generic medicines among community pharmacists. One-to-one semistructured interviews were performed with a convenience sample of 44 community pharmacists (from approximately 4,500 pharmacists in Ireland) recruited from Ireland's Midwest, South, and Southwest regions. Interviews were transcribed and analysed using NVivo (version 9). 98% of pharmacists believed that generics were of a similar quality to the originator, and 96% stated that they were as effective as the originator. However, a small number demonstrated some reticence regarding generics: 9% believed that generics were not manufactured to the same quality as the originator; 7% stated they would prefer to take an originator medicine themselves; and 7% reported having experienced quality issues with generic medicines. 89% of pharmacists reported receiving patient complaints regarding use of generic medicine, although 64% suggested that this was due to a nocebo effect (i.e., a result of patients' preconceived notions that generics were inferior). Only a minority (21%) reported that they had attempted to educate patients as to the equivalency of generics. Although 80% were in favor of Ireland's new legislation promoting the use generic medicines, 46% expressed concerns regarding its practical implementation. This key stakeholder group had positive attitudes towards generics and the legislation that promotes their use. Concerns regarding patient perception and experience, clinical effectiveness, and manufacturing quality were identified. We propose that interventions supporting

  1. The Role of the Black Church in Community Medicine

    PubMed Central

    Levin, Jeffrey S.

    1984-01-01

    Historically, the black church has been the preserver and the perpetuator of the black ethos, the radix from which its defining values and norms have been generated, and the autonomous social institution that has provided order and meaning to the black experience in the United States. The traditional ethic of community-oriented service in the black ethos is highly compatible with the communitarian ethic of community medicine. Given this congruence and the much-documented fact that black Americans are an at-risk and under-served group regarding health status indicators and the provision of preventive health care, respectively, the black church is an extremely relevant locus for the practice of community medicine. A number of health programs based in or affiliated with the black church have operated throughout the United States, and these programs, along with the corpus of literature comprising conceptual articles favorable toward such a role for the black church, are reviewed within four areas of community medicine: primary care delivery, community mental health, health promotion and disease prevention, and health policy. PMID:6737505

  2. [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).

  3. Patient knowledge of medicines dispensed from Ghanaian community pharmacies

    PubMed Central

    Marfo, Afia Frimpomaa; Owusu-Daaku, Frances Thelma; Kyerewaa-Akromah, Evelyn

    Background One vital requirement for patient adherence to medicines is good patient knowledge of the medicines dispensed and this will invariably be linked to good labelling and counselling. Objective The aim of this study was to evaluate the quality of labelling of medicines and determine patient knowledge of the administration of medicines dispensed from a community pharmacy in Ghana. Methods From 6th to 29th January, 2010, dispensed prescriptions of 280 clients were purposely sampled to evaluate the quality of labelling. These clients were also interviewed about their knowledge of the last medicine received immediately after dispensing. A scoring system was employed by awarding a point for each attribute written on the package and each attribute stated by the patient. The dispensing attributes noted were name, dosage, frequency, duration, quantity and route of administration. Results Of the 280 patients interviewed, 157 (56%) were males. Thirty one (11%) had no education and 99(35%) were secondary school graduates. Antimalarials comprised 17.9% and analgesics, 15.4% of medicines dispensed. The name, quantity, dosage, frequency, duration of therapy and route of administration were written on the label in 98%, 99%, 55%, 54%, 6% and 2% respectively of the dispensed medicines. The mean labelling score was 3.096 (SD=1.05) out of 6. The corresponding patient knowledge values were 63%, 80%, 80%, 75%, 57% and 86%. The mean knowledge score was 4.375 (SD; 1.38) out of 6. The chi square test p-value for the effect of demographic characteristics (sex, educational background, location) on patient knowledge of medicines dispensed were p=0.454; p=0.000, and p=0.138 respectively. Conclusions Patient knowledge of the administration of dispensed medicines was rated good; and this largely corresponded with the quality of labelling, except that the duration of therapy and route of administration was not frequently written and so labelling was rated just above average. PMID:24155852

  4. Ethnopharmacological survey of medicinal plants used in traditional medicine by the communities of Mount Hermon, Lebanon.

    PubMed

    Baydoun, Safaa; Chalak, Lamis; Dalleh, Helena; Arnold, Nelly

    2015-09-15

    Medicinal plant species in Lebanon are experiencing severe threats because of various environmental conditions, human expansion footprints and recent growing global demand. Organized research and information on indigenous medicinal plants and knowledge have been very limited and little efforts have been invested to develop a complete inventory for native medicinal plants and associated traditional knowledge in the country. Recognized as a key biodiversity area of the Mediterranean Basin, Mount Hermon hosts important richness of medicinal plants that has been traditionally used in treatment of many illnesses since generations. Novel knowledge gathered by the present investigation is important in preserving indigenous knowledge of Mount Hermon community and revitalizing traditional herbal medicines. Ethnopharmacological information was collected by semi-structured interviews with 53 native informants (herbalists, traditional healers, midwives and local adult villagers) in 13 towns and villages surrounding Mount Hermon. The interviews were conducted through guided field visits and discussion groups whilst collecting plants specimens. Taxonomical identification of plant species was based on the determination keys of the "New Flora of Lebanon and Syria" and specimens were deposited at the herbarium of the Research Center for Environment and Development at Beirut Arab University. The results obtained indicate that 124 plant species of Mount flora are still used in traditional medicine by the local communities as an important source of primary health care and treatment of a wide range of different illnesses. These species belonged to 42 families and 102 genera. Compositae (19 species), Labiatae (18 species), Rosaceae (11) and Umbelliferae (11) formed the dominant families. Informants' Consensus Factor (FIC) analysis revealed that among the 14 illness categories used, respiratory (0.94), gastrointestinal and renal (0.93), genital systems (0.92) had the highest FIC values

  5. Returned medicines in community pharmacies of Barcelona, Spain.

    PubMed

    Coma, Anna; Modamio, Pilar; Lastra, Cecilia F; Bouvy, Marcel L; Mariño, Eduardo L

    2008-06-01

    To monitor the amount of unused drugs and the cost to the public health system. Setting A random sample of community pharmacies in Barcelona, Spain. Method The drugs were collected from 38 community pharmacies over a period of 7 consecutive working days (excluding Sundays). A questionnaire was designed to evaluate each returned medicine. The resulting data were analyzed and evaluated. The number of drugs collected at the pharmacy, the characteristics of the clients and the reasons why they returned the drugs, and finally the economic value of the drugs returned and the cost to the public health system. A total of 227 clients (54.6% women, 64 +/- 20 years-old) returned 1,176 packages to the pharmacy. The number of packages collected in one return ranged from 1 to 121. The number of packages collected per pharmacy ranged from 0 to 188. In more than half of the cases (52.4%) the patients returned their drug in person and in 32.2% of the cases a relative returned it on their behalf. The main reason (28.2%) why drugs were returned was the expiry date. In 24.9% of the cases the patient's condition had improved and there was no further need for the drug. In 20.8% the patient had died. The estimated total cost of the collected drugs was euro8,539.9. Over 75% of this amount (euro6,463.9) had been paid by the public health system. This study confirms the importance of analyzing the return of unwanted medicines to reduce unnecessary health expenditure. It also highlights the inadequacies of the Spanish health system in the areas of prescription, dispensing and use of medicines. Establishing strategies to reduce the wastage of unused medicines is necessary.

  6. Community-Responsive Medicine: A Call for a New Academic Discipline.

    ERIC Educational Resources Information Center

    Smith, David R.; Anderson, Ron J.

    1990-01-01

    Traces academic medicine's historical opposition to community medicine and its emphasis on traditional hospital-cased curricula subspecialties, to the neglect of primary and preventive care, community-oriented medicine, and public health. Calls for reducing barriers to basic medical services for all, and for training physicians equipped to respond…

  7. Community case management of malaria: exploring support, capacity and motivation of community medicine distributors in Uganda.

    PubMed

    Banek, Kristin; Nankabirwa, Joaniter; Maiteki-Sebuguzi, Catherine; DiLiberto, Deborah; Taaka, Lilian; Chandler, Clare I R; Staedke, Sarah G

    2015-05-01

    In Uganda, community services for febrile children are expanding from presumptive treatment of fever with anti-malarials through the home-based management of fever (HBMF) programme, to include treatment for malaria, diarrhoea and pneumonia through Integrated Community Case Management (ICCM). To understand the level of support available, and the capacity and motivation of community health workers to deliver these expanded services, we interviewed community medicine distributors (CMDs), who had been involved in the HBMF programme in Tororo district, shortly before ICCM was adopted. Between October 2009 and April 2010, 100 CMDs were recruited to participate by convenience sampling. The survey included questionnaires to gather information about the CMDs' work experience and to assess knowledge of fever case management, and in-depth interviews to discuss experiences as CMDs including motivation, supervision and relationships with the community. All questionnaires and knowledge assessments were analysed. Summary contact sheets were made for each of the 100 interviews and 35 were chosen for full transcription and analysis. CMDs faced multiple challenges including high patient load, limited knowledge and supervision, lack of compensation, limited drugs and supplies, and unrealistic expectations of community members. CMDs described being motivated to volunteer for altruistic reasons; however, the main benefits of their work appeared related to 'becoming someone important', with the potential for social mobility for self and family, including building relationships with health workers. At the time of the survey, over half of CMDs felt demotivated due to limited support from communities and the health system. Community health worker programmes rely on the support of communities and health systems to operate sustainably. When this support falls short, motivation of volunteers can wane. If community interventions, in increasingly complex forms, are to become the solution to

  8. Evidence-based medicine among internal medicine residents in a community hospital program using smart phones.

    PubMed

    León, Sergio A; Fontelo, Paul; Green, Linda; Ackerman, Michael; Liu, Fang

    2007-02-21

    This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resources internal medicine residents were using and whether providing bedside, real-time access to medical information would be perceived useful for patient care and academic activities. We equipped the medical teams in the hospital wards with smart phones (mobile phone/PDA hybrid devices) to provide immediate access to evidence-based resources developed at the National Library of Medicine as well as to other medical Websites. The emphasis of this project was to measure the convenience and feasibility of real-time access to current medical literature using smart phones. The smart phones provided real-time mobile access to medical literature during daily rounds and clinical activities in the hospital. Physicians found these devices easy to use. A post-study survey showed that the information retrieved was perceived to be useful for patient care and academic activities. In community hospitals and ambulatory clinics without wireless networks where the majority of physicians work, real-time access to current medical literature may be achieved through smart phones. Immediate availability of reliable and updated information obtained from authoritative sources on the Web makes evidence-based practice in a community hospital a reality.

  9. Evidence-based medicine among internal medicine residents in a community hospital program using smart phones

    PubMed Central

    León, Sergio A; Fontelo, Paul; Green, Linda; Ackerman, Michael; Liu, Fang

    2007-01-01

    Background This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resources internal medicine residents were using and whether providing bedside, real-time access to medical information would be perceived useful for patient care and academic activities. Methods We equipped the medical teams in the hospital wards with smart phones (mobile phone/PDA hybrid devices) to provide immediate access to evidence-based resources developed at the National Library of Medicine as well as to other medical Websites. The emphasis of this project was to measure the convenience and feasibility of real-time access to current medical literature using smart phones. Results The smart phones provided real-time mobile access to medical literature during daily rounds and clinical activities in the hospital. Physicians found these devices easy to use. A post-study survey showed that the information retrieved was perceived to be useful for patient care and academic activities. Conclusion In community hospitals and ambulatory clinics without wireless networks where the majority of physicians work, real-time access to current medical literature may be achieved through smart phones. Immediate availability of reliable and updated information obtained from authoritative sources on the Web makes evidence-based practice in a community hospital a reality. PMID:17313680

  10. State-of-the-art hand hygiene in community medicine.

    PubMed

    Kampf, Günter

    2003-10-01

    Hand hygiene becomes more important in community medicine not only since antibiotic resistant bacteria such as MRSA spread within the community. Hands may be colonized with transient microorganism in up to 75%. Among those transient pathogens S. aureus, C. difficile or the hepatitis C virus may be found. During patient care the number of microorganisms on the hands steadily increases. In addition hands may be contaminated with different kinds of germs even if only "clean" activities are carried out. Gloves may be worn but do not provide complete protection from contamination due to leaks. Therefore hands should always be treated after gloves are taken off. State-of-the-art treatment of hands is the hygienic hand disinfection with alcohol-based hand rubs. They are more effective, quicker to carry out, better tolerated by the skin, with a positive effect on compliance, and cost effective in comparison to antiseptic soaps based on chlorhexidine or triclosan and in comparison to normal non-medicated soaps. Healthy skin easily tolerates alcohol-based products from the beginning on. Only health care workers with an underlying irritative contact dermatitis which is often caused by bar or liquid antiseptic soaps may have difficulties to use alcohol-based products initially. In such a case treatment of the underlying skin condition is the way to go and not staying with a preparation which has caused the dermatitis. All this knowledge is now reflected in current guidelines on hand hygiene. Beside liquids alcohol-based gels can be used if they have an antimicrobial activity equal to alcohol-based liquid preparations. Hand hygiene remains the single most important tool to avoid cross transmission of microorganisms between patients. This state-of-the-art hand hygiene should also be emphasized more in community medicine. This review may help to go the first step into this direction.

  11. [Important differences between faculties of medicine. Implications for family and community medicine].

    PubMed

    González Lopez-Valcarcel, Beatriz; Ortún, Vicente; Barber, Patricia; Harris, Jeffrey E

    2014-03-01

    To determine if there are significant differences between universities in the proclivity to choose Family and Community Medicine (FCM), given the constraints imposed by the number of choice. To test the hypothesis that the Schools of Medicine that have the FCM as a compulsory subject in the degree (3 of 27) had the highest preference for this specialty. Observational study on the data file of all the individuals taking the MIR examination between 2003 and 2011. Spain. All those who sat the examinations called by MIR 2003-2011. Position in the ranking of each candidate, elected position (specialty and center), post code of residence, sex, nationality and university in which they studied, and post code location for the residence chosen. The percentage electing FCM is highly correlated with the position in the ranking: 8% of graduates for the 'best' college, 46% for the worst. Very noticeable and consistent differences in the preparation for the MIR among the 27 medical schools. Ranking in the exam, female and foreigner, help predict the choice of FCM. The FCM compulsory curriculum from three universities does not seem to exert any influence. The convenient yardstick competition between the schools of medicine, FCM in their curriculum and the emphasis on the most attractive attributes of the specialty can contribute to the necessary renewal of FCM. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  12. A community medicine clerkship on the Navajo Indian reservation.

    PubMed

    Rogers, K D; Coulehan, J L

    1984-12-01

    An elective clerkship in community medicine for medical students has been conducted for 16 years on the Navajo Indian reservation. An important part of the clerkship is a project in which most students select a health problem which they investigate using epidemiological methods of assessment and for which they seek a solution. The requisites for the projects are that real health problems are involved, scientifically sound methods are used, usable information is provided, and data collection can be completed within the clerkship tenure. Topics for the projects are selected jointly by the students and the faculty members from several general subject areas; this allows the work of individual students to be carried out as independent subprojects of larger projects, and this, in turn, produces more information about and has more impact on the problems addressed. Other clerkship objectives also are achieved through investigative projects that may involve students in planning, organization, and evaluation of health care and in public health practice.

  13. Community case management of malaria: exploring support, capacity and motivation of community medicine distributors in Uganda

    PubMed Central

    Banek, Kristin; Nankabirwa, Joaniter; Maiteki-Sebuguzi, Catherine; DiLiberto, Deborah; Taaka, Lilian; Chandler, Clare I R; Staedke, Sarah G

    2015-01-01

    Background In Uganda, community services for febrile children are expanding from presumptive treatment of fever with anti-malarials through the home-based management of fever (HBMF) programme, to include treatment for malaria, diarrhoea and pneumonia through Integrated Community Case Management (ICCM). To understand the level of support available, and the capacity and motivation of community health workers to deliver these expanded services, we interviewed community medicine distributors (CMDs), who had been involved in the HBMF programme in Tororo district, shortly before ICCM was adopted. Methods Between October 2009 and April 2010, 100 CMDs were recruited to participate by convenience sampling. The survey included questionnaires to gather information about the CMDs’ work experience and to assess knowledge of fever case management, and in-depth interviews to discuss experiences as CMDs including motivation, supervision and relationships with the community. All questionnaires and knowledge assessments were analysed. Summary contact sheets were made for each of the 100 interviews and 35 were chosen for full transcription and analysis. Results CMDs faced multiple challenges including high patient load, limited knowledge and supervision, lack of compensation, limited drugs and supplies, and unrealistic expectations of community members. CMDs described being motivated to volunteer for altruistic reasons; however, the main benefits of their work appeared related to ‘becoming someone important’, with the potential for social mobility for self and family, including building relationships with health workers. At the time of the survey, over half of CMDs felt demotivated due to limited support from communities and the health system. Conclusions Community health worker programmes rely on the support of communities and health systems to operate sustainably. When this support falls short, motivation of volunteers can wane. If community interventions, in increasingly

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

    PubMed Central

    2004-01-01

    . Family medicine education must continue to include training in maternity care, the care of hospitalized patients, community and population health, and culturally effective and proficient care. A comprehensive lifelong learning program for each family physician will support continuous personal, professional, and clinical practice assessment and improvement. Ultimately, systemwide changes will be needed to ensure high-quality health care for all Americans. Such changes include taking steps to ensure that every American has a personal medical home, promoting the use and reporting of quality measures to improve performance and service, advocating that every American have health care coverage for basic services and protection against extraordinary health care costs, advancing research that supports the clinical decision making of family physicians and other primary care clinicians, and developing reimbursement models to sustain family medicine and primary care practices. CONCLUSIONS The leadership of US family medicine organizations is committed to a transformative process. In partnership with others, this process has the potential to integrate health care to improve the health of all Americans. PMID:15080220

  15. Community health training for internal medicine residents working with community partners.

    PubMed

    Saravanan, Yamini; Pels, Richard

    2011-10-01

    Graduate and undergraduate medical training are incorporating public health curricula into their programs to enable future physicians to participate in public health activities and improve the health of the communities. This paper highlights two approaches to a community health curriculum implemented at the Cambridge Health Alliance Internal Medicine Training Program from 2008-2010. Between 2008 and 2009, the residency program incorporated a longitudinal curriculum for first-year residents. The goal of the curriculum was to expose residents to basic community health research models while giving them time to participate in a 1-year practicum with the Cambridge Public Health Department. Strengths included increasing resident knowledge about the local public health department and providing residents with an opportunity to work with staff and patients in that setting. Limitations of such a design included staff time constraints for coordinating with community partners as well as resident dissatisfaction with being involved in only select portions of an evolving project. This curriculum was therefore revised into a 1-month ambulatory block consisting of didactics and a practicum with the local YWCA in September 2010. Residents felt that this design yielded more time in didactics than in the practicum. Both designs offer important learning points in terms of practically incorporating public health activities in a tightly scheduled residency-training program. The current paper highlights the importance of partnering with a community organization such as a public health department or the YWCA. Emphasis is placed on the contributions that residents can make to these organizations while they learn how to integrate clinical and community health activities. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Metabolomics enables precision medicine: "A White Paper, Community Perspective".

    PubMed

    Beger, Richard D; Dunn, Warwick; Schmidt, Michael A; Gross, Steven S; Kirwan, Jennifer A; Cascante, Marta; Brennan, Lorraine; Wishart, David S; Oresic, Matej; Hankemeier, Thomas; Broadhurst, David I; Lane, Andrew N; Suhre, Karsten; Kastenmüller, Gabi; Sumner, Susan J; Thiele, Ines; Fiehn, Oliver; Kaddurah-Daouk, Rima

    stratification of patients based on metabolic pathways impacted; (4) reveal biomarkers for drug response phenotypes, providing an effective means to predict variation in a subject's response to treatment (pharmacometabolomics); (5) define a metabotype for each specific genotype, offering a functional read-out for genetic variants: (6) provide a means to monitor response and recurrence of diseases, such as cancers: (7) describe the molecular landscape in human performance applications and extreme environments. Importantly, sophisticated metabolomic analytical platforms and informatics tools have recently been developed that make it possible to measure thousands of metabolites in blood, other body fluids, and tissues. Such tools also enable more robust analysis of response to treatment. New insights have been gained about mechanisms of diseases, including neuropsychiatric disorders, cardiovascular disease, cancers, diabetes and a range of pathologies. A series of ground breaking studies supported by National Institute of Health (NIH) through the Pharmacometabolomics Research Network and its partnership with the Pharmacogenomics Research Network illustrate how a patient's metabotype at baseline, prior to treatment, during treatment, and post-treatment, can inform about treatment outcomes and variations in responsiveness to drugs (e.g., statins, antidepressants, antihypertensives and antiplatelet therapies). These studies along with several others also exemplify how metabolomics data can complement and inform genetic data in defining ethnic, sex, and gender basis for variation in responses to treatment, which illustrates how pharmacometabolomics and pharmacogenomics are complementary and powerful tools for precision medicine. Our metabolomics community believes that inclusion of metabolomics data in precision medicine initiatives is timely and will provide an extremely valuable layer of data that compliments and informs other data obtained by these important initiatives. Our

  17. Study of Scientific Production of Community Medicines' Department Indexed in ISI Citation Databases.

    PubMed

    Khademloo, Mohammad; Khaseh, Ali Akbar; Siamian, Hasan; Aligolbandi, Kobra; Latifi, Mahsoomeh; Yaminfirooz, Mousa

    2016-10-01

    In the scientometric, the main criterion in determining the scientific position and ranking of the scientific centers, particularly the universities, is the rate of scientific production and innovation, and in all participations in the global scientific development. One of the subjects more involved in repeatedly dealt with science and technology and effective on the improvement of health is medical science fields. In this research using scientometric and citation analysis, we studied the rate of scientific productions in the field of community medicine, which is the numbers of articles published and indexed in ISI database from 2000 to 2010. This study is scientometric using the survey and analytical citation. The study samples included all of the articles in the ISI database from 2000 to 2010. For the data collection, the advance method of searching was used at the ISI database. The ISI analyses software and descriptive statistics were used for data analysis. Results showed that among the five top universities in producing documents, Tehran University of Medical Sciences with 88 (22.22%) documents are allocated to the first rank of scientific products. M. Askarian with 36 (90/9%) published documents; most of the scientific outputs in Community medicine, in the international arena is the most active author in this field. In collaboration with other writers, Iranian departments of Community Medicine with 27 published articles have the greatest participation with scholars of English authors. In the process of scientific outputs, the results showed that the scientific process was in its lowest in the years 2000 to 2004, and while the department of Community medicine in 2009 allocated most of the production process to itself. Iranian Journal of Public Health and Saudi Medical Journal each of them had 16 articles which had most participation rate in the publishing of community medicine's department. On the type of carrier, community medicine's department by

  18. Eight years of building community partnerships and trust: the UCLA family medicine community-based participatory research experience.

    PubMed

    Moreno, Gerardo; Rodríguez, Michael A; Lopez, Glenn A; Bholat, Michelle A; Dowling, Patrick T

    2009-10-01

    Acknowledging the growing disparities in health and health care that exist among immigrant families and minority populations in large urban communities, the UCLA Department of Family Medicine (DFM) sought a leadership role in the development of family medicine training and community-based participatory research (CBPR). Performing CBPR requires that academic medicine departments build sustainable and long-term community partnerships. The authors describe the eight-year (2000-2008) process of building sustainable community partnerships and trust between the UCLA DFM and the Sun Valley community, located in Los Angeles County.The authors used case studies of three research areas of concentration (asthma, diabetes prevention, and establishing access to primary care) to describe how they established community trust and sustained long-term community research partnerships. In preparing each case study, they used an iterative process to review qualitative data.Many lessons were common across their research concentration areas. They included the importance of (1) having clear and concrete community benefits, (2) supporting an academic-community champion, (3) political advocacy, (4) partnering with diverse organizations, (5) long-term academic commitment, and (6) medical student involvement. The authors found that establishing a long-term relationship and trust was a prerequisite to successfully initiate CBPR activities that included an asthma school-based screening program, community walking groups, and one of the largest school-based primary care clinics in the United States.Their eight-year experience in the Sun Valley community underscores how academic-community research partnerships can result in benefits of high value to communities and academic departments.

  19. Surveillance and uncertainty: community pharmacy responses to over the counter medicine abuse.

    PubMed

    Cooper, Richard

    2013-05-01

    The sale of over-the-counter (OTC) medicines from community pharmacies offers important opportunities for members of the public to access medicines and self-treat conditions. They are increasingly recognised, however, as having the potential for abuse and harm despite their perceived relative safety. This study reports on a qualitative study that explored the experiences and views of community pharmacy staff in relation to current practices and concerns, management and support relating to OTC medicine abuse. Semi-structured interviews were undertaken with a purposive sample of ten pharmacists and seven medicines counter assistants in the United Kingdom. Analysis of interviews indicated that a range of medicines was implicated, including opiates, sedative antihistamines, laxatives and decongestants. A surveillance role was apparent for assistants, who placed emphasis on regulations, procedure and monitoring frequency of purchases to manage abuse, with referral on to pharmacists. Frequency of purchase was central to assistants' definition of those suspected of OTC medicine abuse, which pharmacists also utilised as well as a distinction between intentional abuse and unintentional medicine misuse. A lack of information about customers, easy access to, and poor communication between community pharmacies were emergent barriers to pharmacists providing more support. Many appeared uncertain of referral options or how pharmacists could effectively stop the problem of abuse. The commercial environment was a particular concern, in relation to customer expectations, medicine advertising and easy access to different community pharmacies. A key tension emerged between providing medicine supplies that permitted consumer freedom, with the needs of healthcare professionals to understand more about those consumers qua patients. Policy implications include the need for improved knowledge for community pharmacy staff about signposting to relevant services, increased awareness of who

  20. Core palliative medicines: meeting the needs of non-complex community patients.

    PubMed

    Tait, Paul; Morris, Bel; To, Timothy

    2014-01-01

    There are a number of challenges facing people in the last days of life who wish to receive care in their home environment. This includes timely access to medicines for symptom control. This article outlines the development of a concise list of core medicines that can provide symptom control in non-complex patients in the last days of life. The list is based on practical criteria including evidence of efficacy, affordability, the option for parenteral administration, availability on the Pharmaceutical Benefits Scheme and the doctors' emergency drug supply list. A list of core medicines can facilitate timely prescribing and supply of essential medicines for end-of-life symptom management. However, the development of this list should not replace planning and routine involvement of community resources. Multidisciplinary education strategies are needed to ensure that the core medicines list is utilised effectively by doctors, pharmacists and community nurses.

  1. Community-Oriented Training in Family Medicine: Integration in an urban residency program.

    PubMed

    Ouchterlony, D P

    1991-07-01

    Family medicine educators are challenged by the need to introduce community experiences into residency training programs. This paper describes one inner-city program's preliminary efforts to join with community-oriented health service agencies in the development of meaningful educational experiences and discusses problems and possible solutions.

  2. Local knowledge in community-based approaches to medicinal plant conservation: lessons from India

    PubMed Central

    Shukla, Shailesh; Gardner, James

    2006-01-01

    Background Community-based approaches to conservation of natural resources, in particular medicinal plants, have attracted attention of governments, non governmental organizations and international funding agencies. This paper highlights the community-based approaches used by an Indian NGO, the Rural Communes Medicinal Plant Conservation Centre (RCMPCC). The RCMPCC recognized and legitimized the role of local medicinal knowledge along with other knowledge systems to a wider audience, i.e. higher levels of government. Methods Besides a review of relevant literature, the research used a variety of qualitative techniques, such as semi-structured, in-depth interviews and participant observations in one of the project sites of RCMPCC. Results The review of local medicinal plant knowledge systems reveals that even though medicinal plants and associated knowledge systems (particularly local knowledge) are gaining wider recognition at the global level, the efforts to recognize and promote the un-codified folk systems of medicinal knowledge are still inadequate. In country like India, such neglect is evident through the lack of legal recognition and supporting policies. On the other hand, community-based approaches like local healers' workshops or village biologist programs implemented by RCMPCC are useful in combining both local (folk and codified) and formal systems of medicine. Conclusion Despite the high reliance on the local medicinal knowledge systems for health needs in India, the formal policies and national support structures are inadequate for traditional systems of medicine and almost absent for folk medicine. On the other hand, NGOs like the RCMPCC have demonstrated that community-based and local approaches such as local healer's workshops and village biologist program can synergistically forge linkages between local knowledge with the formal sciences (in this case botany and ecology) and generate positive impacts at various levels. PMID:16603082

  3. Local knowledge in community-based approaches to medicinal plant conservation: lessons from India.

    PubMed

    Shukla, Shailesh; Gardner, James

    2006-04-07

    Community-based approaches to conservation of natural resources, in particular medicinal plants, have attracted attention of governments, non governmental organizations and international funding agencies. This paper highlights the community-based approaches used by an Indian NGO, the Rural Communes Medicinal Plant Conservation Centre (RCMPCC). The RCMPCC recognized and legitimized the role of local medicinal knowledge along with other knowledge systems to a wider audience, i.e. higher levels of government. Besides a review of relevant literature, the research used a variety of qualitative techniques, such as semi-structured, in-depth interviews and participant observations in one of the project sites of RCMPCC. The review of local medicinal plant knowledge systems reveals that even though medicinal plants and associated knowledge systems (particularly local knowledge) are gaining wider recognition at the global level, the efforts to recognize and promote the un-codified folk systems of medicinal knowledge are still inadequate. In country like India, such neglect is evident through the lack of legal recognition and supporting policies. On the other hand, community-based approaches like local healers' workshops or village biologist programs implemented by RCMPCC are useful in combining both local (folk and codified) and formal systems of medicine. Despite the high reliance on the local medicinal knowledge systems for health needs in India, the formal policies and national support structures are inadequate for traditional systems of medicine and almost absent for folk medicine. On the other hand, NGOs like the RCMPCC have demonstrated that community-based and local approaches such as local healer's workshops and village biologist program can synergistically forge linkages between local knowledge with the formal sciences (in this case botany and ecology) and generate positive impacts at various levels.

  4. Exploring community pharmacists' views on generic medicines: a nationwide study from Malaysia.

    PubMed

    Chong, Chee Ping; Hassali, Mohamed Azmi; Bahari, Mohd Baidi; Shafie, Asrul Akmal

    2011-02-01

    To evaluate the Malaysian community pharmacists' views on generic medicines. A sample of 1419 Malaysian community pharmacies with resident pharmacists. A cross-sectional nationwide survey using a self-completed mailing questionnaire. Pharmacists' views on generic medicines including issues surrounding efficacy, safety, quality and bioequivalence. Responses were received from 219 pharmacies (response rate 15.4%). Only 50.2% of the surveyed pharmacists agreed that all products that are approved as generic equivalents can be considered therapeutically equivalent with the innovator medicines. Around 76% of respondents indicated that generic substitution of narrow therapeutic index medicines is inappropriate. The majority of the pharmacists understood that a generic medicine must contain the same amount of active ingredient (84.5%) and must be in the same dosage form as the innovator brand (71.7%). About 21% of respondents though that generic medicines are of inferior quality compared to innovator medicines. Most of the pharmacists (61.6%) disagreed that generic medicines produce more side-effects than innovator brand. Pharmacists graduated from Malaysian universities, twinning program and overseas universities were not differed significantly in their views on generic medicines. Additionally, the respondents appeared to have difficulty in ascertaining the bioequivalent status of the marketed generic products in Malaysia. The Malaysian pharmacists' have lack of information and/or trust in the generic manufacturing and/or approval system in Malaysia. This issue should be addressed by pharmacy educators and relevant government agencies.

  5. Knowledge of and attitudes to medicines in the Southampton community.

    PubMed Central

    Ridout, S; Waters, W E; George, C F

    1986-01-01

    A 1 in 200 sample of the Southampton electorate was sent a postal questionnaire in January, 1984. Of the 740 adults surveyed, 443 (59.9%) returned completed questionnaires. One hundred and eighty-eight (42.4%) of those replying had been prescribed a medicine within the previous month. Two hundred and seventy-five respondents (62%) felt that not enough was explained about medicines by doctors or pharmacists. Consistent with this, was the fact that 37% were unaware of safe methods of disposal of leftover medicines. In addition, 112 of 154 (72.7%) people currently taking a prescribed medicine knew of no side-effects which could result from this. Eighty-three per cent of respondents thought an information leaflet would be helpful. Of nine items which previous authors had suggested should be included, seven were thought to be important by more than 75% of those replying. Although 54% of people wanted detailed information, 43% stated a preference for short, summarized points. We conclude that most patients need to have more information about prescribed medicines and they would welcome written leaflets. However, further work is necessary to determine the best format for such leaflets. PMID:3741718

  6. Indigenous knowledge of medicinal plants used by Saperas community of Khetawas, Jhajjar District, Haryana, India

    PubMed Central

    2010-01-01

    Background Plants have traditionally been used as a source of medicine in India by indigenous people of different ethnic groups inhabiting various terrains for the control of various ailments afflicting human and their domestic animals. The indigenous community of snake charmers belongs to the 'Nath' community in India have played important role of healers in treating snake bite victims. Snake charmers also sell herbal remedies for common ailments. In the present paper an attempt has been made to document on ethno botanical survey and traditional medicines used by snake charmers of village Khetawas located in district Jhajjar of Haryana, India as the little work has been made in the past to document the knowledge from this community. Methods Ethno botanical data and traditional uses of plants information was obtained by semi structured oral interviews from experienced rural folk, traditional herbal medicine practitioners of the 'Nath' community. A total of 42 selected inhabitants were interviewed, 41 were male and only one woman. The age of the healers was between 25 years and 75 years. The plant specimens were identified according to different references concerning the medicinal plants of Haryana and adjoining areas and further confirmation from Forest Research Institute, Dehradun. Results The present study revealed that the people of the snake charmer community used 57 medicinal plants species that belonged to 51 genera and 35 families for the treatment of various diseases. The study has brought to light that the main diseases treated by this community was snakebite in which 19 different types of medicinal plants belongs to 13 families were used. Significantly higher number of medicinal plants was claimed by men as compared to women. The highest numbers of medicinal plants for traditional uses utilized by this community were belonging to family Fabaceae. Conclusion This community carries a vast knowledge of medicinal plants but as snake charming is banned in

  7. Herbs for medicinal baths among the traditional Yao communities of China.

    PubMed

    Li, Sumei; Long, Chunlin; Liu, Fengyan; Lee, Sangwoo; Guo, Qi; Li, Rong; Liu, Yuheng

    2006-11-03

    Medicinal baths are an important traditional way to prevent and cure common diseases among the traditional Yao communities of Jinping County, Yunnan Province, SW China. Approaches of anthropology, ethnobotany, and participatory rural appraisal (PRA) were used to investigate the herbs used for medicinal baths; and 110 medicinal plant species were found to be used by local people to treat a variety of diseases, such as rheumatic diseases, skin diseases, injuries from falls and gynecopathia. Of these 110 species, 6 (5%) had not been previously identified as having medicinal properties, while 87 (79%) were newly recorded for their use in medicinal baths. These new ethnobotanical and medicinal records are a rich source of further phytochemical, pharmacological, and clinical studies on folk herbs in SW China.

  8. Understanding quality use of medicines in refugee communities in Australian primary care: a qualitative study.

    PubMed

    Kay, Margaret; Wijayanayaka, Shanika; Cook, Harriet; Hollingworth, Samantha

    2016-06-01

    Although refugee health issues are increasingly experienced in primary health care, few studies have explored the quality use of medicines in refugee communities even though access to and quality use of medicines is a key component of care delivery. To identify strategies to support the quality use of medicines in refugee communities. Qualitative study with primary healthcare providers and refugee health leaders in Brisbane, Australia. Semi-structured interviews were conducted with refugee health leaders, pharmacists, practice nurses, and GPs. Data were recorded and transcribed. Thematic analysis was used to identify key barriers and facilitators for the quality use of medicines. Five barriers, including communication and language barriers, limited health literacy and financial cost, and four facilitators, including better coordination between healthcare providers and improved healthcare provider training, were identified. This study provides a rich exploration relating to medication use and examines the engagement between pharmacists and refugees, highlighting some communication concerns. It recognises the supportive role of the practice nurse and offers practical strategies for improving community knowledge about safe medicines use. This preliminary study builds on previous studies investigating refugee health access and health literacy. It offers new understandings towards enhancing quality use of medicines in refugee communities and practical insights to assist the targeting of resources for future interventions. © British Journal of General Practice 2016.

  9. Community medicine in action: an integrated, fourth-year urban continuity preceptorship.

    PubMed

    Brill, John R; Jackson, Thomas C; Stearns, Marjorie A

    2002-07-01

    To provide an opportunity for fourth-year students at the University of Wisconsin Medical School in Madison to immerse in urban community medicine during a 34-week program. This experience enhances the integrity of the fourth year as well as merges medicine and public health perspectives in medical education as called for by the Medicine and Public Health Initiative. A limited number of fourth-year Wisconsin medical students have the opportunity to select a one-year, continuity-based preceptorship at the Milwaukee clinical campus with a focus in one of three domains: family medicine, internal medicine, or women's health. Students participate in the following clinical activities: a one-year, integrated preceptorship (one to three half days per week in a primary preceptor's office), medicine subinternship, senior surgery clerkship, selectives (16-20 weeks of clerkships relevant to preceptorship focus area), and one month of out-of-city electives. Complementing this community-based clinical experience is the opportunity to develop an increased appreciation for urban community health issues and resources by participating in a required urban community medicine clerkship and a mentored student scholarly project focusing on an aspect of urban community medicine and population health. All students begin the year in July with a four-week urban community medicine clerkship, which is based on the St. Luke's family practice residency's community medicine rotation and arranged by residency faculty. They conduct a "windshield survey" of a Milwaukee neighborhood, observing health hazards and identifying assets, and then present these observations to others in the clerkship. During this first month, students are introduced to the work of a variety of social service agencies, the Milwaukee City Health Department, and the Aurora Health Care/UW community clinics, which serve the state's most diverse zip codes. They meet with providers and researchers who share their expertise in

  10. WORKSAFE IOWA Occupational Medicine Associates Network: a university--community partnership in occupational safety and health.

    PubMed

    Merchant, J A; Walkner, L; Mikulski, M

    2001-01-01

    The WORKSAFE IOWA Occupational Medicine Associates Network is a unique health care model for dispensing regional occupational medicine services in the state of Iowa, USA. WORKSAFE IOWA is an educational, informational, and consultation service of the College of Public Health at The University of Iowa. WORKSAFE IOWA includes a fee-for-service industrial hygiene program, the Occupational Medicine Associates Network, and educational and informational services. The Associates Network provides education, information, and consultation in exchange for an annual fee paid by each Associate to the university-based network. The Associates clinics provide comprehensive occupational medicine services to up to 1,500 clients through 66,000 annual clinic visits in their respective communities. The Associates Network has been financially self-sustaining over a period of 10 years, and has proven to provide valuable services to the community-based Associates, and to provide excellent training opportunities for the University students in several occupational safety and health disciplines.

  11. How can departments of community medicine shape the future of public health education in India?

    PubMed

    Negandhi, Himanshu; Sharma, Kavya; Zodpey, Sanjay P

    2010-01-01

    In order to effectively respond to a changing public health paradigm, it is imperative that the medical education and overall public health education (PHE) parallel the public health challenges faced by countries. Community medicine departments play a crucial role in PHE. This review analyzes the current situation of community medicine departments in the context of PHE, using a framework that outlines academic activities undertaken by these departments. This framework includes the syllabus of academic programs, internship, and infrastructure and faculty strength in the community medicine departments. The review also discusses how skill building of existing faculty members can help us in addressing emerging public health issues, and the role of partnerships and collaborative activities in advancing the PHE agenda, thereby continuing to shape the role played by these departments toward shaping the future of PHE in India.

  12. Medicine shortages in Australia: causes, impact and management strategies in the community setting.

    PubMed

    Tan, Yee Xi; Moles, Rebekah J; Chaar, Betty B

    2016-10-01

    Background Medicine shortages are an ongoing global problem. The Therapeutic Goods Administration (TGA) dedicated a website for monitoring of medicine shortages in Australia in May 2014, as part of the Medicine Shortage Information Initiative. This study aimed to explore the views of pharmacists regarding medicine shortages in the community setting and the impact of the TGA website in Australia. Setting Community pharmacies in New South Wales, Australia. Method Twenty semi-structured interviews were conducted with community pharmacists. Data collected were analysed thematically utilising the framework analysis method. Main outcome measure Qualitative analysis conducted using the framework approach. Results Findings clearly indicated that medicine shortages were experienced on a regular basis, but most participants were unaware of the TGA website. Medicine shortages reportedly impacted both pharmacists and consumers; and various workarounds were undertaken to manage the issue. The "price disclosure policy" was found to be a prominent contributing factor in emerging shortages. Suggestions were made for ways to improve the growing occurrence of shortages. Conclusion Overall, the study found that there was a lack of familiarity with the TGA website, despite experiencing regular shortages of medicines in practice. Also highlighted, was the importance of pharmacists prioritising patient care over business decisions. To reduce prescribing of out-of-stock medicines notifying doctors about shortages was also considered important, to allow for early action to be taken at higher levels of the supply chain. Findings of this study may help direct future policy-making around the world, as medicine shortages is a problem shared by healthcare providers in most countries around the world.

  13. Changing the culture of a medical school by orienting students and faculty toward community medicine.

    PubMed

    Duffy, F Daniel; Miller-Cribbs, Julie E; Clancy, Gerard P; Van De Wiele, C Justin; Teague, T Kent; Crow, Sheila; Kollaja, Elizabeth A; Fox, Mark D

    2014-12-01

    Oklahoma's health status has been ranked among the worst in the country. In 1972, the University of Oklahoma established the Tulsa branch of its College of Medicine (COM) to expand the physician workforce for northeastern Oklahoma and to provide care for the uninsured patients of the area. In 2008, the Tulsa branch launched a distinct educational track, the University of Oklahoma COM's School of Community Medicine (SCM), to prepare providers equipped and committed to addressing prevalent health disparities.The authors describe the Tulsa branch's Summer Institute (SI), a signature program of the SCM, and how it is part of SCM's process of institutional transformation to align its education, service, and research missions toward improving the health status of the entire region. The SI is a weeklong, prematriculation immersion experience in community medicine. It brings entering medical and physician assistant students together with students and faculty from other disciplines to develop a shared culture of community medicine. The SI uses an unconventional curriculum, based on Scharmer's Theory U, which emphasizes appreciative inquiry, critical thinking, and collaborative problem solving. Also, the curriculum includes Professional Meaning conversations, small-group sessions to facilitate the integration of students' observations into their professional identities and commitments. Development of prototypes of a better health care system enables participants to learn by doing and to bring community medicine to life.The authors describe these and other curricular elements of the SI, present early evaluation data, and discuss the curriculum's incremental evolution. A longitudinal outcomes evaluation is under way.

  14. Ethnobotanical survey of food and medicinal plants of the Ilkisonko Maasai community in Kenya.

    PubMed

    Kimondo, Julia; Miaron, Jacob; Mutai, Peggoty; Njogu, Peter

    2015-12-04

    Pastoralist communities such as the Maasai are heavily reliant on traditional foods and medicines. This survey sought to identify traditional foods and/or medicinal plants of the Ilkisonko Maasai community living in Kenya. Ethnobotanical knowledge of traditional plants used as food and human/veterinary medicine was obtained using structured and semi-structured questionnaires administered through face to face interviews of key informants. A total of 30 species from 21 families and 25 genera were reportedly used as food and/or medicine by 48 respondents. The most commonly encountered genus was the Fabaceae. The growth forms encountered were tree (47%), shrub (33%) and herb (20%). Plants that were commonly mentioned by respondents were Salvadora persica (85%), Grewia villosa (52%), Ximenia americana (52%), Albizia anthelmintica (50%), Acacia robusta (46%) and Acacia nilotica (42%). The root/root bark was the most commonly used plant part (35%), followed by the stem/stem bark (30%), fruit (15%), leaves (11%) and whole plant (9%). Common ailments treated were stomach aches, constipation, back aches, joint aches, body pains and sexually transmitted infections. The plants were also used as tonics, digestives, and restoratives. It was evident that traditional medicine was the preferred health care system for the Ilkisonko Maasai community. It is important to document and use this knowledge in producing novel products that could improve nutrition and healthcare in rural communities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Community Health Needs Assessment as a Teaching Tool in a Family Medicine Residency.

    PubMed

    Wilder, Venis; Gagnon, Monica; Olatunbosun, Bamidele; Adedokun, Olanrewaju; Blanas, Demetri; Arniella, Guedy; Maharaj-Best, Ayiti-Carmel

    2016-09-01

    Community-based primary care is a fundamental concept taught in family medicine. Best practices for community-oriented and public health training in medical training programs are underreported in the published literature. A Community Health Needs Assessment (CHNA) offers an opportunity for family medicine residents to practice research and evaluation skills while learning about public health and the community they serve. A family medicine residency program in Harlem, NY, conducted a CHNA in order to assess their community's health landscape and as an opportunity to teach the resident trainees research skills. Primary and secondary data were collected by the residents using public databases, surveys, focus groups, and key informant interviews. Residents completed a survey at the project's completion to assess their experience with the CHNA and to obtain suggestions for improving the process in the future. More than 50% of the 15 residents surveyed reported that the CHNA greatly improved their comfort level speaking to patients about social factors that affect their health. Participants responded that they valued the opportunity to engage with community members and to understand their patients on a population level. The greatest challenge for most residents was lack of devoted time to complete the project considering competing residency responsibilities. Conducting a CHNA in a primary care training program can help the next generation of family physicians become culturally competent and community focused in their work.

  16. Community Health Workers and Family Medicine Resident Education: Addressing the Social Determinants of Health.

    PubMed

    McCalmont, Kate; Norris, Jeffrey; Garzon, Agustina; Cisneros, Raquel; Greene, Heather; Regino, Lidia; Sandoval, Virginia; Gomez, Roberto; Page-Reeves, Janet; Kaufman, Arthur

    2016-04-01

    Neither the health care system nor the training of medical residents focus sufficiently on social determinants of health. Community health workers (CHWs) are a growing presence in health care settings. Culturally and linguistically competent, typically they are from underserved communities and spend more time addressing social determinants of health than others on the health care team. However, CHWs are an infrequent presence in resident clinical training environments. The University of New Mexico Family Medicine Residency placed family medicine residents at a community clinic in Albuquerque managed by CHWs, recognizing that CHWs' collaboration with residents would enhance resident competency in multiple domains. Residents gained skills from CHWs in inter-professional teamwork, cultural proficiency in patient care, effective communication, provision of cost-conscious care, and advocating for both individual and community health. Our model recognizes the value of CHW skills and knowledge and creates a powerful rationale for greater recognition of CHW expertise and integration of CHWs as members of the care team.

  17. Endophytic and rhizospheric bacterial communities isolated from the medicinal plants Echinacea purpurea and Echinacea angustifolia.

    PubMed

    Chiellini, Carolina; Maida, Isabel; Emiliani, Giovanni; Mengoni, Alessio; Mocali, Stefano; Fabiani, Arturo; Biffi, Sauro; Maggini, Valentina; Gori, Luigi; Vannacci, Alfredo; Gallo, Eugenia; Firenzuoli, Fabio; Fani, Renato

    2014-09-01

    In this work we analyzed the composition and structure of cultivable bacterial communities isolated from the stem/leaf and root compartments of two medicinal plants, Echinacea purpurea (L.) Moench and Echinacea angustifolia (DC.) Hell, grown in the same soil, as well as the bacterial community from their rhizospheric soils. Molecular PCR-based techniques were applied to cultivable bacteria isolated from the three compartments of the two plants. The results showed that the two plants and their respective compartments were characterized by different communities, indicating a low degree of strain sharing and a strong selective pressure within plant tissues. Pseudomonas was the most highly represented genus, together with Actinobacteria and Bacillus spp. The presence of distinct bacterial communities in different plant species and among compartments of the same plant species could account for the differences in the medicinal properties of the two plants. Copyright© by the Spanish Society for Microbiology and Institute for Catalan Studies.

  18. Patient opinions on medicine-use review: exploring an expanding role of community pharmacists

    PubMed Central

    Aimaurai, Sirinya; Jumpated, Atthapinya; Krass, Ines; Dhippayom, Teerapon

    2017-01-01

    Background Current evidence supports the benefit of medicine-use review (MUR) for the safe and effective use of medicines. However, little is known about opinions of consumers regarding their preference for undertaking MUR, especially in the developing world, eg, in some Asian countries. We aimed to explore patients’ opinions about potential MUR and other enhanced services provided by community pharmacists. Patients and methods A qualitative study using focus groups was conducted at Naresuan University’s community pharmacy, Phitsanulok, Thailand. MUR-naïve patients were recruited from two pharmacies in Phitsanulok. All focus groups were audio-recorded, transcribed, and thematically analyzed. Results Twenty participants attended four focus groups. The following themes were identified: 1) requirement and need for the service, 2) accessibility and convenience of receiving the service, 3) pharmacist attributes needed in delivering the service, and 4) how to promote the use of MUR successfully. The majority of participants had poor understanding about their medicines and were interested in receiving a MUR service. Regarding accessibility, convenience and close proximity of pharmacies to homes were deemed to be supportive of participants to use the service. However, several potential barriers to uptake were identified: perceived difficulty on the part of recipients in making time to receive the service and the inconvenience of having to provide medicines/records of medicines to pharmacists. The following domains of pharmacists’ characteristics were viewed as supportive determinants: personality (friendliness and confidence in giving information) and attitude (willingness to provide the service and not commercially oriented). The participants suggested that promoting the services using a mix of strategies would increase an awareness of MUR service. Conclusion Recognizing the unmet needs of patients for information on their medicines provides a good opportunity for

  19. Use and management of traditional medicinal plants by Maale and Ari ethnic communities in southern Ethiopia.

    PubMed

    Kidane, Berhane; van Andel, Tinde; van der Maesen, Laurentius Josephus Gerardus; Asfaw, Zemede

    2014-06-04

    Around 80% of the people of Ethiopia are estimated to be relying on medicinal plants for the treatment of different types of human health problems. The purpose of this study was to describe and analyse the use and management of medicinal plants used for the treatment of human health problems by the Maale and Ari communities in southern Ethiopia. Quantitative and qualitative ethnobotanical field inquiries and analytical methods including individual and focus group discussions (18), observations, individual interviews (n = 74), preference ranking and paired comparison were used. Data were collected in three study sites and from two markets; the latter surveyed every 15 days from February 2011 to February 2012. A total of 128 medicinal plant species, belonging to 111 genera and 49 families, used as herbal medicine by Maale and Ari communities were documented. Predominantly harvested plant parts were leaves, which are known to have relatively low impact on medicinal plant resources. Species with high familiarity indices included Solanum dasyphyllum, Indigofera spicata, Ruta chalepensis, Plumbago zeylanica and Meyna tetraphylla. Low Jaccards similarity indices (≤ 0.33) indicated little correspondence in medicinal plant use among sites and between ethnic communities. The dominant ways of medicinal plant knowledge acquisition and transfer is vertical: from parents to children through oral means. Gender and site significantly influenced the number of human medicinal plants known currently in the study sites. Age was only a factor of significance in Maale. Marketing of medicinal plants harvested from wild and semi-wild stands is not common. Expansion of agricultural land and lack of cultivation efforts by local communities are mentioned by locals to affect the availability of medicinal plant resources. S. dasyphyllum, I. spicata, P. zeylanica, M. tetraphylla, and Oxalis radicosa need to be considered for phytochemical and pharmacological testing to verify their

  20. Use and management of traditional medicinal plants by Maale and Ari ethnic communities in southern Ethiopia

    PubMed Central

    2014-01-01

    Background Around 80% of the people of Ethiopia are estimated to be relying on medicinal plants for the treatment of different types of human health problems. The purpose of this study was to describe and analyse the use and management of medicinal plants used for the treatment of human health problems by the Maale and Ari communities in southern Ethiopia. Methods Quantitative and qualitative ethnobotanical field inquiries and analytical methods including individual and focus group discussions (18), observations, individual interviews (n = 74), preference ranking and paired comparison were used. Data were collected in three study sites and from two markets; the latter surveyed every 15 days from February 2011 to February 2012. Results A total of 128 medicinal plant species, belonging to 111 genera and 49 families, used as herbal medicine by Maale and Ari communities were documented. Predominantly harvested plant parts were leaves, which are known to have relatively low impact on medicinal plant resources. Species with high familiarity indices included Solanum dasyphyllum, Indigofera spicata, Ruta chalepensis, Plumbago zeylanica and Meyna tetraphylla. Low Jaccards similarity indices (≤ 0.33) indicated little correspondence in medicinal plant use among sites and between ethnic communities. The dominant ways of medicinal plant knowledge acquisition and transfer is vertical: from parents to children through oral means. Gender and site significantly influenced the number of human medicinal plants known currently in the study sites. Age was only a factor of significance in Maale. Marketing of medicinal plants harvested from wild and semi-wild stands is not common. Expansion of agricultural land and lack of cultivation efforts by local communities are mentioned by locals to affect the availability of medicinal plant resources. Conclusion S. dasyphyllum, I. spicata, P. zeylanica, M. tetraphylla, and Oxalis radicosa need to be considered for phytochemical and

  1. Herbal medicines supplied by community pharmacies in Lagos, Nigeria: pharmacists’ knowledge

    PubMed Central

    Oshikoya, Kazeem Adeola; Oreagba, Ibrahim A.; Ogunleye, Olayinka O.; Oluwa, Rashidat; Senbanjo, Idowu O.; Olayemi, Sunday O.

    Background The use of herbal medicines is on the increase globally and they are usually supplied in pharmacies as non-prescription medicines. Pharmacists are, therefore, responsible for educating and informing the consumers about rational use of herbal medicines. Objective To evaluate the knowledge of pharmacists in Lagos, Nigeria with regards to the herbal medicines they supplied by their pharmacies. Methods Pharmacists in charge of randomly selected 140 community pharmacies from 20 Local Government Areas in Lagos were required to fill out a self-administered questionnaire. We gathered information on their knowledge of the indications, adverse effects, potential drug-herb interactions and contraindications of the herbal medicines they supply in their pharmacies. Results Of the 140 questionnaires distributed, 103 (72.9%) participants completed the questionnaire appropriately. The majority (74; 71.8%) of the participants were males and 36-50 years (56; 54.4%). The pharmacies supplied mostly Yoyo cleanser bitters® (101; 98.5%), ginseng (97; 98.5%), Jobelyn® (91; 88.3%), Ciklavit® (68; 66.6%), gingko (66; 64.1%), herbal tea (66; 64.1%), and Aloe vera (57; 55.3%). The pharmacists self-rated their knowledge of herbal medicines mostly as fair (39%) and good (42%), but they exhibited poor knowledge with regards to the indications, contraindications and safety profiles. Seventy participants consulted reference materials such as leaflet insert in the herbal medicines (56%) and internet (20%) before supplying herbal medicines. The information most frequently sought was herb-drug interactions (85%), contraindications (75%) and adverse effects (70%). Conclusions Community pharmacists need to be informed about the indications and safety profiles of herbal medicines. PMID:24367462

  2. Medicinal wild plant knowledge and gathering patterns in a Mapuche community from North-western Patagonia.

    PubMed

    Estomba, Diego; Ladio, Ana; Lozada, Mariana

    2006-01-03

    Medicinal plant use has persisted as a long standing tradition in the Mapuche communities of Southern Argentina and Chile. An ethnobotanical survey was conducted in the rural Curruhuinca community located near the mountain city of San Martin de los Andes, Argentina. Semi-structured interviews were carried out on 22 families in order to examine the present use of medicinal plants and their reputed therapeutic effects. Ecological variables, such as distance to the gathering site and biogeographical origin were also analyzed. Our results showed that the Curruhuinca dwellers cited 89 plant species for medicinal purposes, both of native and exotic origin. They know about 47 native plants, of which they use 40, and they know of 42 exotic medicinal plants of which they use 34. A differential pattern was observed given that only native species, relevant for the traditional Mapuche medicine, were collected at more distant gathering sites. The interviewees mentioned 268 plant usages. Those most frequently reported had therapeutic value for treating digestive ailments (33%), as analgesic/anti-inflammatory (25%) and antitusive (13%). Native species were mainly cited as analgesics, and for gynecological, urinary and "cultural syndrome" effects, whereas exotic species were mainly cited for digestive ailments. The total number of medicinal plants known and used by the interviewees was positively correlated with people's age, indicating that this ancient knowledge tends to disappear in the younger generations.

  3. Community pharmacist's responsibilities with regards to traditional medicine/complementary medicine products: A systematic literature review.

    PubMed

    Ung, Carolina Oi Lam; Harnett, Joanna; Hu, Hao

    The use of Traditional Medicine/Complementary Medicine (TM/CM) products has gained popularity in many countries. There is a growing body of evidence to support that concomitant use of TM/CM products with certain pharmaceutical medicines may adversely affect treatment outcomes. There is a general consensus that pharmacists have a role to play in the safe and appropriate use of these products. However, the extent of their involvement and responsibilities are not yet defined. Clear guidelines that inform their duty of care are essential for pharmacists to establish their role in the management of TM/CM product use. The purpose of this study was to determine pharmacist's responsibilities with regards to TM/CM products that have been discussed in the literature since 2000. A literature search in 3 electronic databases (Web of Science, Science Direct and PubMed) was used to extract publications from 2000 to 2015 that related pharmacist to TM/CM products. Out of the 2859 publications extracted for abstract review, 171 documents were selected for full text assessment. 41 publications which reported findings from exploratory studies or discussed pharmacists' responsibilities towards TM/CM products were selected for inclusion in this study. Seven major responsibilities were frequently discussed in the literature: (1) to acknowledge the use; (2) to be knowledgeable about the TM/CM products; (3) to ensure safe use of TM/CM products; (4) to document the use of TM/CM products; (5) to report ADRs related to TM/CM products; (6) to educate about TM/CM products; and (7) to collaborate with other health care professionals. Various forms and levels of pharmacists' responsibilities with TM/CM products have been mentioned in the literature. Subsequent work towards a common consensus must take into account three influential factors strategically: the scope of TM/CM products, objectives of pharmacists' involvement and the perspectives of key stakeholders. Copyright © 2016 Elsevier Inc

  4. Traditional healing practice and folk medicines used by Mishing community of North East India

    PubMed Central

    Shankar, Rama; Lavekar, G. S.; Deb, S.; Sharma, B. K.

    2012-01-01

    Assam and Arunachal Pradesh have very rich tradition of herbal medicines used in the treatment of various ailments. Tribal communities practice different types of traditional healing practices. Enough documentation is available on the healing practices in other tribal communities except Mishing community of Assam and foot hill of East Siang district of Arunachal Pradesh hence the attempt was made for the same. A survey on folk medicinal plants and folk healers of Mishing tribe was conducted in few places of Lakhimpur and Dhemaji district of Assam and East Siang district of Arunachal Pradesh, where this ethnic group is living since time immemorial. All information was collected based on interview and field studies with local healers within the community. The identification of medicinal plants collected with help of indigenous healers was done. Such medicines have been shown to have significant healing power, either in their natural state or as the source of new products processed by them. This study is mainly concentrated with plants used to cure diseases and to enquire about different healing systems. Detail note on the method of preparation of precise dose, the part/parts of plants used and method of application is given. PMID:23125508

  5. Non-European traditional herbal medicines in Europe: a community herbal monograph perspective.

    PubMed

    Qu, Liping; Zou, Wenjun; Zhou, Zhenxiang; Zhang, Tingmo; Greef, JanVander; Wang, Mei

    2014-10-28

    The European Directive 2004/24/EC introducing a simplified registration procedure for traditional herbal medicinal products, plays an important role in harmonising the current legislation framework for all herbal medicinal products in the European Union (EU). Although substantial achievements have been made under the new scheme, only a limited number of herbal medicinal products from non-European traditions commonly used in Europe have been registered. Therefore, identification of the obstacles, and determination of appropriate means to overcome the major challenges in the registration of non-European traditional herbal medicinal products are of critical importance for the EU herbal medicinal product market. The primary aims of this study were to understand the key issues and obstacles to registration of non-European traditional herbal medicinal products within the EU. The findings may identify the need for more attention on the Community herbal monographs elaborated by the Herbal Medicinal Products Committee (HMPC), as well as further evidence based scientific research on non-European herbal substances/preparations by the scientific community. A systematic evaluation of the herbal substances and preparations included in Community herbal monographs and public statements has been carried out. The focus was herbal substances and preparations derived from non-European traditions. Of the 109 adopted Community herbal monographs, 10 are herbal substances used in Chinese traditional medicine. Where the HMPC issued a public statement because it was unable to elaborate a monograph more than half-involved herbal substances/preparations from non-European traditions. The main reasons herbal substances/preparations from non-European traditions were not accepted for inclusion in the Community herbal monographs have been identified as due to unfulfilled requirements of Directive 2004/24/EC. The most common reasons were the lack of evidence to demonstrate a 15-year minimum

  6. Availability of and attitudes toward resources on alternative medicine products in the community pharmacy setting.

    PubMed

    Nathan, Joseph P; Cicero, Lorraine A; Koumis, Tina; Rosenberg, Jack M; Feifer, Stanley; Maltz, Fraidy

    2005-01-01

    To examine the availability of resources on dietary supplements in the community pharmacy setting and to assess the attitudes of community pharmacists toward these resources. Cross-sectional study. Community pharmacies in New York and New Jersey that serve as experiential sites for senior student pharmacists at the Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University. Preceptors or full-time pharmacists. Mailed survey. Frequency of use, availability of, and pharmacists' satisfaction with resources on alternative medicines, defined in the survey as any product including herbal remedies, vitamins, minerals, and natural products that may be purchased at a health food store, pharmacy, supermarket, alternative medicine store/magazine for the purpose of self-treatment. A total of 64 pharmacists characterized their frequency of use of resources on alternative medicines while formulating responses to questions as: never (n = 5; 7.8%), seldom (n = 31; 48.4%), often (n = 24; 37.5%), or always (n = 4; 6.3%). A total of 30 different resources were available to 40 respondents. The most commonly available resources were the PDR for Herbal Medicines (42.5%), The Review of Natural Products (20.0%), and the Web site of the National Center for Complementary and Alternative Medicine (12.5%). Of 54 respondents, 4 (7.1%) reported being completely dissatisfied with the available resources; 17 (31.5%) were somewhat dissatisfied; 25 (46.3%) were somewhat satisfied; and 8 (14.8%) were completely satisfied with the resources available to them. Topics the pharmacists most commonly wanted to see improved included safety (72.7%), interactions (70.9%), and uses (69.1%). Community pharmacists do not use information resources on alternative medicine products frequently, and many are not satisfied with the resources available to them.

  7. Complementary alternative medicine use among Chinese Americans: findings from a community mental health service population.

    PubMed

    Fang, Lin; Schinke, Steven P

    2007-03-01

    Complementary alternative medicine use among Asian Americans is widespread, yet poorly understood. This study explored its use among Chinese Americans reporting mental health symptoms. A cross-sectional survey determined the prevalence and correlates of complementary alternative medicine use in an urban sample seen at a community mental health service. Out of 153 Chinese-American patients, 126 (82%) reported current use of complementary therapies (megavitamin therapy, 46%; herbal medicine, 43%; massage, acupuncture, and spiritual healing, about 25% each). Compared with nonusers, users were older, female, employed, less well functioning physically, and less acculturated. Growing immigrant populations and increasing mental health services consumption by members of ethnic-racial groups in the United States call for more attention to complementary alternative medicine use and its potential to aid conventional medical and mental services delivery.

  8. Changing Medicine and Building Community: Maine’s Adverse Childhood Experiences Momentum

    PubMed Central

    Forstadt, Leslie; Cooper, Sally; Andrews, Sue Mackey

    2015-01-01

    Physicians are instrumental in community education, prevention, and intervention for adverse childhood experiences. In Maine, a statewide effort is focusing on education about adverse childhood experiences and ways that communities and physicians can approach childhood adversity. This article describes how education about adversity and resilience can positively change the practice of medicine and related fields. The Maine Resilience Building Network brings together ongoing programs, supports new ventures, and builds on existing resources to increase its impact. It exemplifies the collective impact model by increasing community knowledge, affecting medical practice, and improving lives. PMID:25902346

  9. Traditional medicine practices among community members with chronic kidney disease in northern Tanzania: an ethnomedical survey.

    PubMed

    Stanifer, John W; Lunyera, Joseph; Boyd, David; Karia, Francis; Maro, Venance; Omolo, Justin; Patel, Uptal D

    2015-10-23

    In sub-Saharan Africa, chronic kidney disease (CKD) is being recognized as a non-communicable disease (NCD) with high morbidity and mortality. In countries like Tanzania, people access many sources, including traditional medicines, to meet their healthcare needs for NCDs, but little is known about traditional medicine practices among people with CKD. Therefore, we sought to characterize these practices among community members with CKD in northern Tanzania. Between December 2013 and June 2014, we administered a previously-developed survey to a random sample of adult community-members from the Kilimanjaro Region; the survey was designed to measure traditional medicine practices such as types, frequencies, reasons, and modes. Participants were also tested for CKD, diabetes, hypertension, and HIV as part of the CKD-AFRiKA study. To identify traditional medicines used in the local treatment of kidney disease, we reviewed the qualitative sessions which had previously been conducted with key informants. We enrolled 481 adults of whom 57 (11.9 %) had CKD. The prevalence of traditional medicine use among adults with CKD was 70.3 % (95 % CI 50.0-84.9 %), and among those at risk for CKD (n = 147; 30.6 %), it was 49.0 % (95 % CI 33.1-65.0 %). Among adults with CKD, the prevalence of concurrent use of traditional medicine and biomedicine was 33.2 % (11.4-65.6 %). Symptomatic ailments (66.7 %; 95 % CI 17.3-54.3), malaria/febrile illnesses (64.0 %; 95 % CI 44.1-79.9), and chronic diseases (49.6 %; 95 % CI 28.6-70.6) were the most prevalent uses for traditional medicines. We identified five plant-based traditional medicines used for the treatment of kidney disease: Aloe vera, Commifora africana, Cymbopogon citrullus, Persea americana, and Zanthoxylum chalybeum. The prevalence of traditional medicine use is high among adults with and at risk for CKD in northern Tanzania where they use them for a variety of conditions including other NCDs. Additionally, many of these same people

  10. Sponsorship of Internal Medicine Subspecialty Fellowships Since 2000: Trends and Community Hospital Involvement

    PubMed Central

    Ferguson, Robert; Porto Carreiro, Fernanda; Camire, Lyn

    2009-01-01

    Background: Since 2002, market studies have predicted a physician shortage with an increasing need for future subspecialists. A Residency Review Committee (RRC) rule that restricted sponsorship of fellowships was eliminated in 2005, but the influence of this change on the number of fellowships is not known. We believed that the rules change might make it possible for community hospitals to offer fellowships. Our objectives were to determine the extent of change in the number of fellowships in university and community hospitals from 2000 through 2008, both before and after the RRC regulation change in 2005, and to determine whether community hospitals contributed substantially to the number of new fellowships available to internal medicine graduates. Methods: We used archived Accreditation Council for Graduate Medical Education (ACGME) data from July 2000 through June 2008. The community hospital category included multispecialty clinics, community programs, and municipal hospitals. Results: Of the 94 newly approved internal medicine subspecialty fellowships in this time period, 59 (63%) were community sponsored. As of 6/02/08, all were in good standing. Thirteen programs were started as a department of medicine solo fellowship since 2005. The number of new programs approved between 2005 and 2008 was roughly three times the number approved between 2000 and 2004. Conclusions: The number of subspecialty fellowship programs and approved positions has increased dramatically in the last 8 years. Many of the new programs were at community hospitals. The change in RRC rules has been associated with increased availability of fellowship programs in the university and community hospital setting for subspecialty training. PMID:20165522

  11. Factors influencing purchase of and counselling about prescription and OTC medicines at community pharmacies in Tallinn, Estonia.

    PubMed

    Villako, Peeter; Volmer, Daisy; Raal, Ain

    2012-01-01

    The aims of the current survey were to evaluate factors influencing purchase of prescription and OTC medicines of pharmacy customers in Tallinn, Estonia and to identify the role of community pharmacists in counselling of prescription and OTC medicines. Structured questionnaire was used to interview pharmacy customers (n = 1820) in six community pharmacies of Tallinn, the capital city of Estonia. The survey instrument consisted of 15 multiple-choice items. According to the survey results, prescription and OTC medicines were bought from community pharmacies almost equally. The most popular OTC medicines were analgesics (38%), cold and cough medicines (21%). The older survey participants and these with lower income and with elementary school education bought more prescription medicines (p < 0.01). Survey participants with higher income were purchasing more OTC medicines and food supplements (p < 0.01). Before purchase of medicines recommendations were received mainly from physicians about prescription and from pharmacists about OTC medicines. However, the counselling provided by community pharmacists in selecting of both types of medicines was highly appreciated. Pharmacists as source for drug information were less trusted among the survey participants < 25 and 26-40 years (p < 0.01). Fast service and confidential counselling about medicines was less important for the respondents with elementary school education (p < 0.01).

  12. Health and disease in context: a community-based social medicine curriculum.

    PubMed

    Gregg, Jessica; Solotaroff, Rachel; Amann, Ted; Michael, Yvonne; Bowen, Judith

    2008-01-01

    Despite the increasing attention paid to the role of social forces in determining health, most physicians finish their training ill-prepared to address these issues. The authors describe their efforts to fill that training gap for internal medicine residents at Oregon Health and Science University through a community-based social medicine curriculum, designed in 2006 in conjunction with community partners at Central City Concern (CCC), an organization addressing homelessness, poverty, and addiction in downtown Portland, Oregon. The challenge was to develop a curriculum that would (1) fit within the scheduling constraints of an established categorical internal medicine residency program, (2) give all internal medicine residents a chance to better understand how social forces affect health, and (3) help show how they, as health professionals, might intervene to improve health and health care. The authors maintain that by developing this curriculum with community partners--who took the lead in deciding what residents should learn about their community and how they should learn it--the residency program is providing a relatively brief but extremely rich opportunity for residents to engage the personal, social, and health-related issues experienced by clients served by CCC. The authors first provide a brief overview of the curriculum and describe how the principles and practices of community-based participatory research were used in its development. They then discuss the challenges involved in teaching medical residents about social determinants of health, how their academic-community partnership approaches those challenges, and the recently established methods of evaluating the curriculum.

  13. Non-prescription medicines: a process for standards development and testing in community pharmacy.

    PubMed

    Benrimoj, Shalom Charlie I; Gilbert, Andrew; Quintrell, Neil; Neto, Abilio C de Almeida

    2007-08-01

    The objective of the study was to develop and test standards of practice for handling non-prescription medicines. In consultation with pharmacy registering authorities, key professional and consumer groups and selected community pharmacists, standards of practice were developed in the areas of Resource Management; Professional Practice; Pharmacy Design and Environment; and Rights and Needs of Customers. These standards defined and described minimum professional activities required in the provision of non-prescription medicines at a consistent and measurable level of practice. Seven standards were described and further defined by 20 criteria, including practice indicators. The Standards were tested in 40 community pharmacies in two States and after further adaptation, endorsed by all Australian pharmacy registering authorities and major Australian pharmacy and consumer organisations. The consultation process effectively engaged practicing pharmacists in developing standards to enable community pharmacists meet their legislative and professional responsibilities. Community pharmacies were audited against a set of standards of practice for handling non-prescription medicines developed in this project. Pharmacies were audited on the Standards at baseline, mid-intervention and post-intervention. Behavior of community pharmacists and their staff in relation to these standards was measured by conducting pseudo-patron visits to participating pharmacies. The testing process demonstrated a significant improvement in the quality of service delivered by staff in community pharmacies in the management of requests involving non-prescription medicines. The use of pseudo-patron visits, as a training tool with immediate feedback, was an acceptable and effective method of achieving changes in practice. Feedback from staff in the pharmacies regarding the pseudo-patron visits was very positive. Results demonstrated the methodology employed was effective in increasing overall

  14. Creation of medicinal chemistry learning communities through enhanced technology and interdisciplinary collaboration.

    PubMed

    Henriksen, Brian; Roche, Victoria

    2012-10-12

    Objectives. To build an integrated medicinal chemistry learning community of campus and distance pharmacy students though the use of innovative technology and interdisciplinary teaching.Design. Mechanisms were implemented to bring distance students into campus-based medicinal chemistry classrooms in real time, stimulate interaction between instructors and various student cohorts, and promote group work during class. Also, pharmacy clinician colleagues were recruited to contribute to the teaching of the 3 medicinal chemistry courses.Assessment. Student perceptions on the value of technology to build community and advance learning were gleaned from course evaluations, in class feedback, and conversations with class officers and student groups. Responses on a survey of second-year students confirmed the benefits of interdisciplinary content integration on engagement and awareness of the connection between drug chemistry and pharmacy practice. A survey of clinician colleagues who contributed to teaching the 3 medicinal chemistry courses found their views were similar to those of students.Conclusions. The purposeful use of technology united learners, fostered communication, and advanced content comprehension in 3 medicinal chemistry courses taught to campus and distance students. Teaching collaboration with pharmacy clinicians enhanced learner interest in course content and provided insight into the integrated nature of the profession of pharmacy.

  15. Effect of a Community-Based Service Learning Experience in Geriatrics on Internal Medicine Residents and Community Participants.

    PubMed

    Miller, Rachel K; Michener, Jennifer; Yang, Phyllis; Goldstein, Karen; Groce-Martin, Jennine; True, Gala; Johnson, Jerry

    2017-09-01

    Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources. Residents evaluated the experience. Postgraduate Year 3 internal medicine residents (n = 71) delivered 64 sessions. Residents felt that the experience increased their ability to communicate effectively with older adults (mean 3.91 ± 0.73 on a Likert scale with 5 = strongly agree), increased their knowledge of resources (4.09 ± 1.01), expanded their knowledge of a health topic pertinent to aging (3.48 ± 1.09), and contributed to their capacity to evaluate and care for older adults (3.84 ± 0.67). Free-text responses demonstrated that residents thought that this program would change their practice. Of 815 older adults surveyed from 36 discrete teaching sessions, 461 (56%) thought that the medical residents delivered health information clearly (4.55 ± 0.88) and that the health topics were relevant (4.26 ± 0.92). Free-text responses showed that the program helped them understand their health concerns. This CBSL program is a feasible and effective tool for teaching internal medicine residents and older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  16. The perceptions of one department of preventive medicine about its obligations to the larger community.

    PubMed

    Louria, D B

    1989-01-01

    We believe that Department of Preventive Medicine must be actively involved in important societal issues. We have attempted to meet our commitments by: (I) developing position papers for distribution to our state legislators and Congressional delegation; (2) a focus on problems plaguing the community (cancer care, drug abuse, lead poisoning); (3) developing and implementing a health promotion program that is inexpensive, adequately documented, and effective; (4) being involved in various international medicine activities; and (5) starting a chapter of the World Future Society as part of an attempt to introduce futurism into universities, colleges and high schools in New Jersey.

  17. Emergency medicine redux: the rise and fall of a community medical specialty.

    PubMed

    Crippen, D W

    1984-07-01

    The specialty of Emergency Medicine has evolved circuitously . The poor relation of medicine, previously the domain of moonlighting dermatologists and semi-retired physicians, we considered it a diamond in the rough, a wealth of opportunity hidden by the prejudice of established specialties . We tailored the discipline to meet our needs and desires. As we created form from void, we generated an interest in a practical area of medicine previously indulged only theoretically. Now we are enlarging geometrically as a specialty and have discovered that our actual role as practicing physicians in the community hospital setting has turned out differently than we had conceived in training. As we overpower the available market by expanding our numbers, we are learning about some practical realities that are only now becoming apparent.

  18. Community-based perceptions of emergency care in Zambian communities lacking formalised emergency medicine systems.

    PubMed

    Broccoli, Morgan C; Cunningham, Charmaine; Twomey, Michele; Wallis, Lee A

    2016-12-01

    In Zambia, an increasing burden of acute illness and injury emphasised the necessity of strengthening the national emergency care system. The objective of this study was to identify critical interventions necessary to improve the Zambian emergency care system by determining the current pattern of emergency care delivery as experienced by members of the community, identifying the barriers faced when trying to access emergency care and gathering community-generated solutions to improve emergency care in their setting. We used a qualitative research methodology to conduct focus groups with community members and healthcare providers in three Zambian provinces. Twenty-one community focus groups with 183 total participants were conducted overall, split equally between the provinces. An additional six focus groups were conducted with Zambian healthcare providers. Data were coded, aggregated and analysed using the content analysis approach. Community members in Zambia experience a wide range of medical emergencies. There is substantial reliance on family members and neighbours for assistance, commonly with transportation. Community-identified and provider-identified barriers to emergency care included transportation, healthcare provider deficiencies, lack of community knowledge, the national referral system and police protocols. Creating community education initiatives, strengthening the formal prehospital emergency care system, implementing triage in healthcare facilities and training healthcare providers in emergency care were community-identified and provider-identified solutions for improving access to emergency care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Herbal Medicines: Personal Use, Knowledge, Attitude, Dispensing Practice, and the Barriers among Community Pharmacists in Gondar, Northwest Ethiopia

    PubMed Central

    Birarra, Mequanent Kassa

    2017-01-01

    Background Herbal medicine use is increasing and the global market is estimated to be US$107 billion by the year 2017. Objectives This study aimed at assessing community pharmacists' personal use, knowledge, attitude, dispensing practice, and the barriers regarding herbal medicines. Methods Institution based cross-sectional study was conducted among 47 community pharmacists in Gondar, Northwest Ethiopia, using a structured interviewing questionnaire. Results Nearly half of the respondents (n = 22, 46.8%) sometimes use herbal medicines. Although knowledge related to such preparations was self-rated as poor/acceptable (n = 34, 72.4%), majority (n = 44, 93.7%) of community pharmacists agree/strongly agree that herbal medicines have beneficial effects. Only 6 (12.7%) of them are sometimes/often engaged in dispensing herbal medicines and most of them (n = 34, 72.3%) rarely/never counseled clients regarding these preparations. Limited knowledge on and access to information regarding herbal medicines are the main barriers to the pharmacists' practice. Conclusion Although community pharmacists in Gondar, Northwest Ethiopia, commonly use and demonstrated good attitude towards herbal medicines, they are less involved in dispensing such products. They are also challenged with limited knowledge on and access to herbal medicine information. Thus, pharmacy educators, professional organizations, and the government shall pay more attention to solve the problem. Regulatory provisions on herbal medicine dispensing must be enacted and communicated very well. PMID:28904558

  20. Community pharmacist-delivered Medicare Annual Wellness Visits within a family medicine practice.

    PubMed

    Evans, Taylor A; Fabel, Patricia H; Ziegler, Bryan

    To identify the steps to implement a community pharmacist into a family medicine practice to deliver Medicare Annual Wellness Visits (AWVs). Medicine Mart Pharmacy is a locally owned and operated pharmacy that has served the West Columbia, SC, area for over 30 years. The services offered by the pharmacy have expanded over the past 3 years through the addition of a community pharmacy resident. A stepwise approach was developed for a community pharmacist to identify, market, and establish an AWV service through a collaborative practice agreement with a local family medicine practice. The pharmacy team contacted each office and obtained information about the physician practices and their willingness to participate in the program. Two financial models were created and evaluated to determine budget implications. Many patients were seen at the physician offices; they were eligible for AWV, but had not received them. Meetings were scheduled with 3 of the 6 offices; however, none of the offices moved forward with the proposed program. Integrating a pharmacist into the AWV role may be profitable to both the pharmacy and the medical office with persistence and time to have a successful collaboration. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  1. A study of the medicinal plants used by the Marakwet Community in Kenya

    PubMed Central

    2014-01-01

    Background The medicinal plants used by herbalists in Kenya have not been well documented, despite their widespread use. The threat of complete disappearance of the knowledge on herbal medicine from factors such as deforestation, lack of proper regulation, overexploitation and sociocultural issues warrants an urgent need to document the information. The purpose of the study was to document information on medicinal plants used by herbalists in Marakwet District towards the utilization of indigenous ethnobotanical knowledge for the advancement of biomedical research and development. Methods Semi- structured oral interviews were conducted with 112 practicing herbalists. The types of plants used were identified and the conditions treated recorded. Results Herbal practice is still common in the district, and 111 plants were identified to have medicinal or related uses. Different herbal preparations including fruits and healing vegetables are employed in the treatment of various medical conditions. Veterinary uses and pesticides were also recorded. Conclusion The study provides comprehensive ethnobotanical information about herbal medicine and healing methods among the Marakwet community. The identification of the active ingredients of the plants used by the herbalists may provide some useful leads for the development of new drugs. PMID:24555424

  2. A Black Theological Response to Race-Based Medicine: Reconciliation in Minority Communities.

    PubMed

    Johnson, Kirk A

    2017-06-01

    The harm race-based medicine inflicts on minority bodies through race-based experimentation and the false solutions a race-based drug ensues within minority communities provokes concern. Such areas analyze the minority patient in a physical proxy. Though the mind and body are important entities, we cannot forget about the spirit. Healing is not just a physical practice; it includes spiritual practice. Efficient medicine includes the holistic elements of the mind, body, and spirit. Therefore, the spiritual discipline of black theology can be used as a tool to mend the harms of race-based medicine. It can be an avenue of research to further particular concerns for justice in medical care . Such theology contributes to the discussion of race-based medicine indicating the need for the voice, participation, and interdependence of minorities. Black theology can be used as a tool of healing and empowerment for health equity and awareness by exploring black theology's response to race-based medicine, analyzing race in biblical literature, using biblical literature as a tool for minority patient empowerment, building on past and current black church health advocacy with personal leadership in health advocacy.

  3. Examination of England's New Medicine Service (NMS) of complex health care interventions in community pharmacy.

    PubMed

    Latif, Asam; Waring, Justin; Watmough, Deborah; Barber, Nick; Chuter, Anthony; Davies, James; Salema, Nde-Eshimuni; Boyd, Matthew J; Elliott, Rachel A

    Community pharmacies are increasingly commissioned to deliver new, complex health interventions in response to the growing demands on family doctors and secondary health care services. Little is known about how these complex interventions are being accommodated and translated into the community pharmacy setting and whether their aims and objectives are realized in practice. The New Medicine Service (NMS) is a complex medicine management intervention that aims to support patients' adherence to newly prescribed medicines for a long-term condition. This study explores the recent implementation of the NMS in community pharmacies across England. It also seeks to understand how the service is becoming manifest in practice and what lessons can be learned for future service implementation. Structured, organizational ethnographic observations and in situ workplace interviews with pharmacists and support staff were undertaken within 23 English community pharmacies. Additionally, one-to-one, semi-structured interviews were carried out with 47 community pharmacists and 11 general practitioners (GPs). Observational and interview data were transcribed and analyzed thematically and guided by Damschroder's consolidated framework for implementation research. The NMS workload had been implemented and absorbed into pharmacists' daily routines alongside existing responsibilities with no extra resources and little evidence of reduction in other responsibilities. Pharmacists were pragmatic, simplifying, and adapting the NMS to facilitate its delivery and using discretion to circumvent perceived non-essential paperwork. Pharmacist understanding of the NMS was found to impact on what they believed should be achieved from the service. Despite pharmacists holding positive views about the value of the NMS, not all were convinced of its perceived benefits and necessity, with reports that many consultations did not identify any problems with the patients' medicines. GPs were generally

  4. Medicinal use of fauna by a traditional community in the Brazilian Amazonia.

    PubMed

    Barros, Flávio B; Varela, Susana A M; Pereira, Henrique M; Vicente, Luís

    2012-09-27

    Zootherapy inventories are important as they contribute to the world documentation of the prevalence, importance and diversity of the medicinal use of animals in traditional human communities. The present study aims to contribute with a more valuable example of the zootherapy practices of a traditional community in the Brazilian Amazonia - the "Riozinho do Anfrísio" Extractive Reserve, in Northern Brazil. We used the methods of participant observation and semi-structured interviews, applied to 25 informants. We employed the combined properties of two indices to measure the medicinal importance of each cited species to the studied community, as well as their versatility in the treatment of diseases: the well known Use Value (UV) and the Medicinal Applications Value (MAV) that we developed. We recorded 31 species of medicinal animals from six taxonomic categories, seven of which are new to science. The species are used for the treatment of 28 diseases and one species is used as an amulet against snakebites. The five species with the highest UV indices are the most popular and valued by the studied community. Their contrasting MAV indices indicate that they have different therapeutic properties: specific (used for the treatment of few diseases; low versatility) and all-purpose (several diseases; high versatility). Similarly, the most cited diseases were also those that could be treated with a larger number of animal species. Ten species are listed in the CITES appendices and 21 are present in the IUCN Red List. The knowledge about the medicinal use of the local fauna is distributed evenly among the different age groups of the informants. This study shows that the local fauna represents an important medicinal resource for the inhabitants of the protected area. The combined use of the UV and MAV indices allowed identifying the species with the highest therapeutic potential. This type of information about a species may be of interest to pharmacological research, and is

  5. Medicinal use of fauna by a traditional community in the Brazilian Amazonia

    PubMed Central

    2012-01-01

    Background Zootherapy inventories are important as they contribute to the world documentation of the prevalence, importance and diversity of the medicinal use of animals in traditional human communities. The present study aims to contribute with a more valuable example of the zootherapy practices of a traditional community in the Brazilian Amazonia – the “Riozinho do Anfrísio” Extractive Reserve, in Northern Brazil. Methods We used the methods of participant observation and semi-structured interviews, applied to 25 informants. We employed the combined properties of two indices to measure the medicinal importance of each cited species to the studied community, as well as their versatility in the treatment of diseases: the well known Use Value (UV) and the Medicinal Applications Value (MAV) that we developed. Results We recorded 31 species of medicinal animals from six taxonomic categories, seven of which are new to science. The species are used for the treatment of 28 diseases and one species is used as an amulet against snakebites. The five species with the highest UV indices are the most popular and valued by the studied community. Their contrasting MAV indices indicate that they have different therapeutic properties: specific (used for the treatment of few diseases; low versatility) and all-purpose (several diseases; high versatility). Similarly, the most cited diseases were also those that could be treated with a larger number of animal species. Ten species are listed in the CITES appendices and 21 are present in the IUCN Red List. The knowledge about the medicinal use of the local fauna is distributed evenly among the different age groups of the informants. Conclusions This study shows that the local fauna represents an important medicinal resource for the inhabitants of the protected area. The combined use of the UV and MAV indices allowed identifying the species with the highest therapeutic potential. This type of information about a species may be of

  6. Community pharmacists' attitudes toward the quality and price of locally manufactured generic medicines in Kabul, Afghanistan.

    PubMed

    Bashaar, Mohammad; Hassali, Mohamed Azmi; Saleem, Fahad

    2015-01-01

    To report the attitudes of community pharmacists in Kabul, Afghanistan, concerning the quality and price of locally manufactured medicines. A cross-sectional descriptive study, involving a sample of 198 community pharmacists was conducted in Kabul city. With a response rate of 100%, most of the respondents 70.7% had 11-20 years experience working as a pharmacist. About 84.3% of the pharmacists dispensed imported generic medicines from Pakistan, Iran, India, and the UAE. Only 15.7% of pharmacists were dispensing locally produced generics from Ariana (i.e. a local pharmaceutical manufacturer). Exactly half of the pharmacists 50.0% reported that locally produced generics were equally safe and efficacious as the imported generics, while 70.7% of the respondents believed that the local manufacturers of generic products had reliable logistics and supply systems. However, 80.8% of respondents expressed concerns regarding their own credibility when stocking the medicines. Consequently, 80.3% of the sample only stocked well-advertised domestic generics, which were likely to be seen by consumers as more credible alternatives. Most of the respondents 82.8% were confident that the locally manufactured generics were cheaper than imported generics. Interestingly, 80.8% of the respondents favoured the establishment of a national brand substitution policy. Furthermore, 90.4% of the respondents believed that it was the responsibility of the Afghan regulatory authorities to educate pharmacists on the quality of domestic generics. Although community pharmacists had a positive attitude towards the quality and affordability of locally manufactured medicines, due to lack of resources most of their medicines are imported. Despite their positivity towards the quality and price of generics, the community pharmacists only dispense them to a minimal degree, because of low local production levels among other reasons. The findings call for improvements in the local pharmaceutical industry in

  7. Innovations in service learning: a novel program for community service at NYU School of Medicine.

    PubMed

    Herlihy, Nola Seta; Brown, Christina

    2015-01-01

    As NYU medical students, the authors determined that there was no structured form of service learning in their curriculum. They sought to establish a service program that recognizes students for their dedication to community service in both the NYU and NYC communities. In 2012, with the support of the Office of Student Affairs (OSA), the authors created the NYU School of Medicine Community Service Program (CSP). The program tracks and verifies students' participation in service projects. It sets a goal for students to complete 100 service hours through at least five unique service initiatives. Two reflective essays at the completion of pre-clinical and core clerkship curricula challenge students to express how their service experiences will inform their future careers in medicine. The authors developed an innovative online portal for students to track their service involvement and allow the committee to easily approve hours. They created the Community Service Committee, made up of two representatives from each class year, to be in charge of regulating the program together with the OSA. The class of 2015 is the first class to participate; thus far, 13 students have met program requirements. In the classes of 2016 and 2017, 20 and 41 students, respectively, are expected to receive the award. Total participation has significantly increased in successive class years. The authors seek to gather data on CSP participants' changing perspectives and hope the program can serve as a model for other schools to build service learning into their curricula.

  8. Innovations in service learning: a novel program for community service at NYU School of Medicine

    PubMed Central

    Herlihy, Nola Seta; Brown, Christina

    2015-01-01

    Problem As NYU medical students, the authors determined that there was no structured form of service learning in their curriculum. They sought to establish a service program that recognizes students for their dedication to community service in both the NYU and NYC communities. Approach In 2012, with the support of the Office of Student Affairs (OSA), the authors created the NYU School of Medicine Community Service Program (CSP). The program tracks and verifies students’ participation in service projects. It sets a goal for students to complete 100 service hours through at least five unique service initiatives. Two reflective essays at the completion of pre-clinical and core clerkship curricula challenge students to express how their service experiences will inform their future careers in medicine. The authors developed an innovative online portal for students to track their service involvement and allow the committee to easily approve hours. They created the Community Service Committee, made up of two representatives from each class year, to be in charge of regulating the program together with the OSA. Outcomes The class of 2015 is the first class to participate; thus far, 13 students have met program requirements. In the classes of 2016 and 2017, 20 and 41 students, respectively, are expected to receive the award. Total participation has significantly increased in successive class years. Next steps The authors seek to gather data on CSP participants’ changing perspectives and hope the program can serve as a model for other schools to build service learning into their curricula. PMID:26387908

  9. Treatment of Diarrhoea in Rural African Communities: An Overview of Measures to Maximise the Medicinal Potentials of Indigenous Plants

    PubMed Central

    Njume, Collise; Goduka, Nomalungelo I.

    2012-01-01

    Diarrhoea is a major cause of morbidity and mortality in rural communities in Africa, particularly in children under the age of five. This calls for the development of cost effective alternative strategies such as the use of herbal drugs in the treatment of diarrhoea in these communities. Expenses associated with the use of orthodox medicines have generated renewed interest and reliance on indigenous medicinal plants in the treatment and management of diarrhoeal infections in rural communities. The properties of many phenolic constituents of medicinal plants such as their ability to inhibit enteropooling and delay gastrointestinal transit are very useful in the control of diarrhoea, but problems such as scarcity of valuable medicinal plants, lack of standardization of methods of preparation, poor storage conditions and incertitude in some traditional health practitioners are issues that affect the efficacy and the practice of traditional medicine in rural African communities. This review appraises the current strategies used in the treatment of diarrhoea according to the Western orthodox and indigenous African health-care systems and points out major areas that could be targeted by health-promotion efforts as a means to improve management and alleviate suffering associated with diarrhoea in rural areas of the developing world. Community education and research with indigenous knowledge holders on ways to maximise the medicinal potentials in indigenous plants could improve diarrhoea management in African rural communities. PMID:23202823

  10. 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 ...

  11. A nationwide study on generic medicines substitution practices of Australian community pharmacists and patient acceptance.

    PubMed

    Chong, Chee Ping; March, Geoff; Clark, Alice; Gilbert, Andrew; Hassali, Mohamed Azmi; Bahari, Mohd Baidi

    2011-02-01

    This study evaluated Australian community pharmacists' rate of generic medicine substitution, patient acceptance of generic substitution and cost-savings achieved for patients from substitution. A national stratified sample of 500 Australian pharmacies was randomly selected from different geographical areas. The data of the first 25 original PBS prescription items dispensed on one working day eligible for generic substitution were collected from each pharmacy. Responses were received from 82 pharmacies with a response rate of 16.4%. The pharmacists recommended generics for 96.4% (1461/1515) of the prescription items which were eligible for substitution. The generic substitution recommendation rate in urban (98.7%) and rural areas (98.0%) was significantly higher than remote areas (91.6%). Conversely, patients' acceptance in remote areas (84.5%) was significantly higher than rural (78.6%) and urban areas (73.2%). Patients with chronic diseases demonstrated significantly lower acceptability (72.4%) than patients with acute conditions (81.6%). Through acceptance of substitution, the patients' medicines expenditure reduced by around 21%. Australian community pharmacists demonstrated a high rate of recommending generic substitution. However, to optimize the generic medicines utilization, patients' acceptance requires further improvement. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. An assessment of implementation of Community-Oriented Primary Care in Kenyan family medicine postgraduate medical education programmes

    PubMed Central

    Shabani, Jacob; Taché, Stephanie; Mohamoud, Gulnaz; Mahoney, Megan

    2016-01-01

    Background and objectives Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC) curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya. Method Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC educators, practitioners and academic stakeholders in two family medicine postgraduate programmes in Kenya. Discussions were transcribed, inductively coded and thematically analysed. Results Two focus groups with eight family medicine postgraduate students and interviews with five faculty members at two universities were conducted. Two broad themes emerged from the analysis: expected learning outcomes and important community-based enablers. Three learning outcomes were (1) making a community diagnosis, (2) understanding social determinants of health and (3) training in participatory research. Three community-based enablers for sustainability of COPC were (1) partnerships with community health workers, (2) community empowerment and engagement and (3) institutional financial support. Conclusions Our findings illustrate the expected learning outcomes and important community-based enablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya. PMID:28155322

  13. Application of teledentistry in oral medicine in a community dental service, N. Ireland.

    PubMed

    Bradley, M; Black, P; Noble, S; Thompson, R; Lamey, P J

    2010-10-23

    Currently, patients with oral medicine conditions from all areas of Northern Ireland are referred by dentists and doctors to a small number of specialist services: predominantly, the Regional Oral Medicine Consultant at the School of Dentistry, Belfast. On receipt of the referral the consultant makes an assessment of the urgency of the case and the patient is placed on a waiting list. Until the recent implementation of waiting list initiatives (Elective Access Protocol, Department of Health, N. Ireland, 2006), patients remained on the waiting list for long periods of time. Analysis of these patient profiles highlights that many need both multiple treatment and review appointments of their chronic conditions, and consequently remain in the hospital system for significant periods of time. This increases the waiting time for these services. The idea of using teledentistry to triage referrals, and its potential as a tool to support locally based treatment, poses an alternative approach to the management of oral medicine referrals. It may be of particular interest to practitioners in rural locations where distance from the regional centre is significant. In 2005, to test this theory, a prototype teledentistry system was set up as part of a service improvement scheme by the Community Dental Service of the Homefirst Legacy Trust (now Northern Trust) in partnership with the Oral Medicine Department at the School of Dentistry, Royal Group of Hospitals Legacy Trust (now Belfast Trust). This paper describes the feasibility study.

  14. Rhizosphere and non-rhizosphere bacterial community composition of the wild medicinal plant Rumex patientia.

    PubMed

    Qi, Xiaojuan; Wang, Ensi; Xing, Ming; Zhao, Wei; Chen, Xia

    2012-05-01

    To investigate bacterial communities between rhizosphere and non-rhizosphere soils of the wild medicinal plant Rumex patientia of Jilin, China, small subunit rRNAs (16S rDNA) from soil metagenome were amplified by polymerase chain reaction using primers specific to the domain bacteria and analysed by cloning and sequencing. The relative proportion of bacterial communities in rhizosphere soils was similar to non-rhizosphere soils in five phylogenetic groups (Proteobacteria, Actinobacteria, Acidobacteria, Chloroflexi and Planctomycetes). But there were differences in five other phylogenetic groups (Firmicutes, Bacteroidetes, Gemmatimonadetes, Verrucomicrobia and Unclassified bacteria). Over 97.24 % of the sequenced clones were found to be unique to rhizosphere and non-rhizosphere soils, while 2.76 % were shared by both of them. Our results indicate that there are differences in the composition and proportion of bacterial communities between rhizosphere and non-rhizosphere soils. Furthermore, the unique bacterial clones between rhizosphere and non-rhizosphere soils of the wild medicinal plant R. patientia have obvious differences.

  15. Education for Community-based Family Medicine: A Social Need in the Real World

    PubMed Central

    Taniguchi, Shin-ichi; Park, Daeho; Inoue, Kazuoki; Hamada, Toshihiro

    2017-01-01

    One of the most critical social problems in Japan is the remarkable increase in the aging population. Elderly patients with a variety of complications and issues other than biomedical problems such as dementia and life support with nursing care have been also increasing. Ever since the Japanese economy started to decline after the economic bubble burst of 1991 and the Lehman Brothers bankruptcy in 2008, how we can resolve health problems of the elderly at a lower cost has become one of our most challenging social issues. On the other hand, the appropriate supply of medical and welfare resources is also a fundamental problem. The disparity of physician distribution leads to a marked lack of medical services especially in remote and rural areas of Japan. The government has been attempting to recruit physicians into rural areas through a regional quota system. Based on this background, the medical field pays a great amount of attention to community-based family medicine (CBFM). CBFM requires basic knowledge of community health and family medicine. The main people involved in CBFM are expected to be a new type of general practitioner that cares for residents in targeted communities. To improve the performance of CBFM doctors, we need to establish a better CBFM education system and assess it appropriately when needed. Here, we review the background of CBFM development and propose an effective education system. PMID:28701889

  16. Education for Community-based Family Medicine: A Social Need in the Real World.

    PubMed

    Taniguchi, Shin-Ichi; Park, Daeho; Inoue, Kazuoki; Hamada, Toshihiro

    2017-06-01

    One of the most critical social problems in Japan is the remarkable increase in the aging population. Elderly patients with a variety of complications and issues other than biomedical problems such as dementia and life support with nursing care have been also increasing. Ever since the Japanese economy started to decline after the economic bubble burst of 1991 and the Lehman Brothers bankruptcy in 2008, how we can resolve health problems of the elderly at a lower cost has become one of our most challenging social issues. On the other hand, the appropriate supply of medical and welfare resources is also a fundamental problem. The disparity of physician distribution leads to a marked lack of medical services especially in remote and rural areas of Japan. The government has been attempting to recruit physicians into rural areas through a regional quota system. Based on this background, the medical field pays a great amount of attention to community-based family medicine (CBFM). CBFM requires basic knowledge of community health and family medicine. The main people involved in CBFM are expected to be a new type of general practitioner that cares for residents in targeted communities. To improve the performance of CBFM doctors, we need to establish a better CBFM education system and assess it appropriately when needed. Here, we review the background of CBFM development and propose an effective education system.

  17. DEVELOPMENT OF A RURAL COMMUNITY HEALTH CARE MODEL BASED ON INDIAN INDIGENOUS SYSTEM OF MEDICINE

    PubMed Central

    Hyma, B.; Ramesh, A.; Subhadra, N.L.

    1988-01-01

    Based on the principles of primary health care as outlined by WHO at the Alma Ata Conference in 1978, many voluntary organizations in India have been formulating, organizing and experimenting with the comprehensive rural community health Schemes. The goal is to indentify the felt needs at both individual and community levels and facilitate direct participation in decision making, develop suitable alternative, ecologically Sound indigenous models for socioeconomic well-being. In this context the Indian system of medicine has a useful and complementary role to play in the preventive and curative aspects of primary health care programmes. With the above objectives in mind the investigators undertook a brief survey of a “comprehensive rural health” project. The primary aim of this project is to develop a community health care model using innovative alternative methods using Indian indigenous system of medicine and participatory research techniques to improve rural health services of the surrounding under privileged villages. Many gaps exist in the assessment, however, a birds eye-view is presented here. PMID:22557645

  18. Medicinal plants used by the Tamang community in the Makawanpur district of central Nepal

    PubMed Central

    2014-01-01

    Background We can conserve cultural heritage and gain extensive knowledge of plant species with pharmacological potential to cure simple to life-threatening diseases by studying the use of plants in indigenous communities. Therefore, it is important to conduct ethnobotanical studies in indigenous communities and to validate the reported uses of plants by comparing ethnobotanical studies with phytochemical and pharmacological studies. Materials and methods This study was conducted in a Tamang community dwelling in the Makawanpur district of central Nepal. We used semi-structured and structured questionnaires during interviews to collect information. We compared use reports with available phytochemical and pharmacological studies for validation. Results A total of 161 plant species belonging to 86 families and 144 genera to cure 89 human ailments were documented. Although 68 plant species were cited as medicinal in previous studies, 55 different uses described by the Tamang people were not found in any of the compared studies. Traditional uses for 60 plant species were consistent with pharmacological and phytochemical studies. Conclusions The Tamang people in Makawanpur are rich in ethnopharmacological understanding. The present study highlights important medicinal plant species by validating their traditional uses. Different plant species can improve local economies through proper harvesting, adequate management and development of modern techniques to maximize their use. PMID:24410808

  19. Teaching cultural competency through narrative medicine: intersections of classroom and community.

    PubMed

    DasGupta, Sayantani; Meyer, Dodi; Calero-Breckheimer, Ayxa; Costley, Alex W; Guillen, Sobeira

    2006-01-01

    Cultural competency and narrative medicine are perspectives that assist medical educators in teaching effective, empathetic communication and service delivery to a variety of patients. In this article, we describe a unique educational activity at the crossroads of these perspectives in which pediatric residents participated in a monthly reading and discussion group with staff members of an inner-city Dominican American community organization. By discussing a literary text rather than cases and facilitating discussions with particular attention to power, not only were historic conflicts between the groups circumvented, but an environment was created in which discussants drew heavily from personal and professional experiences. Qualitative evaluation of both groups revealed improved self-reported understanding of (a) issues of cultural diversity, (b) issues of medical culture, and (c) physicians' attitudes and behaviors in practice. Methodologies drawing from cultural competency and narrative medicine can be used to help physicians work in multidisciplinary, multicultural teams in and out of the medical institution.

  20. Medicinal plants used to treat the most frequent diseases encountered in Ambalabe rural community, Eastern Madagascar.

    PubMed

    Rakotoarivelo, Nivo H; Rakotoarivony, Fortunat; Ramarosandratana, Aro Vonjy; Jeannoda, Vololoniaina H; Kuhlman, Alyse R; Randrianasolo, Armand; Bussmann, Rainer W

    2015-09-15

    Traditional medicine remains the only health care available in many rural areas in Madagascar like the rural community of Ambalabe, located in a very remote area in the eastern part of the country. With limited access to modern medicine, the local population uses medicinal plants to treat most diseases. In this study, we aimed to inventory medicinal plants used by local people and how those relate to the treatment of the most frequent diseases encountered in Ambalabe. We interviewed participants in order to identify the most frequent diseases in the region and the medicinal plants used to treat them. The local physician was asked about the most frequent diseases, and ethnobotanical surveys to record medicinal plants and their uses, using semi-structured interviews and free listing, were conducted among 193 informants in local villages, of which 54 % were men and 46 % were women, ageing from 16 to 86 years. The local names, the uses of each plant species and the way they are prepared and administered were recorded and accompanied by herbarium specimens for identification. We also interviewed four traditional healers to elicit more details on the preparation and the use of plants. Our research allowed us to identify six most frequent diseases, namely diarrhea, malaria, stomach-ache, cough, bilharzia and dysentery. Among 209 plant species identified as having medicinal use, 83 species belonging to 49 families and 77 genera were used to treat these diseases. Our analyses highlighted the 11 commonly used species for their treatment, and also 16 species with a high fidelity level (FL ≥ 75 %) for each ailment. Diarrhea is one of the diseases with high number of species recorded. This study highlighted the closed relationship between people in Ambalabe and plant species, especially when faced with frequent diseases. However, most of the species used were collected in the surroundings of the villages. Few species were from Vohibe forest in which a management system on

  1. Community-based clinical education increases motivation of medical students to medicine of remote area: comparison between lecture and practice.

    PubMed

    Tani, Kenji; Yamaguchi, Harutaka; Tada, Saaya; Kondo, Saki; Tabata, Ryo; Yuasa, Shino; Kawaminami, Shingo; Nakanishi, Yoshinori; Ito, Jun; Shimizu, Nobuhiko; Obata, Fumiaki; Shin, Teruki; Bando, Hiroyasu; Kohno, Mitsuhiro

    2014-01-01

    In this study, we administered a questionnaire to medical students to evaluate the effect of community-based clinical education on their attitudes to community medicine and medicine in remote area. Questionnaires were given 4 times to all the students from first-year to sixth-year. Of 95 students, 65 students (68.4%) who completed all questionnaires, were used in this study. The intensity of students' attitudes was estimated by using visual analogue scale. The intensity of interest, a sense of fulfillment and passion in medicine of remote area was significantly increased after the community-based practice. On the other hand, the level of understanding in medicine in remote area was increased by the lecture not by the practice. The intensity of desire both to become a generalist and a specialist was significantly increased when the grade went up. Most of sixth-year students desired to have abilities of a generalist and a specialist simultaneously. This study shows that the community-based practice is more meaningful in increasing motivation in medicine in remote area than the lecture, and suggests that it is important to prepare more courses to experience community medicine to increase the number of physicians who desire to work in remote area.

  2. Implementing Community Engagement as a Mission at the David Geffen School of Medicine at the University of California, Los Angeles.

    PubMed

    Chung, Bowen; Brown, Arleen; Moreno, Gerardo; Cuen, Pattie; Uy, Visith; Vangala, Sitaram; Bell, Douglas; Washington, A Eugene; Norris, Keith C; Mangione, Carol

    2016-02-01

    This manuscript describes the development and implementation of community engagement as a mission at UCLA's David Geffen School of Medicine (DGSOM) and UCLA Health System, and summarizes survey results documenting existing community-engaged projects and interest between 2010 to 2013.

  3. Implementing Community Engagement as a Mission at the David Geffen School of Medicine at the University of California, Los Angeles

    PubMed Central

    Chung, Bowen; Brown, Arleen; Moreno, Gerardo; Cuen, Pattie; Uy, Visith; Vangala, Sitaram; Bell, Douglas; Washington, A. Eugene; Norris, Keith C.; Mangione, Carol

    2015-01-01

    Summary This manuscript describes the development and implementation of community engagement as a mission at UCLA’s David Geffen School of Medicine (DGSOM) and UCLA Health System, and summarizes survey results documenting existing community-engaged projects and interest between 2010 to 2013. PMID:27158216

  4. Do community medicine residency trainees learn through journal club? An experience from a developing country.

    PubMed

    Akhund, Saima; Kadir, Muhammad Masood

    2006-08-22

    Journal clubs are an internationally recognized teaching tool in many postgraduate medical education fields. In developing countries lack of funds for current print materials may have limited journal club use. But with advancing information technology trainees in developing countries increasingly have more access to high quality journals online. However, we are aware of no studies describing journal club existence and effectiveness in postgraduate medical training in Pakistan. Also we have found no published effectiveness studies of this teaching modality in Community Medicine (Public Health) in any country. This study evaluated the effectiveness of Community Medicine (Public Health) Resident Journal Club (CMR-JC) in Aga Khan University, Pakistan using international criteria for successful journal clubs (2 years continuous existence and more than 50% attendance) and examining resident and alumni satisfaction. Journal club effectiveness criteria were searched using electronic search databases. Departmental records were reviewed from September 1999-September 2005. Ninety percent of residents and alumni of Community Medicine Residency Programme participated voluntarily in a confidential survey. The CMR-JC was regularly conducted. More than 95% of residents attended. (Total residents in the CMR-Programme: 32). Twenty-seven out of 29 current residents/alumni responded to the anonymous questionnaire. Acquisition of critical appraisal skills (23 respondents) and keeping up with current literature (18 respondents) were the two most important objectives achieved. Respondents recommended improved faculty participation and incorporating a structured checklist for article review. CMR-JC fulfils criteria for effective journal clubs. Residents and alumni agree CMR-JC meets its objectives. Incorporating suggested recommendations will further improve standards. The journal club learning modality should be included in residency training programs in developing countries. Effective

  5. Understanding Community-Based Rehabilitation and the role of physical and rehabilitation medicine: a discussion paper.

    PubMed

    Seijas, Vanessa; Lugo, Luz H; Cano, Blanca; Escobar, Luz M; Quintero, Carlos; Nugraha, Boya; Gutenbrunner, Christoph

    2016-12-19

    Community Based Rehabilitation (CBR) is an accepted model to improve the delivery of rehabilitation in the community. It includes the access to health care, education, labor and accessible environments. The role of Specialists in Physical and Rehabilitation Medicine in this strategy (SPRM) is not very well defined. On the occasion of the international consultation for the WHO Action Plan for persons with disabilities, a discussion about the meaning of CBR and the role of SPRM on CBR has occurred among the International Society of Physical and Rehabilitation medicine (ISPRM) members. The following major questions were identified; what is CBR? What is the role of Specialists in Physical and Rehabilitation Medicine (SPMR) in CBR? A review of the literature and a discussion among experts was held to answer these questions. It is of major importance to distinguish between the two concepts of CBR: The first one is the policy or management strategy of CBR that was developed by WHO about 30 years ago. The second one is the provision of basic rehabilitation services offered at the community level. CBR strategy must also addresses the need for optimal access to specialized rehabilitation services and will have a key role in the design and building of so-called "Basic Rehabilitation Services". The authors proposed a scheme, which integrates all relevant aspects surrounding the concept of CBR; levels of care rehabilitation services and the roles proposed for SPRM. In addition, the convention for the rights of persons with disabilities and the conceptual framework of the ICF was taken into account.

  6. Do community medicine residency trainees learn through journal club? An experience from a developing country

    PubMed Central

    Akhund, Saima; Kadir, Muhammad Masood

    2006-01-01

    Background Journal clubs are an internationally recognized teaching tool in many postgraduate medical education fields. In developing countries lack of funds for current print materials may have limited journal club use. But with advancing information technology trainees in developing countries increasingly have more access to high quality journals online. However, we are aware of no studies describing journal club existence and effectiveness in postgraduate medical training in Pakistan. Also we have found no published effectiveness studies of this teaching modality in Community Medicine (Public Health) in any country. This study evaluated the effectiveness of Community Medicine (Public Health) Resident Journal Club (CMR-JC) in Aga Khan University, Pakistan using international criteria for successful journal clubs (2 years continuous existence and more than 50% attendance) and examining resident and alumni satisfaction. Methods Journal club effectiveness criteria were searched using electronic search databases. Departmental records were reviewed from September1999–September 2005. Ninety percent of residents and alumni of Community Medicine Residency Programme participated voluntarily in a confidential survey. Results The CMR-JC was regularly conducted. More than 95% of residents attended. (Total residents in the CMR-Programme: 32). Twenty-seven out of 29 current residents/alumni responded to the anonymous questionnaire. Acquisition of critical appraisal skills (23 respondents) and keeping up with current literature (18 respondents) were the two most important objectives achieved. Respondents recommended improved faculty participation and incorporating a structured checklist for article review. Conclusion CMR-JC fulfils criteria for effective journal clubs. Residents and alumni agree CMR-JC meets its objectives. Incorporating suggested recommendations will further improve standards. The journal club learning modality should be included in residency training

  7. [Marketing of medicinal products in the European Community. The Mutual Recognition and Decentralised Procedures].

    PubMed

    Bachmann, Peter

    2008-07-01

    The Mutual Recognition Procedure (MRP) and the Decentralised Procedure (DCP), which were first established in late 2005, can be regarded as the backbone for marketing authorisation of medicinal products in the European Community (EC) and the European Economic Area (EEA). Both procedures are compared and advantages and disadvantages are discussed. However, the focus is more related to current developments than the detailed comparison of both procedures. The role of the Coordination Group for Mutual Recognition and Decentralised Procedures-Human (CMD(h)) and the decision making process in relation to the MRP and DCP is also discussed.

  8. Environmental and occupational medicine and injury prevention: education and impact, classroom and community.

    PubMed

    Richter, Elihu D; Berman, Tamar

    2002-01-01

    The core value guiding the work of physicians and health workers, including those in Environmental and Occupational Epidemiology and Medicine and Injury Prevention, is to protect the health of the public, especially its most vulnerable individuals. In these fields, we emphasize teaching the use of epidemiology, the core discipline of public health, as a tool for early detection and prevention of disease and injury, as well as an instrument for hypothesis testing. The classic core topics are toxic and physical exposures and their effects, and strategies for their prevention; emerging issues are child labor, mass violence, and democide. In environmental health, students need to be prepared for the reality that the most important and severe problems are often the most difficult to investigate, solve, and evaluate. The following are some recommendations for producing graduates who are effective in protecting communities from environmental hazards and risks: (1) Teach the precautionary principle and its application; (2) Evaluate programs for teaching environmental and occupational health, medicine and epidemiology in schools of public health by their impact on the WHO health indicators and their impact on measures of ecosystem sustainability; (3) Develop problem-oriented projects and give academic credit for projects with definable public health impact and redefine the role of the health officer as the chief resident for Schools of Public Health and Community Medicine; (4) Teach the abuses of child labor and working conditions of women in the workplace and how to prevent the hazards and risks from the more common types of child work; (5) Upgrade teaching of injury prevention and prevention of deaths from external causes; (6) Teach students to recognize the insensitivity of epidemiology as a tool for early detection of true risk; (7) Teach the importance of context in the use of tests of statistical significance; (8) Teach the epidemiologic importance of short latency

  9. Antiprotozoal activity of medicinal plants used by Iquitos-Nauta road communities in Loreto (Peru).

    PubMed

    Vásquez-Ocmín, Pedro; Cojean, Sandrine; Rengifo, Elsa; Suyyagh-Albouz, Soulaf; Amasifuen Guerra, Carlos A; Pomel, Sébastien; Cabanillas, Billy; Mejía, Kember; Loiseau, Philippe M; Figadère, Bruno; Maciuk, Alexandre

    2017-09-05

    In the Peruvian Amazon, the use of medicinal plants is a common practice. However, there is few documented information about the practical aspects of their use and few scientific validation. The starting point for this work was a set of interviews of people living in rural communities from the Peruvian Amazon about their uses of plants. Protozoan diseases are a public health issue in the Amazonian communities, who partly cope with it by using traditional remedies. Validation of these traditional practices contributes to public health care efficiency and may help identify new antiprotozoal compounds. to inventory and validate the use of medicinal plants by rural people of Loreto region. Rural mestizos were interviewed about traditional medication of parasite infections with medicinal plants. Ethnopharmacological surveys were undertaken in two villages along Iquitos-Nauta road (Loreto region, Peru), namely 13 de Febrero and El Dorado communities. Forty-six plants were collected according to their traditional use for the treatment of parasitic diseases, 50 ethanolic extracts (different parts for some of the plants) were tested in vitro on Plasmodium falciparum (3D7 sensitive strain and W2 chloroquine resistant strain), Leishmania donovani LV9 strain and Trypanosoma brucei gambiense. Cytotoxic assessment (HUVEC cells) of the active extracts was performed. Two of the most active plants were submitted to preliminary bioguided fractionation to ascertain and explore their activities. From the initial plants list, 10 were found to be active on P. falciparum, 15 on L. donovani and 2 on the three parasites. The ethanolic extract from Costus curvibracteatus (Costaceae) leaves and Grias neuberthii (Lecythidaceae) bark showed strong in vitro activity on P. falciparum (sensitive and resistant strain) and L. donovani and moderate activity on T. brucei gambiense. The Amazonian forest communities in Peru represents a source of knowledge on the use of medicinal plants. In this work

  10. An assessment of implementation of CommunityOriented Primary Care in Kenyan family medicine postgraduate medical education programmes.

    PubMed

    Nelligan, Ian J; Shabani, Jacob; Taché, Stephanie; Mohamoud, Gulnaz; Mahoney, Megan

    2016-12-02

    Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC) curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya. Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC educators, practitioners and academic stakeholders in two family medicine postgraduate programmes in Kenya. Discussions were transcribed, inductively coded and thematically analysed. Two focus groups with eight family medicine postgraduate students and interviews with five faculty members at two universities were conducted. Two broad themes emerged from the analysis: expected learning outcomes and important community-based enablers. Three learning outcomes were (1) making a community diagnosis, (2) understanding social determinants of health and (3) training in participatory research. Three community-based enablers for sustainability of COPC were (1) partnerships with community health workers, (2) community empowerment and engagement and (3) institutional financial support. Our findings illustrate the expected learning outcomes and important communitybased enablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya.

  11. Improving community access to terminal phase medicines in Australia: identification of the key considerations for the implementation of a ?core medicines list.

    PubMed

    Tait, Paul A; Cheung, Weng Hou; Wiese, Michael; Staff, Kirsten

    2017-05-11

    During the terminal phase, access to medicines is critical for people wishing to spend their last days of life at home. Yet, access to medicines can be problematic. The aim of this study was to report the perspectives of specialist and generalist health professionals (HPs) on the issues of community access to medicines for this vulnerable group. A qualitative descriptive study design investigated the views of HPs working in palliative care roles in South Australia. Nurses, doctors and pharmacists described their experiences of accessing medicines for management of terminal phase symptoms during semi-structured focus group discussions. Content analysis identified six themes including: 'Medication Supply', 'Education and Training', 'Caregiver Burden', 'Safety', 'Funding' and 'Clinical Governance'. Future projects should aim to address these themes when developing strategies for the management of people wishing to die at home.

  12. 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

    2014-09-02

    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.

  13. Roles of Medicines Counter Assistants in advice giving in community pharmacies: a Discourse Analysis.

    PubMed

    Ylänne, Virpi; John, Dai N

    2008-04-01

    Research in interaction and communication in community pharmacies has been reported in a number of countries but to date, talk at the micro-level in the community pharmacy context in the UK has received virtually no study. The objective of this exploratory study was to identify what light a Discourse Analytic approach could shed to describe the role(s) of Medicines Counter Assistants (MCAs) when dealing with clients relating to health, illness or medicines. Discourse Analysis is a growing field of study which has its roots in linguistics, but also in critical theory, philosophy, sociology, psychology and more. It is used in various ways by social scientists studying spoken and written language in use. Following research ethics approval and informed consent from participants, audio-recordings of staff-client interactions in three community pharmacies in Wales, UK were transcribed and analysed from a Discourse Analytic perspective, focussing on the emerging role of the MCA in the negotiation of advice. Main outcome measure Transcripts of interactions in community pharmacies analysed using Discourse Analysis. Ten hours of recordings were made. Of the 41 recorded interactions obtained, 29 involved an MCA regarding health and/or medicines. Example extracts represent different ways in which MCAs are involved in the interactions, ranging from dealing solely with the client, to the MCA dealing with the client but checking advice with the pharmacist, the MCA acting as a gatekeeper, the pharmacist intervening in the MCA-client interaction, the MCA keeping the client 'on hold' until the pharmacist is ready to interact with them and the MCA acting as an active intermediary. With the differing involvement, slightly different institutional and participant roles emerge for the MCAs through talk and interaction. This exploratory study succeeded in producing transcripts of interactions between MCAs, and clients and indicated that Discourse Analysis is helpful in assisting our

  14. Rural Australian community pharmacists' views on complementary and alternative medicine: a pilot study

    PubMed Central

    2011-01-01

    Background Complementary and alternative medicines (CAMs) are being used increasingly across the world. In Australia, community pharmacists are a major supplier of these products but knowledge of the products and interactions with other medicines is poor. Information regarding the use of CAMs by metropolitan pharmacists has been documented by the National Prescribing Service (NPS) in Australia but the views of rural/regional community pharmacists have not been explored. The aim of this pilot study was to explore the knowledge, attitudes and information seeking of a cohort of rural community pharmacists towards CAMs and to compare the findings to the larger NPS study. Methods A cross sectional self-administered postal questionnaire was mailed to all community pharmacists in one rural/regional area of Australia. Using a range of scales, data was collected regarding attitudes, knowledge, information seeking behaviour and demographics. Results Eighty eligible questionnaires were returned. Most pharmacists reported knowing that they should regularly ask consumers if they are using CAMs but many lacked the confidence to do so. Pharmacists surveyed for this study were more knowledgeable in regards to side effects and interactions of CAMs than those in the NPS survey. Over three quarters of pharmacists surveyed reported sourcing CAM information at least several times a month. The most frequently sought information was drug interactions, dose, contraindications and adverse effects. A variety of resources were used to source information, the most popular source was the internet but the most useful resource was CAM text books. Conclusions Pharmacists have varied opinions on the use of CAMs and many lack awareness of or access to good quality CAMs information. Therefore, there is a need to provide pharmacists with opportunities for further education. The data is valuable in assisting interested stakeholders with the development of initiatives to address the gaps in attitudes

  15. Family medicine residency training in community health centers: a national survey.

    PubMed

    Morris, Carl G; Lesko, Sarah E; Andrilla, Holly A; Chen, Frederick M

    2010-10-01

    For more than 25 years, family medicine residencies (FMRs) have worked with community health centers (CHCs) to train family physicians. In light of the long history and current policy focus on this training model, the authors sought to evaluate comprehensively the scope and extent of family physician training occurring in CHCs. The authors conducted a cross-sectional survey of 439 U.S. FMR directors in 2007. FMR directors were asked to provide information regarding the number, type, location, and length of any CHC training affiliations and to rate their satisfaction with such affiliations. Of 354 respondents (80% response rate), 83 FMRs (23.4%) provided some type of CHC training experience; 32 (9%) had their main residency continuity training site in a CHC. Respondents reported that 10.5% (788) of family medicine residents were trained in a CHC continuity clinic. The average length of affiliation was 10.2 years. Residency directors reported high satisfaction with CHC training affiliations. Almost one-quarter of FMRs in 2007 provided some training in CHCs. However, the proportion of residencies providing continuity training in CHCs--the type of training associated with enhanced recruitment and retention of family medicine graduates in underserved areas--was limited and relatively unchanged since 1992.

  16. Community pharmacists' experience of over-the-counter medicine misuse in Scotland.

    PubMed

    MacFadyen, L; Eadie, D; McGowan, T

    2001-09-01

    Over the last decade Britain has observed a trend towards the re-regulation of 'prescription only medicines' in favour of pharmacy status drugs. This move towards self-treatment to reduce pressures on general practitioner drug budgets and workloads has focused attention on the need for community pharmacists to extend their patient education and screening roles. In response to these changes, this study was conducted to explore: the type of over-the-counter (OTC) medicine being misused in Scotland; pharmacists' professional attitudes and management of OTC misuse; and the training and support needs of pharmacists. A postal questionnaire was designed. This was informed by an earlier stage of qualitative research and the available literature. It was then piloted and administered to all 110 pharmacies in the study area. A 79% response rate was achieved. The research found that OTC misuse, particularly of certain analgesics, sleeping prescriptions, products containing codeine or pseudoephedrine, caffeine, cough mixtures, and laxatives was common. The estimated mean number of patients suspected of misusing medicines in a typical week was 5.63. Pharmacies in urban areas were more likely than those in rural areas to report suspected misuse. The research identified a number of intervention strategies relating to: patient/pharmacist interaction; information provision; removal of products from the point of sale; sharing of information with other local pharmacists; and referral to other members of the primary care team. Pharmacists expressed a need for support in managing OTC misuse and in organising 'early warning systems' to share information locally.

  17. Scientific validation of medicinal plants used by Yakkha community of Chanuwa VDC, Dhankuta, Nepal.

    PubMed

    Subba, Bimala; Srivastav, Chitranjan; Kandel, Ram Chandra

    2016-01-01

    Ethnobotanical knowledge is important among tribal people, but much of the information is empirical due to the lack of scientific validation. The purpose of this study was to document the medicinal plants used by an ethnic group (Yakkha) at Chanuwa VDC of Dhankuta district in Nepal and to validate scientifically in the use of plants based on results of phytochemical, antimicrobial and antioxidant property analyses and available literature reports. Data were collected through interviews of the Yakkha people with the help of a semi-structured questionnaire and the guided field walk method. A total of 30 different medicinal plants were recorded along with their vernacular names (for few plants) used by the Yakkha community's people. Literature review reveals that most of the plant species described herein have also been used in other countries, too. Among 30 plants selected for this study methanol extract of five ethno-medicinal plants viz., Dendrocnide sinuata, Solanum anguivi, Pogostemon cablin, Boehmeria platyphylla and Clerodendrum trichotomum and ethanol extract of C. trichotomum were subjected for antibacterial and antioxidant properties. The antimicrobial activities were measured using the paper disc diffusion method. The antioxidant properties of plants were measured by DPPH and FRAP reduction assay. Among all extracts, ethanol extract of C. trichotomum and methanol extract of B. platyphylla displayed the highest antibacterial and antioxidant activities, respectively.

  18. Provision of travel medicine advice through community pharmacies: assessment of knowledge, attitudes and practices of pharmacists in Malaysia.

    PubMed

    Taha, Nur Akmar; See, Yee Lian

    2016-10-01

    The risk for travel-related illnesses has increased with significant growth in international travel, but very few travellers seek travel advice. Community pharmacists can play a vital role in the provision of travel medicine advice due to their accessibility. This study aimed to assess travel medicine knowledge, attitudes and practices (KAP) among community pharmacists in Kuala Lumpur, Malaysia. A self-administered KAP questionnaire was distributed to a convenience sample of pharmacists in Kuala Lumpur identified from the list of licensed community pharmacists in Malaysia year 2014. Questionnaires were returned by 111 pharmacists of 143 distributed (response rate, 78%). Most of the respondents (82%) were not trained in travel medicine. Overall, mean knowledge score was 4.4 ( ± 1.7), indicating a moderate level of knowledge on a variety of travel-related health issues. Community pharmacists who graduated from foreign universities possessed significantly higher knowledge scores than did those who graduated locally (P < 0.05). The majority had a positive attitude towards travel medicine. A vast majority provided travel medicine advice mainly to adults who travel as tourists, and the primary travel advice given was on traveller's diarrhoea. There are gaps in the knowledge and practice of travel medicine among Malaysian pharmacists. Positive attitudes of pharmacists towards travel medicine and appropriate interventions, such as incorporation of travel medicine in local pharmacy curricula, continuous pharmacy education or certified training may improve the quality of travel advice given and allow pharmacists to be recognised as a credible source of information on travel medicine. © 2016 Royal Pharmaceutical Society.

  19. Availability and needs of herbal medicinal information resources at community pharmacy, Riyadh region, Saudi Arabia

    PubMed Central

    Al-Arifi, Mohamed N.

    2013-01-01

    A cross-sectional survey of community pharmacists in Riyadh region, Saudi Arabia was conducted over a period of 6 months from July through December 2011. Data collection was carried out using a structured self-administered questionnaire. The survey questionnaire consisted of a brief introduction to the study and eleven questions. The questions consisted of close ended, multiple-choice, and fill-in short answers. A stratified random sample of one thousand and seven hundred registered pharmacy practitioners all over Saudi Arabia were randomly chosen to respond to the survey. The data from each of the returned questionnaire were coded and entered into Statistical Package for the Social Sciences (SPSS) version 19 software (SPSS Inc., Chicago, IL, USA) which was used for statistical analysis. Only one thousand four hundred one pharmacists responded to the survey (response rate is 82.4%) with a completely answered questionnaire. The study results show that 59.7% of the participants sometimes discuss herbal medicine use with their patients, while only 4.25% never discuss it. The study shows 48.5% of participated pharmacists record herbal medicine use sometimes where only 9.4% of them never did so. However, with regard to initiation of the discussion, the study shows that 44.3% of the respondents reported that patients initiate herbal issue discussion while 20.8% reported that pharmacists initiate the discussion. This discussion was reported to be a one time discussion or an ongoing discussion by 14.3% or 9.9% of the respondents respectively. According to the study results, respondents reported that the most common barriers that limit discussing herbal medicines’ use with their patients were lack of time due to other obligations assigned to the community pharmacist (46%), lack of reliable resources (30.3%), lack of scientific evidence that support herbal medicine use (15.2%), or lack of knowledge of herbal medicines (13.4%). Yet, a small number of respondents was

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

    PubMed

    Stevens, Brenda J; Gruen, Margaret E

    2014-01-01

    Shelter medicine is a rapidly developing field of great importance, and shelters themselves provide abundant training opportunities for veterinary medical students. Students trained in shelter medicine have opportunities to practice zoonotic and species-specific infectious disease control, behavioral evaluation and management, primary care, animal welfare, ethics, and public policy issues. A range of sheltering systems now exists, from brick-and-mortar facilities to networks of foster homes with no centralized facility. Exposure to a single shelter setting may not allow students to understand the full range of sheltering systems that exist; a community-classroom approach introduces students to a diverse array of sheltering systems while providing practical experience. This article presents the details and results of a series of 2-week elective clinical rotations with a focus on field and service learning in animal shelters. The overall aim was to provide opportunities that familiarized students with sheltering systems and delivered primary-care training. Other priorities included increasing awareness of public health concerns and equipping students to evaluate shelters on design, operating protocols, infectious disease control, animal enrichment, and community outreach. Students were required to participate in rounds and complete a project that addressed a need recognized by them during the rotation. This article includes costs associated with the rotation, a blueprint for how the rotation was carried out at our institution, and details of shelters visited and animals treated, including a breakdown of treatments provided. Also discussed are the student projects and student feedback on this valuable clinical experience.

  1. [Starting points for the Italian actualization derived from the experience of community medicine in developing countries].

    PubMed

    Fara, G M; Tarsitani, G

    1989-01-01

    The Authors have studied the salient features of Community Medicine from three different aspects: 1) the theory of primary health care, as defined by the WHO, as a fundamental element in Community Medicine; 2) the characteristics it assumes in health planning in developing countries, where it is designed to meet the special local requirements; 3) the situation in Italy, where local medical care is regarded as a favoured sphere for projects, but where different planning and policies are required. From this study we have selected a number of ideas gathered during our experience in developing countries, which are suitable for adoption in Italy: the setting up of health care systems on global, capillary and participatory lines, aimed jointly at prevention, diagnosis and therapy: the use of scientific methodologies which are both thorough and accurate, and which are available for user countries; adequate personnel training; coordination between medical care and the working world; all this with the aim of enabling each and every individual to lead a socially and economically productive life, by ensuring the greatest possible physical and mental well being.

  2. Ethnopharmacological survey on medicinal plants used in herbal drinks among the traditional communities of Pakistan.

    PubMed

    Ahmad, Mushtaq; Khan, Muhammad Pukhtoon Zada; Mukhtar, Anam; Zafar, Muhammad; Sultana, Shazia; Jahan, Sarwat

    2016-05-26

    There is very limited information regarding medicinal plants used by traditional healers in Pakistan, for treating wide-ranging diseases. Current study provides significant ethnopharmacological information, both qualitative and quantitative on medical plants in Pakistan and the pharmacological importance of herbal drinks, especially in the discovery of new drugs. The current ethnomedicinal field study was conducted from various traditional communities of Pakistan to document usage of medicinal plants as herbal drinks. Data was collected through field interviews from local people and using semi-structured questionnaires. Data was analyzed using quantitative indices such as UV (use value), RFC (Relative frequency of citation), and FL (Fidelity level). The present study recorded 217 plant species belonging to 174 genera and 69 families used in herbal drinks preparations. Major herbal preparations include decoctions, infusions and juice. According to use reports, significant species were Aloe vera, Artemisia fragrans, Allium cepa, Senegalia catechu, Alternanthera sessilis, Malva ludwigii, Arnebia benthamii, Cichorium intybus, Coccinia grandis, Dalbergia sissoo. Major ailment treated with herbal drinks include heartburn, fever, diarrhea, hypertension, and others. Use value (UV) varies from 0.23 to 0.02, with Mentha arvensis (0.23) having the highest value of UV followed by Mentha longifolia (0.22), Plantago lanceolate (0.19), Achillea millefolium (0.18), Coriandrum sativum (0.18), Justicia adhatoda and Malva sylvestris (0.17). Values of RFC varies from 0.28 to 0.09 while Fidelity level (FL) among plants varies from 37.5 to 100. Alternanthera sessilis, Oxytropis lapponica, Millettia pinnata and Salvia bucharica had the highest FL value (100). The use of medicinal plants is prevalent in traditional communities of Pakistan. Different herbal preparations are in common practice including various herbal drinks a common tradition and much favoured herbal preparation in terms

  3. Objective Evaluation of Otoscopy Skills Among Family and Community Medicine, Pediatric, and Otolaryngology Residents.

    PubMed

    Oyewumi, Modupe; Brandt, Michael G; Carrillo, Brian; Atkinson, Adelle; Iglar, Karl; Forte, Vito; Campisi, Paolo

    2016-01-01

    The objective of this study is to evaluate and compare the perceived need for otolaryngology training and otoscopy diagnostic skills in primary care (Family and Community Medicine, Pediatric Medicine), and Otolaryngology Head and Neck Surgery (OTO-HNS) postgraduate trainees. Participant otoscopy skills were evaluated using the OtoSim simulator. Family and Community Medicine, Pediatric, and OTO-HNS residents were recruited. Each resident participated in 3 separate otoscopy training and assessment sessions. The ability to correctly identify middle ear pathology was objectively evaluated using OtoSim™. Pretest, posttest, and 3-month retention test results were compared among residents in a paired comparison paradigm. Survey data assessing exposure to OTO-HNS during undergraduate and postgraduate training were also collected. A total of 57 residents participated in the study. All residents reported limited exposure to OTO-HNS during undergraduate medical training. Primary care trainees performed poorly on pretest assessments (30% ± 7.8%; 95% CI). Significant improvement in diagnostic accuracy was demonstrated following a single 1-hour teaching session (30%-62%; p < 0.001). Primary care residents demonstrated a significant decrease in diagnostic accuracy at a 3-month follow-up assessment (62%-52%, p < 0.001). Self-perceived comfort with otology was poorly correlated to pretest performance among primary care trainees (r = 0.26) and showed a stronger positive correlation among OTO-HNS trainees (r = 0.56). A single teaching session with an otoscopy simulator significantly improved diagnostic accuracy in primary care and OTO-HNS trainees. Improved performance is susceptible to deterioration at 3 months if acquired skills are not frequently used. Self-perceived comfort with otology may not be an accurate predictor of otoscopic diagnostic skill. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. [A model of occupational, environmental and community medicine. History and evolution of the Hospital Unit of Occupational Medicine (UOOML) in Lombardia].

    PubMed

    Cirla, A M; Feltrin, G

    1998-01-01

    The authors describe the historical evolution of the prevention in Lombardia, and the role of the Hospital Units for Occupational Medicine, not only on the clinical oriented fields, but also on the areas of formation and training. Hospital Units for Occupational Medicine are today the best synthesis of "occupational-environmental-community health". There development is based on adequate standards of human and instrumental resources, as so as a real financial budget. At last, it's important that these Units are allocated in a so-called "bipolar department", open to the hospital and also open to the territorial structures for prevention and safety (department of occupational health).

  5. Building learning communities: evolution of the colleges at Vanderbilt University School of Medicine.

    PubMed

    Fleming, Amy; Cutrer, William; Moutsios, Sandi; Heavrin, Benjamin; Pilla, Michael; Eichbaum, Quentin; Rodgers, Scott

    2013-09-01

    Learning communities, which are an emerging trend in medical education, create a foundation for professional and academic development through the establishment of longitudinal relationships between students and faculty. In this article, the authors describe the robust learning community system at Vanderbilt University School of Medicine, which encompasses wellness, career planning, professional development, and academics.The Vanderbilt Advisory Colleges Program introduced in 2006 initially focused on two goals: promoting wellness and providing career advising. In the 2011-2012 academic year, the focus of the colleges expanded to incorporate an enhanced level of personal career advising and an academic component. In the four-year College Colloquium course, faculty selected as college mentors teach the medical humanities and lead sessions dedicated to student professional development in the areas of leadership, research, and service-learning. This academic and professional development program builds on the existing strengths of the colleges and has transformed the colleges into learning communities.The authors reflect on lessons learned and discuss future plans. They report that internal data and data from the Association of American Medical Colleges Medical School Graduation Questionnaire support consistently high and increasing satisfaction among Vanderbilt medical students, across the metrics of personal counseling, faculty mentoring, and career planning.

  6. A Survey of Staff Perceptions of an Emergency Medicine Pharmacist Program in a Community Hospital: A Brief Report.

    PubMed

    Splawski, Jennifer; Horner, Deanna; Tao, Kevin

    2017-03-01

    For an emergency medicine pharmacist to become a well-integrated multidisciplinary team member, his or her services need to be accepted by the emergency department (ED) staff. There have been 2 published studies attesting the value of the emergency medicine pharmacist by ED staff: at an academic medical and trauma center in 2007 and a large academic medical center in 2011. The aim of this study is to determine whether the emergency medicine pharmacist's value, as perceived by ED staff, would be similarly accepted at a smaller community hospital with limited clinical pharmacist services. This prospective, descriptive survey examined the perceptions of ED providers and nurses in regard to the emergency medicine pharmacist at a 26-bed Level II trauma center with 65,135 annual visits. Of the 90 participants polled, 50% (45) responded. Overall, the ED staff's perceptions of an emergency medicine pharmacist were positive. Eighty-six percent of all participants surveyed had consulted the emergency medicine pharmacist at least once in their last 5 shifts. Thirty-one percent answered that being available for consultation was the most important aspect of the emergency medicine pharmacist's role, whereas attending codes (22%) and patient education (20%) were the next most important activities. Providers consulted with the emergency medicine pharmacist most for antibiotic stewardship (including guided empiric therapy and culture callbacks) drug-drug and drug-disease state interactions, and dosing of pediatric medications. Nurses referred to the emergency medicine pharmacist most for compatibility consultations, medication retrieval, and high-risk medication verification. As was previously found in academic settings, an emergency medicine pharmacist is an invaluable addition to the health care team and can be incorporated into an existing pharmacy staffing model at a small, community hospital. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc

  7. Complementary and alternative medicine in the management of hypertension in an urban Nigerian community

    PubMed Central

    2010-01-01

    Background Hypertension is a common non communicable condition worldwide. In developing countries (including Nigeria), the use of complementary and alternative medicine (CAM) is common. This study investigated the frequency and factors associated with use of CAM among hypertensive subjects in an urban Nigerian community. Perspectives about the management of hypertension were obtained from CAM practitioners in the community. Methods Four hundred and forty hypertensive subjects in Idikan community, Ibadan, were interviewed using a semi-structured survey instrument. Association between categorical variables was tested using the chi-square test. Logistic regression analysis was done to identify independent predictor variables of CAM use, with CAM use as the outcome variable and the demographic and belief items as predictor variables. In-depth interviews were conducted with all known CAM practitioners in the community on issues relating to their beliefs, knowledge, practice and experiences in managing patients with hypertension in the community. Results In the study sample, 29% used CAM in the management of their hypertension. Among those using CAM, the most common forms used were herbs (63%) and garlic (21%). Logistic regression analysis revealed that four variables were independent predictors of CAM use: being male (OR 2.58, p < 0.0001), belief in supernatural causes of hypertension (OR 2.11, p = 0.012), lack of belief that hypertension is preventable (OR 0.57, p = 0.014) and having a family history of hypertension (OR1.78, p = 0.042). Other factors such as age, educational level and occupation were not independent predictors of CAM use. Interviews with CAM practitioners revealed that they believed hypertension was caused by evil forces, stress or "too much blood in the body". They also thought they could cure hypertension but that reduced costs (compared to hospitals) was one of the reasons most of their clients consult them. Conclusions The use of CAM is common

  8. Professional status in a changing world: The case of medicines use reviews in English community pharmacy.

    PubMed

    McDonald, Ruth; Cheraghi-Sohi, Sudeh; Sanders, Caroline; Ashcroft, Darren

    2010-08-01

    The health professions are engaged in an ongoing and dynamic process involving reflection and adaptation, with factors such as socio-economic and cultural developments and technological innovations compelling professions to respond to changed circumstances. This paper concerns English community pharmacy, where recent reforms provide financial incentives to deliver interventions, which have the potential for pharmacists to promote their knowledge and skills, as part of a professionalising strategy. The paper, drawing on interviews with 49 pharmacists, describes how responses to reforms are not necessarily in accordance with either national policy goals or enhancement of professional status. Debates about professional status and role extension have often focused on health professions' subordination to medicine. This paper highlights the importance and interplay of other factors which help explain the inability to capitalise fully on the potential contribution to professional status, which reforms to extend professional roles afford.

  9. Factors that contribute to social media influence within an Internal Medicine Twitter learning community.

    PubMed

    Desai, Tejas; Patwardhan, Manish; Coore, Hunter

    2014-01-01

    Medical societies, faculty, and trainees use Twitter to learn from and educate other social media users. These social media communities bring together individuals with various levels of experience. It is not known if experienced individuals are also the most influential members. We hypothesize that participants with the greatest experience would be the most influential members of a Twitter community. We analyzed the 2013 Association of Program Directors in Internal Medicine Twitter community. We measured the number of tweets authored by each participant and the number of amplified tweets (re-tweets). We developed a multivariate linear regression model to identify any relationship to social media influence, measured by the PageRank. Faculty (from academic institutions) comprised 19% of the 132 participants in the learning community (p < 0.0001). Faculty authored 49% of all 867 tweets (p < 0.0001). Their tweets were the most likely to be amplified (52%, p < 0.01). Faculty had the greatest influence amongst all participants (mean 1.99, p < 0.0001). Being a faculty member had no predictive effect on influence (β = 0.068, p = 0.6). The only factors that predicted influence (higher PageRank) were the number of tweets authored (p < 0.0001) and number of tweets amplified (p < 0.0001) The status of "faculty member" did not confer a greater influence. Any participant who was able to author the greatest number of tweets or have more of his/her tweets amplified could wield a greater influence on the participants, regardless of his/her authority.

  10. Prevalence of insomnia and use of sleep medicines in urban communities of Karachi, Pakistan.

    PubMed

    Kidwai, Rubeena; Ahmed, Syed Haroon

    2013-11-01

    To assess the prevalence of insomnia, its associated factors and the use of sleep medicines. The cross-sectional survey of 1488 adults from five urban and semi urban communities of Karachi, Pakistan, was conducted from August 2007 to July 2008. All face-to-face interviews were conducted in Urdu and data was entirely based on self-reported information by the respondents. Data was analysed using STATA 10.1. Of the total, 466 (31.3%) respondents reported insomnia out of which 141 (30.2%) reported using sleep medicines. These medicines were most frequently prescribed by some family physician (114/141; 80.8%). The odds of having insomnia were three times as likely if someone scored positive for psychological distress (OR 3.09; CI 2.30 -4.15) and two times as likely if he/she was troubled by health related issues (OR = 2.40; CI 1.84 - 3.13) or had been exposed to adverse events (OR = 2.02; CI 1.18 - 3.45). Those who experienced financial problems were 59% more likely to report sleep problems (OR = 1.59; CI 1.20 - 2.12). Gender, age, income or occupational status were not found to be associated with insomnia, but married persons tended to enjoy better sleep. Every third respondent reported insomnia and one-third of these were taking a sleeping pill prescribed by a family physician. Married people enjoyed better sleep. Gender, age or income was not associated with sleep difficulties.

  11. [South-South cooperation to strengthen the medicines control laboratories of the Caribbean community (CARICOM)].

    PubMed

    Parisi, José María; Castro, José Luis; Luque, María Celina; Spinetto, Marta; Saidón, Patricia; Fitzgerald, James

    2016-05-01

    Objective To describe the benefits obtained through South-South and triangular cooperation as a potential tool for strengthening medicine quality control in official medicines control laboratories (OMCLs) of the Region of the Americas. Methods Descriptive study of the project for strengthening drug quality control in OMCLs of the Caribbean community (CARICOM). Results Staff members of Argentina's National Administration for Drugs, Food, and Medical Technology (ANMAT) provided training to professionals from Guyana, Jamaica, Suriname, and Trinidad and Tobago. The project was funded by the Argentine Fund for South-South and Triangular Cooperation (FO.AR) and coordinated by the Pan American Health Organization (PAHO). Documents on good laboratory practice (GLP) developed by the World Health Organization (WHO) and the Pan American Network for Drug Regulatory Harmonization (PANDRH) were reviewed, and the area of physical and chemical controls was strengthened, primarily for drugs to treat tuberculosis, malaria, and HIV/AIDS, all of which are strategically important to those countries. Conclusion This type of collaboration makes it possible to share experiences, optimize resources, harmonize procedures and regulations, and strengthen human resource capacities. In addition, it is a valuable tool for reducing asymmetries in various areas among the different countries of our Region.

  12. [Effects of intercropping peanut with medicinal plants on soil microbial community].

    PubMed

    Xie, Hui; Wang, Xing-Xiang; Dai, Chuan-Chao; Chen, Jia-Xin; Zhang, Tao-Lin

    2007-03-01

    With pot experiment, this paper studied the quantitative variations of bacteria, actinomyces, mould and yeast in soils of peanut intercropped with medicinal plants, aimed to test if such an intercropping pattern could remove the obstacles of peanut's continuous cropping. The results showed that Atractylodes lancea and Euphorbia pekinensis had the strongest inhibitory effect on mould. Compared with CK (mono-cropping peanut), the CFU of mould in the treatments intercropped with A. lancea and E. pekinensis was decreased by 53.87% and 29.59%, respectively during flowering-pegging stage of peanut, but increased after harvesting, which was in favor of substance circulation and nutrient returning. The CFU of bacteria in treatments intercropped with A. lancea, E. pekinensis and Pinellia ternate was all increased, and that of yeast in all five intercropping treatments was increased during the flowering-pegging stage of peanut. No familiar pathogens were found in the treatments intercropped with A. lancea, E. pekinensis and Diosoren zingiberebsis. Peanut intercropped with medicinal plants could regulate soil microbial community effectively.

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

    PubMed Central

    Stevens, Brenda J.; Gruen, Margaret E.

    2015-01-01

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

  14. User Perceptions of an mHealth Medicine Dosing Tool for Community Health Workers.

    PubMed

    Palazuelos, Daniel; Diallo, Assiatou B; Palazuelos, Lindsay; Carlile, Narath; Payne, Jonathan D; Franke, Molly F

    2013-04-04

    Mobile health (mHealth) technologies provide many potential benefits to the delivery of health care. Medical decision support tools have shown particular promise in improving quality of care and provider workflow. Frontline health workers such as Community Health Workers (CHWs) have been shown to be effective in extending the reach of care, yet only a few medicine dosing tools are available to them. We developed an mHealth medicine dosing tool tailored to the skill level of CHWs to assist in the delivery of care. The mHealth tool was created for CHWs with primary school education working in rural Mexico and Guatemala. Perceptions and impressions of this tool were collected and compared to an existing paper-based medicine dosing tool. Seventeen Partners In Health CHWs in rural Mexico and Guatemala completed a one-day training in the mHealth medicine dosing tool. Following the training, a prescription dosing test was administered, and CHWs were given the choice to use the mHealth or paper-based tool to answer 7 questions. Subsequently, demographic and qualitative data was collected using a questionnaire and an in-person interview conducted in Spanish, then translated into English. The qualitative questions captured data on 4 categories: comfort, acceptability, preference, and accuracy. Qualitative responses were analyzed for major themes and quantitative variables were analyzed using SAS. 82% of the 17 CHWs chose the mHealth tool for at least 1 of 7 questions compared to 53% (9/17) who chose to use the paper-based tool. 93% (13/14) rated the phone as being easy or very easy to use, and 56% (5/9) who used the paper-based tool rated it as easy or very easy. Dosing accuracy was generally higher among questions answered using the mHealth tool relative to questions answered using the paper-based tool. Analysis of major qualitative themes indicated that the mHealth tool was perceived as being quick, easy to use, and as having complete information. The mHealth tool was seen

  15. Ethnobotany of Indigenous Saraguros: Medicinal Plants Used by Community Healers “Hampiyachakkuna” in the San Lucas Parish, Southern Ecuador

    PubMed Central

    Lucero Mosquera, Hernán; Armijos, Chabaco

    2017-01-01

    This paper reports the results of an ethnobotanical survey on the use of medicinal plants by community healers “Hampiyachakkuna” in the San Lucas Parish, province of Loja, Ecuador. A particular ethnic group, the indigenous Saraguros, inhabits this region. This study reports 183 plant species used in 75 different curative therapies by the Saraguro healers. PMID:28744470

  16. Use of medicines and adherence to standard treatment guidelines in rural community health centers, Timor-Leste.

    PubMed

    Higuchi, Michiyo; Okumura, Junko; Aoyama, Atsuko; Suryawati, Sri; Porter, John

    2015-03-01

    The use of medicines and nurses'/midwives' adherence to standard treatment guidelines (STGs) were examined in Timor-Leste during the early stage of the nation's new health system development. A cross-sectional study was conducted as the quantitative element of mixed methods research. Retrospective samples from patient registration books and prospective observations were obtained in 20 randomly selected rural community health centers. The medicines use indicators, in particular the level of injection use, in Timor-Leste did not suggest overprescription. Prescribers with clinical nurse training prescribed significantly fewer antibiotics than those without such training (P < .01). The adjusted odds ratio of prescribing adherence for clinical nurse training, after accounting for confounders and prescriber clustering, was 6.6 (P < .01). STGs for nonphysician health professionals at the primary health care level have potential value in basic health care delivery, including appropriate use of medicines, in resource-limited communities when strategically developed and introduced.

  17. Evaluating the implementation fidelity of New Medicines Service for asthma patients in community pharmacies in Belgium.

    PubMed

    Fraeyman, Jessica; Foulon, Veerle; Mehuys, Els; Boussery, Koen; Saevels, Jan; De Vriese, Carine; Dalleur, Olivia; Housiaux, Marie; Steurbaut, Stephane; Naegels, Marc; De Meyer, Guido Ry; De Loof, Hans; Van Hal, Guido; Van den Broucke, Stephan

    In October 2013, a New Medicines Service (NMS) was introduced in community pharmacies in Belgium to support asthma patients who are novice users of inhaler devices with corticosteroids. The protocol-based intervention used the Asthma Control Test (ACT) and the Medication Adherence Report Scale (MARS) to assess asthma control and medication adherence. The NMS is the first initiative that puts advanced pharmaceutical care into practice in Belgium. The present study evaluated the degree to which the NMS program is delivered as intended, drawing on the concept of implementation fidelity (IF). The main dimensions of IF and potential moderating and facilitating factors for the implementation of NMS in community pharmacies were evaluated using telephone interviews with pharmacists (n = 497), semi-structured interviews with patients eligible for NMS (n = 30), focus groups among general practitioners (n = 72) and lung specialists (n = 5), and a work system analysis in community pharmacies (n = 19). The uptake of NMS in Belgian community pharmacies remains low. In addition to practical barriers, pharmacists found it difficult to identify new asthmatic patients when they were not informed about the diagnosis. A lack of commitment from physicians, patients and pharmacists was noted in the early start-up phase of the program. Many pharmacists did not see how NMS differed from existing pharmaceutical care. Physicians considered this service as part of their own tasks and discouraged ACT for asthma follow-up in the community pharmacy. The introduction of the NMS program was not sufficiently embedded in the Belgian health care organization, causing low uptake and resistance to its implementation by pharmacists, patients, and other health care professionals. To increase the uptake of this type of service and its possible extension to other patient groups, more collaboration among the different health care professionals during design and implementation is necessary, as

  18. Medicinal use of wild fauna by mestizo communities living near San Guillermo Biosphere Reserve (San Juan, Argentina).

    PubMed

    Hernandez, Jorge; Campos, Claudia M; Borghi, Carlos E

    2015-01-21

    Wild and domestic animals and their by-products are important ingredients in the preparation of curative, protective and preventive medicines. Despite the medicinal use of animals worldwide, this topic has received less attention than the use of medicinal plants. This study assessed the medicinal use of animals by mestizo communities living near San Guillermo MaB Reserve by addressing the following questions: What animal species and body parts are used? What ailments or diseases are treated with remedies from these species? To what extent do mestizo people use animals as a source of medicine? Is the use related to people's age? We conducted semi-structured interviews with 171 inhabitants (15-93 years old) of four villages close to the Reserve: Tudcúm, Angualasto, Malimán and Colangüil. We calculated the informant consensus factor and fidelity level to test homogeneity of knowledge and to know the importance of different medicinal uses for a given species. The medicinal use of animals was reported by 57% of the surveyed people. Seven species were mentioned: Rhea pennata, Lama guanicoe, Puma concolor, Pseudalopex sp., Lama vicugna, Lepus europaeus and Conepatus chinga. Several body parts were used: fat, leg, bezoar-stone, stomach, feather, meat, blood, feces, wool, and liver. The fat of R. pennata was the most frequently used animal part, followed by the bezoar stone and the leg of L. guanicoe. Animals were used to treat 22 ailments, with respiratory and nervous system disorders being the most frequently treated diseases with a high degree of consensus. Old people used animals as remedies more frequently than young residents, showing some differences among villages. A low number of animal species was mentioned as used for medicinal purposes, which could be explained by the perception of strong control related the legislation that bans hunting and the erosion of traditional knowledge produced by mestizaje. However, the presence of a traditional medicine is deeply

  19. Ethnopharmacological evaluation of medicinal plants used against malaria by quilombola communities from Oriximiná, Brazil.

    PubMed

    Oliveira, Danilo R; Krettli, Antoniana U; Aguiar, Anna Caroline C; Leitão, Gilda G; Vieira, Mariana N; Martins, Karine S; Leitão, Suzana G

    2015-09-15

    Malaria is the most important parasitic disease in the world, including in the Amazon region, due to its high incidence. In addition, malaria is difficult to control because of the geographical characteristics of the endemic Amazon region. The quilombola communities of Oriximina, located in remote rainforest areas, have extensive experience with medicinal plants due to their close contact with and dependence on local biodiversity as a therapeutic resource. To search for active bioproducts against malaria, based on in vitro tests using blood culture-derived parasites and plants selected by an ethno-directed approach in traditional quilombola communities of Oriximiná, in the Amazon region of Brazil. Ethnobotanical data were collected from 35 informants in the quilombola communities of Oriximiná, Brazil, by a free-listing method for the survey of species locally indicated to be effective against malaria and related symptoms. Data were analyzed by salience index (S) and major use agreement. The activity of extracts from 11 plants, selected based on their Salience values (four plants with S>1; seven plants with S<0.1), was measured in vitro in cultures of W2 clone Plasmodium falciparum parasites resistant to chloroquine. Thirty-five ethnospecies comprising 40 different plants belonging to 23 botanical families and 37 genera were listed as antimalarials by the ethno-directed approach. Among these, 11 species selected based on their S values were assayed against P. falciparum. The most active plant extracts, with an IC50 as low as 1.6μg/mL, were obtained from Aspidosperma rigidum (Apocynaceae), Bertholletia excelsa (Lecythidaceae) and Simaba cedron (Simaroubaceae), all of which displayed an S value>1. A strong correlation between the consensus of the informants from quilombola communities living in a malaria endemic area and the salience index indicating antiplasmodial activity was observed, where the ethnospecies mostly cited to be effective against malaria produced

  20. Ethnobotany of medicinal plants among the communities of Alpine and Sub-alpine regions of Pakistan.

    PubMed

    Kayani, Sadaf; Ahmad, Mushtaq; Sultana, Shazia; Khan Shinwari, Zabta; Zafar, Muhammed; Yaseen, Ghulam; Hussain, Manzoor; Bibi, Tahira

    2015-04-22

    To best of our knowledge it is first quantitative ethno-botanical study from Alpine and Sub-alpine, Western Himalaya of Pakistan. The study aims to report, compare the uses and highlight the ethno-botanical significance of medicinal plants for treatment of various diseases. A total of 290 (278 males and 12 females) informants including 14 Local Traditional Healers (LTHs) were interviewed. Information was collected using semi-structured interviews, analyzed and compared by quantitative ethno-botanical indices such as Informant Consensus Factor (ICF), Relative frequency of citation (RFC), use value (UV), Fidelity Level (FL) and Jaccard index (JI). A total of 125 plant species (Gymnosperms 7 species, Monocotyledons 2 and 116 Di-cotyledons) belonging to 41 families are collected, identified and ethno-botanically assessed. The most dominant family is Ranunculaceae (20 species) followed by Rosaceae (14 species). In diseases treated, gastrointestinal tract (GIT) diseases have highest proportion (27.5%) followed by respiratory diseases (20%) in the mountain communities. The most dominant life form of plants used is herbs (78%) followed by shrubs (19%) while the most commonly used plant parts are leaves (44 reports) followed by underground part, the roots (37 reports). The highest ICF (0.68) is found for ear, nose and eye disease category followed by respiratory disorders (0.46). There are 15 medicinal plants having 100% FL. Use value (UV) and Relative frequency of citation (RFC) range from 0.03 to 0.53 and 0.04 to 0.23 respectively. In comparison, maximum similarity index is found in the studies with JI 19.52 followed by 17.39. Similarity percentage of plant uses range from 1.69% to 19.52% while dissimilarity percentage varies from 0% to 20%. The Alpine and Sub-alpine regions of Pakistan are rich in medicinal plants and still need more research exploration. On the other hand, ethno-botanical knowledge in study areas is decreasing day by day due to high emigration rates

  1. The prevalence of traditional herbal medicine use among hypertensives living in South African communities.

    PubMed

    Hughes, Gail D; Aboyade, Oluwaseyi M; Clark, Bobby L; Puoane, Thandi R

    2013-02-18

    In South Africa, over 6 million people are hypertensive and the burden of disease shows that cardiovascular diseases (CVDs) are the leading cause of death among adults. Although treatments exist, few people comply or adhere to recommended treatment due to side effects or costs of the drugs, hence the reliance on alternative forms of treatment. Traditional herbal medicines (THM) are used for the management of hypertension but the prevalence of its use among hypertensive patients living in South African communities is not sufficiently known. This was a cross-sectional descriptive study to determine the prevalence of THM use for hypertension, among 135 purposefully selected South African participants of the Prospective Urban and Rural Epidemiological (PURE) study, who are THM users. Data on THM use were collected by way of face to face interviews using structured questionnaires administered by trained field workers. Standard descriptive measures were used to characterize the study sample and responses to the questionnaire. Chi-square test was used when making comparisons between groups. There were 135 THM users, 21% of whom used THM to treat hypertension. Majority (82.1%) of the hypertensive THM users were females, only 29% were married or co-habitating, virtually all (96%) were unemployed and 86% were Christians. More than half (56%) of the respondents were aged between 55 and 64 years. THM was occasionally used (51.9%) as a combination of tea and other mixtures (63%) and prescribed by family/ friends/self-administered. There was a significant difference in the age, marital and employment status, as well as the form and frequency of THM use of hypertensive THM users compared to other THM users. The study gives an insight into the prevalence of THM use by hypertensive patients in selected South African communities. The practice of self-medication was also observed which raises concern regarding the safety of medications taken by the participants. Health care providers

  2. The cultivation of wild food and medicinal plants for improving community livelihood: The case of the Buhozi site, DR Congo

    PubMed Central

    Karhagomba, Innocent Balagizi; Mirindi T, Adhama; Mushagalusa, Timothée B.; Nabino, Victor B.; Koh, Kwangoh

    2013-01-01

    This study aims to demonstrate the effect of farming technology on introducing medicinal plants (MP) and wild food plants (WFP) into a traditional agricultural system within peri-urban zones. Field investigations and semi-structured focus group interviews conducted in the Buhozi community showed that 27 health and nutrition problems dominated in the community, and could be treated with 86 domestic plant species. The selected domestic MP and WFP species were collected in the broad neighboring areas of the Buhozi site, and introduced to the experimental field of beans and maize crops in Buhozi. Among the 86 plants introduced, 37 species are confirmed as having both medicinal and nutritional properties, 47 species with medicinal, and 2 species with nutritional properties. The field is arranged in a way that living hedges made from Tithonia diversifolia provide bio-fertilizers to the plants growing along the hedges. The harvest of farming crops does not disturb the MP or WFP, and vice-versa. After harvesting the integrated plants, the community could gain about 40 times higher income, than from harvesting farming crops only. This kind of field may be used throughout the year, to provide both natural medicines and foods. It may therefore contribute to increasing small-scale crop producers' livelihood, while promoting biodiversity conservation. This model needs to be deeply documented, for further pharmaceutical and nutritional use. PMID:24353838

  3. The cultivation of wild food and medicinal plants for improving community livelihood: The case of the Buhozi site, DR Congo.

    PubMed

    Karhagomba, Innocent Balagizi; Mirindi T, Adhama; Mushagalusa, Timothée B; Nabino, Victor B; Koh, Kwangoh; Kim, Hee Seon

    2013-12-01

    This study aims to demonstrate the effect of farming technology on introducing medicinal plants (MP) and wild food plants (WFP) into a traditional agricultural system within peri-urban zones. Field investigations and semi-structured focus group interviews conducted in the Buhozi community showed that 27 health and nutrition problems dominated in the community, and could be treated with 86 domestic plant species. The selected domestic MP and WFP species were collected in the broad neighboring areas of the Buhozi site, and introduced to the experimental field of beans and maize crops in Buhozi. Among the 86 plants introduced, 37 species are confirmed as having both medicinal and nutritional properties, 47 species with medicinal, and 2 species with nutritional properties. The field is arranged in a way that living hedges made from Tithonia diversifolia provide bio-fertilizers to the plants growing along the hedges. The harvest of farming crops does not disturb the MP or WFP, and vice-versa. After harvesting the integrated plants, the community could gain about 40 times higher income, than from harvesting farming crops only. This kind of field may be used throughout the year, to provide both natural medicines and foods. It may therefore contribute to increasing small-scale crop producers' livelihood, while promoting biodiversity conservation. This model needs to be deeply documented, for further pharmaceutical and nutritional use.

  4. Use of Traditional and Complementary Medicine as Self-Care Strategies in Community Health Centers

    PubMed Central

    Chung, Vincent C.H.; Wong, Samuel Y.S.; Wang, Harry H.X.; Wong, Martin C.S.; Wei, Xiaolin; Wang, Jiaji; Liu, Siya; Ho, Robin S.T.; Yu, Ellen L.M.; Griffiths, Sian M.

    2016-01-01

    Abstract In China, Community Health Centers (CHCs) are major providers of primary care services, but their potential in empowering patients’ self-management capacity has not been assessed. This study aims to describe self-care practice patterns amongst CHC attendees in urban China. In this cross-sectional quantitative study, 3360 CHC patients from 6 cities within the Pearl Delta Region were sampled using multistage cluster sampling. Thirty-seven per cent had used with over-the-counter Chinese herbal medicines (OTC CHMs) in the past year and majority of respondents found OTC CHMs effective. OTC CHMs were more popular amongst those who needed to pay out of pocket for CHC services. Less than 10% used vitamins and minerals, and those with a lower socioeconomic background have a higher propensity to consume. Although doubts on their usefulness are expressed, their use by the vulnerable population may reflect barriers to access to conventional health care, cultural affinity, or a defense against negative consequences of illnesses. About 25% performed physical exercise, but the prevalence is lower amongst women and older people. Taiji seems to be an alternative for these populations with promising effectiveness, but overall only 6% of CHC attendees participated. These results suggest that CHCs should start initiatives in fostering appropriate use of OTC CHM, vitamins, and minerals. Engaging community pharmacists in guiding safe and effective use of OTC CHM amongst the uninsured is essential given their low accessibility to CHC services. Prescription of Taiji instead of physical exercises to women and older people could be more culturally appropriate, and the possibility of including this as part of the CHC services worth further exploration. PMID:27281074

  5. Public health, medicine, and dentistry as partners in community health: a pioneering initiative in interprofessional, practice-based education.

    PubMed

    McCloskey, Lois; Condon, Rebecca; Shanahan, Christopher W; Wolff, James; Culler, Corinna; Kalish, Richard

    2011-01-01

    As public health challenges grow more complex, the call for professional education to be interprofessional, collaborative, and grounded in real world practice has intensified. In this article, we describe the development, implementation, and results of one pioneering course at Boston University that aims to prepare public health, medical, and dental students for their combined roles in community health settings. The Schools of Public Health, Medicine, and Dental Medicine jointly offered the course in partnership with 3 community organizations. Participants include MPH, MD, and DMD candidates. The course design integrates the use of "The Challenge Model" (created by Management Sciences for Health) with training in public health consultation techniques (eg, community-based participatory research, logic models, monitoring and evaluation). Teams of 6 to 8 medical and public health students collaborate with managers and staff of a community health center to address 1 organizational challenge and recommend a sustainability plan. Postcourse evaluations revealed that a cross-disciplinary, practice-based education model is feasible and can meet students' learning objectives and exceed expectations of community partners. We overcame formidable obstacles related to the "silo'ed" nature of academic institutions and the competing priorities within overburdened community organizations. We found that sustained project implementation was attained at some but not all sites, yet all sites highly valued the perspective and contribution of student teams. Dynamic and replicable, this practice-based education model is adaptable to professional schools whose work intersects in the real world and calls for collaborative leadership.

  6. Chemosensory perception and medicinal plants for digestive ailments in a Mapuche community in NW Patagonia, Argentina.

    PubMed

    Molares, Soledad; Ladio, Ana

    2009-06-25

    To document the richness of plant species used in gastrointestinal disorders and to investigate about the criteria of aroma and flavor associated with its recognition, classification, selection and use. Ethnobotanical fieldwork consisted of interviews to 30 inhabitants living in a Mapuche community of Northwestern Patagonia; data collected was analyzed by means of non-parametric statistics. This work records 75 ethnospecies, pertaining to 40 botanic families. Lamiaceae, Asteraceae and Chenopodiaceae were the most frequently mentioned and described in terms of smell and taste. Most of species (69%) have notable aroma and/or flavor characteristics. The species presenting highest consensus in the population are positively associated with a higher frequency of organoleptic descriptions. In addition, local people consider these perceptions to be potentially useful in the search for substitutes when species are scarce or disappear from a locality. It is possible to establish a preliminary system of classification of medicinal plants based on their organoleptic characteristics and relate this to their effects on health. Moreover the cultural interpretation of smell and taste is of great heuristic importance to ethnopharmacology, in that it indicates which plants are most likely to contain the main active ingredients sought.

  7. Patent medicine vendors, community pharmacists and STI management in Abuja, Nigeria.

    PubMed

    Okonkwo, A D; Okonkwo, U P

    2010-09-01

    Increasingly, literature indicates that Patent Medicine Vendors (PMVs) and Community Pharmacists (CPs) provide sexual reproductive health services and products to their young patrons. This study explored the validity of literature claims, principally from CPs and PMVs perspective in Abuja, Nigeria. Participants were recruited with convenience sampling based on their willingness to participate in the study and our judgement of their professional competence. They were administered a semi-structured questionnaire, which was modelled after McCracken's long interview. We empirically assessed the validity of CPs and PMVs opinions with an exit interview of seven consenting patrons. Interviews were audio taped, transcribed verbatim and subjected to iterative thematic analysis. Participants' accounts and our observations indicate that PMVs and CPs serve young people's sexual reproductive healthcare needs in Abuja. CPs and PMVs provide young people with a seamless and non-judgemental access to contraceptives, sexual health advice and post-sexual risk exposure care. The study corroborates literature claims that CPs and PMVs provide sexual reproductive health advice, services and products to young people. However, participants contend that the current pharmacy practice laws in Nigeria constrain the scope and quality of services that young unmarried people require. Because it is unlikely that Nigeria will reinvigorate her primary healthcare system soon, we call for the formal co-option of CPs and PMVs into the sexual reproductive health management system to standardize and improve services.

  8. Antagonistic interactions between endophytic cultivable bacterial communities isolated from the medicinal plant Echinacea purpurea.

    PubMed

    Maida, Isabel; Chiellini, Carolina; Mengoni, Alessio; Bosi, Emanuele; Firenzuoli, Fabio; Fondi, Marco; Fani, Renato

    2016-09-01

    In this work we have studied the antagonistic interactions existing among cultivable bacteria isolated from three ecological niches (rhizospheric soil, roots and stem/leaves) of the traditional natural medicinal plant Echinacea purpurea. The three compartments harboured different taxonomic assemblages of strains, which were previously reported to display different antibiotic resistance patterns, suggesting the presence of differential selective pressure due to antagonistic molecules in the three compartments. Antagonistic interactions were assayed by the cross-streak method and interpreted using a network-based analysis. In particular 'within-niche inhibition' and 'cross-niche inhibition' were evaluated among isolates associated with each compartment as well as between isolates retrieved from the three different compartments respectively. Data obtained indicated that bacteria isolated from the stem/leaves compartment were much more sensitive to the antagonistic activity than bacteria from roots and rhizospheric soil. Moreover, both the taxonomical position and the ecological niche might influence the antagonistic ability/sensitivity of different strains. Antagonism could play a significant role in contributing to the differentiation and structuring of plant-associated bacterial communities. © 2015 Society for Applied Microbiology and John Wiley & Sons Ltd.

  9. [Implementation of preventive activities by family and community medicine residents in primary care clinics].

    PubMed

    Urbano, David Paniagua; Pérula de Torres, Luis Ángel; Ruiz del Moral, Roger; Moral, Enrique Gavilán

    2010-10-01

    To determine the level of preventive activities carried out by Family and Community Medicine medical residents during their stay in the Health Centre, as well as to estimate the time involved in carrying them out. Cross-sectional, descriptive, observational study. Teaching Health Centres in the Central- Cordoba and Guadalquivir Primary Care Districts. Forty medical residents and 384 clinical interviews with patients who were seen at the clinic. The consultations were video recorded and looked at by three medical residents who recorded the preventive activities carried out according to the 2005 PAPPS (Health Promotion and Disease Prevention Activities) recommendations, as well as the time employed in performing these activities. No preventive activities were performed in 72.1% (95% CI: 67.6 to 76.5%) of the consultations. The most frequent activities were secondary prevention (70.1%), mainly the taking of blood pressure (8.1%). The mean consultation time when there were no preventive activities carried out was 5.6 min (SD=3.1), whilst in those that did perform them it was 7.04 min (SD=3.05) (P<0.0001). The performing of preventive activities by medical residents in Primary Care clinics is very limited. A consultation that includes preventive activities requires a significantly longer time than in those that do not include them. Copyright © 2009 Elsevier España, S.L. All rights reserved.

  10. Opioid Addiction Treatment Using Buprenorphine-Naloxone In A Community-Based Internal Medicine Practice.

    PubMed

    Van Doren, Bryan A; Foulks-Rodriguez, Kristin A; Yarborough, William

    2015-07-01

    Opioid dependency currently affects over 2.5 million patients in the United States and is increasing in incidence. Office-based opioid therapy with buprenorphine-naloxone provides greater patient access to treatment and has significantly improved therapeutic outcomes. We conducted a study of 100 consecutive patients treated for opioid dependence with buprenorphine-naloxone in a single provider's community-based internal medicine practice. The primary outcome measures were retention in therapy, wellness, and abstinence from ongoing drug use. Data were obtained from frequent physical examinations, self-report data, and periodic urine drug screening. The retention rate in therapy was 75%. A multidimensional evaluation of wellness improved in 75% of the patients. Eighty-five percent reported no opiate relapse during therapy. Office-based opioid therapy with buprenorphine-naloxone has provided greater access to therapy with improved therapeutic outcomes. Our findings support the mounting literature that more patients should be offered office-based opioid therapy for opioid dependency.

  11. What proportion of prescription items dispensed in community pharmacies are eligible for the New Medicine Service?

    PubMed Central

    2014-01-01

    Background The payment structure for the New Medicine Service (NMS) in England is based on the assumption that 0.5% of prescription items dispensed in community pharmacies are eligible for the service. This assumption is based on a theoretical calculation. This study aimed to find out the actual proportion of prescription items eligible for the NMS dispensed in community pharmacies in order to compare this with the theoretical assumption. The study also aimed to investigate whether the proportion of prescription items eligible for the NMS is affected by pharmacies’ proximity to GP practices. Methods The study collected data from eight pharmacies in Nottingham belonging to the same large chain of pharmacies. Pharmacies were grouped by distance from the nearest GP practice and sampled to reflect the distribution by distance of all pharmacies in Nottingham. Data on one thousand consecutive prescription items were collected from each pharmacy and the number of NMS eligible items recorded. All NHS prescriptions were included in the sample. Data were analysed and proportions calculated with 95% confidence intervals used to compare the study results against the theoretical figure of 0.5% of prescription items being eligible for the NMS. Results A total of 8005 prescription items were collected (a minimum of 1000 items per pharmacy) of which 17 items were eligible to receive the service. The study found that 0.25% (95% confidence intervals: 0.14% to 0.36%) of prescription items were eligible for the NMS which differs significantly from the theoretical assumption of 0.5%. The opportunity rate for the service was lower, 0.21% (95% confidence intervals: 0.10% to 0.32%) of items, as some items eligible for the NMS did not translate into opportunities to offer the service. Of all the prescription items collected in the pharmacies, 28% were collected by patient representatives. Conclusions The results of this study show that the proportion of items eligible for the NMS

  12. What proportion of prescription items dispensed in community pharmacies are eligible for the New Medicine Service?

    PubMed

    Wells, Katharine M; Boyd, Matthew J; Thornley, Tracey; Boardman, Helen F

    2014-03-07

    The payment structure for the New Medicine Service (NMS) in England is based on the assumption that 0.5% of prescription items dispensed in community pharmacies are eligible for the service. This assumption is based on a theoretical calculation. This study aimed to find out the actual proportion of prescription items eligible for the NMS dispensed in community pharmacies in order to compare this with the theoretical assumption. The study also aimed to investigate whether the proportion of prescription items eligible for the NMS is affected by pharmacies' proximity to GP practices. The study collected data from eight pharmacies in Nottingham belonging to the same large chain of pharmacies. Pharmacies were grouped by distance from the nearest GP practice and sampled to reflect the distribution by distance of all pharmacies in Nottingham. Data on one thousand consecutive prescription items were collected from each pharmacy and the number of NMS eligible items recorded. All NHS prescriptions were included in the sample. Data were analysed and proportions calculated with 95% confidence intervals used to compare the study results against the theoretical figure of 0.5% of prescription items being eligible for the NMS. A total of 8005 prescription items were collected (a minimum of 1000 items per pharmacy) of which 17 items were eligible to receive the service. The study found that 0.25% (95% confidence intervals: 0.14% to 0.36%) of prescription items were eligible for the NMS which differs significantly from the theoretical assumption of 0.5%. The opportunity rate for the service was lower, 0.21% (95% confidence intervals: 0.10% to 0.32%) of items, as some items eligible for the NMS did not translate into opportunities to offer the service. Of all the prescription items collected in the pharmacies, 28% were collected by patient representatives. The results of this study show that the proportion of items eligible for the NMS dispensed in community pharmacies is lower than

  13. Popularity and customer preferences for over-the-counter Chinese medicines perceived by community pharmacists in Shanghai and Guangzhou: a questionnaire survey study

    PubMed Central

    2014-01-01

    Background This study interviewed community pharmacists in Shanghai and Guangzhou for their perception of the popular categories of over-the-counter (OTC) Chinese medicines and the factors affecting customer preferences for OTC Chinese medicines. Methods A cross-sectional survey was carried out in six main administrative districts in Guangzhou and eight main administrative districts in Shanghai, China. Descriptive statistical analysis was conducted in this study. Results OTC Chinese medicines contributed 21–50% among all the pharmaceutical sales by the community pharmacies. The prevalent categories of OTC Chinese medicines were common cold medicines, respiratory system medicines, digestive system agents, gynecological medicines, health tonic medicines, and qing re (heat-clearing) and qu du (detoxifying) medicines. Customers were more concerned about medical factors of OTC Chinese medicines than business factors. Among the medical factors, the most important was drug safety, followed by efficacy, contraindications, indications, and side effects. Among the business factors, the most important were brand and price. Conclusions This study identified the top sales categories of OTC Chinese medicines in Shanghai and Guangzhou and the important factors such as drug safety, efficacy, period of validity, contraindications, and indications that are affecting the customer preferences for OTC Chinese medicines. PMID:25243017

  14. Does deregulation in community pharmacy impact accessibility of medicines, quality of pharmacy services and costs? Evidence from nine European countries.

    PubMed

    Vogler, Sabine; Habimana, Katharina; Arts, Danielle

    2014-09-01

    To analyse the impact of deregulation in community pharmacy on accessibility of medicines, quality of pharmacy services and costs. We analysed and compared community pharmacy systems in five rather deregulated countries (England, Ireland, the Netherlands, Norway, Sweden) and four rather regulated countries (Austria, Denmark, Finland, Spain). Data were collected by literature review, a questionnaire survey and interviews. Following a deregulation, several new pharmacies and dispensaries of Over-the-Counter (OTC) medicines tended to be established, predominantly in urban areas. Unless prevented by regulation, specific stakeholders, e.g. wholesalers, were seen to gain market dominance which limited envisaged competition. There were indications for an increased workload for pharmacists in some deregulated countries. Economic pressure to increase the pharmacy turnover through the sale of OTC medicines and non-pharmaceuticals was observed in deregulated and regulated countries. Prices of OTC medicines were not found to decrease after a deregulation in pharmacy. Access to pharmacies usually increases after a deregulation but this is likely to favour urban populations with already good accessibility. Policy-makers are recommended to take action to ensure equitable accessibility and sustainable competition in a more deregulated environment. No association between pharmaceutical expenditure and the extent of regulation/deregulation appears to exist. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Traditional medicine practices among community members with diabetes mellitus in Northern Tanzania: an ethnomedical survey.

    PubMed

    Lunyera, Joseph; Wang, Daphne; Maro, Venance; Karia, Francis; Boyd, David; Omolo, Justin; Patel, Uptal D; Stanifer, John W

    2016-08-11

    Diabetes is a growing burden in sub-Saharan Africa where traditional medicines (TMs) remain a primary form of healthcare in many settings. In Tanzania, TMs are frequently used to treat non-communicable diseases, yet little is known about TM practices for non-communicable diseases like diabetes. Between December 2013 and June 2014, we assessed TM practices, including types, frequencies, reasons, and modes, among randomly selected community members. To further characterize TMs relevant for the local treatment of diabetes, we also conducted focus groups and semi-structured interviews with key informants. We enrolled 481 adults of whom 45 (9.4 %) had diabetes. The prevalence of TM use among individuals with diabetes was 77.1 % (95 % CI 58.5-89.0 %), and the prevalence of using TMs and biomedicines concurrently was 37.6 % (95 % CI 20.5-58.4 %). Many were using TMs specifically to treat diabetes (40.3 %; 95 % CI 20.5-63.9), and individuals with diabetes reported seeking healthcare from traditional healers, elders, family, friends, and herbal vendors. We identified several plant-based TMs used toward diabetes care: Moringa oleifera, Cymbopogon citrullus, Hagenia abyssinica, Aloe vera, Clausena anisata, Cajanus cajan, Artimisia afra, and Persea americana. TMs were commonly used for diabetes care in northern Tanzania. Individuals with diabetes sought healthcare advice from many sources, and several individuals used TMs and biomedicines together. The TMs commonly used by individuals with diabetes in northern Tanzania have a wide range of effects, and understanding them will more effectively shape biomedical practitices and public health policies that are patient-centered and sensitive to TM preferences.

  16. Chronicity of Voice-Related Health Care Utilization in the General Medicine Community.

    PubMed

    Cohen, Seth M; Lee, Hui-Jie; Roy, Nelson; Misono, Stephanie

    2017-04-01

    Objectives To examine voice-related health care utilization of patients in the general medical community without otolaryngology evaluation and explore factors associated with prolonged voice-related health care. Study Design Retrospective cohort analysis. Setting Large, national administrative US claims database. Subjects and Methods Patients with voice disorders per International Classification of Diseases, Ninth Revision, Clinical Modification ( ICD-9-CM) codes from January 1, 2010, to December 31, 2012, seen by a general medical physician, and who did not see an otolaryngologist in the subsequent year were included. Voice-related health care utilization, patient demographics, comorbid conditions, and index laryngeal diagnosis were collected. Logistic regression with variable selection was performed to evaluate the association between predictors and ≥30 days of voice-related health care use. Results In total, 46,205 unique voice-disordered patients met inclusion criteria. Of these patients, 8.5%, 10.0%, and 12.5% had voice-related health care use of ≥90, ≥60, and ≥30 days, respectively. Of the ≥30-day subset, 80.3% and 68.5%, respectively, had ≥60 and ≥90 days of voice-related health care utilization. The ≥30-day subset had more general medicine and nonotolaryngology specialty physician visits, more prescriptions and procedures, and 4 times the voice-related health care costs compared with those in the <30-day subset. Age, sex, employment status, initial voice disorder diagnosis, and comorbid conditions were related to ≥30 days of voice-related health care utilization. Conclusions Thirty days of nonotolaryngology-based care for a voice disorder may represent a threshold beyond which patients are more likely to experience prolonged voice-related health care utilization. Specific factors were associated with extended voice-related health care.

  17. An in-depth study of patent medicine sellers' perspectives on malaria in a rural Nigerian community

    PubMed Central

    Okeke, Theodora A; Uzochukwu, Benjamin SC; Okafor, Henrietta U

    2006-01-01

    Background Malaria remains a major cause of mortality among under five children in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with antimalarial drugs bought from medicine sellers. These have led to increasing calls for interventions to improve treatment obtained in these outlets. However, information about the current practices of these medicine sellers is needed before such interventions. This study aims to determine the medicine sellers' perspectives on malaria and the determinants that underlie their dispensing patterns of antimalarial drugs. Methods The study was conducted in Ugwugo-Nike, a rural community in south-east Nigeria. It involved in-depth interviews with 13 patent medicine sellers. Results A majority of the medicine sellers were not trained health professionals and malaria is recognized as a major health problem by them. There is poor knowledge and poor dispensing behaviour in relation to childhood malaria episodes. Although referral of severe malaria is common, there are those who will not refer. Verbal advice is rarely given to the care-givers. Conclusion More action research and interventions to improve prescription and referral practices and giving verbal advice to care-givers is recommended. Ways to integrate the drug sellers in the health system are also recommended. PMID:17078875

  18. Pastoral power in the community pharmacy: A Foucauldian analysis of services to promote patient adherence to new medicine use.

    PubMed

    Waring, Justin; Latif, Asam; Boyd, Matthew; Barber, Nick; Elliott, Rachel

    2016-01-01

    Community pharmacists play a growing role in the delivery of primary healthcare. This has led many to consider the changing power of the pharmacy profession in relation to other professions and patient groups. This paper contributes to these debates through developing a Foucauldian analysis of the changing dynamics of power brought about by extended roles in medicines management and patient education. Examining the New Medicine Service, the study considers how both patient and pharmacist subjectivities are transformed as pharmacists seek to survey patient's medicine use, diagnose non-adherence to prescribed medicines, and provide education to promote behaviour change. These extended roles in medicines management and patient education expand the 'pharmacy gaze' to further aspects of patient health and lifestyle, and more significantly, established a form of 'pastoral power' as pharmacists become responsible for shaping patients' self-regulating subjectivities. In concert, pharmacists are themselves enrolled within a new governing regime where their identities are conditioned by corporate and policy rationalities for the modernisation of primary care.

  19. Comparison of Medical Students' Satisfaction with Family Medicine Clerkships between University Hospitals and Community Hospitals or Clinics

    PubMed Central

    2016-01-01

    Background The purpose of this study was to compare students' awareness of and satisfaction with clerkships in family medicine between a university hospital and a community hospital or clinic. Methods Thirty-eight 4th year medical students who were undergoing a clerkship in family medicine in the 1st semester of 2012 were surveyed via questionnaire. The questionnaire was administered both before and after the clerkship. Results External clerkships were completed in eight family medicine clinics and two regional hospitals. At preclerkship, participants showed strong expectation for understanding primary care and recognition of the need for community clerkship, mean scores of 4.3±0.5 and 4.1±0.7, respectively. At post-clerkship, participants showed a significant increase in recognition of the need for community clerkship (4.7±0.5, P<0.001). The pre-clerkship recognition of differences in patient characteristics between university hospitals and community hospitals or clinics was 4.1±0.7; at post-clerkship, it was 3.9±0.7. Students' confidence in their ability to see a first-visit patient and their expectation of improved interviewing skills both significantly increased at post-clerkship (P<0.01). Satisfaction with feedback from preceptors and overall satisfaction with the clerkship also significantly increased, but only for the university hospital clerkship (P<0.01). Conclusion Students' post-clerkship satisfaction was uniformly high for both clerkships. At pre-clerkship, students were aware of the differences in patient characteristics between university hospitals and community hospitals or clinics, and this awareness did not change by the end of the clerkship. PMID:27900072

  20. Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq.

    PubMed

    Al-Dabbagh, Samim A; Al-Taee, Waleed G

    2005-08-22

    The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC) in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students) was exposed to the experimental model and the control group (56 students) received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999-2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established.

  1. What influences availability of medicines for the community management of childhood illnesses in central Uganda? Implications for scaling up the integrated community case management programme.

    PubMed

    Bagonza, James; Rutebemberwa, Elizeus; Eckmanns, Tim; Ekirapa-Kiracho, Elizabeth

    2015-11-25

    The integrated Community Case Management (iCCM) of childhood illnesses strategy has been adopted world over to reduce child related ill health and mortality. Community Health workers (CHWs) who implement this strategy need a regular supply of drugs to effectively treat children under 5 years with malaria, pneumonia and diarrhea. In this paper, we report the prevalence and factors influencing availability of medicines for managing malaria, pneumonia and diarrhea in communities in central Uganda. A cross sectional study was conducted among 303 CHWs in Wakiso district in central Uganda. Eligible CHWs from two randomly selected Health Sub Districts (HSDs) were interviewed. Questionnaires, check lists, record reviews were used to collect information on CHW background characteristics, CHW's prescription behaviors, health system support factors and availability of iCCM drugs. Multivariable logistic regression analysis was done to assess factors associated with availability of iCCM drugs. Out of 300 CHWs, 239 (79.9%) were females and mean age was 42.1 (standard deviation =11.1 years). The prevalence of iCCM drug availability was 8.3% and 33 respondents (11%) had no drugs at all. Factors associated with iCCM drug availability were; being supervised within the last month (adjusted OR = 3.70, 95% CI 1.22-11.24), appropriate drug prescriptions (adjusted OR = 3.71, 95% CI 1.38-9.96), regular submission of drug reports (adjusted OR = 4.02, 95% CI 1.62-10.10) and having a respiratory timer as a diagnostic tool (adjusted OR =3.11, 95% CI 1.08-9.00). The low medicine stocks for the community management of childhood illnesses calls for strengthening of CHW supervision, medicine prescription and reporting, and increasing availability of functional diagnostic tools.

  2. Use and commercialization of Podocnemis expansa (Schweiger 1812) (Testudines: Podocnemididae) for medicinal purposes in two communities in North of Brazil

    PubMed Central

    Alves, Rômulo RN; Santana, Gindomar G

    2008-01-01

    Background Throughout Brazil a large number of people seek out reptiles for their meat, leather, ornamental value and supposed medicinal importance. However, there is a dearth of information on the use of reptiles in folk medicine. In North Brazil, the freshwater turtle, Podocnemis expansa, is one of the most frequently used species in traditional medicines. Many products derived from P. expansa are utilized in rural areas and also commercialized in outdoor markets as a cure or treatment for different diseases. Here we document the use and commercialization of P. expansa for medicinal purposes in the state of Pará, Northern Brazil. Methods Data were gathered through interview-questionnaires, with some questions left open-ended. Information was collected in two localities in Pará State, North of Brazil. In the City of Belém, data was collected through interviews with 23 herbs or root sellers (13 men and 10 women). Attempts were made to interview all animal merchants in the markets visited. In fishing community of the Pesqueiro Beach, interviews were done with 41 inhabitants (23 men and 18 women) and during the first contacts with the local population, we attempted to identify local people with a specialized knowledge of medicinal animal usage. Results P. expansa was traded for use in traditional medicines and cosmetics. Fat and egg shells were used to treat 16 different diseases. Turtle fat was the main product sold. The demand for these products is unknown. However, the use of this species in folk medicine might have a considerable impact on wild population, and this must be taken into account for the conservation and management of this species. Conclusion Our results indicated that the use and commercialization of P. expansa products for medicinal purposes is common in North of Brazil. More studies regarding the use and commerce of Brazilian turtles are urgently needed in order to evaluate the real impact of such activities on natural populations. We hope that

  3. [N. I. Teziakov's contribution to the development of community medicine and sanitation in the Saratov Province (on the occasion of the 150th anniversary of his birth)].

    PubMed

    Rakhmanin, Iu A; Lutsevich, I N; Zav'ialov, A I; Miasnikov, I V

    2009-01-01

    The paper provides N. I. Tezyakov's concise biographical and historical data pertaining to a sanitary service in the Saratov Province. It shows his scientific contribution to the development of community medicine and sanitation in Russia.

  4. The revised 'Early Learning in Medicine' curriculum at the University of Otago--focusing on students, patients, and community.

    PubMed

    Perez, David; Rudland, Joy R; Wilson, Hamish; Roberton, Gayle; Gerrard, David; Wheatley, Antony

    2009-04-03

    This article describes recent changes to years 2 and 3 of undergraduate medical education at the University of Otago, now termed 'Early Learning in Medicine'. These changes focus on learning that is contextually relevant, student centred, horizontally and vertically integrated, and community based. Three new programmes have been introduced to the course; Integrated Cases, Clinical Skills, and Healthcare in the Community. Innovative teaching and learning activities have been implemented to prepare students for a greater level of interaction with patients, carers, health professionals, and community organisations. This curriculum also aims to increase the relevance of their theoretical learning within and across years, and foster an early appreciation of professional responsibilities. Challenges to facilitating this direction are described and framed by an evolutionary approach that builds upon the strong features of the previous course.

  5. The Northern Ontario School of Medicine: responding to the needs of the people and communities of Northern Ontario.

    PubMed

    Strasser, Roger; Lanphear, Joel

    2008-12-01

    Northern Ontario, like many rural and remote regions around the world, has a chronic shortage of health professionals. Recognizing that medical graduates who have grown up in rural areas are more likely to practice in rural settings, the Government of Ontario, Canada established a new medical school with a social accountability mandate to contribute to improving the health of the peoples and communities of Northern Ontario. The Northern Ontario School of Medicine (NOSM) is a joint initiative of Laurentian University in Sudbury and Lakehead University in Thunder Bay, cities one thousand kilometers apart. The NOSM model of medical education is built on several recent educational developments including rural-based medical education, social accountability of medical education and electronic distance education. This paper describes these developments as background to presenting the Northern Ontario School of Medicine as a socially accountable, geographically distributed rural-based medical school. NOSM MD PROGRAM: The school actively seeks to recruit students for the MD program from Northern Ontario or similar northern, rural, remote, Aboriginal, and Francophone backgrounds. The holistic, cohesive curriculum is grounded in Northern Ontario and relies heavily on broadband electronic communications to support distributed, community engaged learning. Students, both in classroom and clinical settings, explore cases as if they were physicians in Northern Ontario communities. Clinical education takes place in a wide range of community and health service settings so that students can experience the diversity of communities and cultures in Northern Ontario. Although NOSM is still in the early stages of development, there are encouraging signs that the school's evidence-based model of medical education will be successful in developing a sustainable, community responsive health workforce for Northern Ontario.

  6. Community Consultation and Communication for a Population-Based DNA Biobank: the Marshfield Clinic Personalized Medicine Research Project

    PubMed Central

    McCarty, Catherine A.; Chapman-Stone, Donna; Derfus, Teresa; Giampietro, Philip F.; Fost, Norman

    2008-01-01

    The purpose of this paper is to describe community consultation and communication efforts for the Personalized Medicine Research Project (PMRP), a population-based biobank. A series of focus group discussions was held in the year preceding initial recruitment efforts with potentially eligible community residents and slightly less than a year after initial recruitment with eligible residents who had declined participation in PMRP. A Community Advisory Group, with 19 members reflecting the demographics of the eligible community, was formed and meets twice yearly to provide advice and feedback to the PMRP Principal Investigator and the local IRB. Ongoing communication with study subjects, who consent on the condition that personal genetic results will not be disclosed, takes place through a newsletter that is distributed twice yearly, community talks and media coverage. Most focus group participants were concerned about the confidentiality of both their medical and genetic data. Focus group discussions with eligible residents who elected not to participate in PMRP revealed that many knew very little about the project, but thought that too much information had been provided, leading them to believe that it would take too long for them to understand and enroll in the study. In conclusion, an engaged community advisory group can provide a sounding board to study investigators for many study issues and can provide guidance for broader communication activities. Researchers need to balance the provision of information for potential subjects to make informed decisions about study participation, with respect for individuals’ time to read and interpret study materials. PMID:19006210

  7. Exploration of ethno-medicinal knowledge among rural communities of Pearl Valley; Rawalakot, District Poonch Azad Jammu and Kashmir

    PubMed Central

    Shaheen, Humaira; Qaseem, Mirza Faisal; Amjad, Muhammad Shoaib; Bruschi, Piero

    2017-01-01

    Background Medicinal plants are the basic source of health care in the Pearl Valley District Poonch, Azad Jammu, and Kashmir. The basic aim of present study was to record information about the use of plants in herbal preparation and quantification of recorded data. Materials and methods The research was conducted with the null hypothesis that there was no differential distribution of knowledge among the communities between genders and among different age groups in the study area and across cultural medicinal uses of the plants are similar. To check these hypotheses information about medicinal plants was collected from 46 laypeople and 18 herbalists by using an open ended and semistructured questionnaire. Different ethnobotanical indices were calculated in order to quantify the knowledge on the medicinal plants reported in the study. Results Our study recorded 136 species of medicinal plants belonging to 45 families with Asteraceae (14 species) as the dominant family of the area. Decoction (26 species), juice and powder (24 species each) were most common methods of preparation. Spearman’s correlation analysis showed that age and gender had the significant effect on both numbers of mentioned species and different uses. A number of known medicinal plants and the number of different uses (H: 38.51; p < 0.001) differ significantly as indicated by Kruskal-Wallis tests. These results showed that the knowledge about the plant varies among different age groups, which were the first hypothesis of the present study. The highest use values (UVs) were reported for Berberis lyceum and Ajuga bracteosa (1.13 each) followed by Abies pindrow (1.03). Highest informant consensus factor (ICF) values were recorded for digestive system diseases (ICF = 0.90) and muscular and skeletal system diseases (ICF = 0.89). The value of Jaccarad index ranged from 6.11 to 32.97 with an average value of 19.84, percentage of similarity was highest between study area and Pir Lasura National Park (34

  8. Exploration of ethno-medicinal knowledge among rural communities of Pearl Valley; Rawalakot, District Poonch Azad Jammu and Kashmir.

    PubMed

    Shaheen, Humaira; Qaseem, Mirza Faisal; Amjad, Muhammad Shoaib; Bruschi, Piero

    2017-01-01

    Medicinal plants are the basic source of health care in the Pearl Valley District Poonch, Azad Jammu, and Kashmir. The basic aim of present study was to record information about the use of plants in herbal preparation and quantification of recorded data. The research was conducted with the null hypothesis that there was no differential distribution of knowledge among the communities between genders and among different age groups in the study area and across cultural medicinal uses of the plants are similar. To check these hypotheses information about medicinal plants was collected from 46 laypeople and 18 herbalists by using an open ended and semistructured questionnaire. Different ethnobotanical indices were calculated in order to quantify the knowledge on the medicinal plants reported in the study. Our study recorded 136 species of medicinal plants belonging to 45 families with Asteraceae (14 species) as the dominant family of the area. Decoction (26 species), juice and powder (24 species each) were most common methods of preparation. Spearman's correlation analysis showed that age and gender had the significant effect on both numbers of mentioned species and different uses. A number of known medicinal plants and the number of different uses (H: 38.51; p < 0.001) differ significantly as indicated by Kruskal-Wallis tests. These results showed that the knowledge about the plant varies among different age groups, which were the first hypothesis of the present study. The highest use values (UVs) were reported for Berberis lyceum and Ajuga bracteosa (1.13 each) followed by Abies pindrow (1.03). Highest informant consensus factor (ICF) values were recorded for digestive system diseases (ICF = 0.90) and muscular and skeletal system diseases (ICF = 0.89). The value of Jaccarad index ranged from 6.11 to 32.97 with an average value of 19.84, percentage of similarity was highest between study area and Pir Lasura National Park (34.62%). High similarity might be due to the

  9. 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

  10. Medicinal plants used by 'Passo da Ilha' rural community in the city of Pato Branco, southern Brazil.

    PubMed

    Marchese, José A; Ming, Lin C; Franceschi, Lucia de; Camochena, Rubia C; Gomes, Greice D R; Paladini, Marcos V; Capelin, Diogo; Marchese, Cristine F

    2009-12-01

    The scope of this work was to rescue and document the traditional knowledge regarding the medicinal plants used by Passo da Ilha rural community, in Pato Branco, Paraná State, Southern Brazil (26 degrees 11' S, 52 degrees 36' W and 760 m high). Structured interviews were made in field research with 16 informants who had the traditional knowledge about medicinal plants. The research was carried out from October to December 2000. The plants were collected in the field, identified and their vouchers were housed at the Herbarium 'Irina Delanova De Gemtchjnicov' (BOTU) of São Paulo State University, in Botucatu. A total of 47 botanical families and 114 species of medicinal plants were identified. These plants ere suitable for ore than 30 different edicinal uses. The residents are mainly of European descent, which justify the presence of many exotic plants. The knowledge on how to use medicinal plants properly is held mainly by the females, and decreases in the newer generations, denoting 'cultural erosion' in progress.

  11. Medicinal plants used by the villagers of a Sundanese community in West Java, Indonesia.

    PubMed

    Roosita, Katrin; Kusharto, Clara M; Sekiyama, Makiko; Fachrurozi, Yulian; Ohtsuka, Ryutaro

    2008-01-04

    Based on the authors' fieldwork in a Sundanese village, Indonesia, this paper aimed to elucidate the roles of herbal medicine in treatment of illnesses and to report medicinal plants and their uses, comparing with those mentioned in the encyclopedic book series of Plant Resources of South-East Asia (PROSEA). Interview survey was conducted for all of the 19 herbalist healers about their therapies for the past 1-month period, and the medicinal plants used were botanically identified. For 70 non-healer households, treatments for all members' illness episodes in the past 1-month period were asked. Medicinal plants were used in two-thirds of illness cases, either through the villagers' self-treatment (60.9%) or by the healers (6.5%). The healers made 96 therapies for illnesses (classified into 23 categories), using 117 plant species. There were 257 types of illness-plant pairs, and only 114 of them (44.4%) were judged conformed to those mentioned in the PROSEA. Sundanese villagers have depended heavily on herbal medicine, and high proportion of non-conformed illness-plant pairs suggests necessity of further studies about Sundanese medicinal plants, particularly their pharmacological effects.

  12. Japanese Community Pharmacists’ Dispensing Influences Medicine Price Reduction more than Prescription Numbers

    PubMed Central

    Yokoi, Masayuki; Tashiro, Takao

    2016-01-01

    This study examined the economic efficiency of the separation of prescription and dispensation medicines between doctors in medical institutions and pharmacists in pharmacies. The separation system in Japanese prefectures was examined with publicly available data (Ministry of Health, Labour and Welfare, 2012–2014; retrieved from http://www.mhlw.go.jp/topics/medias/year). We investigated whether the separation system reduces the number of medicines or the medication cost of a prescription because of separating the economic management between prescribing and dispensing and the effect of mutual observation between doctors and pharmacists. It is optional for Japanese medical institutions to participate in the separation system. Consequently, the spreading rate of the separation system in each administrative district is highly variable. We examined the separation system effect using the National Healthcare Insurance data for three years, 2012–2014. We tested whether the separation system ratio for each prefecture was significantly correlated to the medication price or the number of medicines on a prescription. If spreading the separation system influenced the price of prescribed daily medications or the number of medicines, the correlation would be significant. As a result, the medication price was significantly negatively correlated with the separation system ratio, but the number of medicines was not significant. Therefore, the separation system was effective in reducing daily medication cost but had little influence on reducing the number of daily medicines. This was observed over three years in Japan. PMID:27157157

  13. Medicine-related services in community pharmacy: public preferences for pharmacy attributes and promotional methods and comparison with pharmacists’ perceptions

    PubMed Central

    Gammie, Shivaun M; Rodgers, Ruth M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet

    2016-01-01

    Background Public awareness of pharmacy services designed to support the use of medicines is low, yet little is known about how the public view promotion of these services, or their preferences for the attributes of pharmacies from which they would like to receive them. Objective To compare the public’s preferred attributes of pharmacies and methods for promoting medicine-related services with community pharmacists’ perceptions of their customers’ views. Methods Parallel surveys were conducted in South East England, using a street survey for the general public and a postal survey for community pharmacists. Results Response rates were as follows: public 47.2% (1,000/2,012) and pharmacists 40.8% (341/836). Pharmacists’ perceptions of customer preferences for using the same pharmacy, independent ownership, and personal knowledge of the pharmacist were higher than actual public preferences. More pharmacists than public respondents also believed that approachability and previous good service would be important. The public’s desires for long opening hours and for a pharmacy with a good relationship with their doctor’s surgery were higher than pharmacists believed. The majority of the public prefer not to interrupt a pharmacist who is busy in the dispensary, which was not perceived by pharmacists as a factor. Pharmacists’ perceptions aligned more with the preferences of regular medicine users and frequent pharmacy users. Both groups viewed direct recommendation as the most effective approach for promoting pharmacy services, particularly by doctors and pharmacy staff. Pharmacists’ expectations of the effectiveness of posters and mass media methods were much higher than those of the public. Conclusion Pharmacists and pharmacy owners must ensure good relationships with local medical practices to enable them to maximize opportunities for using the promotional methods judged most effective in encouraging the use of medicine-related services. Staff must be

  14. Comparison of pharmacist and public views and experiences of community pharmacy medicines-related services in England

    PubMed Central

    Rodgers, Ruth M; Gammie, Shivaun M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet

    2016-01-01

    Background Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. Objective To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Methods Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Results Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists’ perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists. Conclusion Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a

  15. Medicine-related services in community pharmacy: public preferences for pharmacy attributes and promotional methods and comparison with pharmacists' perceptions.

    PubMed

    Gammie, Shivaun M; Rodgers, Ruth M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet

    2016-01-01

    Public awareness of pharmacy services designed to support the use of medicines is low, yet little is known about how the public view promotion of these services, or their preferences for the attributes of pharmacies from which they would like to receive them. To compare the public's preferred attributes of pharmacies and methods for promoting medicine-related services with community pharmacists' perceptions of their customers' views. Parallel surveys were conducted in South East England, using a street survey for the general public and a postal survey for community pharmacists. Response rates were as follows: public 47.2% (1,000/2,012) and pharmacists 40.8% (341/836). Pharmacists' perceptions of customer preferences for using the same pharmacy, independent ownership, and personal knowledge of the pharmacist were higher than actual public preferences. More pharmacists than public respondents also believed that approachability and previous good service would be important. The public's desires for long opening hours and for a pharmacy with a good relationship with their doctor's surgery were higher than pharmacists believed. The majority of the public prefer not to interrupt a pharmacist who is busy in the dispensary, which was not perceived by pharmacists as a factor. Pharmacists' perceptions aligned more with the preferences of regular medicine users and frequent pharmacy users. Both groups viewed direct recommendation as the most effective approach for promoting pharmacy services, particularly by doctors and pharmacy staff. Pharmacists' expectations of the effectiveness of posters and mass media methods were much higher than those of the public. Pharmacists and pharmacy owners must ensure good relationships with local medical practices to enable them to maximize opportunities for using the promotional methods judged most effective in encouraging the use of medicine-related services. Staff must be approachable and enable access to pharmacists, ensuring that

  16. Comparison of pharmacist and public views and experiences of community pharmacy medicines-related services in England.

    PubMed

    Rodgers, Ruth M; Gammie, Shivaun M; Loo, Ruey Leng; Corlett, Sarah A; Krska, Janet

    2016-01-01

    Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists' perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists. Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a better awareness of what the public, especially

  17. Do pharmaceuticals displace local knowledge and use of medicinal plants? Estimates from a cross-sectional study in a rural indigenous community, Mexico.

    PubMed

    Giovannini, Peter; Reyes-García, Victoria; Waldstein, Anna; Heinrich, Michael

    2011-03-01

    Researchers examining the relationships between traditional medicine and biomedicine have observed two conflicting tendencies. Some suggest that the use of biomedicine and biomedical concepts displaces the use of traditional medicine and medical beliefs. Other scholars have found that traditional medicine and biomedicine can co-exist, complement, and blend with each other. In this paper we use an econometric model and quantitative data to test the association between individual knowledge of pharmaceuticals and individual knowledge of medicinal plants. We use data from a survey among 136 household heads living in a rural indigenous community in Oaxaca, Mexico. Data were collected as a part of long term fieldwork conducted between April 2005 and August 2006 and between December 2006 and April 2007. We found a significant positive association between an individual's knowledge of medicinal plants and the same individual's knowledge of pharmaceuticals, as well as between her use of medicinal plants and her use of pharmaceuticals. We also found a negative association between the use of medicinal plants and schooling. Our results suggest that, in the study site, individual knowledge of medicinal plants and individual knowledge of pharmaceuticals co-exist in a way which might be interpreted as complementary. We conclude that social organization involved in the use of medicines from both traditional medicine and biomedicine is of particular significance, as our findings suggest that the use of pharmaceuticals alone is not associated with a decline in knowledge/use of medicinal plants.

  18. Asháninka medicinal plants: a case study from the native community of Bajo Quimiriki, Junín, Peru

    PubMed Central

    2010-01-01

    Background The Asháninka Native Community Bajo Quimiriki, District Pichanaki, Junín, Peru, is located only 4 km from a larger urban area and is dissected by a major road. Therefore the loss of traditional knowledge is a main concern of the local headman and inhabitants. The present study assesses the state of traditional medicinal plant knowledge in the community and compares the local pharmacopoeia with the one from a related ethnic group. Methods Fieldwork was conducted between July and September 2007. Data were collected through semi-structured interviews, collection of medicinal plants in the homegardens, forest walks, a walk along the river banks, participant observation, informal conversation, cross check through voucher specimens and a focus group interview with children. Results Four-hundred and two medicinal plants, mainly herbs, were indicated by the informants. The most important families in terms of taxa were Asteraceae, Araceae, Rubiaceae, Euphorbiaceae, Solanaceae and Piperaceae. Eighty-four percent of the medicinal plants were wild and 63% were collected from the forest. Exotics accounted to only 2% of the medicinal plants. Problems related to the dermal system, digestive system, and cultural belief system represented 57% of all the medicinal applications. Some traditional healers received non-indigenous customers, using their knowledge as a source of income. Age and gender were significantly correlated to medicinal plant knowledge. Children knew the medicinal plants almost exclusively by their Spanish names. Sixteen percent of the medicinal plants found in this community were also reported among the Yanesha of the Pasco Region. Conclusions Despite the vicinity to a city, knowledge on medicinal plants and cultural beliefs are still abundant in this Asháninka Native Community and the medicinal plants are still available in the surroundings. Nevertheless, the use of Spanish names for the medicinal plants and the shift of healing practices towards a

  19. How do Danish community pharmacies vary in engaging customers in medicine dialogues at the counter – an observational study

    PubMed Central

    Kaae, Susanne; Saleem, Sahdia; Kristiansen, Maria

    2014-01-01

    Background Counter counseling is an important part of community pharmacies service delivery. Difficulties arise because customers appear less interested than the staff in discussing their medicine. It is unclear how individual pharmacies differ with regard to overcoming these obstacles. Objective This study explores differences in the communication practices of pharmacies with regard to engaging customers in medicine dialogues. Methods The work of Stevenson et al. describing five types of interaction scenarios at the counter was used for structured overt non-participant observations of 100 encounters in each of five Danish pharmacies. Variation in pharmacies success in engaging customers in medicine dialogues were calculated using descriptive statistics, and the statistical significance of observed differences across pharmacies was analyzed using odds ratios (OR). Results Considerable differences between the pharmacies were identified. Differences exist in how often pharmacy staff attempts to encourage customers to participate in medication dialogues and how often they succeed. The pharmacies serving the most customers per day were the most successful. A possible link between a low number of refill customers offered counseling and ‘success rate’ was identified. Conclusions The pharmacies showed considerable variation in attempts to engage customers in medication dialogues at the counter and success in doing so. The reasons for the identified patterns are unclear. PMID:25243031

  20. The economic contribution of the Northern Ontario School of Medicine to communities participating in distributed medical education.

    PubMed

    Hogenbirk, John C; Robinson, David R; Hill, Mary Ellen; Pong, Raymond W; Minore, Bruce; Adams, Ken; Strasser, Roger P; Lipinski, Joe

    2015-01-01

    The economic contribution of medical schools to major urban centres can be substantial, but there is little information on the contribution to the economy of participating communities made by schools that provide education and training away from major cities and academic health science centres. We sought to assess the economic contribution of the Northern Ontario School of Medicine (NOSM) to northern Ontario communities participating in NOSM's distributed medical education programs. We developed a local economic model and used actual expenditures from 2007/08 to assess the economic contribution of NOSM to communities in northern Ontario. We also estimated the economic contribution of medical students or residents participating in different programs in communities away from the university campuses. To explore broader economic effects, we conducted semistructured interviews with leaders in education, health care and politics in northern Ontario. The total economic contribution to northern Ontario was $67.1 million based on $36.3 million in spending by NOSM and $1.0 million spent by students. Economic contributions were greatest in the university campus cities of Thunder Bay ($26.7 million) and Sudbury ($30.4 million), and $0.8-$1.2 million accrued to the next 3 largest population centres. Communities might realize an economic contribution of $7300-$103 900 per pair of medical learners per placement. Several of the 59 interviewees remarked that the dollar amount could be small to moderate but had broader economic implications. Distributed medical education at the NOSM resulted in a substantial economic contribution to participating communities.

  1. Complementary and Alternative Medicine in Rural Communities: Current Research and Future Directions

    ERIC Educational Resources Information Center

    Wardle, Jon; Lui, Chi-Wai; Adams, Jon

    2012-01-01

    Contexts: The consumption of complementary and alternative medicine (CAM) in rural areas is a significant contemporary health care issue. An understanding of CAM use in rural health can provide a new perspective on health beliefs and practice as well as on some of the core service delivery issues facing rural health care generally. Purpose: This…

  2. Complementary and Alternative Medicine in Rural Communities: Current Research and Future Directions

    ERIC Educational Resources Information Center

    Wardle, Jon; Lui, Chi-Wai; Adams, Jon

    2012-01-01

    Contexts: The consumption of complementary and alternative medicine (CAM) in rural areas is a significant contemporary health care issue. An understanding of CAM use in rural health can provide a new perspective on health beliefs and practice as well as on some of the core service delivery issues facing rural health care generally. Purpose: This…

  3. Faculty Development for Medical School Community-Based Faculty: A Council of Academic Family Medicine Educational Research Alliance Study Exploring Institutional Requirements and Challenges.

    PubMed

    Drowos, Joanna; Baker, Suzanne; Harrison, Suzanne Leonard; Minor, Suzanne; Chessman, Alexander W; Baker, Dennis

    2017-08-01

    Community-based faculty play a large role in training medical students nationwide and require faculty development. The authors hypothesized that positive relationships exist between clerkships paying preceptors and requiring faculty development, and between protected clerkship directors' time and delivering face-to-face preceptor training, as well as with the number or length of community-based preceptor visits. Through under standing the quantity, delivery methods, barriers, and institutional support for faculty development provided to community-based preceptors teaching in family medicine clerkships, best practices can be developed. Data from the 2015 Council of Academic Family Medicine's Educational Research Alliance survey of Family Medicine Clerkship Directors were analyzed. The cross-sectional survey of clerkship directors is distributed annually to institutional representatives of U.S. and Canadian accredited medical schools. Survey questions focused on the requirements, delivery methods, barriers, and institutional support available for providing faculty development to community-based preceptors. Paying community-based preceptors was positively correlated with requiring faculty development in family medicine clerkships. The greatest barrier to providing faculty development was community-based preceptor time availability; however, face-to-face methods remain the most common delivery strategy. Many family medicine clerkship directors perform informal or no needs assessment in developing faculty development topics for community-based faculty. Providing payment to community preceptors may allow schools to enhance faculty development program activities and effectiveness. Medical schools could benefit from constructing a formal curriculum for faculty development, including formal preceptor needs assessment and program evaluation. Clerkship directors may consider recruiting and retaining community-based faculty by employing innovative faculty development delivery

  4. Family medicine education in rural communities as a health service intervention supporting recruitment and retention of physicians: Advancing Rural Family Medicine: The Canadian Collaborative Taskforce.

    PubMed

    Soles, Trina Larsen; Ruth Wilson, C; Oandasan, Ivy F

    2017-01-01

    To develop a pan-Canadian rural education road map to advance the recruitment and retention of family physicians in rural, remote, and isolated regions of Canada in order to improve access and health care outcomes for these populations. Members of the task force were chosen from key stakeholder groups including educators, practitioners, the College of Family Physicians of Canada education committee chairs, deans, chairs of family medicine, experts in rural education, and key decision makers. The task force members were purposefully selected to represent a mix of key perspectives needed to ensure the work produced was rigorous and of high quality. Observers from the Canadian Medical Association and Health Canada's Council on Health Workforce, and representatives from the Royal College of Physicians and Surgeons of Canada, were also invited to provide their perspectives and to encourage and coordinate multiorganization action. The task force commissioned a focused literature review of the peer-reviewed and gray literature to examine the status of rural medical education, training, and practice in relation to the health needs of rural and remote communities in Canada, and also completed an environmental scan. The environmental scan included interviews with more than 100 policy makers, government representatives, providers, educators, learners, and community leaders; 17 interviews with practising rural physicians; and 2 surveys administered to all 17 faculties of medicine. The gaps identified from the focused literature review and the results of the environmental scan will be used to develop the task force's recommendations for action, highlighting the role of key partners in implementation and needed action. The work of the task force provides an opportunity to bring the various partners together in a coordinated way. By understanding who is responsible and the actions each stakeholder needs to take to make the recommendations a reality, the task force can lay the

  5. Knowledge, behaviors and practices of community and hospital pharmacists towards biosimilar medicines: Results of a French web-based survey.

    PubMed

    Beck, Morgane; Michel, Bruno; Rybarczyk-Vigouret, Marie-Christine; Levêque, Dominique; Sordet, Christelle; Sibilia, Jean; Velten, Michel

    This study's aims were: 1) to extract a comprehensive overview of the knowledge, experience and opinions of both community pharmacists and hospital pharmacists regarding biosimilar medicines in France; and 2) to identify the perceived problems and solutions to promoting their prescription. A 2015 web-based survey was conducted by the Observatoire des Médicaments, des Dispositifs Médicaux et de l'Innovation Thérapeutique of Alsace. A total of 802 pharmacists responded to the survey. Many (536, 66.8%, [95% confidence interval (CI) 63.6-70.1]) indicated that they were not familiar with biosimilars. Half of community pharmacists (95% CI 42.7-57.3) stated that they were not at all informed about biosimilar drugs, compared with 15.7% (95% CI 12.9-18.6) of hospital pharmacists. Almost all respondents (781, 97.4%, [95% CI 96.3-98.5]) had at least one pending question on biosimilars. Most of the questions were related to the manufacturing process, safety, substitution rules and the international non-proprietary name prescription. At the time of the study, 467 pharmacists (58.2%, [95% CI 54.8-61.6]) had already validated a prescription for a biosimilar drug, mainly for filgrastim. These latter were more comfortable in explaining the benefit of biosimilar medicines to the patient. Pharmacists were rather favorable to biosimilar drugs, and about 9 of 10 quoted healthcare cost savings as incentives to their prescription. However, many did not agree with allowing biosimilar substitution. "Patients' wishes to be treated with the originator" and "indication extrapolation" were the two main constraints identified. The survey highlighted the need to provide French pharmacists with accurate and comprehensive information regarding biosimilar medicines.

  6. Attitudes towards African traditional medicine and Christian spiritual healing regarding treatment of epilepsy in a rural community of northern Tanzania.

    PubMed

    Winkler, Andrea Sylvia; Mayer, Michael; Ombay, Michael; Mathias, Bartholomayo; Schmutzhard, Erich; Jilek-Aall, Louise

    2009-12-30

    Most people with epilepsy (PWE) live in developing countries with limited access to health care facilities. In sub-Saharan Africa with approximately 12 million PWE, 90% do not receive adequate medical treatment. In this context, traditional medicine, being easily accessible, plays an important role. However, in sub- Saharan Africa, studies on the attitude of people (both affected and not affected by epilepsy) towards traditional medicine for treatment of epilepsy are scarce. In this study, 167 people (59 PWE, 62 relatives, 46 villagers) were interviewed at the hospital and in the community with a semi-structured validated questionnaire regarding the prevailing attitude towards traditional medicine for treatment of epilepsy in a rural area of northern Tanzania. Various traditional healing methods (THM) could be ascertained, i.e. traditional herbal medicine, spiritual healing, scarifications and spitting. 44.3% (n=74/167) of the interviewed people were convinced that epilepsy could be treated successfully with THM. Interestingly, 34.1% (n=57/167) thought that Christian prayers could cure the cause and/or treat symptoms of epilepsy. Significantly more PWE and their relatives were in favour of THM compared to villagers not knowing about epilepsy or not being immediately affected by epilepsy (χ(2)-test, p=0.004). Further factors influencing people's attitudes towards THM were gender, tribe, religion and urbanity of people's dwellings. Our study demonstrates that not only THM but also prayers in the Christian sense seem to play an important role in people's beliefs regarding successful treatment of epilepsy. Factors influencing this belief system have been identified and are discussed.

  7. Medicinal plants used for the treatment of various skin disorders by a rural community in northern Maputaland, South Africa

    PubMed Central

    2013-01-01

    allopathic medicine by most of the interviewees strengthens previous studies on the importance that traditional medicine can have in the primary health care system in this rural community. Studies to validate the potential of these plants independently and in their various combinations is underway to provide insight into the anti-infective role of each plant. PMID:23870616

  8. Medicinal plants used for the treatment of various skin disorders by a rural community in northern Maputaland, South Africa.

    PubMed

    De Wet, Helene; Nciki, Sibongile; van Vuuren, Sandy F

    2013-07-19

    interviewees strengthens previous studies on the importance that traditional medicine can have in the primary health care system in this rural community. Studies to validate the potential of these plants independently and in their various combinations is underway to provide insight into the anti-infective role of each plant.

  9. A commitment to high-value care education from the internal medicine community.

    PubMed

    Smith, Cynthia D; Levinson, Wendy S

    2015-05-05

    The Alliance for Academic Internal Medicine, American Board of Internal Medicine (ABIM), ABIM Foundation, and American College of Physicians are collaborating to enhance the education of physicians in high-value care (HVC) and make its practice an essential competency in undergraduate and postgraduate education by 2017. This article serves as the organizations' formal commitment to providing a foundation of HVC education on which others may build. The 5 key targets for HVC education are experiential learning and curriculum, environment and culture, clinical support, regulatory requirements, and sustainability. The goal is to train future health care professionals for whom HVC is part of normal practice, thus providing patients with improved clinical outcomes at a lower cost.

  10. Medicinal plants potential and use by pastoral and agro-pastoral communities in Erer Valley of Babile Wereda, Eastern Ethiopia

    PubMed Central

    2012-01-01

    Background Ethiopian plants have shown remarkably effective medicinal values for many human and livestock ailments. Some research results are found on medicinal plants of the south, south west, central, north and north western parts of Ethiopia. However, there is lack of data that quantitatively assesses the resource potential and the indigenous knowledge on use and management of medicinal plants in eastern Ethiopia. The main thrust of the present ethnobotanical study centres around the potential and use of traditional medicinal plants by pastoral and agro-pastoral communities in Babile Wereda (district) of eastern Ethiopia. The results can be used for setting up of conservation priorities, preservation of local biocultural knowledge with sustainable use and development of the resource. Materials and methods Fifty systematically selected informants including fifteen traditional herbalists (as key informants) participated in the study. Semi-structured interviews, discussions and guided field walk constituted the main data collection methods. Techniques of preference ranking, factor of informant consensus and Spearman rank correlation test were employed in data analysis. Medicinal plant specimens were collected, identified and kept at the National Herbarium (ETH) of Addis Ababa University and Haramaya University Herbarium. Results Fifty-one traditional medicinal plant species in 39 genera and 28 families were recorded, constituting 37% shrubs, 29% trees, 26% herbs, 6% climbers and 2% root parasites. Leaves contributed to 35.3% of the preparations, roots (18.8%) and lower proportions for other parts. Formulations recorded added to 133 remedies for 54 human ailments, in addition to some used in vector control. The majority of remedies were the juice of single species, mixtures being generally infrequent. Aloe pirottae, Azadirachta indica and Hydnora johannis were the most cited and preferred species. Aloe pirottae, a species endemic to Ethiopia, is valued as a remedy

  11. Medicinal plants potential and use by pastoral and agro-pastoral communities in Erer Valley of Babile Wereda, Eastern Ethiopia.

    PubMed

    Belayneh, Anteneh; Asfaw, Zemede; Demissew, Sebsebe; Bussa, Negussie F

    2012-10-22

    Ethiopian plants have shown remarkably effective medicinal values for many human and livestock ailments. Some research results are found on medicinal plants of the south, south west, central, north and north western parts of Ethiopia. However, there is lack of data that quantitatively assesses the resource potential and the indigenous knowledge on use and management of medicinal plants in eastern Ethiopia. The main thrust of the present ethnobotanical study centres around the potential and use of traditional medicinal plants by pastoral and agro-pastoral communities in Babile Wereda (district) of eastern Ethiopia. The results can be used for setting up of conservation priorities, preservation of local biocultural knowledge with sustainable use and development of the resource. Fifty systematically selected informants including fifteen traditional herbalists (as key informants) participated in the study. Semi-structured interviews, discussions and guided field walk constituted the main data collection methods. Techniques of preference ranking, factor of informant consensus and Spearman rank correlation test were employed in data analysis. Medicinal plant specimens were collected, identified and kept at the National Herbarium (ETH) of Addis Ababa University and Haramaya University Herbarium. Fifty-one traditional medicinal plant species in 39 genera and 28 families were recorded, constituting 37% shrubs, 29% trees, 26% herbs, 6% climbers and 2% root parasites. Leaves contributed to 35.3% of the preparations, roots (18.8%) and lower proportions for other parts. Formulations recorded added to 133 remedies for 54 human ailments, in addition to some used in vector control. The majority of remedies were the juice of single species, mixtures being generally infrequent. Aloe pirottae, Azadirachta indica and Hydnora johannis were the most cited and preferred species. Aloe pirottae, a species endemic to Ethiopia, is valued as a remedy for malaria, tropical ulcer, gastro

  12. Community pharmacists' knowledge, practices and beliefs about complementary and alternative medicine in Palestine: a cross-sectional study.

    PubMed

    Shraim, Naser Y; Shawahna, Ramzi; Sorady, Muna A; Aiesh, Banan M; Alashqar, Ghadeer Sh; Jitan, Raghad I; Abu Hanieh, Waed M; Hotari, Yasmeen B; Sweileh, Waleed M; Zyoud, Sa'ed H

    2017-08-29

    Complementary and alternative medicine (CAM) utilization is dramatically increasing among patients. As community pharmacies are a major provider of CAM products, community pharmacists need to have the sufficient knowledge and information to advice their patients, answer their inquiries and to be proactive in the healthcare process to ensure optimal therapy outputs and minimize both drug-drug and drug-herb interactions. Therefore, the main objective of this study was to assess the knowledge, beliefs, and practices of community pharmacists in Palestine about CAM. The study was conducted in a cross-sectional design in which a questionnaire was administered on a sample of licensed community pharmacists from Palestine. The questionnaire was of 5 sections: demographic and practice details of the participants, practice, beliefs, and knowledge about CAM. Mann-Whitney-U or Kruskal-Wallis tests were used to comparison of different issues as appropriate. P-values of <0.05 were considered significant. A total of 284 community pharmacists were surveyed, however, 281 were included in the analysis as they met inclusion criteria. Out of the 281, 149 (53.0%) of the participants were males and the rest were females. About 40% of the participants were between 20 to 29 years old. Pharmacists frequently recommended CAM modalities. Exercises (84.0%) and food supplements (82.6%) were the most commonly recommended modalities. In the last year, vitamin B12 was the most frequently prescribed supplement. The median knowledge score was 5 out of 8 and the median beliefs about CAM score was 4.0 out of 7.0. CAM recommendations by pharmacists appear to be commonplace. Although their knowledge scores were fair to average, pharmacists still need more education and training about CAM in order to be more qualified to provide better pharmaceutical care and improve their patient's outcome.

  13. Use patterns and knowledge of medicinal species among two rural communities in Brazil's semi-arid northeastern region.

    PubMed

    Monteiro, Julio Marcelino; de Albuquerque, Ulysses Paulino; Lins-Neto, Ernani Machado de Freitas; de Araújo, Elcida Lima; de Amorim, Elba Lúcia Cavalcanti

    2006-04-21

    The present work seeks to quantify the knowledge of two rural communities in the semi-arid region of the state of Pernambuco (northeastern Brazil) concerning two species of native medicinal plants: "aroeira do sertão", Myracrodruon urundeuva (Engl.) Fr. All. (Anacardiaceae) and "angico", Anadenanthera colubrina (Vell.) Brenan (Mimosaceae). Semi-structured interviews were carried out, combined with a checklist/inventory method, which yielded different indexes for quantifying knowledge and use of these species. In addition, the reliability of local knowledge was tested using analytical techniques to determine actual tannin concentrations. Although both communities possess knowledge concerning these two species, one of them stood out in terms of the diversity of information presented (P < 0.05), a difference that may be related to its lower degree of modernization. In general, older people had a greater variety of information about these plants, although both men and women demonstrated similar knowledge. Of the 101 people interviewed in Riachão, 85% stated that they knew of uses for both species studied; in Ameixas, of the 55 interviewees, 63% responded that they knew of uses for Myracrodruon urundeuva, and 45% knew of uses for Anadenanthera colubrina. A total of 97 different uses were reported by all informants for the two species studied. Of these, 62 were mentioned in only a single community, confirming our hypothesis of differences in knowledge between them. Informants from both communities knew of a great variety of uses for these plants as well as a number of different collection techniques. We expected that knowledge about the two species would differ in relation to both gender and age, but this was only true for one of the communities. Greater concentrations of tannins were expected to be found consistently in the tree bark, but experimental data demonstrated that tannin concentrations can vary among plant parts during the year.

  14. Alternative medicine in a sample of 655 community-dwelling elderly.

    PubMed

    Dello Buono, M; Urciuoli, O; Marietta, P; Padoani, W; De Leo, D

    2001-03-01

    Use and satisfaction with herbal/homeopathic remedies, acupuncture and relaxation techniques were examined in an Italian elderly population. Data were collected as part of a survey on an elderly population, conducted in 1996--1997 in the urban centre of Padua, Italy. A total of 1362 elderly received a letter inviting them to participate and to accept the visit of an interviewer at home. Of these, 212 were unable to do so for insurmountable reasons and 666 gave consent to take part in the study with a response rate of 65%. Eleven participants were excluded from the study because cognitively impaired. Among the 655 respondents, overall use of at least one alternative medicine was 29.5%. Herbs/phytotherapeutics (47%) and acupuncture (34%) were the most frequently cited therapies. The use of alternative medical practices seems rather widespread among the elderly population in Padua, especially among females with depressive symptoms, pain and discomfort, but not suffering from chronic somatic disease. A percentage of 3.7% of the sample used exclusively alternative medicines; those subjects seemed to be younger, less likely to be physically ill and to report functional disorders and chronic somatic disease. Alternative medicines seem to have a complementary role for the elderly with self-perceived psychological symptomatology or disorders, particularly of depressive nature. They may constitute an attempt at self-treatment, probably concealing the difficulties encountered by the elderly subjects in seeking specialist advice for these problems.

  15. Traditional use of medicinal plants among the tribal communities of Chhota Bhangal, Western Himalaya

    PubMed Central

    Uniyal, Sanjay Kr; Singh, KN; Jamwal, Pankaj; Lal, Brij

    2006-01-01

    The importance of medicinal plants in traditional healthcare practices, providing clues to new areas of research and in biodiversity conservation is now well recognized. However, information on the uses for plants for medicine is lacking from many interior areas of Himalaya. Keeping this in view the present study was initiated in a tribal dominated hinterland of western Himalaya. The study aimed to look into the diversity of plant resources that are used by local people for curing various ailments. Questionnaire surveys, participatory observations and field visits were planned to illicit information on the uses of various plants. It was found that 35 plant species are commonly used by local people for curing various diseases. In most of the cases (45%) under ground part of the plant was used. New medicinal uses of Ranunculus hirtellus and Anemone rupicola are reported from this area. Similarly, preparation of "sik" a traditional recipe served as a nutritious diet to pregnant women is also not documented elsewhere. Implication of developmental activities and changing socio-economic conditions on the traditional knowledge are also discussed. PMID:16545146

  16. Hot and cold: medicinal plant uses in Quechua speaking communities in the high Andes (Callejón de Huaylas, Ancash, Perú).

    PubMed

    de la Cruz, Mercedes Gonzales; Malpartida, Severo Baldeón; Santiago, Hamilton Beltrán; Jullian, Valérie; Bourdy, Geneviève

    2014-09-11

    An ethnopharmacological survey has been set up in high altitude Quechua speaking communities dwelling in Callejón de Huaylas (Ancash department, Peru) and in medicinal plant markets in order to document the medicinal plants use of 178 species within the frame of a traditional Andean medicinal system. A sound ethnopharmacological survey was performed during the years 2011, 2012 and 2013 in different places along Callejón de Huaylas valley in the peruvian Andes, were Quechua speaking communities dwell. Two different methodologies were used: first, plant uses were recorded during walks with informants and in medicinal plant markets held on a regular bases in the area (Huaraz, Carhuaz, Yungay). Secondly, traditional healers (curanderas, curanderos) were interviewed about their practices and healing sessions were observed, in order to understand better the traditional medicinal system as a whole (disease aetiology, diagnosis, treatments, healers). Altogether, 178 medicinal species were collected. Most of the plants found on the market were also found in the wild and vice-versa. Medicinal plant trade is exclusively held by women, selling their merchandise to local people or to big retailer. Plants are classified according their hot or cold virtues, this in accordance with the local conception of the body physiology and disease aetiology, based on a hot-cold polarity. Main use notified for medicinal plants is "(bath) against cold", a prophylactic measure against diseases of cold nature. Other uses include culture bound illnesses i.e. susto, aire, nervios, or heart pain, commonly cited in South America. Regarding symptoms, rheumatic/arthritic pain, musculoskeletal traumas, cough, pulmonary and respiratory problems, gastritis and stomach ache, were the most frequently cited. Diagnosis and treatment are intrinsically linked together and mainly based upon divination techniques using egg and cuy (Cavia porcellus L., Caviidae). Medicinal plants use and traditional medicinal

  17. The treatment of jaundice with medicinal plants in indigenous communities of the Sub-Himalayan region of Uttarakhand, India.

    PubMed

    Sharma, Jyotsana; Gairola, Sumeet; Gaur, R D; Painuli, R M

    2012-08-30

    Inspite of tremendous advances made in allopathic medical practices, herbs still play an important role in the management of various liver diseases. A large number of plants and formulations have been claimed to have hepatoprotective activity. Jaundice is a symptom, indicative of the malfunctioning of the liver. This paper provides ethnomedicinal information on the plants used to treat jaundice by three important indigenous communities, i.e., nomadic Gujjars, Tharu and Bhoxa of Sub-Himalayan region, Uttarakhand, India. To record herbal preparations used by the studied indigenous communities in treatment of jaundice and discuss hepatoprotective properties of the recorded plants. The traditional knowledge of the studied indigenous communities on herbal preparations used for treating jaundice was collected through structured questionnaire and personal interviews. The interviews were conducted with 91 traditional healers (29 Bhoxa, 35 Tharu and 27 nomadic Gujjars) in Sub-Himalayan region of Uttarakhand, India. More than 250 research papers reporting ethnomedicinal information on the hepatoprotective plants used by various communities from different parts of India were extensively reviewed. A total of 40 medicinal plants belonging to 31 families and 38 genera were recorded to be used by the studied communities in 45 formulations as a remedy of jaundice. Bhoxa, nomadic Gujjars and Tharu communities used 15, 23 and 9 plants, respectively. To our knowledge eight plants reported in the present survey viz., Amaranthus spinosus L., Cissampelos pareira L., Ehretia laevis Roxb., Holarrhena pubescens Wall., Ocimum americanum L., Physalis divaricata D. Don, Solanum incanum L. and Trichosanthes cucumerina L. have not been reported earlier as remedy of jaundice in India. Literature review revealed that a total of 214 (belonging to 181 genus and 78 families), 19 (belonging to 18 genus and 12 families) and 14 (belonging to 14 genus and 11 families) plant species are used as internal

  18. Medicinal plants used for management of malaria among the Luhya community of Kakamega East sub-County, Kenya.

    PubMed

    Mukungu, Nillian; Abuga, Kennedy; Okalebo, Faith; Ingwela, Raphael; Mwangi, Julius

    2016-12-24

    Malaria remains a major health problem worldwide especially in sub-Saharan Africa. In Kenya, 80% of the population is at risk of contracting the disease. Pregnant mothers and children under five years are the most affected by this disease. Antimalarial drug resistance poses a major threat in the fight against malaria necessitating continuous search for new antimalarial drugs. Due to inadequate and inaccessible health facilities, majority of people living in rural communities heavily depend on traditional medicine which involves the use of medicinal plants for the management of malaria. Most of these indigenous knowledge is undocumented and risks being lost yet such information could be useful in the search of new antimalarial agents. An ethnobotanical survey was carried out among the Luhya community of Kakamega East sub-County, a malaria epidemic region, with the aim of documenting the plants used in the management of malaria. Semi-structured questionnaires were used to collect information from 21 informants who included traditional medicine practitioners and other caregivers who had experience in use of plants in management of malaria. These were drawn from 4 villages located in Kakamega East sub-county, within Kakamega County based on their differences in topography. Information recorded included plant names, parts used, mode of preparation and administration and the sources of plant materials. A literature search was conducted using PubMed and google scholar to identify the reported traditional uses of these plants and studied antiplasmodial activities. In this study, 57% of the informants were aged above 50 years and a total of 61% had either no formal education or had only attained primary school education. A total of 42 plant species belonging to 24 families were identified. Most plants used in the management of malaria in this community belonged to Lamiaceae (18%), Leguminosae (9%) and Compositae (9%) plant families. Plants mostly used included Melia

  19. Views and experiences of community pharmacists and superintendent pharmacists regarding the New Medicine Service in England prior to implementation.

    PubMed

    Wells, Katharine M; Thornley, Tracey; Boyd, Matthew J; Boardman, Helen F

    2014-01-01

    The New Medicine Service (NMS) was introduced to community pharmacies in England in October 2011. The NMS aims to improve adherence to new medicines in patients with selected long term conditions. The service consists of two follow-up consultations within 1 month in addition to usual care. This study explored community pharmacist and superintendent pharmacist views and experiences of the NMS in the 5 weeks prior to its implementation to identify potential facilitators and barriers to its success. The study also investigated participant experiences of the introduction and provision of existing pharmacy services in order to contrast with the implementation of the NMS. This study consisted of four focus groups with a total of 15 community pharmacists representing locums and employees of small, medium and large chain pharmacies. In addition, 5 semi-structured interviews were conducted with superintendent pharmacists representing independent, small chain, supermarket and large multiple pharmacies. Data were audio-recorded, transcribed verbatim and thematically analyzed. Both pharmacists and superintendent pharmacists were positive about the NMS and identified potential benefits for patients and the pharmacy profession. Awareness of the service was high, however, some confusion between the NMS and changes to Medicine Use Reviews was evident in all focus groups due to their similarity and coincidental implementation. This confusion was not observed in the interviews with superintendent pharmacists. Participants identified pharmacists' positive attitude, the similarity to current practice and the self-accreditation procedure as potential facilitators to service implementation. Potential barriers identified included a perceived lack of interest and awareness by GPs of the service, and the payment structure. Participants were concerned about the speed of implementation, and the absence of some materials needed prior to the start of the service. Participants were enthusiastic

  20. Health care professionals' perceptions of a community based 'virtual ward' medicines management service: A qualitative study.

    PubMed

    Kirkcaldy, Andrew; Jack, Barbara A; Cope, Louise C

    2017-02-03

    This article describes a qualitative research study using focus groups to explore the views and experiences of a medicines management team (MMT) on the service they deliver within a 'Virtual Ward' (VW); and those of the wider multidisciplinary team of healthcare professionals on the service provided by the MMT. Several themes emerged from the focus groups, including impact on patients and carers, team working and issues and challenges. A dedicated MMT was seen as a positive contribution to the VW, which potentially increased the quality of patient care, and appeared to be a positive experience for both the MM and wider multidisciplinary team.

  1. Friends Can Be Good Medicine: Educating the Community about Social Support and Health.

    ERIC Educational Resources Information Center

    Hunter, Lisa; Lloyd-Kolkin, Donna

    Traditionally, the medical field has researched the physical components of health but neglected interpersonal, social factors such as the quality of supportive relationships. To communicate the critical importance of social support to health maintenance, and to stimulate community activities which connect people and provide opportunities to…

  2. Comprehensive dataset of the medicinal plants used by a Tashelhit speaking community in the High Atlas, Morocco.

    PubMed

    Teixidor-Toneu, Irene; Martin, Gary J; Ouhammou, Ahmed; Puri, Rajindra K; Hawkins, Julie A

    2016-09-01

    This dataset describes medicinal plants used in a poorly studied area of Morocco: the High Atlas mountains, inhabited by Ishelhin people, the southern Moroccan Amazigh (Berber) ethnic group, "An ethnomedicinal survey of a Tashelhit-speaking community in the High Atlas, Morocco" (Teixidor-Toneu et al., 2016) [1]. It includes a comprehensive list of the plants used in the commune, as well as details on the plant voucher specimens collected and a glossary of Tashelhit terminology relevant to the study. To collect the data, semi-structured and structured interviews were carried out, as well as focus group discussions. Free prior informed consent was obtained for all interactions. A hundred and six adults were interviewed and 2084 use reports were collected; a hundred fifty-one vernacular names corresponding to 159 botanical species were found.

  3. Cancer care experiences and the use of complementary and alternative medicine at end of life in Nova Scotia's Black Communities.

    PubMed

    Maddalena, Victor J; Bernard, Wanda Thomas; Etowa, Josephine; Murdoch, Sharon Davis; Smith, Donna; Marsh Jarvis, Phyllis

    2010-04-01

    This qualitative study examines the meanings that African Canadians living in Nova Scotia, Canada, ascribe to their experiences with cancer, family caregiving, and their use of complementary and alternative medicine (CAM) at end of life. Case study methodology using in-depth interviews were used to examine the experiences of caregivers of decedents who died from cancer in three families. For many African Canadians end of life is characterized by care provided by family and friends in the home setting, community involvement, a focus on spirituality, and an avoidance of institutionalized health services. Caregivers and their families experience multiple challenges (and multiple demands). There is evidence to suggest that the use of CAM and home remedies at end of life are common. The delivery of palliative care to African Canadian families should consider and support their preference to provide end-of-life care in the home setting.

  4. Receiving money for medicine: some tensions and resolutions for community-based private complementary therapists.

    PubMed

    Andrews, Gavin J; Peter, Elizabeth; Hammond, Robin

    2003-03-01

    During recent years, private complementary medicine has grown as a significant provider of healthcare in the UK and much of this provision is through small private businesses financed by out-of-pocket payments made by privately paying clients. Using a combined questionnaire (n = 426) and interview survey (n = 49), the present paper considers the potential tensions and dilemmas which therapists face and the resolutions which they come to in being carers, but in market terms, also profit makers. Therapists generally identified with being carers first and business people second, and this was reflected in their caring decisions. Indeed, under circumstances where the roles potentially conflicted (e.g. when clients could no longer afford to pay for their treatments), most therapists claimed that they continued to provide care, either by providing their services free-of-charge, at a reduced rate, by deferring payment or by accepting alternative forms of compensation. There is a relative lack of dedicated research literature on complementary therapists, their attitudes and actions, and this paper provides some important data on their specific management and caring decisions. At the same time, the evidence also provides some initial food-for-thought and indicates some potential research directions for exploring ethical issues in the private practice of complementary medicine.

  5. Collective intelligence for translational medicine: Crowdsourcing insights and innovation from an interdisciplinary biomedical research community.

    PubMed

    Budge, Eleanor Jane; Tsoti, Sandra Maria; Howgate, Daniel James; Sivakumar, Shivan; Jalali, Morteza

    2015-01-01

    Translational medicine bridges the gap between discoveries in biomedical science and their safe and effective clinical application. Despite the gross opportunity afforded by modern research for unparalleled advances in this field, the process of translation remains protracted. Efforts to expedite science translation have included the facilitation of interdisciplinary collaboration within both academic and clinical environments in order to generate integrated working platforms fuelling the sharing of knowledge, expertise, and tools to align biomedical research with clinical need. However, barriers to scientific translation remain, and further progress is urgently required. Collective intelligence and crowdsourcing applications offer the potential for global online networks, allowing connection and collaboration between a wide variety of fields. This would drive the alignment of biomedical science with biotechnology, clinical need, and patient experience, in order to deliver evidence-based innovation which can revolutionize medical care worldwide. Here we discuss the critical steps towards implementing collective intelligence in translational medicine using the experience of those in other fields of science and public health.

  6. [Patient safety culture in family and community medicine residents in Aragon].

    PubMed

    Rodríguez-Cogollo, R; Paredes-Alvarado, I R; Galicia-Flores, T; Barrasa-Villar, J I; Castán-Ruiz, S

    2014-01-01

    having an appropriate patient safety culture is the first recommendation to improve it. The aim of this article is to determine the safety culture in family medicine residents and then to identify improvement strategies. an online cross-sectional survey of residents in family medicine teaching units of Aragon using the translated, validated and adapted to Spanish, Medical Office Survey on Patient Safety Culture (MOSPS) questionnaire. The results were grouped in 12-dimensional responses for analysis, and the mean value of each dimension was calculated. Perceptions were described by Percentages of Positive (PRP) and Negative Responses (PRN) to each dimension. positive results were seen in «the Patient Care Tracking/Follow-up». There were significant differences in the «Information Exchange With Other Settings», «Staff Training» and «Overall Perceptions of Patient Safety and Quality». Study participants viewed «Work Pressure and Pace» negatively. the institutions providing health services, as well as their staff, are increasingly aware of the importance of improving Patient Safety, and the results of this study allowed us to present information that helps identify weaknesses, and to design initiatives and strategies to improve care practices. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  7. Popular medicine and self-care in a Mexican migrant community: toward an explanation of an epidemiological paradox.

    PubMed

    Waldstein, Anna

    2010-01-01

    While Hispanics are among the most economically disadvantaged groups in the United States, immigrants from Latin America have health profiles equal to or better than Americans of European descent. Research on this epidemiological paradox suggests that aspects of Hispanic culture prevent negative health outcomes associated with poverty, poor education, and barriers to professional care. However, little attention has been given to the ethnomedical beliefs and practices of any Hispanic subgroup. Here I present an ethnographic study of women's popular medicine in a Mexican migrant community in Athens, Georgia. Migrant women promote healthy behaviors, diagnose sick family members, and prescribe home remedies. These practices stem from long traditions of self-medication and family care, which have experienced less disruption by the biomedical profession than have other North American popular medical systems. Examining Mexican popular medicine within the context of scientific literature suggests that these self-care practices protect health and should be considered by investigators of the "Hispanic health paradox." The study also suggests that directing more attention to self-care will be fruitful for medical anthropology.

  8. [Investigation on species and community ecology of cheyletoid mites breeding in the stored traditional Chinese medicinal materials].

    PubMed

    Li, Chao-Pin; Zhan, Xiao-Dong; Sun, En-Tao; Zhao, Jin-Hong; Guo, Wei; Wang, Shao-Sheng

    2013-09-01

    To investigate the species of Cheyletoid mites breeding status in the stored traditional Chinese medicinal materials and the relationship between its community and habitats. A total of 60 samples of the traditional Chinese medicinal materials were collected from Huainan, Wuhu and Xuancheng in China. The mites were isolated with shakesieve shock, directicopy, Tullgren funnel, waternacopy and redricopy, and identified and counted under the light microscope. Cheyletoid mites were represented in 48 of the 60 samples, and the breeding rate accounted for as high as 80.0% (48/60). Totally, 6 species of Cheyletoid mites were identified, which belonged to Cheyletus, Acaropsis, Cheletomorpha, Eucheyletic and Pseudocheyles genera under the family of Cheyletidae. In the three investigated areas, the average breeding density of Cheyletoid mites was 109.75 heads/g, and average richness index was 1.54. The index of species diversity was 2.55 and the number of evenness was 0.95. This result entails positive prevention and control of the mite breeding in storage and processing of herbal materials.

  9. Evolving from reactive to proactive medicine: community lead (Pb) and clinical disparities in pre- and post-Katrina New Orleans.

    PubMed

    Mielke, Howard W; Gonzales, Christopher; Powell, Eric; Mielke, Paul W

    2014-07-21

    In 2012 the U.S. Centers for Disease Control (CDC) set the blood Pb reference value at ≥5 µg/dL. Clinical analysis of children's blood Pb levels is the common way to diagnose environmental Pb contamination, and intervention ensues with education and household dust cleanup. Recent review indicates that education and household dust cleanup are not effective at reducing children's Pb exposure. Here we review mapping environmental Pb and children's blood Pb response as an alternative approach for proactive Pb dust intervention. New Orleans was divided into a high (≥100 mg/kg) and low (<100 mg/kg) soil Pb communities. The children's blood Pb prevalence ≥5 µg/dL for the high and low Pb domains were 58.5% and 24.8% respectively pre-Katrina vs. 29.6% and 7.5% post-Katrina. Elevated soil Pb (mg/kg) and consequently Pb loading (µg/square area) permeates the high Pb domain and outdoor locations lack Pb dust safe play areas. The U.S. EPA 400 mg/kg soil Pb standard poses an outside Pb dust loading burden >37 times larger than allowed on interior residential floor environments. Environmental Pb dust is decreasing because of the transfer of large quantities of low Pb soil into selected communities. City-scale soil Pb mapping is an alternative diagnostic tool that provides information for planning proactive medicine to prevent clinical Pb exposure in the first place.

  10. From the community to the classroom: the Aboriginal health curriculum at the Northern Ontario School of Medicine.

    PubMed

    Jacklin, Kristen; Strasser, Roger; Peltier, Ian

    2014-01-01

    More undergraduate medical education programs are including curricula concerning the health, culture and history of Aboriginal people. This is in response to growing international recognition of the large divide in health status between Aboriginal and non-Aboriginal people, and the role medical education may play in achieving health equity. In this paper, we describe the development and delivery of the Aboriginal health curriculum at the Northern Ontario School of Medicine (NOSM). We describe a process for curriculum development and delivery, which includes ongoing engagement with Aboriginal communities as well as faculty expertise. Aboriginal health is delivered as a core curriculum, and learning is evaluated in summative assessments. Aboriginal health objectives are present in 4 of 5 required courses, primarily in years 1 and 2. Students attend a required 4-week Aboriginal cultural immersion placement at the end of year 1. Resources of Aboriginal knowledge are integrated into learning. In this paper, we reflect on the key challenges encountered in the development and delivery of the Aboriginal health curriculum. These include differences in Aboriginal and non-Aboriginal knowledge; risk of reinforcing stereotypes in case presentations; negotiation of curricular time; and faculty readiness and development. An organizational commitment to social accountability and the resulting community engagement model have been instrumental in creating a robust, sustainable program in Aboriginal health at NOSM.

  11. Emergency supply of prescription-only medicines to patients by community pharmacists: a mixed methods evaluation incorporating patient, pharmacist and GP perspectives

    PubMed Central

    Morecroft, Charles W; Mackridge, Adam J; Stokes, Elizabeth C; Gray, Nicola J; Wilson, Sarah E; Ashcroft, Darren M; Mensah, Noah; Pickup, Graham B

    2015-01-01

    Objective To evaluate and inform emergency supply of prescription-only medicines by community pharmacists (CPs), including how the service could form an integral component of established healthcare provision to maximise adherence. Design Mixed methods. 4 phases: prospective audit of emergency supply requests for prescribed medicines (October–November 2012 and April 2013); interviews with CPs (February–April 2013); follow-up interviews with patients (April–May 2013); interactive feedback sessions with general practice teams (October–November 2013). Setting 22 community pharmacies and 6 general practices in Northwest England. Participants 27 CPs with experience of dealing with requests for emergency supplies; 25 patients who received an emergency supply of a prescribed medicine; 58 staff at 6 general practices. Results Clinical audit in 22 pharmacies over two 4-week periods reported that 526 medicines were requested by 450 patients. Requests peaked over a bank holiday and around weekends. A significant number of supplies were made during practice opening hours. Most requests were for older patients and for medicines used in long-term conditions. Difficulty in renewing repeat medication (forgetting to order, or prescription delays) was the major reason for requests. The majority of medicines were ‘loaned’ in advance of a National Health Service (NHS) prescription. Interviews with CPs and patients indicated that continuous supply had a positive impact on medicines adherence, removing the need to access urgent care. General practice staff were surprised and concerned by the extent of emergency supply episodes. Conclusions CPs regularly provide emergency supplies to patients who run out of their repeat medication, including during practice opening hours. This may aid adherence. There is currently no feedback loop, however, to general practice. Patient care and interprofessional communication may be better served by the introduction of a formally structured

  12. Supporting underserved patients with their medicines: a study protocol for a patient/professional coproduced education intervention for community pharmacy staff to improve the provision and delivery of Medicine Use Reviews (MURs)

    PubMed Central

    Latif, Asam; Pollock, Kristian; Anderson, Claire; Waring, Justin; Solomon, Josie; Chen, Li-Chia; Anderson, Emma; Gulzar, Sulma; Abbasi, Nasa; Wharrad, Heather

    2016-01-01

    Introduction Community pharmacy increasingly features in global strategies to modernise the delivery of primary healthcare. Medicine Use Reviews (MURs) form part of the English Government's medicines management strategy to improve adherence and reduce medicine waste. MURs provide space for patient–pharmacist dialogue to discuss the well-known problems patients experience with medicine taking. However, ‘underserved’ communities (eg, black and minority ethnic communities, people with mental illness), who may benefit the most, may not receive this support. This study aims to develop, implement and evaluate an e-learning education intervention which is coproduced between patients from underserved communities and pharmacy teams to improve MUR provision. Methods and analysis This mixed-methods evaluative study will involve a 2-stage design. Stage 1 involves coproduction of an e-learning resource through mixed patient–professional development (n=2) and review (n=2) workshops, alongside informative semistructured interviews with patients (n=10) and pharmacy staff (n=10). Stage 2 involves the implementation and evaluation of the intervention with community pharmacy staff within all community pharmacies within the Nottinghamshire geographical area (n=237). Online questionnaires will be completed at baseline and postintervention (3 months) to assess changes in engagement with underserved communities and changes in self-reported attitudes and behaviour. To triangulate findings, 10 pharmacies will record at baseline and postintervention, details of actual numbers of MURs performed and the proportion that are from underserved communities. Descriptive and inferential statistics will be used to analyse the data. The evaluation will also include a thematic analysis of one-to-one interviews with pharmacy teams to explore the impact on clinical practice (n=20). Interviews with patients belonging to underserved communities, and who received an MUR, will also be conducted (n

  13. Knowledge, Attitudes and Awareness of Community Pharmacists Towards the Use of Herbal Medicines in Muscat Region

    PubMed Central

    Duraz, Anas Younis; Khan, Shah Alam

    2011-01-01

    Objective This study aims to investigate the knowledge and attitudes among pharmacists in Oman towards the specific use and knowledge of herbal drugs. Methods The study was conducted on 100 pharmacists employed in Oman. The data was collected using two self- administered questionnaire containing 7 and 11 closed ended questions in each, respectively. Results The mean age of pharmacists was 32.6 (SD=5.6) years. The majority of pharmacists were interested in herbal information and their herbal information mainly comes from their previous classes during college. Most of them have belief on the effectiveness of herbal products. Pharmacists were more knowledgeable on specific therapeutic indications of herbal products rather than on other areas such as drug- herb interaction or side effects. Conclusion In summary, Pharmacists need to be informed on the therapeutic indications, drug interactions, dose, active constituent and precautions of herbal products. Concerned bodies must also provide them with regular continuing education programs apart from putting their effects to incorporate relevant topics in herbal medicine in pharmacy curriculum. PMID:22253959

  14. Factors influencing emergency medicine physicians' management of sports-related concussions: a community-wide study.

    PubMed

    Giebel, Stephen; Kothari, Rashmi; Koestner, Amy; Mohney, Gretchen; Baker, Robert

    2011-12-01

    Numerous guidelines to grade and manage sports-related concussions have been published. However, little is known about how frequently they are implemented in the emergency department. This study evaluates the current practices of emergency physicians (EPs) in managing sports-related concussions. To evaluate the current practice of EP evaluation and management of sports-related concussions. All EPs and emergency medicine residents in Kalamazoo County were surveyed regarding their management of sports-related concussions. The surveys obtained demographic data, participants' use of guidelines, and the importance of clinical and non-clinical factors in deciding when to allow a player to return to play. Of the 73 EP respondents, only 23% used a nationally recognized guideline, with no significant difference between attending and resident EPs. The symptomatic complaints of loss of consciousness, amnesia of the event, and difficulty concentrating were ranked most important by EPs in assessing patients with sports-related concussions. Among non-clinical factors, residents were significantly more likely than attendings to report that medical-legal, parental, and players' concerns were more likely to influence their decision in allowing a patient to return to play. EPs take into consideration important clinical factors in assessing patients with sports-related concussion. However, almost 75% do not use any nationally recognized guideline in their evaluation. Residents are more likely than attendings to be influenced by non-clinical factors. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Feasibility of Energy Medicine in a Community Teaching Hospital: An Exploratory Case Series

    PubMed Central

    Dufresne, Francois; Simmons, Bonnie; Vlachostergios, Panagiotis J.; Fleischner, Zachary; Joudeh, Ramsey; Blakeway, Jill

    2015-01-01

    Abstract Background: Energy medicine (EM) derives from the theory that a subtle biologic energy can be influenced for therapeutic effect. EM practitioners may be trained within a specific tradition or work solo. Few studies have investigated the feasibility of solo-practitioner EM in hospitals. Objective: This study investigated the feasibility of EM as provided by a solo practitioner in inpatient and emergent settings. Design: Feasibility study, including a prospective case series. Settings: Inpatient units and emergency department. Outcome measures: To investigate the feasibility of EM, acceptability, demand, implementation, and practicality were assessed. Short-term clinical changes were documented by treating physicians. Participants: Patients, employees, and family members were enrolled in the study only if study physicians expected no or slow improvement in specific symptoms. Those with secondary gains or who could not communicate perception of symptom change were excluded. Results: EM was found to have acceptability and demand, and implementation was smooth because study procedures dovetailed with conventional clinical practice. Practicality was acceptable within the study but was low upon further application of EM because of cost of program administration. Twenty-four of 32 patients requested relief from pain. Of 50 reports of pain, 5 (10%) showed no improvement; 4 (8%), slight improvement; 3 (6%), moderate improvement; and 38 (76%), marked improvement. Twenty-one patients had issues other than pain. Of 29 non–pain-related problems, 3 (10%) showed no, 2 (7%) showed slight, 1 (4%) showed moderate, and 23 (79%) showed marked improvement. Changes during EM sessions were usually immediate. Conclusions: This study successfully implemented EM provided by a solo practitioner in inpatient and emergent hospital settings and found that acceptability and demand justified its presence. Most patients experienced marked, immediate improvement of symptoms associated

  16. The Use of Traditional Vietnamese Medicine Among Vietnamese Immigrants Attending an Urban Community Health Center in the United States

    PubMed Central

    Kaptchuk, Ted J.; Davis, Roger B.; Nguyen, Giac; Pham, Van; Tringale, Stephen M.; Loh, Yen Lin; Gardiner, Paula

    2016-01-01

    Abstract Objectives: Little is known about Traditional Vietnamese Medicine (TVM) and its use among Vietnamese immigrants in the United States. This study aimed to characterize TVM and improve understanding of its use among Vietnamese outpatients attending an urban clinic. Methods: This cross-sectional observation study was performed by mailing bilingual surveys to a stratified random sample of 400 Vietnamese adult patients (≥18 years of age) who had visited a community health center in Boston, Massachusetts, at least once in the prior 12 months. The data were analyzed by using descriptive and multivariable regression statistics. The use of TVM and the factors influencing their use were reported. Results: Among the 216 respondents, 68% reported using TVM. Of those users, the median age was 56 years and 68% were female, 51% had lived in the United States for less than 13 years, and 91% spoke English “not well or not at all.” Among the 89% who reported using TVM of indigenous origin, 62% used “wind scraping,” 35% used herbal pills/products, and 30% used “wind snatching.” Sixty-one percent used therapies of foreign origin; of those, 51% used Asian-originated TVM (herbs, 25%; Eastern massage, 23%) and 38% used Western-influenced TVM (diet supplements, 28%; Western massage, 8%). TVM was mostly used for pain conditions (57%), “staying well” (38%), and cough/colds (27%). Forty-five percent ignored the question on revealing TVM use to providers; of those who answered, 57% said “no.” Fifty-one percent of TVM users reported using Western medicine for the same problem, while 46% used TVM and Western medicine within 2 days of each other. Self-rated health (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.34–5.06), household size (OR, 2.09; 95% CI, 1.04–4.22), and education (OR, 2.65; 95% CI, 1.03–6.80) were associated with TVM use. Conclusion: TVM is an important component of the healthcare of urban Vietnamese and needs to be further

  17. Family medicine education in rural communities as a health service intervention supporting recruitment and retention of physicians

    PubMed Central

    Soles, Trina Larsen; Ruth Wilson, C.; Oandasan, Ivy F.

    2017-01-01

    Abstract Objective To develop a pan-Canadian rural education road map to advance the recruitment and retention of family physicians in rural, remote, and isolated regions of Canada in order to improve access and health care outcomes for these populations. Composition of the task force Members of the task force were chosen from key stakeholder groups including educators, practitioners, the College of Family Physicians of Canada education committee chairs, deans, chairs of family medicine, experts in rural education, and key decision makers. The task force members were purposefully selected to represent a mix of key perspectives needed to ensure the work produced was rigorous and of high quality. Observers from the Canadian Medical Association and Health Canada’s Council on Health Workforce, and representatives from the Royal College of Physicians and Surgeons of Canada, were also invited to provide their perspectives and to encourage and coordinate multiorganization action. Methods The task force commissioned a focused literature review of the peer-reviewed and gray literature to examine the status of rural medical education, training, and practice in relation to the health needs of rural and remote communities in Canada, and also completed an environmental scan. Report The environmental scan included interviews with more than 100 policy makers, government representatives, providers, educators, learners, and community leaders; 17 interviews with practising rural physicians; and 2 surveys administered to all 17 faculties of medicine. The gaps identified from the focused literature review and the results of the environmental scan will be used to develop the task force’s recommendations for action, highlighting the role of key partners in implementation and needed action. Conclusion The work of the task force provides an opportunity to bring the various partners together in a coordinated way. By understanding who is responsible and the actions each stakeholder

  18. Peer-support writing group in a community family medicine teaching unit: Facilitating professional development.

    PubMed

    Al-Imari, Lina; Yang, Jaisy; Pimlott, Nicholas

    2016-12-01

    Aspiring physician writers need an environment that promotes self-reflection and can help them improve their skills and confidence in writing. To create a peer-support writing group for physicians in the Markham-Stouffville community in Ontario to promote professional development by encouraging self-reflection and fostering the concept of physician as writer. The program, designed based on a literature review and a needs assessment, was conducted in 3 sessions over 6 months. Participants included an emergency physician, 4 family physicians, and 3 residents. Four to 8 participants per session shared their projects with guest physician authors. Eight pieces of written work were brought to the sessions, 3 of which were edited. A mixed quantitative and qualitative evaluation model was used with preprogram and postprogram questionnaires and a focus group. This program promoted professional development by increasing participants' frequency of self-reflection and improving their proficiency in writing. Successful elements of this program include creating a supportive group environment and having a physician-writer expert facilitate the peer-feedback sessions. Similar programs can be useful in postgraduate education or continuing professional development. Copyright© the College of Family Physicians of Canada.

  19. Peer-support writing group in a community family medicine teaching unit

    PubMed Central

    Al-Imari, Lina; Yang, Jaisy; Pimlott, Nicholas

    2016-01-01

    Abstract Problem addressed Aspiring physician writers need an environment that promotes self-reflection and can help them improve their skills and confidence in writing. Objective of program To create a peer-support writing group for physicians in the Markham-Stouffville community in Ontario to promote professional development by encouraging self-reflection and fostering the concept of physician as writer. Program description The program, designed based on a literature review and a needs assessment, was conducted in 3 sessions over 6 months. Participants included an emergency physician, 4 family physicians, and 3 residents. Four to 8 participants per session shared their projects with guest physician authors. Eight pieces of written work were brought to the sessions, 3 of which were edited. A mixed quantitative and qualitative evaluation model was used with preprogram and postprogram questionnaires and a focus group. Conclusion This program promoted professional development by increasing participants’ frequency of self-reflection and improving their proficiency in writing. Successful elements of this program include creating a supportive group environment and having a physician-writer expert facilitate the peer-feedback sessions. Similar programs can be useful in postgraduate education or continuing professional development. PMID:27965348

  20. The four or more medicines (FOMM) support service: results from an evaluation of a new community pharmacy service aimed at over-65s.

    PubMed

    Twigg, Michael J; Wright, David; Barton, Garry R; Thornley, Tracey; Kerr, Clare

    2015-12-01

    Inappropriate prescribing and nonadherence have a significant impact on hospital admissions and patient quality of life. The English government has identified that community pharmacy could make a significant contribution to reducing nonadherence and improving the quality of prescribing, reducing both hospital admissions and medicines wastage. The objective of this study is to evaluate a community pharmacy service aimed at patients over the age of 65 years prescribed four or more medicines. Patients were invited to participate in the service by the community pharmacy team. The pharmacist held regular consultations with the patient and discussed risk of falls, pain management, adherence and general health. They also reviewed the patient's medication using STOPP/START criteria. Data were analysed for the first 6 months of participation in the service. Six hundred twenty patients were recruited with 441 (71.1%) completing the 6-month study period. Pharmacists made 142 recommendations to prescribers in 110 patients largely centred on potentially inappropriate prescribing of NSAIDs, PPIs or duplication of therapy. At follow-up, there was a significant decrease in the total number of falls (mean -0.116 (-0.217--0.014)) experienced and a significant increase in medicine adherence (mean difference in Morisky Measure of Adherence Scale-8: 0.513 (0.337-0.689)) and quality of life. Cost per quality-adjusted life year estimates ranged from £11 885 to £32 466 depending on the assumptions made. By focussing on patients over the age of 65 years with four or more medicines, community pharmacists can improve medicine adherence and patient quality of life. © 2015 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.

  1. Emergency Medicine Evaluation of Community-Acquired Pneumonia: History, Examination, Imaging and Laboratory Assessment, and Risk Scores.

    PubMed

    Long, Brit; Long, Drew; Koyfman, Alex

    2017-09-20

    Pneumonia is a common infection, accounting for approximately one million hospitalizations in the United States annually. This potentially life-threatening disease is commonly diagnosed based on history, physical examination, and chest radiograph. To investigate emergency medicine evaluation of community-acquired pneumonia including history, physical examination, imaging, and the use of risk scores in patient assessment. Pneumonia is the number one cause of death from infectious disease. The condition is broken into several categories, the most common being community-acquired pneumonia. Diagnosis centers on history, physical examination, and chest radiograph. However, all are unreliable when used alone, and misdiagnosis occurs in up to one-third of patients. Chest radiograph has a sensitivity of 46-77%, and biomarkers including white blood cell count, procalcitonin, and C-reactive protein provide little benefit in diagnosis. Biomarkers may assist admitting teams, but require further study for use in the emergency department. Ultrasound has shown utility in correctly identifying pneumonia. Clinical gestalt demonstrates greater ability to diagnose pneumonia. Clinical scores including Pneumonia Severity Index (PSI); Confusion, blood Urea nitrogen, Respiratory rate, Blood pressure, age 65 score (CURB-65); and several others may be helpful for disposition, but should supplement, not replace, clinical judgment. Patient socioeconomic status must be considered in disposition decisions. The diagnosis of pneumonia requires clinical gestalt using a combination of history and physical examination. Chest radiograph may be negative, particularly in patients presenting early in disease course and elderly patients. Clinical scores can supplement clinical gestalt and assist in disposition when used appropriately. Published by Elsevier Inc.

  2. Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans

    PubMed Central

    Mielke, Howard W.; Gonzales, Christopher; Powell, Eric; Mielke, Paul W.

    2014-01-01

    In 2012 the U.S. Centers for Disease Control (CDC) set the blood Pb reference value at ≥5 µg/dL. Clinical analysis of children’s blood Pb levels is the common way to diagnose environmental Pb contamination, and intervention ensues with education and household dust cleanup. Recent review indicates that education and household dust cleanup are not effective at reducing children’s Pb exposure. Here we review mapping environmental Pb and children’s blood Pb response as an alternative approach for proactive Pb dust intervention. New Orleans was divided into a high (≥100 mg/kg) and low (<100 mg/kg) soil Pb communities. The children’s blood Pb prevalence ≥5 µg/dL for the high and low Pb domains were 58.5% and 24.8% respectively pre-Katrina vs. 29.6% and 7.5% post-Katrina. Elevated soil Pb (mg/kg) and consequently Pb loading (µg/square area) permeates the high Pb domain and outdoor locations lack Pb dust safe play areas. The U.S. EPA 400 mg/kg soil Pb standard poses an outside Pb dust loading burden >37 times larger than allowed on interior residential floor environments. Environmental Pb dust is decreasing because of the transfer of large quantities of low Pb soil into selected communities. City-scale soil Pb mapping is an alternative diagnostic tool that provides information for planning proactive medicine to prevent clinical Pb exposure in the first place. PMID:25050655

  3. Intracultural Variation in the Knowledge of Medicinal Plants in an Urban-Rural Community in the Atlantic Forest from Northeastern Brazil

    PubMed Central

    de Almeida, Cecília de Fátima Castelo Branco Rangel; Ramos, Marcelo Alves; Silva, Rafael Ricardo Vasconcelos; de Melo, Joabe Gomes; Medeiros, Maria Franco Trindade; Araújo, Thiago Antonio de Sousa; de Almeida, Alyson Luiz Santos; de Amorim, Elba Lúcia Cavalcanti; Alves, Rômulo Romeu da Nóbrega; de Albuquerque, Ulysses Paulino

    2012-01-01

    This study assessed the intracultural knowledge of the use of medicinal plants in an urban-rural community in an Atlantic forest fragment in northeastern Brazil. We examined the importance of native and exotic species and the effects of gender and age on that knowledge. We also compared data obtained from different groups of informants (local experts and general community). We conducted 194 interviews between June 2007 and January 2008, using the freelist technique and semistructured forms to collect ethnobotanical data. Information obtained from the community was compared with that from six local experts who participated in a survey in 2003. From a total of 209 ethnospecies, exotic and herbaceous plants presented higher richness. With respect to the number of citations, women and older informants were shown to know a higher number of medicinal plants. Comparing knowledge of local experts with that of the general community, we noted that experts know a similar wealth of plant families and therapeutic indications, but the community knows a greater species richness. These results indicate that local experts may provide useful information for studies that search for a quick diagnosis of the knowledge of a given community. PMID:22110546

  4. Intracultural variation in the knowledge of medicinal plants in an urban-rural community in the atlantic forest from northeastern Brazil.

    PubMed

    de Almeida, Cecília de Fátima Castelo Branco Rangel; Ramos, Marcelo Alves; Silva, Rafael Ricardo Vasconcelos; de Melo, Joabe Gomes; Medeiros, Maria Franco Trindade; Araújo, Thiago Antonio de Sousa; de Almeida, Alyson Luiz Santos; de Amorim, Elba Lúcia Cavalcanti; Alves, Rômulo Romeu da Nóbrega; de Albuquerque, Ulysses Paulino

    2012-01-01

    This study assessed the intracultural knowledge of the use of medicinal plants in an urban-rural community in an Atlantic forest fragment in northeastern Brazil. We examined the importance of native and exotic species and the effects of gender and age on that knowledge. We also compared data obtained from different groups of informants (local experts and general community). We conducted 194 interviews between June 2007 and January 2008, using the freelist technique and semistructured forms to collect ethnobotanical data. Information obtained from the community was compared with that from six local experts who participated in a survey in 2003. From a total of 209 ethnospecies, exotic and herbaceous plants presented higher richness. With respect to the number of citations, women and older informants were shown to know a higher number of medicinal plants. Comparing knowledge of local experts with that of the general community, we noted that experts know a similar wealth of plant families and therapeutic indications, but the community knows a greater species richness. These results indicate that local experts may provide useful information for studies that search for a quick diagnosis of the knowledge of a given community.

  5. A cross-sectional survey of the access of older people in the Scottish Highlands to general medical practices, community pharmacies and prescription medicines.

    PubMed

    Rushworth, Gordon F; Cunningham, Scott; Pfleger, Sharon; Hall, Jenny; Stewart, Derek

    2017-01-25

    Access to medicines and healthcare is more problematic in remote and rural areas. To quantify issues of access to general practitioners (GPs), community pharmacies and prescribed medicines in older people resident in the Scottish Highlands. Anonymized questionnaires were mailed to a random sample of 2000 older people (≥60 years) resident in the Scottish Highlands. Questionnaire items were: access and convenience to GP and pharmacy services (10 items); prescribed medicines (13 items); attitudinal statements based on the Theoretical Domains Framework (12 items); quality of life (SF8, 8 items); and demographics (12 items). Results were analysed using descriptive, inferential and spatial statistics, and principal component analysis (PCA) of attitudinal items. With a response rate of 54.2%, the majority reported convenient access to GPs (89.1%) and community pharmacies (84.3%). Older age respondents (p < 0.0001) were more likely to state that their access to GP services was not convenient and those in rural areas to community pharmacies (p < 0.01). For access to prescribed medicines, those in poorer health (p < 0.001) and taking five or more regular prescribed medicines (p = 0.002) were more likely to state access not convenient. PCA identified three components of beliefs of capabilities, emotions and memory. Those with poorer health had more negative scores for all (p < 0.001). Those reporting issues of access to prescribed medicines had more negative scores for beliefs of capabilities (p < 0.001) while those of older age, living alone, and taking five or more regular prescribed medicines (all p < 0.001) had more negative scores for emotions. While the majority of respondents have convenient access to their GP practice, pharmacy and prescribed medicines, there is a need for further review of the pharmaceutical care of those of older age with poorer health, living alone in the more remote and rural areas and taking five or more prescribed medicines

  6. [Development of an advanced education program for community medicine by Nagasaki pharmacy and nursing science union consortium].

    PubMed

    Teshima, Mugen; Nakashima, Mikiro; Hatakeyama, Susumi

    2012-01-01

    The Nagasaki University School of Pharmaceutical Sciences has conducted a project concerning "development of an advanced education program for community medicine" for its students in collaboration with the University's School of Nursing Sciences, the University of Nagasaki School of Nursing Sciences, and the Nagasaki International University School of Pharmaceutical Sciences. The project was named "formation of a strategic base for the integrated education of pharmacy and nursing science specially focused on home-healthcare and welfare", that has been adopted at "Strategic University Cooperative Support Program for Improving Graduate" by the Ministry of Education, Culture, Sports, Science and Technology, Japan from the 2009 academic year to the 2011 academic year. Our project is a novel education program about team medical care in collaboration with pharmacist and nurse. In order to perform this program smoothly, we established "Nagasaki pharmacy and nursing science union consortium (Nagasaki University, The University of Nagasaki, Nagasaki International University, Nagasaki Pharmaceutical Association, Nagasaki Society of Hospital Pharmacists, Nagasaki Nursing Association, Nagasaki Medical Association, Nagasaki Prefectural Government)". In this symposium, we introduce contents about university education program and life learning program of the project.

  7. ABC-VED Analysis of a Drug Store in the Department of Community Medicine of a Medical College in Delhi

    PubMed Central

    Anand, T.; Ingle, G. K.; Kishore, J.; Kumar, R

    2013-01-01

    A matrix based on coupling of cost (always, better and control) analysis and criticality (vital, essential and desirable) analysis was employed for drug inventory containing 129 items of drug store in the Department of Community Medicine of a Medical College in Delhi. The annual drug expenditure incurred on 129 drug items for the year 2010-2011 was found to be Rs. 4,35,847.85. On always, better and control analysis, 18.6, 24.0 and 57.4% drugs were found to be always, better and control category items, respectively, amounting for 69.1, 20.8 and 10.1% of annual drug expenditure. About 13.2 (17), 38.8 (50) and 48.0% (62) items were found to be vital, essential and desirable category items, respectively, amounting for 18.7, 49.5 and 31.8% of annual drug expenditure. Based on always, better and control-vital, essential and desirable matrix analysis there were 37 (28.68%) items in category I, 53 (41.09%) items in category II and 39 (30.23%) items in category III, amounting for 73.0, 22.2 and 4.8% of annual drug expenditure, respectively. To conclude, scientific inventory management tools are needed to be applied in routine for efficient management of the pharmacy stores as it contributes to not only in improvement in patient care but also judicious use of resources as well. PMID:23901172

  8. 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)

  9. 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)

  10. Psycho-socioeconomic factors affecting complementary and alternative medicine use among selected rural communities in Malaysia: a cross-sectional study.

    PubMed

    Ganasegeran, Kurubaran; Rajendran, Anantha Kumar; Al-Dubai, Sami Abdo Radman

    2014-01-01

    The use of complementary and alternative medicine (CAM) as a source of cure has gained much spectrum worldwide, despite skeptics and advocates of evidence-based practice conceptualized such therapies as human nostrum. This study aimed to explore the factors affecting CAM use among rural communities in Malaysia. A cross-sectional study was carried out on 288 occupants across four rural villages within the District of Selama, Perak, Malaysia. A survey that consisted of socio-economic characteristics, history of CAM use and the validated Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were used. The prevalence of self-reported CAM use over the past one year was 53.1%. Multiple logistic regression analyses yielded three significant predictors of CAM use: monthly household income of less than MYR 2500, higher education level, and positive attitude towards CAM. Psycho-socioeconomic factors were significantly associated with CAM use among rural communities in Malaysia.

  11. Psycho-Socioeconomic Factors Affecting Complementary and Alternative Medicine Use among Selected Rural Communities in Malaysia: A Cross-Sectional Study

    PubMed Central

    Ganasegeran, Kurubaran; Rajendran, Anantha Kumar; Al-Dubai, Sami Abdo Radman

    2014-01-01

    Introduction The use of complementary and alternative medicine (CAM) as a source of cure has gained much spectrum worldwide, despite skeptics and advocates of evidence-based practice conceptualized such therapies as human nostrum. Objective This study aimed to explore the factors affecting CAM use among rural communities in Malaysia. Methods A cross-sectional study was carried out on 288 occupants across four rural villages within the District of Selama, Perak, Malaysia. A survey that consisted of socio-economic characteristics, history of CAM use and the validated Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were used. Results The prevalence of self-reported CAM use over the past one year was 53.1%. Multiple logistic regression analyses yielded three significant predictors of CAM use: monthly household income of less than MYR 2500, higher education level, and positive attitude towards CAM. Conclusion Psycho-socioeconomic factors were significantly associated with CAM use among rural communities in Malaysia. PMID:25375256

  12. Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.

    PubMed

    Berkowitz, Scott A; Ishii, Lisa; Schulz, John; Poffenroth, Matt

    2016-03-01

    Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context.

  13. Health, healthcare access, and use of traditional versus modern medicine in remote Peruvian Amazon communities: a descriptive study of knowledge, attitudes, and practices.

    PubMed

    Williamson, Jonathan; Ramirez, Ronald; Wingfield, Tom

    2015-04-01

    There is an urgent need for healthcare research, funding, and infrastructure in the Peruvian Amazon. We performed a descriptive study of health, health knowledge and practice, and healthcare access of 13 remote communities of the Manatí and Amazon Rivers in northeastern Peru. Eighty-five adults attending a medical boat service were interviewed to collect data on socioeconomic position, health, diagnosed illnesses, pain, healthcare access, and traditional versus modern medicine use. In this setting, poverty and gender inequality were prevalent, and healthcare access was limited by long distances to the health post and long waiting times. There was a high burden of reported pain (mainly head and musculoskeletal) and chronic non-communicable diseases, such as hypertension (19%). Nearly all participants felt that they did not completely understand their diagnosed illnesses and wanted to know more. Participants preferred modern over traditional medicine, predominantly because of mistrust or lack of belief in traditional medicine. Our findings provide novel evidence concerning transitional health beliefs, hidden pain, and chronic non-communicable disease prevalence in marginalized communities of the Peruvian Amazon. Healthcare provision was limited by a breach between health education, knowledge, and access. Additional participatory research with similar rural populations is required to inform regional healthcare policy and decision-making. © The American Society of Tropical Medicine and Hygiene.

  14. Protocol for the New Medicine Service Study: a randomized controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England.

    PubMed

    Boyd, Matthew; Waring, Justin; Barber, Nick; Mehta, Rajnikant; Chuter, Antony; Avery, Anthony J; Salema, Nde-Eshimuni; Davies, James; Latif, Asam; Tanajewski, Lukasz; Elliott, Rachel A

    2013-12-01

    Medication non-adherence is considered an important cause of morbidity and mortality in primary care. This study aims to determine the effectiveness, cost effectiveness and acceptability of a complex intervention delivered by community pharmacists, the New Medicine Service (NMS), compared with current practice in reducing non-adherence to, and problems with, newly prescribed medicines for chronic conditions. Research subject group: patients aged 14 years and above presenting in a community pharmacy for a newly prescribed medicine for asthma/chronic obstructive pulmonary disease (COPD); hypertension; type 2 diabetes or anticoagulant/antiplatelet agents in two geographical regions in England. parallel group patient-level pragmatic randomized controlled trial. patients randomized to either: (i) current practice; or (ii) NMS intervention comprising pharmacist-delivered support for a newly prescribed medicine. proportion of adherent patients at six, ten and 26 weeks from the date of presenting their prescriptions at the pharmacy; cost effectiveness of the intervention versus current practice at 10 weeks and 26 weeks; in-depth qualitative understanding of the operationalization of NMS in pharmacies. impact of NMS on: patients' understanding of their medicines, pharmacovigilance, interprofessional and patient-professional relationships and experiences of service users and stakeholders.Economic analysis: Trial-based economic analysis (cost per extra adherent patient) and long-term modeling of costs and health effects (cost per quality-adjusted-life-year) will be conducted from the perspective of National Health Service (NHS) England, comparing NMS with current practice.Qualitative analysis: a qualitative study of NMS implementation in different community settings, how organizational influences affect NMS delivery, patterns of NMS consultations and experiences of professionals and patients participating in NMS, and patients receiving current practice. 250 patients in each

  15. Protocol for the New Medicine Service Study: a randomized controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England

    PubMed Central

    2013-01-01

    Background Medication non-adherence is considered an important cause of morbidity and mortality in primary care. This study aims to determine the effectiveness, cost effectiveness and acceptability of a complex intervention delivered by community pharmacists, the New Medicine Service (NMS), compared with current practice in reducing non-adherence to, and problems with, newly prescribed medicines for chronic conditions. Methods/design Research subject group: patients aged 14 years and above presenting in a community pharmacy for a newly prescribed medicine for asthma/chronic obstructive pulmonary disease (COPD); hypertension; type 2 diabetes or anticoagulant/antiplatelet agents in two geographical regions in England. Design: parallel group patient-level pragmatic randomized controlled trial. Interventions: patients randomized to either: (i) current practice; or (ii) NMS intervention comprising pharmacist-delivered support for a newly prescribed medicine. Primary outcomes: proportion of adherent patients at six, ten and 26 weeks from the date of presenting their prescriptions at the pharmacy; cost effectiveness of the intervention versus current practice at 10 weeks and 26 weeks; in-depth qualitative understanding of the operationalization of NMS in pharmacies. Secondary outcomes: impact of NMS on: patients’ understanding of their medicines, pharmacovigilance, interprofessional and patient-professional relationships and experiences of service users and stakeholders. Economic analysis: Trial-based economic analysis (cost per extra adherent patient) and long-term modeling of costs and health effects (cost per quality-adjusted-life-year) will be conducted from the perspective of National Health Service (NHS) England, comparing NMS with current practice. Qualitative analysis: a qualitative study of NMS implementation in different community settings, how organizational influences affect NMS delivery, patterns of NMS consultations and experiences of professionals and

  16. [The physician manager--building a clinical leadership in community medicine--the Maccabi Healthcare Services (MHS) model].

    PubMed

    Kokia, Ehud; Siegal, Neomi; Shemer, Joshua

    2008-05-01

    Community medicine around the world is facing constant trends of changes. The need to overcome the huge burden of chronic diseases, the need to prioritize and adapt new technologies, and above all, the fact that all these must be done within a given, restricted budget, calls for advanced medical management. In this review we focused on the development of the role of the physician manager in Maccabi Healthcare Services (MHS) over the last 60 years. From what was once a reactive, utilization control-oriented administrative physician role, there has emerged a proactive, formally educated, health quality leader who is expected to lead his clinical colleagues towards achieving the organization's goals. Every organization should answer 4 basic questions in order to encourage/develop the new generation of physician managers. 1. Who am I?--What is the profile and what are the tasks of the physician manager's role? 2. What is the time allocation allotted to the physician manager by the organization to enable him to do his job? 3. What are the educational and managerial tools provided for the 'new" physician manager? 4. What are the rewards that the organization grants to its best people? By addressing the above questions MHS has successfully developed new generations of young clinical leaders who can help MHS management conduct a real dialogue with its clinical physicians in order to maximize the services that our beneficiaries are receiving from the HMO. Our conclusion is that choosing the right people, providing them with the right tools and positioning the physician manager appropriately in the organization's hierarchy will enable the medical care delivery system in Israel to achieve the level of clinical leadership that can lead us towards a better future.

  17. The use of complementary and alternative medicine in the general population: results from a longitudinal community study.

    PubMed

    Rössler, Wulf; Lauber, Christoph; Angst, Jules; Haker, Helene; Gamma, Alex; Eich, Dominique; Kessler, Ronald C; Ajdacic-Gross, Vladeta

    2007-01-01

    Many patients with psychological or physical problems are interested in non-medical approaches. The reasons for the growing popularity of complementary and alternative medicine (CAM) are not well understood considering that evidence of the effectiveness of conventional therapies is greater than ever before. We have examined data from the Zurich Study to determine trends and predictors of CAM use in Switzerland. The Zurich Study is a longitudinal community study that was started in 1979 with a sample of 591 participants born in 1958 and 1959. In 1999, the last of six interview waves with face-to-face interviews was conducted. CAM use was analyzed with data from interviews in 1993 and 1999. Polytomous logistic regression analysis focused on the personal, demographic and sociocultural background of CAM users. CAM use in the last 12 months was reported by 21.9% of the participants in 1993 and by 29.5% in 1999. CAM use among those exhibiting either physical or psychological problems was in the ratio of two to one. There was a trend from alternative variants of CAM (homeopathy) to complementary ones (massage, osteopathy, acupuncture). The vast majority of CAM use was in addition to conventional therapies. Predictors of CAM use were, among others, attribution of physical complaints to stress and other psychological variables, very low education level in parents, and lacking political interest. Besides the sociocultural background, characteristics such as the psychological attribution style play an important role in CAM use. CAM use in Switzerland is mainly of a complementary rather than an alternative nature.

  18. Medicinal plants of Cree communities (Québec, Canada): antioxidant activity of plants used to treat type 2 diabetes symptoms.

    PubMed

    Fraser, Marie-Hélène; Cuerrier, Alain; Haddad, Pierre S; Arnason, John T; Owen, Patrick L; Johns, Timothy

    2007-11-01

    Traditional medicines (TM) used to treat symptoms of diabetes by two Cree communities were assessed for their free radical scavenging activity using the stable 1,1-diphenyl-2-picrylhydrazyl radical, and their ability to protect human low-density lipoprotein from Cu2+-mediated oxidation by measuring lag time before the appearance of conjugated dienes and formation of thiobarbituric acid-reactive substances. Water-soluble phenolic content was also measured. A total of 20 medicinal plants from Whapmagoostui and 16 from Mistissini were compared with 16 extracts of plants that were not used medicinally. Medicinal plant extracts, particularly those from Larix laricina, displayed high antioxidant activity, comparable with ascorbic acid, Trolox, and the known antioxidant flavonoids quercetin, epicatechin, catechin. Extracts of Pinaceae and Ericaceae contained the highest levels of phenolics. Factors such as season and area of plant collection, as well as the plant part from which the extract was derived, affected antioxidant activity. Positive correlations were found between the established traditional knowledge of Cree Elders and Healers and the antioxidant activity for medicinal plants used in Mistissini (r = 0.3134; p = 0.058) and in Whapmagoostui (r = 0.5165; p = 0.001). Significant correlations between phenolic content were also seen with the existing ethnobotanical data (r = 0.5015; p = 0.003) and bioassays (r = 0.4178; p = 0.003). These results indicate that a clear majority of plants used by the Cree are excellent sources of antioxidants.

  19. Rehabilitation for the management of knee osteoarthritis using comprehensive traditional Chinese medicine in community health centers: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background It is becoming increasingly necessary for community health centers to make rehabilitation services available to patients with osteoarthritis of the knee. However, for a number of reasons, including a lack of expertise, the small size of community health centers and the availability of only simple medical equipment, conventional rehabilitation therapy has not been widely used in China. Consequently, most patients with knee osteoarthritis seek treatment in high-grade hospitals. However, many patients cannot manage the techniques that they were taught in the hospital. Methods such as acupuncture, tuina, Chinese medical herb fumigation-washing and t’ai chi are easy to do and have been reported to have curative effects in those with knee osteoarthritis. To date, there have been no randomized controlled trials validating comprehensive traditional Chinese medicine for the rehabilitation of knee osteoarthritis in a community health center. Furthermore, there is no standard rehabilitation protocol using traditional Chinese medicine for knee osteoarthritis. The aim of the current study is to develop a comprehensive rehabilitation protocol using traditional Chinese medicine for the management of knee osteoarthritis in a community health center. Method/design This will be a randomized controlled clinical trial with blinded assessment. There will be a 4-week intervention utilizing rehabilitation protocols from traditional Chinese medicine and conventional therapy. Follow-up will be conducted for a period of 12 weeks. A total of 722 participants with knee osteoarthritis will be recruited. Participants will be randomly divided into two groups: experimental and control. Primary outcomes will include range of motion, girth measurement, the visual analogue scale, and results from the manual muscle, six-minute walking and stair-climbing tests. Secondary outcomes will include average daily consumption of pain medication, ability to perform daily tasks and health

  20. Rehabilitation for the management of knee osteoarthritis using comprehensive traditional Chinese medicine in community health centers: study protocol for a randomized controlled trial.

    PubMed

    Yan, Hu; Su, Youxin; Chen, Lidian; Zheng, Guohua; Lin, Xueyi; Chen, Baojun; Zhou, Bihong; Zhang, Qing

    2013-11-04

    It is becoming increasingly necessary for community health centers to make rehabilitation services available to patients with osteoarthritis of the knee. However, for a number of reasons, including a lack of expertise, the small size of community health centers and the availability of only simple medical equipment, conventional rehabilitation therapy has not been widely used in China. Consequently, most patients with knee osteoarthritis seek treatment in high-grade hospitals. However, many patients cannot manage the techniques that they were taught in the hospital. Methods such as acupuncture, tuina, Chinese medical herb fumigation-washing and t'ai chi are easy to do and have been reported to have curative effects in those with knee osteoarthritis. To date, there have been no randomized controlled trials validating comprehensive traditional Chinese medicine for the rehabilitation of knee osteoarthritis in a community health center. Furthermore, there is no standard rehabilitation protocol using traditional Chinese medicine for knee osteoarthritis. The aim of the current study is to develop a comprehensive rehabilitation protocol using traditional Chinese medicine for the management of knee osteoarthritis in a community health center. This will be a randomized controlled clinical trial with blinded assessment. There will be a 4-week intervention utilizing rehabilitation protocols from traditional Chinese medicine and conventional therapy. Follow-up will be conducted for a period of 12 weeks. A total of 722 participants with knee osteoarthritis will be recruited. Participants will be randomly divided into two groups: experimental and control. Primary outcomes will include range of motion, girth measurement, the visual analogue scale, and results from the manual muscle, six-minute walking and stair-climbing tests. Secondary outcomes will include average daily consumption of pain medication, ability to perform daily tasks and health-related quality-of-life assessments

  1. Wild medicinal and food plants used by communities living in Mopane woodlands of southern Angola: Results of an ethnobotanical field investigation.

    PubMed

    Urso, Valeria; Signorini, Maria Adele; Tonini, Matteo; Bruschi, Piero

    2016-01-11

    Mopane woodlands play an important role in the livelihood strategies of local populations; however, they have been scarcely investigated by ethnobiologists and very little is currently known about plants traditionally used by local communities, especially about medicinal plants. Our investigation was aimed to document ethnobotanical knowledge in seven communities living in conditions of extreme poverty in a Mopane area of southern Angola (Namibe province). We focused on plants used as medicines and/or food, in order to highlight the role of wild plants in the livelihood of local communities, and possibly to find out plants with potential pharmacological interest. Ethnobotanical data were recorded through semi-structured interviews, filed in a database and quantitatively analyzed. The following synthetic indexes were used: Cultural Importance index (CI), Informant Consensus Factor (FIC), Fidelity Level (FL). Sixty-six informants (26 males, 40 females) were interviewed. A total of 1247 citations were recorded, concerning 132 ethnospecies (folk taxonomic units not necessarily corresponding to single botanical species); 104 were identified at different taxonomic levels. For medicinal purposes, 116 ethnospecies and 20 different uses (650 citations) were reported; for food purposes, 33 ethnospecies and 8 different uses (597 citations). The main used parts resulted to be fruit (471 citations; 21 ethnospecies), followed by underground organs (288, 82) and leaves (175, 41). According to CI values, Berchemia discolor, Ximenia americana var. americana and Adansonia digitata have the highest cultural value in the investigated communities. All of them are woody plants, as well as most of the identified ethnospecies (trees 34.6%, shrubs 32.7%, perennials 21.2%, annuals 8.7%, others 2.8%). Medicinal plants are especially used to treat disorders of the gastrointestinal tract (52 ethnospecies, 205 citations), obstetric/gynecological troubles (27, 40) and colds and respiratory tract

  2. Electronic capture of dispensing data by the New Zealand Intensive Medicines Monitoring Programme: a consultation study of community and hospital pharmacists.

    PubMed

    Harrison-Woolrych, Mira; Jamieson, Simon; Malik, Muzaffar; Holt, Alec; Herbison, Peter

    2011-04-01

    To obtain pharmacists' views on proposals for electronic transmission of dispensing data to the New Zealand Intensive Medicines Monitoring Programme (IMMP). Consultation with a randomly selected group of 100 community pharmacists and all 28 hospital pharmacies in New Zealand was conducted by postal survey. A specific questionnaire was designed to obtain pharmacists' views on several aspects of electronic data transmission including willingness to co-operate with a new system, awareness of other electronic systems and views on security. Survey response rates were 95% for community pharmacists and 73% for hospital pharmacists. Ninety (95%) of the community pharmacists and 18 (95%) of the hospital pharmacists who responded stated they would use the IMMP proposed method of electronic data transmission. Some 91% of community pharmacists and 100% of hospital pharmacists considered the proposed new method would be equally or more secure than the present hard-copy system of posting dispensing records. There is a high level of support from New Zealand pharmacists for electronic capture of prescription dispensing data for medicines monitored by the IMMP. This electronic method will now be implemented. Development of such systems is important for enhancing patient safety and pharmacovigilance programmes worldwide. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

  3. Communities.

    ERIC Educational Resources Information Center

    Ruth, Amy, Ed.

    1995-01-01

    This issue of the Goldfinch focuses on communities. Ethnic groups, religious groups, schools, families, even the Internet, are used as examples of communities in Iowa. Forced communities are exemplified by migration, law, natural disasters, and sometimes education. Photographs from Iowa's past show the changing nature of communities and encourage…

  4. Community Pharmacists' Perceptions about Pharmaceutical Care of Traditional Medicine Products: A Questionnaire-Based Cross-Sectional Study in Guangzhou, China

    PubMed Central

    Chen, Xi; Ung, Carolina Oi Lam; Hu, Hao; Liu, Xiaodan; Zhao, Jing; Hu, Yuanjia; Li, Peng; Yang, Qing

    2016-01-01

    This study aimed to investigate community pharmacists' perceived responsibility, practice behaviors, knowledge, perceived barriers, and improvement measures towards provision of pharmaceutical care in relation to traditional medicine (TM) products in Guangzhou, China. A self-completion questionnaire was used to survey licensed pharmacists working at community pharmacies. This study found that the community pharmacists in Guangzhou, China, were involved in the provision of TM products during their daily practice but only provided pharmaceutical care in this area with a passive attitude. Extrinsic barriers such as lack of scientific evidence for the safety and efficacy of TM products and unclear definition of their roles and responsibilities were highlighted while intrinsic factors such as insufficient TM knowledge were identified. PMID:27066101

  5. Over-the-counter advice seeking about complementary and alternative medicines (CAM) in community pharmacies and health shops: an ethnographic study.

    PubMed

    Cramer, Helen; Shaw, Alison; Wye, Lesley; Weiss, Marjorie

    2010-01-01

    In many ways, consumers of complementary and alternative medicine (CAM) embody the values that current policies aim to encourage such as self-caring and private consumption. For example, the British Government's choice agenda suggests patient choice and self-management are key government priorities and state that good information should be at the heart of all services. However, research on community pharmacies suggests that there is a continued lack of knowledge about CAM, especially herbal medicines and the limited research on health shops indicates that advice about CAM products is varied and inconsistent. Recognising the underlying tension of community pharmacies and health shops which combine both retail roles and promotion of patient wellbeing, we set out to examine customer advice seeking about CAM. The settings included independent and chain stores, selling varying amounts and types of CAM products. Data collection was ethnographic involving observation of staff-customer interactions, and semi-structured interviews with counter staff and people who purchased CAM products. The findings identified six main types of staff-customer interactions regarding over-the-counter CAM products. This typology ranged from needing significant amounts of help to needing very little including: help with diagnosis; help finding a general remedy; help with a specific product; free advice; pastoral care; and 'just buying'. The implications of these findings are discussed in the light of ongoing debates about the place of CAM in UK mainstream medicine and the evidence base for CAM. Potentially a highly valuable community resource, there is a lack of support for community pharmacies and health shops despite the government's choice agenda.

  6. Health, Healthcare Access, and Use of Traditional Versus Modern Medicine in Remote Peruvian Amazon Communities: A Descriptive Study of Knowledge, Attitudes, and Practices

    PubMed Central

    Williamson, Jonathan; Ramirez, Ronald; Wingfield, Tom

    2015-01-01

    There is an urgent need for healthcare research, funding, and infrastructure in the Peruvian Amazon. We performed a descriptive study of health, health knowledge and practice, and healthcare access of 13 remote communities of the Manatí and Amazon Rivers in northeastern Peru. Eighty-five adults attending a medical boat service were interviewed to collect data on socioeconomic position, health, diagnosed illnesses, pain, healthcare access, and traditional versus modern medicine use. In this setting, poverty and gender inequality were prevalent, and healthcare access was limited by long distances to the health post and long waiting times. There was a high burden of reported pain (mainly head and musculoskeletal) and chronic non-communicable diseases, such as hypertension (19%). Nearly all participants felt that they did not completely understand their diagnosed illnesses and wanted to know more. Participants preferred modern over traditional medicine, predominantly because of mistrust or lack of belief in traditional medicine. Our findings provide novel evidence concerning transitional health beliefs, hidden pain, and chronic non-communicable disease prevalence in marginalized communities of the Peruvian Amazon. Healthcare provision was limited by a breach between health education, knowledge, and access. Additional participatory research with similar rural populations is required to inform regional healthcare policy and decision-making. PMID:25688165

  7. Student-centred learning in Community Medicine: An experience from Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry.

    PubMed

    Kar, S S; Premarajan, K C; L, Subitha; Archana, R; Iswarya, S; A, Sujiv

    2014-01-01

    Student-centred learning (SCL) places the student at the centre of policies, practices and decision-making in the teaching-learning process. SCL methodology also advocates active involvement of students in the curriculum planning, selection of teaching-learning methods and assessment process. We planned an education innovation project to assess the perception of fifth semester undergraduate medical students towards implementation of an SCL methodology. The study was done among 87 fifth semester undergraduate medical students (batch of 2010-11) in the noncommunicable disease epidemiology section of Community Medicine at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. The students divided themselves into seven groups and developed the learning objectives, selected teaching-learning methods and assessment process for each session. The facilitators had 3-5 rounds of interaction with each group before the session. Qualitative analysis of feedback collected from students and external faculty after each session was done. The effect of implementing the SCL methodology was assessed by the reaction level of Kirkpatrick's training evaluation model by using a rating scale Results. Of the 87 eligible students, 73 (83.9%) returned the forms for evaluation. All seven groups were able to formulate the learning objectives. Most of the groups had used PowerPoint slides and videos as a teaching-learning tool. Innovative assessment methods such as crosswords and 'chocopati' were used by some groups. In general, the perception of students was favourable towards SCL compared to conventional methods and they felt that this methodology should be adopted more often. Time management and organization of sessions were the main problems encountered by the students. The mean (SD) score for the items 'sessions were useful', 'sessions were enjoyable' and 'sessions improved my knowledge' were 6.2 (1.8), 7.1 (1.8) and 6.3 (1.9), respectively. The

  8. Problem-Based Learning as an Effective Learning Tool in Community Medicine: Initiative in a Private Medical College of a Developing Country.

    PubMed

    Joseph, Nitin; Rai, Sharada; Madi, Deepak; Bhat, Kamalakshi; Kotian, Shashidhar M; Kantharaju, Supriya

    2016-01-01

    Knowledge of community medicine is essential for health care professionals to function as efficient primary health care physicians. Medical students learning Community Medicine as a subject are expected to be competent in critical thinking and generic skills so as to analyze community health problems better. However, current teaching by didactic lectures fails to develop these essential skills. Problem-based learning (PBL) could be an effective strategy in this respect. This study was hence done to compare the academic performance of students who were taught Community Medicine by the PBL method with that of students taught by traditional methods, to assess the generic skills of students taught in a PBL environment and to assess the perception of students toward PBL methodology. This study was conducted among seventh-semester final-year medical students between June and November 2014. PBL was introduced to a randomly chosen group of students, and their performance in an assessment exam at the end of postings was compared with that of the remaining students. Generic skills and perception toward PBL were also assessed using standardized questionnaires. A total of 77 students took part in the brainstorming session of PBL. The correlation between self-assigned scores of the participants and those assigned by the tutor in the brainstorming session of PBL was significant (r = 0.266, P = 0.05). Out of 54 students who took part in the presentation session, almost all 53 (98.1%) had good perception toward PBL. Demotivational scores were found to be significantly higher among males (P = 0.024). The academic performance of students (P < 0.001) and success rates (P = 0.05) in the examination were higher among students who took part in PBL compared to controls. PBL helped improve knowledge of students in comparison to those exposed only to didactic lectures. As PBL enabled students to identify the gaps in their knowledge and enhanced their group functioning and generic skills

  9. Problem-Based Learning as an Effective Learning Tool in Community Medicine: Initiative in a Private Medical College of a Developing Country

    PubMed Central

    Joseph, Nitin; Rai, Sharada; Madi, Deepak; Bhat, Kamalakshi; Kotian, Shashidhar M; Kantharaju, Supriya

    2016-01-01

    Background: Knowledge of community medicine is essential for health care professionals to function as efficient primary health care physicians. Medical students learning Community Medicine as a subject are expected to be competent in critical thinking and generic skills so as to analyze community health problems better. However, current teaching by didactic lectures fails to develop these essential skills. Problem-based learning (PBL) could be an effective strategy in this respect. This study was hence done to compare the academic performance of students who were taught Community Medicine by the PBL method with that of students taught by traditional methods, to assess the generic skills of students taught in a PBL environment and to assess the perception of students toward PBL methodology. Materials and Methods: This study was conducted among seventh-semester final-year medical students between June and November 2014. PBL was introduced to a randomly chosen group of students, and their performance in an assessment exam at the end of postings was compared with that of the remaining students. Generic skills and perception toward PBL were also assessed using standardized questionnaires. Results: A total of 77 students took part in the brainstorming session of PBL. The correlation between self-assigned scores of the participants and those assigned by the tutor in the brainstorming session of PBL was significant (r = 0.266, P = 0.05). Out of 54 students who took part in the presentation session, almost all 53 (98.1%) had good perception toward PBL. Demotivational scores were found to be significantly higher among males (P = 0.024). The academic performance of students (P < 0.001) and success rates (P = 0.05) in the examination were higher among students who took part in PBL compared to controls. Conclusion: PBL helped improve knowledge of students in comparison to those exposed only to didactic lectures. As PBL enabled students to identify the gaps in their knowledge

  10. The use of community herbal monographs to facilitate registrations and authorisations of herbal medicinal products in the European Union 2004-2012.

    PubMed

    Peschel, Wieland

    2014-12-02

    The provisions for the simplified registration of traditional herbal medicinal products in the European Union were introduced by Directive 2004/24/EC amending Directive 2001/83/EC (Chapter 2a) in 2004. Since implementation in the European member states until December 2012 a total of 1015 registrations (traditional use) and 514 authorisations (well-established use) have been granted for products containing substances/ preparations from about 200 different herbal drugs. The overall number of received applications with more than one third still under assessment suggests a further increase for the next years. This review summarises the main features of registered and authorised herbal medicinal products in the EU and evaluates available data against provisions of Directive 2004/24/EC and European standards established by the Committee on Herbal Medicinal Products at the European Medicines Agency. The supportive function of Community herbal monographs is described as regards availability and their use in national procedures, which is complemented by an analysis of specific future challenges from experiences made with the implementation of Directive 2004/24/EC so far.

  11. Treatment of Depression and Anxiety by Naturopathic Physicians: An Observational Study of Naturopathic Medicine Within an Integrated Multidisciplinary Community Health Center.

    PubMed

    Breed, Cindy; Bereznay, Catherine

    2017-05-01

    This project was designed to assess the quality of care received by patients with depression and anxiety who were seen by naturopathic physicians in a community health center. The Natural Medicine Quality Improvement Project for the Treatment of Depression and Anxiety (NMQP-DA) was conducted over a 26-month period from December 2009 through February 2012 at HealthPoint, a non-profit, consumer-governed, community health center network located in suburban King County, Washington. A total of 112 patients enrolled in the NMQP-DA, and 60 were seen for two or more visits, thus meeting eligibility criteria for inclusion in the study. The mean number of visits was 3.3. The Patient Health Questionnaire (PHQ-9) depression screener and the Generalized Anxiety Disorder 7-item scale (GAD-7) anxiety screener were the outcome measures. The overall improvement in symptoms of depression and anxiety was highly significant (p < 0.0001) when comparing the group's average initial screener scores to their average final screener scores for both depression (16.4 vs. 8.6) and anxiety (12.4 vs. 7.2). The response rate, as measured by a 50% decrease in scores, for those with initial scores ≥10 was 58.6% for depression (PHQ-9) and 50% for anxiety (GAD-7). This study adds new data to the limited literature on the nature and effectiveness of naturopathic medicine to treat anxiety and depression in the context of an integrative community health center.

  12. Medicinal plants used in a Totonac community of the Sierra Norte de Puebla: Tuzamapan de Galeana, Puebla, Mexico.

    PubMed

    Martinez Alfaro, M A

    1984-07-01

    Totonac Indians, like other aboriginal peoples, use many plants, animals and minerals in treating illness. We collected our information among mountain dwelling Totonacs (totonacos de la Sierra). These Totonacs from the mountain areas are only beginning to be studied from an ethnobotanical viewpoint. Here we report on their herbal remedies and briefly discuss their traditional medicine. Finally, the role of Western medicine in Totonac life is analyzed.

  13. The influence of personal communities on the self-management of medication taking: A wider exploration of medicine work.

    PubMed

    Cheraghi-Sohi, Sudeh; Jeffries, Mark; Stevenson, Fiona; Ashcroft, Darren M; Carr, Matthew; Oliver, Kathryn; Rogers, Anne

    2015-06-01

    There is a lack of focus on the broader social context, networks and influences on medicine-taking as part of illness work. This work adopts a social network approach and seeks to explicate the nature of medicine-taking work that people with multiple long-term conditions (LTCs) and their social network members (SNMs) do in attempting to take their medications on a daily basis, the division of labour amongst these members and when and why SNMs become involved in that work. Semi-structured interviews were conducted with 20 people who had multiple LTCs. Medication networks were constructed and the division of labour in relation to medication-work was explored. Four types of medication-work emerged: medication articulation, surveillance, emotional and informational. Involvement of SNMs in medication-work was selective, performed primarily by family members, within the home. Involvement reflected network composition and/or an individual's conceptualisation/presentation of self. Our findings support and extend the conceptualisation of routine medicine-taking as a type of work. Furthermore, we illustrate the involvement of SNMs in aspects of medicine-work. Health professionals should explore and support the role of SNMs in medicine-taking where possible. Future research should explore the implications of network types and compositions on medicine-taking and associated work. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. A review of the information-gathering process for the provision of medicines for self-medication via community pharmacies in developing countries.

    PubMed

    Brata, Cecilia; Gudka, Sajni; Schneider, Carl R; Everett, Alan; Fisher, Colleen; Clifford, Rhonda M

    2013-01-01

    Currently, no review has been completed regarding the information-gathering process for the provision of medicines for self-medication in community pharmacies in developing countries. To review the rate of information gathering and the types of information gathered when patients present for self-medication requests. Six databases were searched for studies that described the rate of information gathering and/or the types of information gathered in the provision of medicines for self-medication in community pharmacies in developing countries. The types of information reported were classified as: signs and symptoms, patient identity, action taken, medications, medical history, and others. Twenty-two studies met the inclusion criteria. Variations in the study populations, types of scenarios, research methods, and data reporting were observed. The reported rate of information gathering varied from 18% to 97%, depending on the research methods used. Information on signs and symptoms and patient identity was more frequently reported to be gathered compared with information on action taken, medications, and medical history. Evidence showed that the information-gathering process for the provision of medicines for self-medication via community pharmacies in developing countries is inconsistent. There is a need to determine the barriers to appropriate information-gathering practice as well as to develop strategies to implement effective information-gathering processes. It is also recommended that international and national pharmacy organizations, including pharmacy academics and pharmacy researchers, develop a consensus on the types of information that should be reported in the original studies. This will facilitate comparison across studies so that areas that need improvement can be identified. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. [Clinical and therapeutic management of respiratory tract infections. Consensus document of the Andalusian Infectious Diseases Society and the Andalusian Family and Community Medicine Society].

    PubMed

    Cordero Matía, Elisa; de Dios Alcántara Bellón, Juan; Caballero Granado, Javier; de la Torre Lima, Javier; Girón González, José Antonio; Lama Herrera, Carmen; Morán Rodríguez, Ana; Zapata López, Angel

    2007-04-01

    Respiratory tract infections are frequent and they are one of the commonest causes of antibiotic prescription. However, there are few clinical guidelines that consider this group of infections. This document has been written by the Andalusian Infectious Diseases Society and the Andalusian Family and Community Medicine Society. The primary objective has been to define the recommendations for the diagnosis and antibiotic treatment of respiratory tract infections apart from pneumonia. The clinical syndromes evaluated have been: a) pharyngitis; b) sinusitis; c) acute otitis media and otitis externa; d) acute bronchitis, laryngitis, epiglottitis; e) acute exacerbation of chronic bronchitis; and f) respiratory infectious in patients with bronchiectasis. This document has focused on immunocompetent patients.

  16. Establishing a minority-based community clinical oncology program: the University of Medicine and Dentistry of New Jersey, New Jersey Medical School-university Hospital Cancer Center experience.

    PubMed

    Wieder, Robert; Teal, Randall; Saunders, Tracie; Weiner, Bryan J

    2013-03-01

    The Minority-Based Community Clinical Oncology Program (MB-CCOP) at University of Medicine and Dentistry of New Jersey, New Jersey Medical School-University Hospital Cancer Center was established to serve an unmet need in a medically, educationally, and socioeconomically underserved community of primarily African American and Latino patients in Newark and Essex County, New Jersey. The MB-CCOP was built on an existing infrastructure of multidisciplinary teams of cancer specialists who collaborated in patient care and an existing clinical research program, which included multilingual staff and a breast cancer navigator. This article highlights some of the unique opportunities and challenges involved in the startup of an MB-CCOP specifically relevant to an academic setting. We present a guide to the necessary infrastructure and institutional support that must be in place before considering such a program and some of the steps an institution can take to overcome barriers preventing successful enrollment of patients onto clinical trials.

  17. Community pharmacists' perceptions about pharmaceutical service of over-the-counter traditional Chinese medicine: a survey study in Harbin of China.

    PubMed

    Song, Menghuan; Ung, Carolina Oi Lam; Lee, Vivian Wing-Yan; Hu, Yuanjia; Zhao, Jing; Li, Peng; Hu, Hao

    2017-01-05

    This study aims to investigate community pharmacist's perception on the provision of over-the-counter (OTC) traditional Chinese medicine (TCM) pharmaceutical services; focusing on the areas of their attitude, general practice, perceived barriers and suggested improvements. Questionnaire survey targeting community pharmacists in Harbin of China was applied in this study. Questionnaires were distributed and collected at community pharmacies. Data was analyzed by combining descriptive analysis and Chi-test. 280 valid questionnaires were collected, giving a response rate of 78%. Respondents generally showed positive attitude towards OTC TCM pharmaceutical services. However, they were uncertain about whether such pharmaceutical services should be considered as their primary responsibility. Respondents indicated that they acted proactively to find out all the medicines taken by their patients and to remind consumers of possible OTC TCM adverse reactions. However, they were less keen on recommending or re-directing consumers to suitable OTC TCM. The three main barriers hindering the provision of OTC TCM pharmaceutical service identified in this study were "insufficient professional knowledge" (54.6%), "ambiguity of the professional role of pharmacists" (54.6%) and "lack of scientific evidence of OTC TCM" (45.4%). The three main actions considered most relevant to improving pharmaceutical service of OTC TCM were "formulating or refining legislation to clarify the legal and professional role of pharmacists with respect to TCM" (60.7%), "strengthening training of pharmacists with respect to TCM" (57.9%), and "promoting public awareness of the pharmacist's role" (53.6%). According to the results of Chi-test, respondents' perceptions about the attitude, practice, perceived barriers, and improvement suggestions were significantly different depending on the education levels, certificate types and workloads of western medicine. The community pharmacists in Harbin, China were

  18. Protecting participants in family medicine research: a consensus statement on improving research integrity and participants' safety in educational research, community-based participatory research, and practice network research.

    PubMed

    Hueston, William J; Mainous, Arch G; Weiss, Barry D; Macaulay, Ann C; Hickner, John; Sherwood, Roger A

    2006-02-01

    Recent events that include the deaths of research subjects and the falsification of data have drawn greater scrutiny on assuring research data integrity and protecting participants. Several organizations have created guidelines to help guide researchers working in the area of clinical trials and ensure that their research is safe and valid. However, family medicine researchers often engage in research that differs from a typical clinical trial. Investigators working in the areas of educational research, community-based participatory research, and practice-based network research would benefit from similar recommendations to guide their own research. With funding from the US Office of Research Integrity and the Association of American Medical Colleges, we convened a panel to review issues of data integrity and participant protection in educational research, community-based participatory research, and research conducted by practice-based networks. The panel generated 11 recommendations for researchers working in these areas. Three key recommendations include the need for (1) all educational research to undergo review and approval by an institutional review board (IRB), (2) community-based participatory research to be approved not just by an IRB but also by appropriate community representatives, and (3) practice-based researchers to undertake only valid and meaningful studies that can be reviewed by a central IRB, rather than separate IRBs for each participating practice.

  19. Medicinal plants in the cultural landscape of a Mapuche-Tehuelche community in arid Argentine Patagonia: an eco-sensorial approach.

    PubMed

    Molares, Soledad; Ladio, Ana

    2014-08-26

    The taste and smell of medicinal plants and their relation to the cultural landscape of a Mapuche-Tehuelche community in the Patagonian steppe was investigated. We assume that the landscapes as a source of therapeutic resources is perceived, classified and named according to different symbolic, ecological and utilitarian criteria which are influenced by chemosensorial appearance of medicinal plants which are valued by inhabitants. Information relating to the cultural landscape experienced by 18 inhabitants, all representing 85% of the families, in terms of medicinal plants, knowledge of species and their organoleptic perception was obtained through participant observation, interviews and free listing. The data were examined using cualitative and quantitative approach, including discourse analysis and non-parametric statistics. Informants use 121 medicinal species, obtained from both wild and non-wild environments, most of which (66%) present aroma and/or taste. It was found that the plants with highest use consensus used for digestive, respiratory, cardio-vascular, analgesic-anti-inflammatory, obstetric-gynaecological and genito-unrinary complaints, have the highest frequencies of cites reporting flavor; and those with the highest frequencies relating to digestive, analgesic-anti-inflammatory and cultural syndromes present the highest frequencies of aroma. Flavor and/or aroma are interpreted as strong or soft, and the strongest are associated with treatment of supernatural ailments. Also, taste is a distinctive trait for the most of the species collected in all natural units of the landscape, while aroma is more closely associated with species growing at higher altitudes. The local pharmacopeia is also enriched with plants that come from more distant phytogeographical environments, such as the Andean forest and the Patagonian Monte, which are obtained through barter with neighboring populations. Herbal products are also obtained in regional shop. The practices of

  20. Medicinal plants in the cultural landscape of a Mapuche-Tehuelche community in arid Argentine Patagonia: an eco-sensorial approach

    PubMed Central

    2014-01-01

    Background The taste and smell of medicinal plants and their relation to the cultural landscape of a Mapuche-Tehuelche community in the Patagonian steppe was investigated. We assume that the landscapes as a source of therapeutic resources is perceived, classified and named according to different symbolic, ecological and utilitarian criteria which are influenced by chemosensorial appearance of medicinal plants which are valued by inhabitants. Methods Information relating to the cultural landscape experienced by 18 inhabitants, all representing 85% of the families, in terms of medicinal plants, knowledge of species and their organoleptic perception was obtained through participant observation, interviews and free listing. The data were examined using cualitative and quantitative approach, including discourse analysis and non-parametric statistics. Results Informants use 121 medicinal species, obtained from both wild and non-wild environments, most of which (66%) present aroma and/or taste. It was found that the plants with highest use consensus used for digestive, respiratory, cardio-vascular, analgesic-anti-inflammatory, obstetric-gynaecological and genito-unrinary complaints, have the highest frequencies of cites reporting flavor; and those with the highest frequencies relating to digestive, analgesic-anti-inflammatory and cultural syndromes present the highest frequencies of aroma. Flavor and/or aroma are interpreted as strong or soft, and the strongest are associated with treatment of supernatural ailments. Also, taste is a distinctive trait for the most of the species collected in all natural units of the landscape, while aroma is more closely associated with species growing at higher altitudes. The local pharmacopeia is also enriched with plants that come from more distant phytogeographical environments, such as the Andean forest and the Patagonian Monte, which are obtained through barter with neighboring populations. Herbal products are also obtained in

  1. Community.

    ERIC Educational Resources Information Center

    Grauer, Kit, Ed.

    1995-01-01

    Art in context of community is the theme of this newsletter. The theme is introduced in an editorial "Community-Enlarging the Definition" (Kit Grauer). Related articles include: (1) "The Children's Bridge is not Destroyed: Heart in the Middle of the World" (Emil Robert Tanay); (2) "Making Bridges: The Sock Doll…

  2. Health Beliefs, Treatment Preferences and Complementary and Alternative Medicine for Asthma, Smoking and Lung Cancer Self-Management in Diverse Black Communities

    PubMed Central

    George, Maureen

    2012-01-01

    Objectives The purpose of this literature review is to characterize unconventional health beliefs and complementary and alternative medicine (CAM) for asthma, smoking and lung cancer as those that are likely safe and those that likely increase risk in diverse Black communities. These findings should provide the impetus for enhanced patient-provider communication that elicits patients’ beliefs and self-management preferences so that they may be accommodated, or when necessary, reconciled through discussion and partnership. Methods Original research articles relevant to this topic were obtained by conducting a literature search of the PubMed Plus, PsychINFO and SCOPUS databases using combinations of the following search terms: asthma, lung cancer, emphysema, chronic obstructive pulmonary disease (COPD), smoking, beliefs, complementary medicine, alternative medicine, complementary and alternative medicine (CAM), explanatory models, African American, and Black. Results Using predetermined inclusion and exclusion criteria, 51 original research papers were retained. Taken together, they provide evidence that patients hold unconventional beliefs about the origins of asthma and lung cancer and the health risks of smoking, have negative opinions of standard medical and surgical treatments, and have favorable attitudes about using CAM. All but a small number of CAM and health behaviors were considered safe. Conclusions When patients’ unconventional beliefs and preferences are not identified and discussed, there is an increased risk that standard approaches to self-management of lung disease will be sub-optimal, that potentially dangerous CAM practices might be used and that timely medical interventions may be delayed. Practice implications Providers need effective communication skills as the medical dialogue forms the basis of patients’ understanding of disease and self-management options. The preferred endpoint of such discussions should be agreement around an

  3. 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.

  4. Data Accuracy of the Bubble Sheet Ambulatory Data System and the KG-Ambulatory Data System in the Internal Medicine Clinic, Bayne-Jones Army Community Hospital, Fort Polk, Louisiana

    DTIC Science & Technology

    2000-06-01

    in the Ambulatory Data System (ADS) for the Internal Medicine Clinic at Bayne-Jones Army Community Hospital, Fort Polk, Louisiana. A secondary purpose...Analysis of the financial data indicated that the hospital was minimally at risk for either fraudulent billing or loss of revenue. However, as the Internal ... Medicine Clinic only accounts for 6.3% of outpatient workload, coding behaviors similar to those observed practiced in other high volume clinics would

  5. A Partnership between the University of Nebraska College of Medicine and the Community: Fostering Positive Attitudes towards the Aged

    ERIC Educational Resources Information Center

    Hinners, Cheryl K.; Potter, Jane F.

    2006-01-01

    Over the last 20 years, older people have served as teachers for students as part of the formal curriculum in geriatrics at the University of Nebraska Medical Center. In recent years, we have supported a more in-depth, longitudinal experience that connects medical students with elders in the community. The program was initiated as a special…

  6. Implementing the ASAM Criteria in community treatment centers in Illinois: opportunities and challenges. American Society of Addiction Medicine.

    PubMed

    Heatherton, B

    2000-01-01

    The incorporation of the ASAM Criteria into addiction treatment centers procedure has afforded us an enormous opportunity to add credibility to our treatment. Herein lies perhaps the strongest argument for these criteria. The ASAM Criteria encourage addiction treatment centers to establish themselves as healthcare providers in their own right. The task is now for Illinois addiction treatment providers; particularly community based providers, to prove our credibility through the legitimate use of the criteria. Since most, if not all, of our patients are without means and without knowledge on quality treatment, they become easy targets for substandard or at least unimaginative and uninspired treatment. It is not that community based treatment centers are, by nature, unprincipled treatment warehouses. But it certainly can be said that our centers are frequently the last to change our treatment practices. Certainly we have become "the last resort" for the courts, overburdened mental health centers and overpopulated homeless shelters with little emphasis on clinical quality of care. Overcoming such programmed ways of viewing treatment was difficult specifically for Triangle Center and generally for community treatment providers throughout Illinois. In fact, I dare say that this transition has not occurred in total as many still passively resist this opportunity. Yet others have viewed this change as the breath of fresh air that our profession has long sought. Such variance in opinion ultimately proves that implementation of the ASAM Criteria, in a community based system, is dependent on the clinician and administrators willingness to understand, recognize and apply the Criteria.

  7. Factors affecting availability of essential medicines among community health workers in Ethiopia, Malawi, and Rwanda: solving the last mile puzzle.

    PubMed

    Chandani, Yasmin; Noel, Megan; Pomeroy, Amanda; Andersson, Sarah; Pahl, Michelle K; Williams, Timothy

    2012-11-01

    To understand how supply chain factors affect product availability at the community level, the Improving Supply Chains for Community Case Management of Pneumonia and Other Common Diseases of Childhood Project developed a theory of change (TOC) framework for gathering, organizing, and interpreting evidence about supply constraints to community case management (CCM). Baseline assessments in Ethiopia, Malawi, and Rwanda conducted in 2010 provided information on the strengths and weaknesses of existing CCM supply chains for five main products: antibiotics for pneumonia, oral rehydration solution, ready to use therapeutic food, zinc, and artemether/lumefantrine. The assessments tested the strength and validity of causal pathways identified in the TOC that were believed to influence availability of CCM products among community health workers (CHWs) for treating common childhood illnesses. Results of the assessments showed product availability to be weak in each country, with more than half of CHWs stocked out of at least one tracer product on the day of the assessment. This report will focus on the findings related to three key preconditions of the TOC and how these were used to inform the design of the CCM supply chain improvement strategy in each country. The three key preconditions include product availability at CHW resupply points, supply chain knowledge and capacity among CHWs and their supervisors, and availability of appropriate transportation.

  8. Cancer Care Experiences and the Use of Complementary and Alternative Medicine at End of Life in Nova Scotia’s Black Communities

    PubMed Central

    Maddalena, Victor J.; Bernard, Wanda Thomas; Etowa, Josephine; Murdoch, Sharon Davis; Smith, Donna; Jarvis, Phyllis Marsh

    2016-01-01

    Purpose This qualitative study examines the meanings that African Canadians living in Nova Scotia, Canada, ascribe to their experiences with cancer, family caregiving, and their use of complementary and alternative medicine (CAM) at end of life. Design Case study methodology using in-depth interviews were used to examine the experiences of caregivers of decedents who died from cancer in three families. Findings For many African Canadians end of life is characterized by care provided by family and friends in the home setting, community involvement, a focus on spirituality, and an avoidance of institutionalized health services. Caregivers and their families experience multiple challenges (and multiple demands). There is evidence to suggest that the use of CAM and home remedies at end of life are common. Discussion The delivery of palliative care to African Canadian families should consider and support their preference to provide end-of-life care in the home setting. PMID:20220031

  9. Cross-sectional studies published in Indian journal of community medicine: evaluation of adherence to strengthening the reporting of observational studies in epidemiology statement.

    PubMed

    Jeelani, A; Malik, Wr; Haq, I; Aleem, S; Mujtaba, M; Syed, N

    2014-11-01

    The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement is a set of recommendations about what should be included in a more accurate and complete description of observational studies. The aim was to assess the quality of reporting of cross-sectional studies by evaluating the extent to which they adhere to the STROBE statement. This study has a cross-sectional design. All the articles published as original articles in Indian Journal of Community Medicine from January 2010 to September 2011 were downloaded from the journal website. A total of 96 articles were downloaded out of which 80 were found to have a cross-sectional design. Variables were: (1) Percentage of STROBE items included in a report and (2) percentage of articles reporting each item in the STROBE checklist. Data analysis was done by descriptive statistics using frequencies and percentages. A total of 80 articles were evaluated. About 46% (37/80) articles reported 12-15 items of the STROBE checklist. Bias, nonparticipants and reasons for nonparticipation, other analyses done, generalizability, and source of funding were reported by < 25% of studies. The most frequently reported items of the checklist were summary of what was done and what was found in the abstract, background/rationale, objectives, setting, outcome data, key results in discussion, interpretation of results. None of the articles reported all items of the STROBE checklist. This study reveals that the quality of reporting cross-sectional studies in Indian Journal of Community Medicine is not satisfactory and there is room for improvement.

  10. Economic benefits of high value medicinal plants to Pakistani communities: an analysis of current practice and potential.

    PubMed

    Sher, Hassan; Aldosari, Ali; Ali, Ahmad; de Boer, Hugo J

    2014-10-10

    Poverty is pervasive in the Swat Valley, Pakistan. Most of the people survive by farming small landholdings. Many earn additional income by collecting and selling plant material for use in herbal medicine. This material is collected from wild populations but the people involved have little appreciation of the potential value of the plant material they collect and the long term impact their collecting has on local plant populations. In 2012, existing practices in collecting and trading high value minor crops from Swat District, Pakistan, were analyzed. The focus of the study was on the collection pattern of medicinal plants as an economic activity within Swat District and the likely destinations of these products in national or international markets. Local collectors/farmers and dealers were surveyed about their collection efforts, quantities collected, prices received, and resulting incomes. Herbal markets in major cities of Pakistan were surveyed for current market trends, domestic sources of supply, imports and exports of herbal material, price patterns, and market product-quality requirements. It was observed that wild collection is almost the only source of medicinal plant raw material in the country, with virtually no cultivation. Gathering is mostly done by women and children of nomadic Middle Hill tribes who earn supplementary income through this activity, with the plants then brought into the market by collectors who are usually local farmers. The individuals involved in gathering and collecting are largely untrained regarding the pre-harvest and post-harvest treatment of collected material. Most of the collected material is sold to local middlemen. After that, the trade pattern is complex and heterogeneous, involving many players. Pakistan exports of high value plants generate over US$10.5 million annually in 2012, with a substantial percentage of the supply coming from Swat District, but its market share has been declining. Reasons for the decline were

  11. “This is the Medicine:” A Kenyan community responds to a sexual concurrency reduction intervention

    PubMed Central

    Knopf, Amelia; Agot, Kawango; Sidle, John; Naanyu, Violet; Morris, Martina

    2014-01-01

    We report the results of the first study designed to evaluate the feasibility and acceptability of an HIV prevention intervention focused on concurrent sexual partnerships. Mathematical models and longitudinal studies of stable couples indicate concurrency plays a critical role in sustaining generalized HIV epidemics in heterosexual populations, and East and Southern African nations identified concurrency reduction as a priority for HIV prevention. "Know Your Network" (KYN) is a single-session community-level concurrency awareness intervention designed to address this need. It is rooted in traditional social network research, but takes advantage of new network methodology and years of participatory action research with communities living in a region of Kenya with the highest HIV prevalence nationally. KYN combines didactic presentation, interactive exercises, high-impact graphics, and a network survey with immediate visualization of the results, to prompt a community conversation about sexual norms. We combined focus group discussions and the traditional east African baraza to evaluate the feasibility and acceptability of KYN for use with adults living in rural Nyanza Province, Kenya. We were able to implement KYN with fidelity to its components. Participants understood the intervention's messages about concurrency and its role in HIV transmission through sexual networks. They agreed to provide anonymous egocentric data on their sexual partnerships, and in return we successfully simulated a representation of their local network for them to view and discuss. This launched a dynamic conversation about concurrency and sexual norms that persisted after the intervention. The concurrency message was novel, but resonant to participants, who reported sharing it with their children, friends, and sexual partners. With clear evidence of KYN's feasibility and acceptability, it would be appropriate to evaluate the effectiveness of the intervention using a community

  12. A pilot study on generic medicine substitution practices among community pharmacists in the State of Penang, Malaysia.

    PubMed

    Ping, Chong Chee; Bahari, Mohd Baidi; Hassali, Mohamed Azmi

    2008-01-01

    The purpose of this study was to evaluate the generic substitution (GS) practices undertaken by community pharmacists in the State of Penang, Malaysia with a focus on the extent of communication between pharmacists and prescribers on issues related to GS, consumer's acceptance on the GS and estimation of cost saving achieved for patients opted for GS. A cross-sectional descriptive study for a period of 2 months using a specific questionnaire as a data collection tool was undertaken with a random sample of 40 community pharmacies located in the State of Penang. By the end of the study period, 34 out of 40 pharmacies contacted participated in the study. Forty-seven per cent of pharmacists consulted prescribers while promoting GS to their consumers. Majority of the prescribers (84.4%) when contacted by the pharmacists accepted the suggestion for substitution. From consumers' perspective, 88% (n = 156) of the consumers involved in this study accepted pharmacist's recommendation to generically substitute their prescribed medications. Through acceptance of GS, it has been estimated that the overall consumers' expenses on drugs can be reduced to a total of RM6137 (US$1615; US$1 = RM3.80) and this corresponds to a cost saving of 61.1%. The outcome of the present study showed that through GS recommendation by community pharmacist, consumers can save the expenditure of their prescribed medications.

  13. Effect of heterogeneous Fenton-like pre-treatment on anaerobic granular sludge performance and microbial community for the treatment of traditional Chinese medicine wastewater.

    PubMed

    Su, Chengyuan; Li, Weiguang; Lu, Yuxiang; Chen, Menglin; Huang, Zhi

    2016-08-15

    The effect of a heterogeneous Fenton-like pre-treatment on the anaerobic processes, characteristics and microbial community of sludge was investigated for traditional Chinese medicine (TCM) wastewater containing rhein. When the concentrations of rhein were 50mg/L and 100mg/L, the toxic effect was physiological toxicity for anaerobic granular sludge. Using a single double circle (DC) reactor for the treatment of TCM wastewater containing rhein at concentrations of 15-20mg/L, the chemical oxygen demand (COD) removal rate was 69%, and coenzyme F420 was nearly undetectable in the 3D-excitation-emission matrix (EEM) spectra of soluble microbial products (SMP). The abundances of Methanoregula, Methanobacterium, Methanosphaerula were only 5.57%, 2.39% and 1.08% in the DC reactor, respectively. TCM wastewater containing rhein could be successfully treated by the combination of the heterogeneous Fenton-like pre-treatment and the DC reactor processes, and the COD removal rate reached 95%. Meanwhile, the abundances of Methanoregula, Methanobacterium, Methanosphaerula increased to 22.5%, 18.5%, and 13.87%, respectively. For the bacterial community, the abundance of Acidobacteria_Gp6 decreased from 6.99% to 1.07%, while the abundances of Acidobacteria_Gp1 and Acidobacteria_Gp2 increased from 1.61% to 6.55% and from 1.28% to 5.87%, respectively. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. A review of antimalarial plants used in traditional medicine in communities in Portuguese-speaking countries: Brazil, Mozambique, Cape Verde, Guinea-Bissau, São Tomé and Príncipe and Angola.

    PubMed

    Silva, Jefferson Rocha de A; Ramos, Aline de S; Machado, Marta; de Moura, Dominique F; Neto, Zoraima; Canto-Cavalheiro, Marilene M; Figueiredo, Paula; do Rosário, Virgilio E; Amaral, Ana Claudia F; Lopes, Dinora

    2011-08-01

    The isolation of bioactive compounds from medicinal plants, based on traditional use or ethnomedical data, is a highly promising potential approach for identifying new and effective antimalarial drug candidates. The purpose of this review was to create a compilation of the phytochemical studies on medicinal plants used to treat malaria in traditional medicine from the Community of Portuguese-Speaking Countries (CPSC): Angola, Brazil, Cape Verde, Guinea-Bissau, Mozambique and São Tomé and Príncipe. In addition, this review aimed to show that there are several medicinal plants popularly used in these countries for which few scientific studies are available. The primary approach compared the antimalarial activity of native species used in each country with its extracts, fractions and isolated substances. In this context, data shown here could be a tool to help researchers from these regions establish a scientific and technical network on the subject for the CPSC where malaria is a public health problem.

  15. The War on Poverty’s Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans†

    PubMed Central

    Bailey, Martha J.; Goodman-Bacon, Andrew

    2015-01-01

    This paper uses the rollout of the first Community Health Centers (CHCs) to study the longer-term health effects of increasing access to primary care. Within ten years, CHCs are associated with a reduction in age-adjusted mortality rates of 2 percent among those 50 and older. The implied 7 to 13 percent decrease in one-year mortality risk among beneficiaries amounts to 20 to 40 percent of the 1966 poor/non-poor mortality gap for this age group. Large effects for those 65 and older suggest that increased access to primary care has longer-term benefits, even for populations with near universal health insurance. (JEL H75, I12, I13, I18, I32, I38, J14) PMID:25999599

  16. Can Andean medicine coexist with biomedical healthcare? A comparison of two rural communities in Peru and Bolivia

    PubMed Central

    2012-01-01

    Background It is commonly assumed that indigenous medical systems remain strong in developing countries because biomedicine is physically inaccessible or financially not affordable. This paper compares the health-seeking behavior of households from rural Andean communities at a Peruvian and a Bolivian study site. The main research question was whether the increased presence of biomedicine led to a displacement of Andean indigenous medical practices or to coexistence of the two healing traditions. Methodology Open-ended interviews and free listing exercises were conducted between June 2006 and December 2008 with 18 households at each study site. Qualitative identification of households’ therapeutic strategies and use of remedies was carried out by means of content analysis of interview transcriptions and inductive interference. Furthermore, a quantitative assessment of the incidence of culture-bound illnesses in local ethnobiological inventories was performed. Results Our findings indicate that the health-seeking behavior of the Andean households in this study is independent of the degree of availability of biomedical facilities in terms of quality of services provided, physical accessibility, and financial affordability, except for specific practices such as childbirth. Preference for natural remedies over pharmaceuticals coexists with biomedical healthcare that is both accessible and affordable. Furthermore, our results show that greater access to biomedicine does not lead to less prevalence of Andean indigenous medical knowledge, as represented by the levels of knowledge about culture-bound illnesses. Conclusions The take-home lesson for health policy-makers from this study is that the main obstacle to use of biomedicine in resource-poor rural areas might not be infrastructural or economic alone. Rather, it may lie in lack of sufficient recognition by biomedical practitioners of the value and importance of indigenous medical systems. We propose that the

  17. Can Andean medicine coexist with biomedical healthcare? A comparison of two rural communities in Peru and Bolivia.

    PubMed

    Mathez-Stiefel, Sarah-Lan; Vandebroek, Ina; Rist, Stephan

    2012-07-24

    It is commonly assumed that indigenous medical systems remain strong in developing countries because biomedicine is physically inaccessible or financially not affordable. This paper compares the health-seeking behavior of households from rural Andean communities at a Peruvian and a Bolivian study site. The main research question was whether the increased presence of biomedicine led to a displacement of Andean indigenous medical practices or to coexistence of the two healing traditions. Open-ended interviews and free listing exercises were conducted between June 2006 and December 2008 with 18 households at each study site. Qualitative identification of households' therapeutic strategies and use of remedies was carried out by means of content analysis of interview transcriptions and inductive interference. Furthermore, a quantitative assessment of the incidence of culture-bound illnesses in local ethnobiological inventories was performed. Our findings indicate that the health-seeking behavior of the Andean households in this study is independent of the degree of availability of biomedical facilities in terms of quality of services provided, physical accessibility, and financial affordability, except for specific practices such as childbirth. Preference for natural remedies over pharmaceuticals coexists with biomedical healthcare that is both accessible and affordable. Furthermore, our results show that greater access to biomedicine does not lead to less prevalence of Andean indigenous medical knowledge, as represented by the levels of knowledge about culture-bound illnesses. The take-home lesson for health policy-makers from this study is that the main obstacle to use of biomedicine in resource-poor rural areas might not be infrastructural or economic alone. Rather, it may lie in lack of sufficient recognition by biomedical practitioners of the value and importance of indigenous medical systems. We propose that the implementation of health care in indigenous

  18. Research-design issues in cancer-symptom-management trials using complementary and alternative medicine: lessons from the National Cancer Institute Community Clinical Oncology Program experience.

    PubMed

    Buchanan, David R; White, Jeffrey D; O'Mara, Ann M; Kelaghan, Joseph W; Smith, Wendy B; Minasian, Lori M

    2005-09-20

    To identify major research-design issues in proposals submitted by investigators in the Community Clinical Oncology Program (CCOP) for clinical trials of complementary and alternative medicine (CAM) for cancer-symptom management. We conducted content analysis of all scientific reviews of concepts and protocols submitted by the CCOP to the National Cancer Institute (NCI) to identify research challenges in conducting clinical trials designed to evaluate CAM interventions for cancer-symptom management. Since the inception of the NCI Office of Cancer Complementary and Alternative Medicine in 1998, a total of 46 symptom-management studies using CAM interventions have been proposed by CCOP investigators, with 20 studies now in progress comprising 22% of the current total CCOP symptom-management portfolio. Proposals fell into four categories: complex natural products; nutritional therapeutics; mind-body interventions; and alternative medical systems. The most significant research-design issues arose as a consequence of the lack of preclinical data for CAM interventions and the lack of quality-control standards comparable with those used in regulating new pharmaceutical agents. Across the different types of CAM interventions, the most common problems found in proposed research designs are related to unwarranted assumptions about the consistency and standardization of CAM interventions, the need for data-based justifications for the study hypotheses, and the need to implement appropriate quality control and monitoring procedures during the course of the trial. To advance the state of the science, future research must address these critical issues if CAM interventions are to be evaluated rigorously and have a consequent impact on clinical practice and general public awareness.

  19. Mothers' perception of recovery and satisfaction with patent medicine dealers' treatment of childhood febrile conditions in rural communities.

    PubMed

    Ibeneme, Georgian Chiaka; Nwaneri, Ada Caroline; Ibeneme, Sam Chidi; Ezenduka, Pauline; Strüver, Vanessa; Fortwengel, Gehard; Okoye, Ifeoma Joy

    2016-06-28

    Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine 'mothers' perception of recovery' and 'mothers' satisfaction' after PMD treatment of childhood febrile conditions, as likely drivers of mothers' health-seeking behaviour, which must be targeted to reverse the trend. Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15-45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21-47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05. Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs' treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers' satisfaction with PMDs' treatment is significantly (p < 0.05) associated with mothers' perception of recovery of their child (χ(2) = 192.94, df = 4; p < 0.0001; Cramer's V = 0.7079). However, predicting mothers' satisfaction with PMDs' treatment from a knowledge of mothers' perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers' perception of recovery based on

  20. Use of Traditional and Complementary Medicine as Self-Care Strategies in Community Health Centers: Cross-Sectional Study in Urban Pearl River Delta Region of China.

    PubMed

    Chung, Vincent C H; Wong, Samuel Y S; Wang, Harry H X; Wong, Martin C S; Wei, Xiaolin; Wang, Jiaji; Liu, Siya; Ho, Robin S T; Yu, Ellen L M; Griffiths, Sian M

    2016-06-01

    In China, Community Health Centers (CHCs) are major providers of primary care services, but their potential in empowering patients' self-management capacity has not been assessed. This study aims to describe self-care practice patterns amongst CHC attendees in urban China.In this cross-sectional quantitative study, 3360 CHC patients from 6 cities within the Pearl Delta Region were sampled using multistage cluster sampling.Thirty-seven per cent had used with over-the-counter Chinese herbal medicines (OTC CHMs) in the past year and majority of respondents found OTC CHMs effective. OTC CHMs were more popular amongst those who needed to pay out of pocket for CHC services. Less than 10% used vitamins and minerals, and those with a lower socioeconomic background have a higher propensity to consume. Although doubts on their usefulness are expressed, their use by the vulnerable population may reflect barriers to access to conventional health care, cultural affinity, or a defense against negative consequences of illnesses. About 25% performed physical exercise, but the prevalence is lower amongst women and older people. Taiji seems to be an alternative for these populations with promising effectiveness, but overall only 6% of CHC attendees participated.These results suggest that CHCs should start initiatives in fostering appropriate use of OTC CHM, vitamins, and minerals. Engaging community pharmacists in guiding safe and effective use of OTC CHM amongst the uninsured is essential given their low accessibility to CHC services. Prescription of Taiji instead of physical exercises to women and older people could be more culturally appropriate, and the possibility of including this as part of the CHC services worth further exploration.

  1. The pedagogical value of a student-run community-based experiential learning project: The Yong Loo Lin School of Medicine Public Health Screening.

    PubMed

    Wee, Liang En; Yeo, Wei Xin; Tay, Clifton M; Lee, Jeannette J M; Koh, Gerald C H

    2010-09-01

    We assessed the pedagogical value of a student-led community-based experiential learning project called the Public Health Screening (PHS) run by medical and nursing students of the National University of Singapore's Yong Loo Lin School of Medicine (NUS YLLSoM). We conducted a cross-sectional study using a self-administered anonymised questionnaire on medical and nursing students who participated in PHS using the Fund for the Improvement of Postsecondary Education (FIPSE) Survey Instrument. Participants also gave an overall score for their learning experience at the PHS. The participation rate was 93.1% (576/619) for medical students and 100% (37/37) for nursing students. All participants gave the PHS learning experience a high rating (median = 8 out of maximum of 10, inter-quartile range, 7 to 9). A majority of participants felt that PHS had helped them to improve across all domains surveyed. For medical students, those in preclinical years and females were independently more likely to feel that PHS had helped them to improve in communication skills, teamwork, ability to identify social issues, taking action, and gaining and applying their knowledge than those in clinical years and males. Improved ability to interact with patients (β=1.64, 95%CI, 1.01-2.27), appreciation of challenges to healthcare faced by Singaporeans from lower income groups (β=0.93, 95%CI, 0.49-1.37), thinking of others (β=0.70, 95%CI, 0.04-1.37) and tolerance of different people (β =0.63, 95%CI, 0.17-1.10) were strongly associated with the overall rating score. PHS was a positive learning experience in a wide range of domains for all students involved. This suggests that student-organised community-based experiential learning projects have potential educational value for both medical and nursing students.

  2. Investigating patient perspectives on medical returns and buying medicines online in two communities in Melbourne, Australia: results from a qualitative study.

    PubMed

    Brijnath, Bianca; Antoniades, Josefine; Adams, Jon

    2015-04-01

    By going online or overseas, patients can purchase a range of prescription and over-the-counter drugs and complementary and alternative medicine (CAM), without prescription and without input from a qualified health professional. Such practices raise questions about medicine safety and how and why patients choose to procure medicines using such methods. The aim of this paper is to examine two unconventional types of medicine procurement-medical returns and purchasing medicines online-from the patient perspective. Data are drawn from a large qualitative study examining health-seeking practices among Indian-Australians (28) and Anglo-Australians (30) living with depression in Melbourne, Australia. Semi-structured face-to-face interviews were undertaken. Thematic analysis was performed. A total of 23 (39.6 %) participants reported having obtained medicines either through the internet or via medical returns. Indian-Australians sourced medicines from India while Anglo-Australians purchased CAM products from domestic and international e-pharmacies. Neither group encountered any difficulties in the medicines entering Australia. Cost and convenience were the main reasons for buying medicines online but dissatisfaction with Australian health services also influenced why Indian-Australians sought medicines from India. Nearly all participants reported benefits from consuming these medicines; only one person reported adverse effects. The increased availability of medicines transnationally and patients' preparedness to procure these medicines from a range of sources raise important issues for the safe use of medicines. Further research is needed to understand how patients forge their own transnational therapeutic regimes, understand and manage their levels of risk in relation to safe medicine use and what points of intervention might be most effective to promote safe medicine use.

  3. A multisite, community oncology-based randomized trial of a brief educational intervention to increase communication regarding complementary and alternative medicine.

    PubMed

    Parker, Patricia A; Urbauer, Diana; Fisch, Michael J; Fellman, Bryan; Hough, Holly; Miller, Jessica; Lanzotti, Victor; Whisnant, Mindy; Weiss, Matthias; Fellenz, Lori; Bury, Martin; Kokx, Patricia; Finn, Kathleen; Daily, Maureen; Cohen, Lorenzo

    2013-10-01

    The use of complementary and alternative medicine (CAM) is widespread, yet there is relatively little discussion regarding its use between oncology patients and their health care practitioners. This multisite randomized trial examined the efficacy of an educational intervention designed to encourage oncology nurses to discuss CAM use with their patients. A total of 175 nurses completed questionnaires about discussing CAM use with patients at baseline and 2 months after the intervention. Patients at baseline (N = 699) and different patients at follow-up (N = 650) completed questionnaires regarding CAM. At the 2-month follow-up, nurses in the intervention reported they were more likely to ask about CAM use than those in the control group (odds ratio, 4.2; P = .005). However, no significant effect was found for the percentage of patients who indicated that they were asked about CAM use (odds ratio, 2.1; P > .10). Approximately 40% of patients reported using CAM after their cancer diagnosis, yet the majority of nurses estimated that < 25% of their patients were using CAM. CAM use in community-based oncology patients is common and is underestimated by oncology nurses. The brief, low-intensity intervention presented herein was found to be sufficiently powerful to change nurses' perceptions of their behavior but may not have been intensive enough to yield changes that were evident to patients. Copyright © 2013 UT MD Anderson Cancer Center. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  4. Physical and rehabilitation medicine section and board of the European Union of Medical Specialists. Community context; history of European medical organizations; actions under way.

    PubMed

    De Korvin, G; Delarque, A

    2009-01-01

    The European Community is based on a series of treaties and legal decisions, which result from preliminary documents prepared long before by different organizations and lobbies. The European union of medical specialists (Union européenne des médecins specialists [UEMS]) came into being in order to address the questions raised by European directives (e.g., free circulation of people and services, reciprocal recognition of diplomas, medical training, quality improvements). The specialty sections of the UEMS contribute actively to this work. The physical and rehabilitation medicine (PRM) section is composed of three committees: the PRM board is devoted to initial and continuing education and has published a harmonized teaching programme and organized a certification procedure, which can be considered as a European seal of quality; the Clinical Affairs Committee is concerned with the quality of PRM care, and it has set up a European accreditation system for PRM programs of care, which will help to describe PRM clinical activity more concretely; and the Professional Practice Committee works on the fields of competence in our specialty. This third committee has already published a White Book, and further documents are being prepared, based on both the International classification of functioning, disability and health (ICF) and reference texts developed by the French Federation of PRM.

  5. Patterns of prescription drugs use among pregnant women at Sultan Qaboos University Hospital and Sultan Qaboos University Hospital Family and Community Medicine Clinic, Oman

    PubMed Central

    Al-Hamimi, J. Z.; Al Balushi, K. A.

    2016-01-01

    Objective: This study evaluates the patterns of prescription drugs use among women attending antenatal clinic at Sultan Qaboos University Hospital (SQUH) and SQUH Family and Community Medicine clinic (FAMCO), Oman. Methods: The study was a descriptive retrospective cross-sectional study on pregnant women who attended the antenatal clinic at SQUH and FAMCO from February to April 2014 and received a prescription containing at least one drug. Patients’ information was extracted from SQUH electronic records. Results: A total of 105 pregnant women were included in the study. Among the recruited pregnant women, 35 (33.3%) had at least one chronic disease. The average number of drugs prescribed per patient per prescription during the period of pregnancy was 2.33 ± 1.43. Vitamins and minerals were the most frequently prescribed class of drugs (30.60%) followed by analgesics (11.19%) and antidiabetic drugs (10.13%). According to the Food and Drug Administration risk classification, most of the prescribed drugs were from category B (30.0%) and C (27.14%). No drug was prescribed from category X. There was a significant decrease in prescribing category A drugs over the three trimesters (20.7%, 12.7%, and 9.3%, respectively) (P < 0.047). Conclusion: The study gives an overview of the extent of drug prescription during pregnancy and increases the awareness of health-care providers and women about the potential risks of drug use during pregnancy. PMID:28216955

  6. 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

  7. A systematic review in select countries of the role of the pharmacist in consultations and sales of non-prescription medicines in community pharmacy.

    PubMed

    van Eikenhorst, Linda; Salema, Nde-Eshimuni; Anderson, Claire

    Much has been studied in regard to non-prescription medicines (NPMs), but the impact of greater emphasis toward patient self-selection of such agents is still not well understood, and evidence in the literature might be equivocal. The aim was to examine whether or not pharmacist interventions are important in the sale of NPMs and to summarize the evidence of pharmacists' contribution in maintaining patient safety and improving the quality of consultations involving NPMs. Seven online databases were searched to identify the literature on studies conducted within the UK and in countries comparable to the UK reporting on consultations and selling of NPMs published between 1980 and 2013. All study designs except for quantitative surveys were eligible for inclusion into the review. The data extraction and quality assessment were performed according to the National Institute for Health and Care Excellence guidelines. The data extracted from the studies were analyzed and presented qualitatively. Eighty-three studies from an original 12,879 citations were included in this review. Just under half of the studies were published between 2000 and 2009 (n = 38; 46%). Thirty-three (44%) of the studies were conducted in the UK. The review showed that in terms of the contribution of community pharmacy staff in consultations for NPMs, non-pharmacist staff dealt with a large proportion of the consultations and pharmacists were usually involved in the consultation through referral from non-pharmacist staff member. Counseling was not consistently offered to everyone. Where counseling was provided it was not always of sufficient quality. Consultations were performed much better when symptoms were presented compared to when people made a direct product request. Pharmacists were reported to conduct better consultations than non-pharmacist staff. There was evidence to suggest that where counseling was appropriately provided this afforded the person a safe environment to utilize their

  8. Do not let precision medicine be kidnapped.

    PubMed

    Yang, Zhiping

    2015-12-01

    Obama’s precision medicine initiative made the medical community boil over after the initiative’s release. Precision medicine has been advocated by the majority of scientists and doctors. However, some experts have questioned this concept. This article does not oppose precision medicine. However, the incentive of vigorously promoting precision medicine at present is a concern.

  9. 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

  10. 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.

  11. 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.

  12. 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)

  13. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

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

  14. Biomarkers in Veterinary Medicine.

    PubMed

    Myers, Michael J; Smith, Emily R; Turfle, Phillip G

    2017-02-08

    This article summarizes the relevant definitions related to biomarkers; reviews the general processes related to biomarker discovery and ultimate acceptance and use; and finally summarizes and reviews, to the extent possible, examples of the types of biomarkers used in animal species within veterinary clinical practice and human and veterinary drug development. We highlight opportunities for collaboration and coordination of research within the veterinary community and leveraging of resources from human medicine to support biomarker discovery and validation efforts for veterinary medicine.

  15. Interprofessional Integrative Medicine Training for Preventive Medicine Residents.

    PubMed

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

    2015-11-01

    Integrative medicine training was incorporated into the Rutgers New Jersey Medical School Preventive Medicine residency at the Rutgers Biomedical and Health Sciences Newark Campus as a collaboration between the Rutgers New Jersey Medical School and the School of Health Related Professions. Beginning in 2012, an interdisciplinary faculty team organized an Integrative Medicine program in a Preventive Medicine residency that leveraged existing resources across Rutgers Biomedical and Health Sciences. The overarching aim of the programs was to introduce residents and faculty to the scope and practice of integrative medicine in the surrounding Newark community and explore evidence-based research on integrative medicine. The faculty team tapped into an interprofessional network of healthcare providers to organize rotations for the preventive medicine residents that reflected the unique nature of integrative medicine in the greater Newark area. Residents provided direct care as part of interdisciplinary teams at clinical affiliates and shadowed health professionals from diverse disciplines as they filled different roles in providing patient care. The residents also participated in research projects. A combination of formal and informal programs on integrative medicine topics was offered to residents and faculty. The Integrative Medicine program, which ran from 2013 through 2014, was successful in exposing residents and faculty to the unique nature of integrative medicine across professions in the community served by Rutgers Biomedical and Health Sciences. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  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. Genetics and genomic medicine.

    PubMed

    Bogaard, Kali; Johnson, Marlene

    2009-01-01

    Genetics is playing an increasingly important role in the diagnosis, monitoring and treatment of diseases, and the expansion of genetics into health care has generated the field of genomic medicine. Health care delivery is shifting away from general diagnostic evaluation toward a generation of therapeutics based on a patient's genetic makeup. Meanwhile, the scientific community debates how best to incorporate genetics and genomic medicine into practice. While obstacles remain, the ultimate goal is to use information generated from the study of human genetics to improve disease treatment, cure and prevention. As the use of genetics in medical diagnosis and treatment increases, health care workers will require an understanding of genetics and genomic medicine.

  18. 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 ...

  19. Widening access to medicine may improve general practitioner recruitment in deprived and rural communities: survey of GP origins and current place of work.

    PubMed

    Dowell, J; Norbury, M; Steven, K; Guthrie, B

    2015-10-01

    Widening access to medicine in the UK is a recalcitrant problem of increasing political importance, with associated strong social justice arguments but without clear evidence of impact on service delivery. Evidence from the United States suggests that widening access may enhance care to underserved communities. Additionally, rural origin has been demonstrated to be the factor most strongly associated with rural practice. However the evidence regarding socio-economic and rural background and subsequent practice locations in the UK has not been explored. The aim of this study was to investigate the association between general practitioners' (GPs) socio-economic and rural background at application to medical school and demographic characteristics of their current practice. The study design was a cross-sectional email survey of general practitioners practising in Scotland. Socio-economic status of GPs at application to medical school was assessed using the self-coded National Statistics Socio-Economic Classification. UK postcode at application was used to define urban-rural location. Current practice deprivation and remoteness was measured using NHS Scotland defined measures based on registered patients' postcodes. A survey was sent to 2050 Scottish GPs with a valid accessible email address, with 801 (41.5 %) responding. GPs whose parents had semi-routine or routine occupations had 4.3 times the odds of working in a deprived practice compared to those with parents from managerial and professional occupations (95 % CI 1.8-10.2, p = 0.001). GPs from remote and rural Scottish backgrounds were more likely to work in remote Scottish practices, as were GPs originating from other UK countries. This study showed that childhood background is associated with the population GPs subsequently serve, implying that widening access may positively affect service delivery in addition to any social justice rationale. Longitudinal research is needed to explore this association and the

  20. [Secret medicines].

    PubMed

    Bonnemain, H

    2001-01-01

    Secret medicines had two characteristics: their formula remained unknown and they were prepared by many kinds of people. Before 1728 there were no general laws about these secret medicines but only peculiar rules. From 1728 to 1778, the King edicted rigorous rules in order to limit the number of secret medicines. Between 1778 and 1789, the law became more definite and the Royal Society of Medicine gave advices. The Law of Germinal An-XI forbid secret medicines but since 1805, some compromises took place. Slowly, secret medicines were replaced by pharmaceutics and new set of laws.

  1. Prevalence and Correlates of Complementary and Alternative Medicine Services Use in Low-Income African Americans and Whites: A Report from the Southern Community Cohort Study

    PubMed Central

    Hargreaves, Margaret K.; Shu, Xiao-Ou; Liu, Jianguo; Kenerson, Donna M.; Signorello, Lisa B.; Blot, William J.

    2012-01-01

    Abstract Objectives This study aimed to examine the prevalence, trends, and correlates of practitioner-based complementary and alternative medicine (CAM) services use according to race in a socioeconomically disadvantaged population. Design Included in this cross-sectional analysis were 50,176 African Americans (AAs) and 19,038 whites enrolled into the Southern Community Cohort Study from March 2002 through September 2009. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of CAM services use associated with participant characteristics. Outcome measures Outcomes include the prevalence of and trends in use of CAM services during 2002–2009 and correlates of use by race. Results CAM services use during 2002–2009 was greater among whites (11.7%) than among AAs (8.5%), but no significant temporal trends within the 8-year period were observed. The significant associations were observed for CAM services use with higher educational attainment (OR 1.78, 95% CI: 1.61–1.96 for college versus less than high school), household income (OR 1.61, 95% CI: 1.44–1.81 for ≥$50,000 versus <$15,000), and having a history of a chronic disease (OR 1.34, 95% CI: 1.21–1.47) among both AAs and whites. Significant differences in findings between AAs and whites were seen for age (with a sharp decline in use with older age among AAs but not whites), sex (with the excess of female users more striking among whites), employment (with the unemployed among AAs but not whites more likely to be users), alcohol consumption (with white but not AA drinkers more likely to report CAM services use), and cigarette smoking status (with negative association of use with current smokers more striking among whites). Conclusions CAM services use is associated with sociodemographic and health-related factors, and racial differences in such use exist. The descriptive findings of this study help supplement the limited information on CAM use among low

  2. Nuclear Medicine

    MedlinePlus

    ... Home » Science Education » Science Topics » Nuclear Medicine SCIENCE EDUCATION SCIENCE EDUCATION Science Topics Resource Links for General Public Resource ... Related Documents: Nuclear Medicine Fact Sheet.pdf SCIENCE EDUCATION Science Topics Resource Links for General Public Resource ...

  3. Herbal Medicine

    MedlinePlus

    ... for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are ... and fresh or dried plants. People use herbal medicines to try to maintain or improve their health. ...

  4. 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.

  5. [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.

  6. Occupational and environmental medicine in a family medicine residency.

    PubMed

    Eckstein, T E; Teitelbaum, H S

    2001-05-01

    Well-rounded instruction in occupational medicine as part of family medicine residency training is feasible through a program that balances a longitudinal curriculum of monthly occupational and environmental medicine (OEM) lectures, community-based OEM patient care, and worksite assessment. Such training would help equip family medicine residents to integrate occupational medicine into their practices, which, in light of a shortage of board-certified practitioners in OEM, would help fill community needs. The Intern-Resident Training Committee of Carson City Hospital in rural Michigan established both learner and institutional goals and objectives for such a program of instruction. A learner-needs assessment found appreciable interest among the residents for occupational medicine training. In addition, results of a survey of the occupational health community suggested there is inadequate coverage of OEM in medical schools and residencies. Furthermore, a focus group of occupational health managers revealed that clarity of communication and standardization of reporting were paramount concerns. Instruments for standardized OEM history and for OEM case management were developed for use within the residency continuity clinic. The curriculum was implemented with a variety of teaching strategies, including worksite assessment. Practice-based, case-oriented instruction was subsequently phased into the program as residents assumed responsibility for managing cases under the supervision of family medicine preceptors knowledgeable in OEM. An occupational medicine rotation was developed that included focused clinical exposure to OEM patients and studies that would lead to eligibility for a certificate of additional qualification in occupational medicine. Learner evaluations included chart reviews and patient satisfaction surveys. Program evaluations included interviews with occupational health managers. The residents were judged by their preceptors to have performed well. The

  7. Academic medicine in Russia.

    PubMed

    Burger, Edward J; Ziganshina, Lilia; Ziganshin, Airat U

    2004-12-01

    Academic medicine, along with professionalism of the medical community in Russia underwent a remarkable evolution from the Revolution through the decline of the Soviet Union. The Soviet period brought about an enormous expansion of numbers of admissions to medical schools and a corresponding increase in the number of new physicians. Academic medical institutions were separated from institutions of higher learning in general and medical science was separated from the mainstream of science. Many of these features have been reversed in the past 14 years and re-professionalization of medicine has resumed.

  8. Precision medicine in cardiology.

    PubMed

    Antman, Elliott M; Loscalzo, Joseph

    2016-10-01

    The cardiovascular research and clinical communities are ideally positioned to address the epidemic of noncommunicable causes of death, as well as advance our understanding of human health and disease, through the development and implementation of precision medicine. New tools will be needed for describing the cardiovascular health status of individuals and populations, including 'omic' data, exposome and social determinants of health, the microbiome, behaviours and motivations, patient-generated data, and the array of data in electronic medical records. Cardiovascular specialists can build on their experience and use precision medicine to facilitate discovery science and improve the efficiency of clinical research, with the goal of providing more precise information to improve the health of individuals and populations. Overcoming the barriers to implementing precision medicine will require addressing a range of technical and sociopolitical issues. Health care under precision medicine will become a more integrated, dynamic system, in which patients are no longer a passive entity on whom measurements are made, but instead are central stakeholders who contribute data and participate actively in shared decision-making. Many traditionally defined diseases have common mechanisms; therefore, elimination of a siloed approach to medicine will ultimately pave the path to the creation of a universal precision medicine environment.

  9. ‘SASA! is the medicine that treats violence’. Qualitative findings on how a community mobilisation intervention to prevent violence against women created change in Kampala, Uganda

    PubMed Central

    Kyegombe, Nambusi; Starmann, Elizabeth; Devries, Karen M.; Michau, Lori; Nakuti, Janet; Musuya, Tina; Watts, Charlotte; Heise, Lori

    2014-01-01

    Background Intimate partner violence (IPV) violates women's human rights and is a serious public health concern. Historically strategies to prevent IPV have focussed on individuals and their relationships without addressing the context under which IPV occurs. Primary prevention of IPV is a relatively new focus of international efforts and what SASA!, a phased community mobilisation intervention, seeks to achieve. Methods Conducted in Kampala, Uganda, between 2007 and 2012, the SASA! Study is a cluster randomised controlled trial to assess the community-level impact of SASA! This nested qualitative study explores pathways of individual- and community-level change as a result of SASA! Forty in-depth interviews with community members (20 women, 20 men) were conducted at follow-up, audio recorded, transcribed verbatim and analysed using thematic analysis complemented by constant comparative methods. Results SASA! influenced the dynamics of relationships and broader community norms. At the relationship level, SASA! is helping partners to explore the benefits of mutually supportive gender roles; improve communication on a variety of issues; increase levels of joint decision-making and highlight non-violent ways to deal with anger or disagreement. Not all relationships experienced the same breadth and depth of change. At the community level, SASA! has helped foster a climate of non-tolerance of violence by reducing the acceptability of violence against women and increasing individuals’ skills, willingness, and sense of responsibility to act to prevent it. It has also developed and strengthened community-based structures to catalyse and support on-going activism to prevent IPV. Discussion This paper provides evidence of the ways in which community-based violence prevention interventions may reduce IPV in low-income settings. It offers important implications for community mobilisation approaches and for prevention of IPV against women. This research has demonstrated the

  10. 'SASA! is the medicine that treats violence'. Qualitative findings on how a community mobilisation intervention to prevent violence against women created change in Kampala, Uganda.

    PubMed

    Kyegombe, Nambusi; Starmann, Elizabeth; Devries, Karen M; Michau, Lori; Nakuti, Janet; Musuya, Tina; Watts, Charlotte; Heise, Lori

    2014-01-01

    Intimate partner violence (IPV) violates women's human rights and is a serious public health concern. Historically strategies to prevent IPV have focussed on individuals and their relationships without addressing the context under which IPV occurs. Primary prevention of IPV is a relatively new focus of international efforts and what SASA!, a phased community mobilisation intervention, seeks to achieve. Conducted in Kampala, Uganda, between 2007 and 2012, the SASA! Study is a cluster randomised controlled trial to assess the community-level impact of SASA! This nested qualitative study explores pathways of individual- and community-level change as a result of SASA! Forty in-depth interviews with community members (20 women, 20 men) were conducted at follow-up, audio recorded, transcribed verbatim and analysed using thematic analysis complemented by constant comparative methods. SASA! influenced the dynamics of relationships and broader community norms. At the relationship level, SASA! is helping partners to explore the benefits of mutually supportive gender roles; improve communication on a variety of issues; increase levels of joint decision-making and highlight non-violent ways to deal with anger or disagreement. Not all relationships experienced the same breadth and depth of change. At the community level, SASA! has helped foster a climate of non-tolerance of violence by reducing the acceptability of violence against women and increasing individuals' skills, willingness, and sense of responsibility to act to prevent it. It has also developed and strengthened community-based structures to catalyse and support on-going activism to prevent IPV. This paper provides evidence of the ways in which community-based violence prevention interventions may reduce IPV in low-income settings. It offers important implications for community mobilisation approaches and for prevention of IPV against women. This research has demonstrated the potential of social norm change

  11. Design, implementation and evaluation of a community health training program in an integrated problem-based medical curriculum: a fifteen-year experience at the University of Geneva Faculty of Medicine

    PubMed Central

    Chastonay, Philippe; Vu, Nu Viet; Humair, Jean-Paul; Mpinga, Emmanuel Kabengele; Bernheim, Laurent

    2012-01-01

    Background In the literature the need for relevance in medical education and training has been stressed. In the last 40 years medical schools have been challenged to train doctors competent to respond to community health needs. In the mid-90s the University of Geneva Faculty of Medicine introduced an integrated medical curriculum. In this initiative a particular emphasis was put in introducing a 6-year longitudinal and multidisciplinary Community Health Program (CHP). Objectives The aims of the present article are to describe the conception, elaboration and implementation of the CHP as well as its evolution over 15 years and the evaluation of its outcomes. Methods The CHP was at its origin elaborated by a small group of highly motivated teachers and later on developed by a multi-disciplinary group of primary care physicians, epidemiologists, public health and bio-ethics specialists, occupational health professionals, lawyers and historians. Evaluation of the program outcomes included educational innovations, new developments of the curriculum and interactions between students and the community. Results The CHP learning objectives and teaching modalities were defined by the multi-disciplinary group in consensus meetings which triggered a collaborative spirit among teachers and facilitated further developments. The evaluation procedures allowed the monitoring of students’ satisfaction which remained high over the years, students’ active participation which decreased over time and success at certifying exams which was globally as good as in basic life sciences. The evaluation also assessed outcomes such as educational innovations, new developments of the curriculum and interactions between students and the community. Conclusion As suggested in the literature, our experience shows that the students’ direct exposure and practice in the community health environment is an effective training approach to broaden students’ education by offering them a community

  12. [Expedition medicine].

    PubMed

    Donlagić, Lana

    2009-01-01

    Expedition and wildeness medicine is a term that combines rescue medicine, sport medicine as well as more specific branches as polar or high altitude medicine. It is being intensively studied both at the reaserch institutes and on expeditions. Ophtalmologists are concentrated on the reaserch of HARH (High Altitude Retinal Hemorrhage), neurologists on HACE reaserch (High Altitude Cerebral Edema), psychologists are developing tests to decsribe cognitive functions and many physicians are being trained to work in extreme enviroment. The result of all this effort are numerous new findings in pathophysiology and therapy of altitude illness, increased security on expedition and further development of expeditionism.

  13. The shifting architectonics of pain medicine: toward ethical realignment of scientific, medical and market values for the emerging global community--groundwork for policy.

    PubMed

    Giordano, James; Benedikter, Roland

    2011-03-01

    Following the Second Industrial Revolution, Western medicine has become an interwoven enterprise of humanitarian and technologic values. In this essay, we posited that rather than being seen as a means toward achieving the ends of providing technically right and morally sound pain care, the resources and goods of pain medicine have been subordinated to a market-based values system that regards these tools as ends unto themselves. We argued that this approach is 1) pragmatically inapt, in that it fails to acknowledge and provide those tools as rightly necessary for the "good" of pain medicine to be enacted; and is therefore 2) morally unsound, in that the good, while recognized, is not afforded, thereby disserving the fiduciary of science/technology, medicine, and economics. We framed these issues within 1) the context(s) and effects of postmodernism and 2) the increasing call for a globally relevant and applicable system of pain care. Toward this latter end, we addressed how policies can be created that accommodate differing social values, and still enable the execution of care in ways that are morally sound, yet economically viable. We posited that such policies need to be finely grained so as to 1) sustain research in pain diagnosis, assessment, treatment, and management; 2) translate research efforts into clinically relevant resources; 3) enable availability and just distribution of both low- and high-tech resources; and 4) prompt fiscal programs that support, allow, and reinforce responsible choice (of such resources) as socioculturally required, valued, and valid.

  14. Ethnobotanical study of nutri-medicinal plants used for the management of HIV/AIDS opportunistic ailments among the local communities of western Uganda.

    PubMed

    Asiimwe, Savina; Kamatenesi-Mugisha, Maud; Namutebi, Agnes; Borg-Karlsson, Anna-Karin; Musiimenta, Peace

    2013-11-25

    Herbal remedies are a source of therapeutics for nearly 80% of the population in Uganda. Poor health facilities and limited access to antiretroviral drugs have perpetuated and increased the use of traditional medicine especially in rural areas for the treatment of opportunistic ailments of HIV/AIDS. To document the traditional uses of nutri-medicinal plants in the management of immunocompromised ailments associated with HIV/AIDS. To document the parts and growth forms of plants used, methods of preparation and administration of the herbal remedies. The study was conducted in Mbarara and Isingiro districts of western Uganda between December 2010 and May 2011. Ethnobotanical information was collected from 64 respondents who were sampled based on recommendations of local elders and administrators. Ethnobotanical data on the use of nutri-medicinal plants for traditional treatment of HIV/AIDS opportunistic ailments were collected by employing semi-structured interviews with selected respondents, house hold visits and field observations as described by (Martin, 1995a). The respondents were mainly traditional medical practitioners who treat patients who are already receiving antiretroviral drugs. Fidelity levels of plant species and informant consensus factor were determined to show the percentage of informants claiming the use of certain plant species for the same major purpose and to analyse people's knowledge of plant use. The study revealed 81 plant species most of which were herbs (49%). Leaves (71%) were the most frequently used parts in remedy preparations which were mainly administered orally (85%). The majority of plants (54%) were harvested from wild populations. Hibiscus sabdariffa L., Plumeria obtusa L., and Abutilon guineense (Shumach.) Baker. F and Exell were the nutri-medicinal plants that scored the highest Fidelity level values. The informant's consensus about usages of plants ranged from 0.75 to 0.80. Plants that are presumed to be effective in treating

  15. [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.

  16. 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.

  17. 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,…

  18. 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…

  19. 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,…

  20. 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…

  1. Complementary medicine.

    PubMed

    Ernst, E

    2003-03-01

    Complementary medicine has become an important subject for rheumatologists, not least because many patients try complementary treatments. Recent clinical trials yield promising results. In particular, evidence suggests that several herbal medicines and dietary supplements can alleviate the pain of osteoarthritis and rheumatoid arthritis. Clearly, rigorous testing of complementary treatments is possible, and considering their popularity, should be encouraged.

  2. 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 ...

  3. Increasing US health plan coverage for exercise programming in community mental health settings for people with serious mental illness: a position statement from the Society of Behavior Medicine and the American College of Sports Medicine.

    PubMed

    Pratt, Sarah I; Jerome, Gerald J; Schneider, Kristin L; Craft, Lynette L; Buman, Matthew P; Stoutenberg, Mark; Daumit, Gail L; Bartels, Stephen J; Goodrich, David E

    2016-09-01

    Adults with serious mental illness die more than 10 years earlier than the average American. Premature mortality is due to the high prevalence of preventable diseases including cardiovascular disease and diabetes. Poor lifestyle behaviors including lack of exercise and physical inactivity contribute to the epidemic levels of obesity, diabetes, and cardiovascular disease observed among adults with serious mental illness. Not surprisingly, people with serious mental illness are among the most costly consumers of health services due to increased visits for poorly managed mental and physical health. Recent studies have demonstrated that exercise interventions based on community mental health settings can significantly improve physical and mental health in people with serious mental illness. However, current funding regulations limit the ability of community mental health settings to offer exercise programming services to people with serious mental illness. Policy efforts are needed to improve the dissemination and sustainability of exercise programs for people with serious mental illness.

  4. [Phronesis: Medicine's indispensable virtue].

    PubMed

    Moreno Villares, José Manuel

    2014-01-01

    Facing those who defend that Medicine is not but an applied science, Pellegrino argues that the ultimate goal of Medicine is facing to a human being in his illness condition. Thus, it is not sufficient to have scientific knowledge but proximity to man kindness. Cure is not the only goal -achievable in only a few cases- but healing, caring with a person as an ill person and as a person. For this reason, professional competence is not enough; the physician needs to have the necessary dispositions to be a good person, a good professional. To get the goals of Medicine, the physician has to achieve those qualities who allow him to do the good he is intended to, that is, he needs to be virtuous. Prudence -phronesis- is the virtue that allows him to apply a general rule to a particular case and, furthermore, addresses his actions to be not only technically correct, but excellent. Prudence is, then, the link between intellectual virtues and moral virtues. Pellegrino's main objective has been to elaborate a Philosophy of Medicine, different from the Philosophy of Science, useful for clinical practice and used by clinical practitioners. By nurturing prudence, a small bit of the final goal is reached: the healing, the goodness for the sick. This should be possible if we are embedded in a moral community, and for Pellegrino, sharing knowledge and ethical values is the way of being part of a moral community.

  5. Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project): a clinical trial by clusters.

    PubMed

    Del Cura-González, Isabel; López-Rodríguez, Juan A; Sanz-Cuesta, Teresa; Rodríguez-Barrientos, Ricardo; Martín-Fernández, Jesús; Ariza-Cardiel, Gloria; Polentinos-Castro, Elena; Román-Crespo, Begoña; Escortell-Mayor, Esperanza; Rico-Blázquez, Milagros; Hernández-Santiago, Virginia; Azcoaga-Lorenzo, Amaya; Ojeda-Ruiz, Elena; González-González, Ana I; Ávila-Tomas, José F; Barrio-Cortés, Jaime; Molero-García, José M; Ferrer-Peña, Raul; Tello-Bernabé, María Eugenia; Trujillo-Martín, Mar

    2016-05-17

    Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6 months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit

  6. 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

  7. Precision Medicine

    PubMed Central

    Cholerton, Brenna; Larson, Eric B.; Quinn, Joseph F.; Zabetian, Cyrus P.; Mata, Ignacio F.; Keene, C. Dirk; Flanagan, Margaret; Crane, Paul K.; Grabowski, Thomas J.; Montine, Kathleen S.; Montine, Thomas J.

    2017-01-01

    Three key elements to precision medicine are stratification by risk, detection of pathophysiological processes as early as possible (even before clinical presentation), and alignment of mechanism of action of intervention(s) with an individual's molecular driver(s) of disease. Used for decades in the management of some rare diseases and now gaining broad currency in cancer care, a precision medicine approach is beginning to be adapted to cognitive impairment and dementia. This review focuses on the application of precision medicine to address the clinical and biological complexity of two common neurodegenerative causes of dementia: Alzheimer disease and Parkinson disease. PMID:26724389

  8. Medicines management.

    PubMed

    Pegram, Anne; Bloomfield, Jacqueline

    2015-04-15

    All newly registered graduate nurses are required to have the appropriate knowledge and understanding to perform the skills required for patient care, specifically the competencies identified in the Nursing and Midwifery Council's essential skills clusters. This article focuses on the fifth essential skills cluster – medicines management. Nursing students should work to attain the knowledge and skills required for effective medicines management throughout their pre-registration education. The roles and responsibilities of the newly registered graduate nurse in the area of medicines management are discussed in this the final article of the essential skills cluster series.

  9. Diabetes Medicines

    MedlinePlus

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Insulin, Medicines, & Other Diabetes Treatments Taking insulin or other ... medication plan. What are the different types of insulin? Several types of insulin are available. Each type ...

  10. COPD Medicine

    MedlinePlus

    ... Education & Training Home Treatment & Programs Medications COPD Medications COPD Medications Make an Appointment Ask a Question Refer ... control the symptoms of chronic obstructive pulmonary disease (COPD). Most people with COPD take long-acting medicine ...

  11. Inquiry-Based Learning for a Virtual Learning Community to Enhance Problem-Solving Ability of Applied Thai Traditional Medicine Students

    ERIC Educational Resources Information Center

    Chanprasitchai, Ong-art; Khlaisang, Jintavee

    2016-01-01

    The recent growth in collaborative and interactive virtual learning communities integrating innovative digital technologies and contemporary learning frameworks is contributing enormously to the use of e-learning in higher education in the twenty-first century. The purpose of this study was to describe the development of a virtual learning…

  12. 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

  13. A Rural Community's Involvement in the Design and Usability Testing of a Computer-Based Informed Consent Process for the Personalized Medicine Research Project

    PubMed Central

    Mahnke, Andrea N; Plasek, Joseph M; Hoffman, David G; Partridge, Nathan S; Foth, Wendy S; Waudby, Carol J; Rasmussen, Luke V; McManus, Valerie D; McCarty, Catherine A

    2014-01-01

    Many informed consent studies demonstrate that research subjects poorly retain and understand information in written consent documents. Previous research in multimedia consent is mixed in terms of success for improving participants’ understanding, satisfaction, and retention. This failure may be due to a lack of a community-centered design approach to building the interventions. The goal of this study was to gather information from the community to determine the best way to undertake the consent process. Community perceptions regarding different computer-based consenting approaches were evaluated, and a computer-based consent was developed and tested. A second goal was to evaluate whether participants make truly informed decisions to participate in research. Simulations of an informed consent process were videotaped to document the process. Focus groups were conducted to determine community attitudes towards a computer-based informed consent process. Hybrid focus groups were conducted to determine the most acceptable hardware device. Usability testing was conducted on a computer-based consent prototype using a touch-screen kiosk. Based on feedback, a computer-based consent was developed. Representative study participants were able to easily complete the consent, and all were able to correctly answer the comprehension check questions. Community involvement in developing a computer-based consent proved valuable for a population-based genetic study. These findings may translate to other types of informed consents, such as genetic clinical trials consents. A computer-based consent may serve to better communicate consistent, clear, accurate, and complete information regarding the risks and benefits of study participation. Additional analysis is necessary to measure the level of comprehension of the check-question answers by larger numbers of participants. The next step will involve contacting participants to measure whether understanding of what they consented to is

  14. The p-medicine portal—a collaboration platform for research in personalised medicine

    PubMed Central

    Schera, Fatima; Weiler, Gabriele; Neri, Elias; Kiefer, Stephan; Graf, Norbert

    2014-01-01

    The European project p-medicine creates an information technology infrastructure that facilitates the development from current medical practice to personalised medicine. The main access point to this infrastructure is the p-medicine portal that provides clinicians, patients, and researchers a platform to collaborate, share data and expertise, and use tools and services to improve personalised treatments of patients. In this document, we describe the community-based structure of the p-medicine portal and provide information about the p-medicine security framework implemented in the portal. Finally, we show the user interface and describe the p-medicine tools and services integrated in the portal. PMID:24567755

  15. The p-medicine portal-a collaboration platform for research in personalised medicine.

    PubMed

    Schera, Fatima; Weiler, Gabriele; Neri, Elias; Kiefer, Stephan; Graf, Norbert

    2014-01-01

    The European project p-medicine creates an information technology infrastructure that facilitates the development from current medical practice to personalised medicine. The main access point to this infrastructure is the p-medicine portal that provides clinicians, patients, and researchers a platform to collaborate, share data and expertise, and use tools and services to improve personalised treatments of patients. In this document, we describe the community-based structure of the p-medicine portal and provide information about the p-medicine security framework implemented in the portal. Finally, we show the user interface and describe the p-medicine tools and services integrated in the portal.

  16. Medicinal attributes of Solanum xanthocarpum fruit consumed by several tribal communities as food: an in vitro antioxidant, anticancer and anti HIV perspective

    PubMed Central

    2014-01-01

    Background Solanum xanthocarpum (Solanaceae) has been used for treatment of many infectious and degenerative diseases in traditional medicine. Present study reports the medicinal efficacy of S. xanthocarpum fruit as antioxidant, anticancer and anti HIV agents. Methods Extracts were prepared using Soxhlet apparatus and partially characterized by thin layer chromatography (TLC). Total flavonoid content was determined spectrophotometrically. Reducing power, DPPH radical scavenging activity and lipid peroxidation inhibition assays were used for measurement of antioxidant potential. Cytotoxic (SRB assay) and anti-HIV RT inhibition (RT assay kit, Roche) activities were determined using ELISA. Results TLC revealed the diversity of phytoconstituents in various sequential extracts of S. xanthocarpum fruit. Total flavonoid contents in extracts ranged between 10.22–162.49 μg quercetin equivalent/mg. Spectroscopic scanning of water soluble phenolics showed maximum absorbance at 250 and 280 nm. Polar extracts displayed potent radical scavenging activity (>80%). Several sub-fractions (spots) of extracts separated on TLC plates also exhibited powerful radical scavenging activity. Considerable reducing power was observed in extracts. Hexane fraction provided 55% lipoprotection in rat kidney homogenate. Non-polar extracts exhibited appreciable cytotoxic activity (70-91%) against leukemia (THP-1) and lung cancer (HOP-62) cell lines. Lower inhibitory activity was observed in extracts against HIV Reverse Transcriptase enzyme. Conclusion The study demonstrated considerable antioxidant and anticancer activities in S. xanthocarpum fruit. PMID:24678980

  17. Thematic planning: the role of the International Atomic Energy Agency in promoting education, medical research, and technology transfer among nuclear medicine communities of developing countries.

    PubMed

    Padhy, Ajit Kumar; Dondi, Maurizio

    2008-03-01

    One of the major mechanisms of implementing the International Atomic Energy Agency's (IAEA) programs in nuclear medicine has been through coordinated research projects (CRPs). In recent years, the IAEA has initiated a new type of CRP, called Doctoral CRP, in an attempt to further improve the effectiveness of its programs. The structure of the Doctoral CRP has been built on the structure of the existing CRP concept, but with a broader "thematic" approach. The word "thematic" indicates that these CRPs should both have a fairly broad scope and be designed so that their outcome, in terms of practical applications, might readily fit into the selected nuclear applications that are offered to Member States under the IAEA's mechanism for thematic planning. The Nuclear Medicine Section of IAEA's Division of Human Health initiated the first Doctoral CRP of IAEA in the year 2000, entitled, "Management of Liver Cancer Using Radionuclide Methods with Special Emphasis on Trans-Arterial Radio-conjugate Therapy and Internal Dosimetry." Since then, the CRP has accomplished several milestones, including development of a new therapeutic radiopharmaceutical ((188)Re lipiodol) and successfully carrying out Phase I and Phase II clinical trials on patients using the new therapeutic radiopharmaceutical.

  18. Patient-centred medicine through student-centred teaching: a student perspective on the key impacts of community- based learning in undergraduate medical education.

    PubMed

    Howe, A

    2001-07-01

    The UK General Medical Council has proposed that increased use of community settings is essential to enhancement of medical education. However, such curriculum developments have been directed by educationalists and clinical faculty; there is to date little to show whether student perspectives accord with such expectations. To examine student views on whether community-based learning during a UK undergraduate medical education course results in new learning in the areas expected, and to elucidate any process factors which enhance attainment of learning objectives. Nominal group technique, to develop consensus on important learning outcomes and process factors, and questionnaire survey, developed from the views of the nominal groups. 89 students participated (response rate 70% for the nominal groups, and 88% for questionnaire). Students perceived increased learning in many of the areas expected. In particular, students reported significant learning from: witnessing the impact of a longer term and more personal relationship with patients; the visible impact of social environment on health; the importance of dealing with people rather than diseases, and the use of the whole team for care. In addition, they emphasized that tutor, staff and patient enthusiasm for student presence and learning greatly enhanced the student learning experience. Community settings appear to achieve the expected attitudinal adaptation of students. The role of the committed tutor and team is seen as pivotal to learning. The conclusions support an increased emphasis in contemporary medical education and related research activity on the key impact of relationships in the learning environment.

  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. 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.

  1. History of Disaster Medicine.

    PubMed

    Suner, Selim

    2015-10-01

    Erik Noji, mentioned, tongue in cheek, Noah as the first disaster manager during a lecture in 2005. The canonical description of "The Genesis Flood" does describe Noah as a master planner and executer of an evacuation of biblical proportions. After gaining knowledge of a potential catastrophic disaster he planned and executed an evacuation to mitigate the effects of the "Genesis Flood" by building the Ark and organizing a mass exodus. He had to plan for food, water, shelter, medical care, waste disposal and other needs of all the evacuees. Throughout history, management of large disasters was conducted by the military. Indeed, the military still plays a large role in disaster response in many countries, particularly if the response is overseas and prolonged. The histories of emergency preparedness, disaster management and disaster medicine have coevolved and are inextricably intertwined. While disaster management in one form or another existed as long as people started living together in communities, the development of disaster medicine took off with the emergence of modern medicine. Similar to disaster management, disaster medicine also has roots in military organizations.

  2. Nuclear Medicine

    PubMed Central

    Streek, Penny Vande; Carretta, Robert; Weiland, Frederick L.

    1994-01-01

    The Council on Scientific Affairs of the California Medical Association presents the following epitomes of progress in nuclear medicine. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and clinical importance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, and scholars to stay abreast of progress in medicine, whether in their own field of special interest or another. The epitomes included here were selected by the Advisory Panel to the Section on Nuclear Medicine of the California Medical Association, and the summaries were prepared under the direction of Dr Lyons and the panel. PMID:7529452

  3. 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.

  4. [Medicinal cannabis].

    PubMed

    Van der Meersch, H; Verschuere, A P; Bottriaux, F

    2006-01-01

    Pharmaceutical grade cannabis is available to Dutch patients from public pharmacies in the Netherlands. The first part of this paper reviews the pharmaceutical and pharmacological properties of medicinal cannabis. Detailed information about its composition and quality, potential applications, methods of administration, adverse reactions, drug interactions and safety during pregnancy or breastfeeding are given. The second part deals with the legal aspects of dispensing medicinal cannabis through pharmacies in view of the Belgian and Dutch legislation. The last part discusses the present Belgian regulation about the possession of cannabis.

  5. Differences in soil properties and bacterial communities between the rhizosphere and bulk soil and among different production areas of the medicinal plant Fritillaria thunbergii.

    PubMed

    Shi, Ji-Yan; Yuan, Xiao-Feng; Lin, Hui-Rong; Yang, Yuan-Qiang; Li, Zong-Yuan

    2011-01-01

    To explore rhizosphere effects, geographical differences and their effects on the bacterial community associated with the geoherb Fritillaria thunbergii, some physicochemical properties of soil samples (3 sampling sites × 2 habitats (rhizosphere and bulk soil)) were measured and the soil bacterial community detected by PCR-denaturing gradient gel electrophoresis (DGGE). Among the three regions, soil pH varied between 4.48 and 7.73 indicating that F. thunbergii could grow both in acid and slightly alkaline soil. As the authentic Dao-di producing area, Ningbo showed the highest soil quality with the highest content of organic matter (OM) (2.46%), phosphatase (268 mg kg(-1) 24 h(-1)) and urease activity (1481 mg kg(-1) 24 h(-1)). In comparison with the bulk soil, pH, organic carbon content, and phosphatase and urease activities were all lower in the rhizosphere, suggesting that the roots may secrete some unique metabolites in root exudates. Statistical analyses showed that soil properties of Ningbo and Panan in Zhejiang province were more similar to each other than those in Nantong in Jiangsu province. In addition, PCR-DGGE analysis showed that main bacterial population identified in F. thunbergii was proteobacteria (18 bands, 55%), acidobacteria (4, 12%), actinobacteria (4, 12%) and bacterioidetes (6, 18%). Overall, soil properties and microbial communities varied not only between the rhizosphere and bulk soil but also among the three regions. We suggest that the plant, together with the soil properties, cooperatively shape the structure of the rhizosphere bacteria, and that the soil properties have a close relationship with the geoherbalism of F. thunbergii.

  6. Differences in Soil Properties and Bacterial Communities between the Rhizosphere and Bulk Soil and among Different Production Areas of the Medicinal Plant Fritillaria thunbergii

    PubMed Central

    Shi, Ji-Yan; Yuan, Xiao-Feng; Lin, Hui-Rong; Yang, Yuan-Qiang; Li, Zong-Yuan

    2011-01-01

    To explore rhizosphere effects, geographical differences and their effects on the bacterial community associated with the geoherb Fritillaria thunbergii, some physicochemical properties of soil samples (3 sampling sites × 2 habitats (rhizosphere and bulk soil)) were measured and the soil bacterial community detected by PCR-denaturing gradient gel electrophoresis (DGGE). Among the three regions, soil pH varied between 4.48 and 7.73 indicating that F. thunbergii could grow both in acid and slightly alkaline soil. As the authentic Dao-di producing area, Ningbo showed the highest soil quality with the highest content of organic matter (OM) (2.46%), phosphatase (268 mg kg−1 24 h−1) and urease activity (1481 mg kg−1 24 h−1). In comparison with the bulk soil, pH, organic carbon content, and phosphatase and urease activities were all lower in the rhizosphere, suggesting that the roots may secrete some unique metabolites in root exudates. Statistical analyses showed that soil properties of Ningbo and Panan in Zhejiang province were more similar to each other than those in Nantong in Jiangsu province. In addition, PCR-DGGE analysis showed that main bacterial population identified in F. thunbergii was proteobacteria (18 bands, 55%), acidobacteria (4, 12%), actinobacteria (4, 12%) and bacterioidetes (6, 18%). Overall, soil properties and microbial communities varied not only between the rhizosphere and bulk soil but also among the three regions. We suggest that the plant, together with the soil properties, cooperatively shape the structure of the rhizosphere bacteria, and that the soil properties have a close relationship with the geoherbalism of F. thunbergii. PMID:21747705

  7. [Intensive medicine in Spain].

    PubMed

    2011-03-01

    Intensive care medicine is a medical specialty that was officially established in our country in 1978, with a 5-year training program including two years of common core training followed by three years of specific training in an intensive care unit accredited for training. During this 32-year period, intensive care medicine has carried out an intense and varied activity, which has allowed its positioning as an attractive and with future specialty in the hospital setting. This document summarizes the history of the specialty, its current situation, the key role played in the programs of organ donation and transplantation of the National Transplant Organization (after more than 20 years of mutual collaboration), its training activities with the development of the National Plan of Cardiopulmonary Resuscitation, with a trajectory of more than 25 years, its interest in providing care based on quality and safety programs for the severely ill patient. It also describes the development of reference registries due to the need for reliable data on the care process for the most prevalent diseases, such as ischemic heart disease or ICU-acquired infections, based on long-term experience (more than 15 years), which results in the availability of epidemiological information and characteristics of care that may affect the practical patient's care. Moreover, features of its scientific society (SEMICYUC) are reported, an organization that agglutinates the interests of more than 280 ICUs and more than 2700 intensivists, with reference to the journal Medicina Intensiva, the official journal of the society and the Panamerican and Iberian Federation of Critical Medicine and Intensive Care Societies. Medicina Intensiva is indexed in the Thompson Reuters products of Science Citation Index Expanded (Scisearch(®)) and Journal Citation Reports, Science Edition. The important contribution of the Spanish intensive care medicine to the scientific community is also analyzed, and in relation to

  8. A comparison of knowledge about medicinal plants for three rural communities in the semi-arid region of northeast of Brazil.

    PubMed

    de Almeida, Cecília de Fátima Castelo Branco Rangel; Ramos, Marcelo Alves; de Amorim, Elba Lúcia Cavalcanti; de Albuquerque, Ulysses Paulino

    2010-02-17

    The aim of this research was to understand the importance of native and exotic plants in local medical systems in the Caatinga of the Brazilian northeast, and the influence of socio-economic factors on the acquisition of knowledge about these resources. A total of 55 people were interviewed in three rural communities using free list and semi-structured interviewes. A total of 108 ethnospecies were reported, 99 of which were identified; 43 of these were preferred by informants. Most of the plants cited were exotic (51) but the difference in diversity among these plants and native plants (48) was not considered significant (p>0.05). The exotic plants were predominantly herbaceous and used to cure diseases that native plants did not seem to treat. There were no differences between men's and women's knowledge of the plants (p>0.05). However, for some communities, factors such as age and income were correlated with the number of citations and indications for plants, which suggested that older people and those with higher income levels had more knowledge about these properties. The data presented in this study showed the importance of exotic species in the region studied and demonstrated that plant knowledge can be perceived as a way to diversify options for medical treatment in the area. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  9. Nuclear Medicine Training: What Now?

    PubMed

    Mankoff, David; Pryma, Daniel A

    2017-10-01

    Although the multidisciplinary nature of nuclear medicine (NM) and clinical molecular imaging is a key strength of the specialty, the breadth of disciplines involved in the practice of NM creates challenges for education and training. The evolution of NM science and technology-and the practice of clinical molecular imaging and theranostics-has created a need for changes in the approach to specialty training. The broader U.S. community of imaging physicians has been slow to accept this change, in good part due to historical divides between the NM and nuclear radiology (NR) communities. In this Journal of Nuclear Medicine Hot Topics discussion, we review the historical pathways to training; discuss the training needs for the modern practice of NM, clinical molecular imaging, and radionuclide therapy; and suggest a path forward for an approach to training that matches the needs of the evolving clinical specialty. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  10. 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…

  11. 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…

  12. [Disaster medicine].

    PubMed

    Ballesteros, J A; Badosa, A M; Usandizaga, I; Zurita, M; Muñoz, J

    1989-01-01

    The authors have reviewed the concept of catastrophe from the health care stand-point as well as, that concerning medicine in catastrophies. The basic outlines for planning adequate health care when a massive number of victims have to be attended are pointed-out as well as, the prevention means for possible flare ups of transmissible diseases.

  13. 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)

  14. Maritime Medicine.

    ERIC Educational Resources Information Center

    Estes, J. Worth

    1996-01-01

    Presents a fascinating look at the practice of medicine aboard commercial and military ships in the 18th and early 19th centuries. Contemporary medical practice believed all diseases were created by one of four "humors." In spite of this, and the constant presence of disease, most seamen led relatively healthy lives. (MJP)

  15. 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…

  16. Medicine Handbook.

    ERIC Educational Resources Information Center

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

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

  17. 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).

  18. 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)

  19. Teaching Cost-Conscious Medicine: Impact of a Simple Educational Intervention on Appropriate Abdominal Imaging at a Community-Based Teaching Hospital

    PubMed Central

    Covington, Matthew F.; Agan, Donna L.; Liu, Yang; Johnson, John O.; Shaw, David J.

    2013-01-01

    Background Rising costs pose a major threat to US health care. Residency programs are being asked to teach residents how to provide cost-conscious medical care. Methods An educational intervention incorporating the American College of Radiology appropriateness criteria with lectures on cost-consciousness and on the actual hospital charges for abdominal imaging was implemented for residents at Scripps Mercy Hospital in San Diego, CA. We hypothesized that residents would order fewer abdominal imaging examinations for patients with complaints of abdominal pain after the intervention. We analyzed the type and number of abdominal imaging studies completed for patients admitted to the inpatient teaching service with primary abdominal complaints for 18 months before (738 patients) and 12 months following the intervention (632 patients). Results There was a significant reduction in mean abdominal computed tomography (CT) scans per patient (1.7–1.4 studies per patient, P < .001) and total abdominal radiology studies per patient (3.1–2.7 studies per patient, P  =  .02) following the intervention. The avoidance of charges solely due to the reduction in abdominal CT scans following the intervention was $129 per patient or $81,528 in total. Conclusions A simple educational intervention appeared to change the radiologic test-ordering behavior of internal medicine residents. Widespread adoption of similar interventions by residency programs could result in significant savings for the health care system. PMID:24404274

  20. Community-applied research of a traditional Chinese medicine rehabilitation scheme on Broca's aphasia after stroke: study protocol for a randomized controlled trial.

    PubMed

    Tao, Jing; Fang, Yunhua; Wu, Zhenkai; Rao, Ting; Su, Yusheng; Lin, Lili; Liu, Wei; Wu, Jinsong; Yang, Shanli; Zheng, Guohua; Chen, Lidian

    2014-07-21

    Aphasia is a common and severely disabling complication in stroke patients. It usually brings about lower rates of functional recovery, longer rehabilitation length of stay (LOS), and significantly poorer LOS efficiency (LOS-Eff), resulting in higher rehabilitation costs compared to patients without aphasia. It also decreases the quality of life and increases the mortality of stroke patients. The evidence currently available suggests that the effect of acupuncture combined with language training for apoplectic aphasia is statistically better than speech and language therapy (SLT) alone, but there remains a lack of high-quality randomized controlled trials. Acupuncture combined with language training is relatively low-cost and especially suitable for community-based rehabilitation for aphasia patients after stroke, taking its medical and health facilities which are always deficient in manpower and material resources into account. The aim of the present study is to develop an effective standard therapeutic program for apoplectic aphasia in communities. In a randomized controlled clinical trial with blinded assessment, 290 eligible patients with aphasia due to stroke will be randomly allocated into a control group or an experimental group. The course of this trial will comprise a 4-week intervention and a 12-week follow-up period. Five assessment points, including baseline, 2 and 4 weeks after treatment, 6 and 12 weeks after follow-up, are set to dynamically observe the changes of curative effects. Primary outcome measures are the differences in the score on both the China rehabilitation research center aphasia examination (CRRCAE) and Boston diagnostic aphasia examination - Chinese version (BDAE-C) after intervention and follow-up. The Modified Barthel Index (MBI), 36-Item Short Form Health Survey (SF-36), and results of blood oxygen level dependent-functional magnetic resonance imaging (BOLD-fMRI) examination are considered as the secondary outcome measures. Other

  1. Community-applied research of a traditional Chinese medicine rehabilitation scheme on Broca’s aphasia after stroke: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Aphasia is a common and severely disabling complication in stroke patients. It usually brings about lower rates of functional recovery, longer rehabilitation length of stay (LOS), and significantly poorer LOS efficiency (LOS-Eff), resulting in higher rehabilitation costs compared to patients without aphasia. It also decreases the quality of life and increases the mortality of stroke patients. The evidence currently available suggests that the effect of acupuncture combined with language training for apoplectic aphasia is statistically better than speech and language therapy (SLT) alone, but there remains a lack of high-quality randomized controlled trials. Acupuncture combined with language training is relatively low-cost and especially suitable for community-based rehabilitation for aphasia patients after stroke, taking its medical and health facilities which are always deficient in manpower and material resources into account. The aim of the present study is to develop an effective standard therapeutic program for apoplectic aphasia in communities. Methods/Design In a randomized controlled clinical trial with blinded assessment, 290 eligible patients with aphasia due to stroke will be randomly allocated into a control group or an experimental group. The course of this trial will comprise a 4-week intervention and a 12-week follow-up period. Five assessment points, including baseline, 2 and 4 weeks after treatment, 6 and 12 weeks after follow-up, are set to dynamically observe the changes of curative effects. Primary outcome measures are the differences in the score on both the China rehabilitation research center aphasia examination (CRRCAE) and Boston diagnostic aphasia examination - Chinese version (BDAE-C) after intervention and follow-up. The Modified Barthel Index (MBI), 36-Item Short Form Health Survey (SF-36), and results of blood oxygen level dependent-functional magnetic resonance imaging (BOLD-fMRI) examination are considered as the

  2. Biomedical informatics and translational medicine

    PubMed Central

    2010-01-01

    Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics) may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records) and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians") can be essential members of translational medicine teams. PMID:20187952

  3. Biomedical informatics and translational medicine.

    PubMed

    Sarkar, Indra Neil

    2010-02-26

    Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics) may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records) and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians") can be essential members of translational medicine teams.

  4. Big Five personality traits may inform public health policy and preventive medicine: Evidence from a cross-sectional and a prospective longitudinal epidemiologic study in a Swiss community.

    PubMed

    Hengartner, Michael P; Kawohl, Wolfram; Haker, Helene; Rössler, Wulf; Ajdacic-Gross, Vladeta

    2016-05-01

    Some evidence documents the importance of personality assessments for health research and practise. However, no study has opted to test whether a short self-report personality inventory may comprehensively inform health policy. Data were taken from a population-based epidemiologic survey in Zurich, Switzerland, conducted from 2010-2012. A short form of the Big Five Inventory was completed by n=1155 participants (54.4% women; mean age=29.6 years), while health-related outcomes were taken from a comprehensive semi-structured clinical interview. A convenience subsample averaging n=171 participants additionally provided laboratory measures and n=133 were subsequently followed-up at least once over a maximal period of 6 months. Personality traits, in particular high neuroticism and low conscientiousness, related significantly to poor environmental resources such as low social support (R(2)=0.071), health-impairing behaviours such as cannabis use (R(2)=0.071), and psychopathology, including negative affect (R(2)=0.269) and various mental disorders (R(2)=0.060-0.195). The proportion of total variance explained was R(2)=0.339 in persons with three or more mental disorders. Personality significantly related to some laboratory measures including total cholesterol (R(2)=0.095) and C-Reactive Protein (R(2)=0.062). Finally, personality prospectively predicted global psychopathological distress and vegetative symptoms over a 6-month observation period. Personality relates consistently to poor socio-environmental resources, health-impairing behaviours and psychopathology. We also found some evidence for an association with metabolic and immune functions that are assumed to influence health. A short personality inventory could provide valuable information for preventive medicine when used as a means to screen entire populations for distinct risk exposure, in particular with respect to psychopathology. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Use and Perceived Effectiveness of Complementary and Alternative Medicine to Treat and Manage the Symptoms of Autism in Children: A Survey of Parents in a Community Population

    PubMed Central

    Madren, Eric; Santianni, Kirsten A.

    2016-01-01

    Abstract Objective: Parents of children with autism spectrum disorders (ASDs) often try a variety of treatments for their children, including complementary and alternative medicine (CAM). The objective of this study was to improve understanding of the frequency of CAM use by parents for their children with autism and to quantify the parents' perceived effectiveness of various CAM therapies in mitigating the health and functioning problems associated with autism. Methods: Parents in southeastern Virginia were recruited for study participation from local autism organizations and a clinical practice where a large proportion of the patients are children with autism. Parents completed an online survey and answered questions about CAM use for their children with autism, and they rated the perceived effectiveness of each therapy. Results: Of 194 parents surveyed, 80.9% reported that they had tried some form of CAM for their child with autism. Among CAM users, the most frequently used therapies were multivitamins (58.6%), the gluten-free casein-free diet (54.8%), and methyl B-12 injections (54.1%). The CAM therapies that received the highest average rating of effectiveness were sensory integration therapy, melatonin, and off-label use of prescription antifungal medications. Conclusion: CAM therapies were frequently used in this population, and many were perceived to be effective in helping to ease some of the health challenges associated with autism. CAM therapies for the autism population should be further studied in well-controlled clinical research settings to provide safety and efficacy data on treatments, as well as validated treatment options for those with ASD. PMID:26654976

  6. Use and Perceived Effectiveness of Complementary and Alternative Medicine to Treat and Manage the Symptoms of Autism in Children: A Survey of Parents in a Community Population.

    PubMed

    Hopf, Kathleen Pillsbury; Madren, Eric; Santianni, Kirsten A

    2016-01-01

    Parents of children with autism spectrum disorders (ASDs) often try a variety of treatments for their children, including complementary and alternative medicine (CAM). The objective of this study was to improve understanding of the frequency of CAM use by parents for their children with autism and to quantify the parents' perceived effectiveness of various CAM therapies in mitigating the health and functioning problems associated with autism. Parents in southeastern Virginia were recruited for study participation from local autism organizations and a clinical practice where a large proportion of the patients are children with autism. Parents completed an online survey and answered questions about CAM use for their children with autism, and they rated the perceived effectiveness of each therapy. Of 194 parents surveyed, 80.9% reported that they had tried some form of CAM for their child with autism. Among CAM users, the most frequently used therapies were multivitamins (58.6%), the gluten-free casein-free diet (54.8%), and methyl B-12 injections (54.1%). The CAM therapies that received the highest average rating of effectiveness were sensory integration therapy, melatonin, and off-label use of prescription antifungal medications. CAM therapies were frequently used in this population, and many were perceived to be effective in helping to ease some of the health challenges associated with autism. CAM therapies for the autism population should be further studied in well-controlled clinical research settings to provide safety and efficacy data on treatments, as well as validated treatment options for those with ASD.

  7. Rebuilding Native American Communities

    ERIC Educational Resources Information Center

    Coyhis, Don; Simonelli, Richard

    2005-01-01

    The Wellbriety Movement in Native American communities draws on the wisdom and participation of traditional elders. Beginning with a basic community teaching called the Four Laws of Change and the Healing Forest Model, the Wellbriety Movement blends Medicine Wheel knowledge with the 12 Steps of Alcoholics Anonymous to provide culture-specific…

  8. Rebuilding Native American Communities

    ERIC Educational Resources Information Center

    Coyhis, Don; Simonelli, Richard

    2005-01-01

    The Wellbriety Movement in Native American communities draws on the wisdom and participation of traditional elders. Beginning with a basic community teaching called the Four Laws of Change and the Healing Forest Model, the Wellbriety Movement blends Medicine Wheel knowledge with the 12 Steps of Alcoholics Anonymous to provide culture-specific…

  9. Cost Effectiveness of Support for People Starting a New Medication for a Long-Term Condition Through Community Pharmacies: An Economic Evaluation of the New Medicine Service (NMS) Compared with Normal Practice.

    PubMed

    Elliott, Rachel A; Tanajewski, Lukasz; Gkountouras, Georgios; Avery, Anthony J; Barber, Nick; Mehta, Rajnikant; Boyd, Matthew J; Latif, Asam; Chuter, Antony; Waring, Justin

    2017-08-03

    The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs. We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients' non-adherence. Clinical event probability, treatment pathway, resource use and costs were extracted from literature and costing tariffs. Incremental costs and outcomes associated with each disease were incorporated additively into a composite probabilistic model and combined with adherence rates and intervention costs from the trial. Costs per extra quality-adjusted life-year (QALY) were calculated from the perspective of NHS England, using a lifetime horizon. NMS generated a mean of 0.05 (95% CI 0.00-0.13) more QALYs per patient, at a mean reduced cost of -£144 (95% CI -769 to 73). The NMS dominates normal practice with a probability of 0.78 [incremental cost-effectiveness ratio (ICER) -£3166 per QALY]. NMS has a 96.7% probability of cost effectiveness compared with normal practice at a willingness to pay of £20,000 per QALY. Sensitivity analysis demonstrated that targeting each disease with NMS has a probability over 0.90 of cost effectiveness compared with normal practice at a willingness to pay of £20,000 per QALY. Our study suggests that the NMS increased patient medicine adherence compared with normal practice, which translated into increased health gain at reduced overall cost. ClinicalTrials.gov Trial reference number NCT01635361 ( http://clinicaltrials.gov/ct2/show/NCT01635361 ). Current Controlled trials: Trial reference number ISRCTN 23560818 ( http://www.controlled-trials.com/ISRCTN23560818

  10. Wilderness medicine.

    PubMed

    Townes, David Andrew

    2002-12-01

    Wilderness medicine is not a single entity. It encompasses clinical practice, instruction, and research as they pertain to wilderness settings. Clinical practice often takes place in removed settings far from traditional medical resources and facilities. Many of the conditions treated are unique to wilderness medicine. Decisions commonly are based on limited information. Practitioners of wilderness medicine must combine specialized training, resourcefulness, and improvisation. Instruction and research in wilderness medicine often are directed at clinical practice, with the focus on maximizing patient outcome. Preparation and planning are the best methods of reducing illness and injury; these involve conditioning and choosing clothing and equipment, including the medical kit. Conditioning should mimic the type of trip or activity, because choice will depend on the type, complexity, and duration of the trip, the anticipated environmental conditions, and specific needs of the group. Equipment should be designed for the type of activity, in good working condition, and familiar to the members of the group. The medical kit should include basic medical supplies, with additional supplies and equipment depending on the specific trip, the anticipated needs of the group, and their level of medical training and expertise. Once in the wilderness, the focus shifts from preparation and planning to prevention of illness and injury. This includes the use of safety equipment, appropriate shelter, water treatment, and location knowledge. The most common methods of water treatment are mechanical filters, chemicals, and heat. When an injury or illness does occur in the wilderness, proper assessment of the patient is essential to determine both the appropriate treatment and the need for evacuation to definitive care. This is best accomplished with an organized, systematic approach. The decision of what treatment should be initiated and if the patient requires evacuation to definitive

  11. Transfusion medicine

    SciTech Connect

    Murawski, K.; Peetoom, F.

    1986-01-01

    These proceedings contain 24 selections, including papers presented at the conference of American Red Cross held in May 1985, on the Subject of transfusion medicine. Some of the titles are: Fluosol/sup R/-DA in Radiation Therapy; Expression of Cloned Human Factor VIII and the Molecular Basis of Gene Defects that Cause Hemophilia; DNA-Probing Assay in the Detection of Hepatitis B Virus Genome in Human Peripheral Blood Cells; and Monoclonal Antibodies: Convergence of Technology and Application.

  12. Community and Virtual Community.

    ERIC Educational Resources Information Center

    Ellis, David; Oldridge, Rachel; Vasconcelos, Ana

    2004-01-01

    Presents a literature review that covers the following topics related to virtual communities: (1) information and virtual community; (2) virtual communities and communities of practice; (3) virtual communities and virtual arenas, including virtual community networks; and (4) networked virtual communities. (Contains 175 references.) (MES)

  13. [Travel medicine].

    PubMed

    Schubert, S; Grimm, M

    2009-07-01

    Travel medicine deals with travellers' diseases. The target group is therefore distinct from tropical medicine. It has gained in significance due to the increase in tourism and professional work abroad in the last 50 years. Dangerous and widespread diseases in tropical countries, in particular tropical malaria, have come into focus in industrialized countries because of their appearance in travellers. Travel medicine deals not only with infectious or transmittable diseases, but also with the ability of patients with chronic diseases to travel, the medical aspects of flying, as well as the health hazards of professional work or high-risk sports abroad. The risk of disease as a result of travelling can be minimized by advice and prophylactic measures, such as vaccinations and drug prophylaxis against malaria, if indicated. On return, medical symptoms should be investigated promptly to ensure early detection of life-threatening disease courses, particularly tropical malaria, as well as to prevent the occurrence of small-scale epidemics. A small number of diseases can also emerge after several years, such as benign types of malaria, amoebic liver abscess and visceral leishmaniasis (kala-azar). Aids also belongs to these diseases. Therefore, in this era of HIV pandemic travellers concerned should be made aware of the risks.

  14. Medicine safety and children

    MedlinePlus

    ... keep purses or bags containing medicine on a high shelf, out of reach. Get rid of any old or expired medicines. Call your city government and ask where you can drop off unused medicines. DO NOT flush medicines down ...

  15. ADHD Medicines (for Kids)

    MedlinePlus

    ... Room? What Happens in the Operating Room? ADHD Medicines KidsHealth > For Kids > ADHD Medicines A A A ... doctor can decide if ADHD medicine is needed. Medicine and the Mind There are a lot of ...

  16. Effect of location on family medicine residents' training.

    PubMed Central

    Lebel, D.; Hogg, W.

    1993-01-01

    A survey of family medicine residents trained at community-based or hospital-based centres suggested differences in experience and in career plans. Community-based residents saw more patients in the same family, believed they knew the community better, made more housecalls, expected to use allied health professionals more frequently, and were more likely to choose a small community practice. PMID:8499787

  17. Behavior medicine specialist.

    PubMed

    Tuso, Phillip

    2014-01-01

    Total Health is a vision for the future and a strategy to prevent preventable disease, save lives, and make health care more affordable. Total Health means health of mind (behavior health) and health of body (physical health). To achieve Total Health we need healthy people in healthy communities. A behavior medicine specialist is a psychologist who works in the medical home with the primary care physician instead of in the Mental Health Department with a psychiatrist. The key to achieving Total Health will be to transform our current health care system from a focus on treating disease to a focus on preventing disease. This transformation will require complex behavior change interventions and services not usually provided in the medical home. The behavior medicine specialist will bring the knowledge and experience used to treat mental illness into the medical home to help the primary care physician improve the care of all patients in the medical home. The behavior medicine specialist will help improve outcomes in synergy with the primary care physician by universal screening of high-risk diseases, stepped care protocols, and efficient use of all resources available to care for patients in the medical home (health education classes, wellness coaches, and online social networking lifestyle management programs). These interventions should increase patient satisfaction, increase access to specialty care (psychiatry), and help us achieve Total Health.

  18. Informal medicine: ethical analysis

    PubMed Central

    Leavitt, F; Peleg, R; Peleg, A

    2005-01-01

    Context: Doctors have been known to treat or give consultation to patients informally, with none of the usual record keeping or follow up. They may wish to know whether this practice is ethical. Objective: To determine whether this practice meets criteria of medical ethics. Design: Informal medicine is analysed according to standard ethical principles: autonomy, beneficence and non-maleficence, distributive and procedural justice, and caring. Setting: Hospital, medical school, and other settings where patients may turn to physicians for informal help. Conclusion: No generalisation can be made to the effect that informal medicine is or is not ethical. Each request for informal consultation must be considered on its own merits. Guidelines: Informal medicine may be ethical if no payment is involved, and when the patient is fully aware of the benefits and risks of a lack of record keeping. When an informal consultation does not entail any danger to the patient or others, the physician may agree to the request. If, however, any danger to the patient or others is foreseen, then the physician must insist on professional autonomy, and consider refusing the request and persuading the patient to accept formal consultation. If a reportable infectious disease, or other serious danger to the community, is involved, the physician should refuse informal consultation or treatment, or at least make a proper report even if the consultation was informal. If agreeing to the request will result in an unfair drain on the physician's time or energy, he or she should refuse politely. PMID:16319228

  19. Adherence of community caretakers of children to pre-packaged antimalarial medicines (HOMAPAK) among internally displaced people in Gulu district, Uganda.

    PubMed

    Kolaczinski, Jan H; Ojok, Naptalis; Opwonya, John; Meek, Sylvia; Collins, Andrew

    2006-05-15

    In 2002, home-based management of fever (HBMF) was introduced in Uganda, to improve access to prompt, effective antimalarial treatment of all fevers in children under 5 years. Implementation is through community drug distributors (CDDs) who distribute pre-packaged chloroquine plus sulfadoxine-pyrimethamine (HOMAPAK) free of charge to caretakers of febrile children. Adherence of caretakers to this regimen has not been studied. A questionnaire-based survey combined with inspection of blister packaging was conducted to investigate caretakers' adherence to HOMAPAK. The population surveyed consisted of internally displaced people (IDPs) from eight camps. A total of 241 caretakers were interviewed. 95.0% (CI: 93.3% - 98.4%) of their children had received the correct dose for their age and 52.3% of caretakers had retained the blister pack. Assuming correct self-reporting, the overall adherence was 96.3% (CI: 93.9% - 98.7%). The nine caretakers who had not adhered had done so because the child had improved, had vomited, did not like the taste of the tablets, or because they forgot to administer the treatment. For 85.5% of cases treatment had been sought within 24 hours. Blister packaging was considered useful by virtually all respondents, mainly because it kept the drugs clean and dry. Information provided on, and inside, the package was of limited use, because most respondents were illiterate. However, CDDs had often told caretakers how to administer the treatment. For 39.4% of respondents consultation with the CDD was their reported first action when their child has fever and 52.7% stated that they consult her/him if the child does not get better. In IDP camps, the HBMF strategy forms an important component of medical care for young children. In case of febrile illness, most caretakers obtain prompt and adequate antimalarial treatment, and adhere to it. A large proportion of malaria episodes are thus likely to be treated before complications can arise. Implementation in

  20. Adherence of community caretakers of children to pre-packaged antimalarial medicines (HOMAPAK®) among internally displaced people in Gulu district, Uganda

    PubMed Central

    Kolaczinski, Jan H; Ojok, Naptalis; Opwonya, John; Meek, Sylvia; Collins, Andrew

    2006-01-01

    Background In 2002, home-based management of fever (HBMF) was introduced in Uganda, to improve access to prompt, effective antimalarial treatment of all fevers in children under 5 years. Implementation is through community drug distributors (CDDs) who distribute pre-packaged chloroquine plus sulfadoxine-pyrimethamine (HOMAPAK®) free of charge to caretakers of febrile children. Adherence of caretakers to this regimen has not been studied. Methods A questionnaire-based survey combined with inspection of blister packaging was conducted to investigate caretakers' adherence to HOMAPAK®. The population surveyed consisted of internally displaced people (IDPs) from eight camps. Results A total of 241 caretakers were interviewed. 95.0% (CI: 93.3% – 98.4%) of their children had received the correct dose for their age and 52.3% of caretakers had retained the blister pack. Assuming correct self-reporting, the overall adherence was 96.3% (CI: 93.9% – 98.7%). The nine caretakers who had not adhered had done so because the child had improved, had vomited, did not like the taste of the tablets, or because they forgot to administer the treatment. For 85.5% of cases treatment had been sought within 24 hours. Blister packaging was considered useful by virtually all respondents, mainly because it kept the drugs clean and dry. Information provided on, and inside, the package was of limited use, because most respondents were illiterate. However, CDDs had often told caretakers how to administer the treatment. For 39.4% of respondents consultation with the CDD was their reported first action when their child has fever and 52.7% stated that they consult her/him if the child does not get better. Conclusion In IDP camps, the HBMF strategy forms an important component of medical care for young children. In case of febrile illness, most caretakers obtain prompt and adequate antimalarial treatment, and adhere to it. A large proportion of malaria episodes are thus likely to be treated

  1. Exchange between Andean and Western medicine.

    PubMed

    Bastien, J W

    1982-01-01

    Western medicine has not been functionally incorporated into Andean economic, cultural, and social systems. Evaluation studies show that even though accessibility to Western medicine has increased considerably for rural Andeans, they still rely on traditional medicine. Western medicine has not been able to articulate with Andean ethnomedicine because of different structural relations within each system. Western medicine assumes a mechanistic ideology, chemical-based cures and technology which function efficiently within an urban-industrial framework; whereas Andean medicine assumes a synchronistic ideology, natural-based cures and personal skills which function efficiently within a mountainous rural area with structural components of verticality, specialization and reciprocity. Verticality implies that Andeans specialize in extracting resources from a limited number of zones and then exchange their resources for those produced by people on other zones. Andean ethnomedicine follows principles of verticality in that certain communities specialize in various aspects of Andean medicines, according to the resources available to that community. These medical practitioners travel to other communities providing their services in exchange for services or goods. The author illustrates this from his research among the Qollahuaya Andeans. The community of Kaata specializes in curing by divination and ritual. These diviners are important for community health of Andeans. The communities of Curva and Chajaya specialize in herbal curing: these herbalists are important for treating physical causes. However, the diviners and herbalists complement each other in providing for the total health of Andeans. The final section deals with concrete suggestions of how certain features of Western medicine can functionally fit Andean economic and social structure.

  2. Community-Oriented Medical Education

    ERIC Educational Resources Information Center

    Hays, Richard

    2007-01-01

    Community-orientated medicine is a topical area for debate in the current discussions about medical education, but it can be argued that medical education has always been in the community because medical practice is located therein. It is widely accepted that community settings provide a wealth of learning opportunities for students and trainees…

  3. Community-Oriented Medical Education

    ERIC Educational Resources Information Center

    Hays, Richard

    2007-01-01

    Community-orientated medicine is a topical area for debate in the current discussions about medical education, but it can be argued that medical education has always been in the community because medical practice is located therein. It is widely accepted that community settings provide a wealth of learning opportunities for students and trainees…

  4. [Psychiatric medicine].

    PubMed

    Ibañez Dominguez, J

    1984-06-01

    The author, after a short historical introduction which shows the Medicine, especially the Neurology, as the predecessor of the Psychiatry, intents to relate in a theorico-practical way the anxiety and the depression within a bio-chemical and endocrinological frame. He presents the hipo and hipercalcemia signals and symptoms demonstrating with a casuistic from his clinical practice the similitude between anxiety and depression respectively. Finally he realizes a theorical analysis about the investigations published over the AMP-ciclic and infers about the hormonal interference and the clinical data linked with the manic-depressive disease.

  5. Optimizing health care delivery by integrating workplaces, homes, and communities: how occupational and environmental medicine can serve as a vital connecting link between accountable care organizations and the patient-centered medical home.

    PubMed

    McLellan, Robert K; Sherman, Bruce; Loeppke, Ronald R; McKenzie, Judith; Mueller, Kathryn L; Yarborough, Charles M; Grundy, Paul; Allen, Harris; Larson, Paul W

    2012-04-01

    momentum and evolving among physicians. But, the potential exists for implementation of both of these concepts across a much broader community of patients. By extending the well-conceived integrative concepts of the PCMH model and ACOs into the workforce via occupational and environmental medicine (OEM) physicians, the power of these concepts would be significantly enhanced. Occupational and environmental medicine provides a well-established infrastructure and parallel strategies that could serve as a force multiplier in achieving the fundamental goals of the PCMH model and ACOs. In this paradigm, the workplace-where millions of Americans spend a major portion of their daily lives-becomes an essential element, next to communities and homes, in an integrated system of health anchored by the PCMH and ACO concepts. To be successful, OEM physicians will need to think and work innovatively about how they can provide today's employer health services-ranging from primary care and preventive care to workers' compensation and disability management-within tomorrow's PCMH and ACO models.

  6. Field medicine: a new paradigm of geriatric medicine.

    PubMed

    Matsubayashi, Kozo; Okumiya, Kiyohito

    2012-01-01

    It is only during the last half century that aging came to be truly thought of as a societal issue rather than simply a personal one, as well as a challenge to be tackled by science and medicine. Diseases used to be studied only in hospitals and laboratories, centering on patients treated there. However, caring for elderly people in hospitals provides only a small glimpse into their world. With an advancing aged population, the reality of old age and age-related chronic illnesses takes place in homes and communities. To truly understand the health issues of the elderly, we ventured into communities and visited elderly persons in their homes and cultural environments in Kochi prefecture. The Department of Geriatric Medicine, Kochi Medical School, was the first in Japan to incorporate the Comprehensive Geriatric Assessment in preventive intervention and evaluation of the medical problems of elderly people in field settings, which could not be completely resolved in the hospital. Geriatric findings in field settings in Kochi before (1990-2000) and after (2000-2010) the introduction of the nationwide long-term care insurance system throughout Japan were reviewed. Field medicine also enables us to explore the aging of people living not only in Japan but also in several Asian communities and, further, into those living in atypical environments such as the Himalayan highlands. Based on the geriatric findings of field medicine carried out in sites with different ecology and cultures, we reconsidered the optimal aging situation based on the activities of daily living and quality of life, as well as chronic diseases of elderly people throughout the world. In this review article, we would like to highlight the importance of field medicine as a new paradigm of geriatric medical research.

  7. 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

  8. Prioritising neonatal medicines research: UK Medicines for Children Research Network scoping survey

    PubMed Central

    Turner, Mark A; Lewis, Sara; Hawcutt, Daniel B; Field, D

    2009-01-01

    Background The dosing regimen and indications for many medicines in current use in neonatology are not well defined. There is a need to prioritise research in this area, but currently there is little information about which drugs are used in UK neonatal units and the research needs in this area as perceived by UK neonatologists. Methods The Neonatal Clinical Studies Group (CSG) of the Medicines for Children Research Network (MCRN) undertook a 2 week prospective scoping survey study to establish which medicines are used in UK neonatal units; how many babies are receiving them; and what clinicians (and other health professionals) believe are important issues for future research. Results 49 out of 116 units responded to at least one element of the survey (42%). 37 units reported the number of neonates who received medicines over a 2 week period. A total of 3924 medicine-patient pairs were reported with 119 different medicines. 70% of medicine-patient pairs involved medicines that were missing either a license or dose for either term or preterm neonates. 4.3% of medicine-patient pairs involved medicines that were missing both license and dose for any neonate. The most common therapeutic gap in need of additional research identified by UK neonatologists was chronic lung disease (21 responding units), followed by patent ductus arteriosus and vitamin supplements (11 responding units for both) Conclusion The research agenda for neonatal medicines can be informed by knowledge of current medicine use and the collective views of the neonatal community. PMID:19674445

  9. 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.

  10. Choosing family medicine residency programs

    PubMed Central

    Lee, Joseph; Alfieri, Marg; Patel, Tejal; Lee, Linda

    2011-01-01

    Abstract Objective To describe key determinants for residents’ selection of a new community-based, interprofessional site for their family medicine training, and to evaluate residents’ satisfaction with their programs. Design Combined qualitative and quantitative methods using in-depth interviews and a survey. Setting McMaster University, including the new site of the Centre for Family Medicine in Kitchener-Waterloo, Ont, and a long-established site in Hamilton, Ont. Participants Eleven first-year and second-year family medicine residents from the Kitchener-Waterloo site participated in in-depth interviews. Forty-four first-year and second-year family medicine residents completed the survey, 22 in Kitchener-Waterloo and 22 in Hamilton. Methods Kitchener-Waterloo residents participated in in-depth interviews during their residency programs in 2008 to 2009 using a semistructured format to explore their choice of site and the effect of an interprofessional environment on their education. Common themes were established using qualitative analysis techniques; based on these themes, a survey was developed and distributed to residents from both sites to further explore factors influencing site selection, satisfaction, and effects of interprofessional education. Main findings Residents identified several reasons for selecting a new community-based, interprofessional family medicine residency program. Reasons included preference for the location and opportunities to learn in an interprofessional teaching environment. A less hierarchical structure and greater opportunities for one-on-one teaching also influenced their choices. Perception of poor communication from the well established site was identified as a challenge. Residents at both sites indicated similarly high levels of program satisfaction. Conclusion Residents selected the new community-based family medicine site for reasons of geographic location and the potential for clinical learning experiences and

  11. The Ramathibodi Community Health Program

    ERIC Educational Resources Information Center

    Buri, Prem; And Others

    1974-01-01

    The Ramathibodi Faculty of Medicine in Bangkok, Thailand, has developed a teaching and research program in community health aimed at brining the institution into close association with the health needs of the country. (Editor)

  12. Depression - stopping your medicines

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000570.htm Depression - stopping your medicines To use the sharing features ... prescription medicines you may take to help with depression, anxiety, or pain. Like any medicine, there are ...

  13. Medicines by Design

    MedlinePlus

    ... Search the NIGMS Website NIGMS Home Research Funding Research Training News & Meetings Science Education About NIGMS NIGMS Home > Science Education > Medicines By Design Medicines By Design Spotlight Nature's Medicine Cabinet A ...

  14. Storing your medicines

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000534.htm Storing your medicines To use the sharing features on this page, ... child latch or lock. Do not use Damaged Medicine Damaged medicine may make you sick. DO NOT ...

  15. Taking multiple medicines safely

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000883.htm Taking multiple medicines safely To use the sharing features on this ... directed. Why You May Need More Than One Medicine You may take more than one medicine to ...

  16. Managing Your Medicines

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Managing Your Medicines Updated:Oct 27,2016 If you have heart ... Weight • Tools & Resources Heart Insight Supplement: Know Your Medicines Keeping track of your medicines can be overwhelming. ...

  17. Medicines for osteoporosis

    MedlinePlus

    ... Evista); Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines ... Your doctor may prescribe certain medicines to help lower your ... make the bones in your hips, spine, and other areas less likely ...

  18. 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 ...

  19. Complementary and Alternative Medicine

    MedlinePlus

    ... use practices like acupuncture in medicine. But until recently, most Western hospitals didn't provide any alternative ... medicine is often used instead of conventional medical techniques. Complementary medicine is used in addition to conventional ...

  20. 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 ...

  1. [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.

  2. [Approach to Teaching Kampo Medicine at Kyoto Pharmaceutical University].

    PubMed

    Matsuda, Hisashi

    2016-01-01

    An approach to educating our pharmaceutical students about Kampo medicine in the six-year system of undergraduate pharmacy education at Kyoto Pharmaceutical University is introduced, including the author's opinions. Curriculum revisions have been made in our university for students entering after 2012. In teaching Kampo medicine at present, a medical doctor and an on-site pharmacist share information difficult to give in a lecture with the teaching staff in my laboratory. For example, before the curriculum revision, we conferred with a pharmacist and a doctor in the course "Kampo Medicine A, B" for 4th year students, in which students were presented a basic knowledge of Kampo medicine, the application of important Kampo medicines, combinations of crude drugs, etc. Further, in our "Introduction to Kampo Medicine" for 6th year students, presented after they have practiced in hospitals and community pharmacies, we again lecture on the pharmacological characteristics of Kampo medicines, on "pattern (Sho)", and on evidence-based medicine (EBM) and research studies of important Kampo medicines. After our curriculum revision, "Kampo Medicine A, B" was rearranged into the courses "Kampo and Pharmacognosy" and "Clinical Kampo Medicine". "Kampo and Pharmacognosy" is now provided in the second semester of the 3rd year, and in this course we lecture on the basic knowledge of Kampo medicine. An advanced lecture will be given on "Clinical Kampo Medicine" in the 6th year. We are searching for the best way to interest students in Kampo medicine, and to counteract any misunderstandings about Kampo medicine.

  3. Moral imperatives for academic medicine.

    PubMed

    Thompson, J N

    1997-12-01

    As the health care system becomes dominated by managed care, academic medicine must do more than simply learn how to continue to offer the same level of care with ever-tightening resources and in new practice environments. Three moral imperatives must guide how medicine is practiced and taught: (1) patients' health and well-being must always be foremost, centered in quality of care and respect for life; (2) the emotional and spiritual needs of patients must be considered, not just the physical needs; (3) academic medicine must instill in its trainees discipline, passion, and skills to meet their obligation to be lifelong learners. These imperatives make it more important than ever for medical educators to tackle two crucial questions: What kind of person makes the best possible physician? And what constitutes the best possible training for that person? Taking these questions seriously in the new era of health care may mean that medical educators need to rethink the teaching of medicine. One example of how this might be done is the Curriculum for 2002 Committee recently formed at the Wake Forest University School of Medicine. It is becoming clear that medical educators can do a better and more comprehensive job of helping future physicians uncover and strengthen their own morality and, in the face of managed care's pressures, renew their loyalty to medicine as a service rather than a business. Morally sensitized physicians can better deal with the hard issues of medicine, such as euthanasia and abortion, and can help their students examine these issues. Most important, they can show their students that physicians are members of a moral community dedicated to something other than its own self-interest.

  4. Rational use of medicines - Indian perspective!

    PubMed

    Mohanta, G P; Manna, P K

    2015-01-01

    Government developed policies and regulations for combating antimicrobial resistance, controlling the prices of medicines, establishing generic medicines stores and advocating for the need for improvement of medicine logistics at state level and prescription auditing system. There is wide variation in medicine procurement and management system among the states. Spending on medicines ranges from as small as 2% of health budget to as high as 17%. The procurement system varies from individual facilities to partial pooled procurement to complete centralised system.There are attempts of developing essential medicine lists, standard treatment guidelines and costing of treatment of common illnesses. Except for the few states, essential medicine list remains an ornamental showpiece. However, with apex court's intervention, the prices are now controlled for all 348 medicines listed in national list. The pharmaceutical companies continue to violate price regulations either through making the medicines at different strengths or new fixed dose combinations (FDCs). Perhaps the largest number of FDCs and many of them with no valid justification are available in the country. Decisions on compulsory licensing have made the new anticancer medicines affordable. Other countries have also benefited from this decision. While some progress has been made for appropriate use of medicines in public health facilities, there are little efforts in private sectors and at community levels. Availability of prescription medicines without much control and free drug advertising are other concerns. Like all other countries irrational use of medicines continues to be of concern in India despite of several attempts of improving use of medicines both in the health system as well as in community. But efforts continue to be made for improving the use of medicines!

  5. Lasers in veterinary medicine: a review

    NASA Astrophysics Data System (ADS)

    Bartels, Kenneth E.

    1994-09-01

    As in other facets of medical science, the use of lasers in veterinary medicine is a relatively new phenomenon. Economic aspects of the profession as well as questionable returns on investment have limited laser applications primarily to the academic community, research institutions, and specialty practices. As technology improves and efficacy is proven, costs should decrease and allow further introduction of laser surgical and diagnostic devices into the mainstream of clinical veterinary medicine.

  6. Bridging Systems Medicine and Patient Needs

    PubMed Central

    Boissel, J-P; Auffray, C; Noble, D; Hood, L; Boissel, F-H

    2015-01-01

    While there is widespread consensus on the need both to change the prevailing research and development (R&D) paradigm and provide the community with an efficient way to personalize medicine, ecosystem stakeholders grapple with divergent conceptions about which quantitative approach should be preferred. The primary purpose of this position paper is to contrast these approaches. The second objective is to introduce a framework to bridge simulation outputs and patient outcomes, thus empowering the implementation of systems medicine. PMID:26225243

  7. General Nuclear Medicine

    MedlinePlus

    ... Children's (Pediatric) Nuclear Medicine Radioactive Iodine (I-131) Therapy Biopsies - Overview Radioimmunotherapy (RIT) Alzheimer's Disease X-ray, Interventional Radiology and Nuclear Medicine ...

  8. Medicines for sleep

    MedlinePlus

    Benzodiazepines; Sedatives; Hypnotics; Sleeping pills; Insomnia - medicines; Sleep disorder - medicines ... are commonly used to treat allergies. While these sleep aids are not addictive, your body becomes used ...

  9. Global obstetric medicine: Collaborating towards global progress in maternal health

    PubMed Central

    Ateka-Barrutia, Oier; Rojas-Suarez, Jose Antonio; Wijeyaratne, Chandrika; Castillo, Eliana; Lombaard, Hennie; Magee, Laura A

    2015-01-01

    Globally, the nature of maternal mortality and morbidity is shifting from direct obstetric causes to an increasing proportion of indirect causes due to chronic conditions and ageing of the maternal population. Obstetric medicine can address an important gap in the care of women by broadening its scope to include colleagues, communities and countries that do not yet have established obstetric medicine training, education and resources. We present the concept of global obstetric medicine by highlighting three low- and middle-income country experiences as well as an example of successful collaboration. The article also discusses ideas and initiatives to build future partnerships within the global obstetric medicine community. PMID:27512469

  10. The forthcoming era of precision medicine.

    PubMed

    Gamulin, Stjepan

    2016-11-01

    The aim of this essay is to present the definition and principles of personalized or precision medicine, the perspective and barriers to its development and clinical application. The implementation of precision medicine in health care requires the coordinated efforts of all health care stakeholders (the biomedical community, government, regulatory bodies, patients' groups). Particularly, translational research with the integration of genomic and comprehensive data from all levels of the organism ("big data"), development of bioinformatics platforms enabling network analysis of disease etiopathogenesis, development of a legislative framework for handling personal data, and new paradigms of medical education are necessary for successful application of the concept of precision medicine in health care.

  11. Nanomedicine, nanotechnology in medicine

    NASA Astrophysics Data System (ADS)

    Boisseau, Patrick; Loubaton, Bertrand

    2011-09-01

    Nanomedicine is a relatively new field of science and technology. It looks sometimes ill defined and interpretations of that term may vary, especially between Europe and the United States. By interacting with biological molecules, therefore at nanoscale, nanotechnology opens up a vast field of research and application. Interactions between artificial molecular assemblies or nanodevices and biomolecules can be understood both in the extracellular medium and inside the human cells. Operating at nanoscale allows to exploit physical properties different from those observed at microscale such as the volume/surface ratio. The investigated diagnostic applications can be considered for in vitro as well as for in vivo diagnosis. In vitro, the synthesised particles and manipulation or detection devices allow for the recognition, capture, and concentration of biomolecules. In vivo, the synthetic molecular assemblies are mainly designed as a contrast agent for imaging. A second area exhibiting a strong development is "nanodrugs" where nanoparticles are designed for targeted drug delivery. The use of such carriers improves the drug biodistribution, targeting active molecules to diseased tissues while protecting healthy tissue. A third area of application is regenerative medicine where nanotechnology allows developing biocompatible materials which support growth of cells used in cell therapy. The application of nanotechnology to medicine raises new issues because of new uses they allow, for instance: Is the power of these new diagnostics manageable by the medical profession? What means treating a patient without any clinical signs? Nanomedicine can contribute to the development of a personalised medicine both for diagnosis and therapy. There exists in many countries existing regulatory frameworks addressing the basic rules of safety and effectiveness of nanotechnology based medicine, whether molecular assemblies or medical devices. However, there is a need to clarify or to

  12. Community Pharmacy Practice in India: Past, Present and Future

    PubMed Central

    Basak, Subal Chandra; Sathyanarayana, Dondeti

    2009-01-01

    Today, community pharmacists play an important role in any country as they take responsibility for patient’s medicine related needs for access to healthcare. However, in India only the supply of medicines remains the core activity of the community pharmacist. Most community pharmacists in the country still hardly offer patient‐oriented service. The role of the pharmacists in the community, and with it their medicine management, may change in the wake of the rapid growth of domestic medicine output and national healthcare expenditure. This article seeks to discuss the genesis of Indian community pharmacy, the majority of which are privately owned, and sketches its education, training and future prospects. PMID:23093872

  13. [The Essenes and medicine].

    PubMed

    Kottek, Samuel

    2011-01-01

    The Essenes were a Jewish sect, which flourished around the first century. We have limited our study to hygienic and medical aspects, as documented in the works of Josephus Flavius, Philo of Alexandria, and Pliny the Elder; Josephus and Philo were personally in contact with these sectarian Jews. We have described the regimen of life of these communities, who lived in strictly organised fashion, their meals taken in common, their bathing in cold water, their clothing, the Sabbath rest, the lavatories, and more. Most Essenes remained single, they adopted however small children, and educated them in accordance to their principles. There was no private property, but old people and sick residents were taken care of by the community. The Essenes, as well as the Therapeuts described by Philo, were knowledgeable in medical lore, they treasured old books and studied the virtues of medicinal plants. There is no clear-cut consensus whether the Essenes, the Therapeuts, and the Qumran residents were one and the same sect, or whether they were similar sub-sects. The calm, strictly regulated and frugal way of life of the Essenes enabled them to attain old age, often beyond 100 years.

  14. "Humanities in medicine".

    PubMed

    Odenbach, V

    1999-01-01

    Progress in medicine and medical technology along with economic constraints have led to increasing structural change in the hospital sector over the past years. As a result of these changes, the social needs of the patients are in danger of being eclipsed by the requirements of the optimization of hospital processes. Cultural activities can be a meaningful way to offset such changes. They stimulate individuals, promote well-being and prompt discussion. Cultural activities in hospitals are directed at patients, hospital employees and people in the community. In Germany, the 'National Association for Culture and Health MediArt' founded in 1995 has been responsible for the UNESCO project "Art in Hospitals" 1988-1997. This paper provides a snapshot of German hospitals that have integrated cultural activities in an exemplary fashion. The activities include such events as 'international cultural days', 'theatre groups', 'dance workshops', 'clinclowns'. Participants include professionals, employees, patients and visitors from the community. The activities are organized by individuals and/or cultural departments created to act as 'health centres' for musical, theatrical, dance and plastic art events.

  15. Tapping the potential of alternative medicine.

    PubMed

    La Puma, J; Eiler, G

    1998-04-01

    Interest in alternative medicine is growing among healthcare consumers. Health plans and healthcare organizations may be able to improve clinical outcomes and benefit financially by providing patients with access to alternative services. Organizations that can assess their communities' particular needs, draw on interested professional staff to help develop alternative medicine programs and protocols, and study quality outcomes will stand a better chance of making such programs successful. Educating medical staff, designing a credible program, and forging strategic alliances with respected partners can help organizations create a sharply focused brand identity in the community.

  16. Canadian rural family medicine training programs

    PubMed Central

    Krupa, Lisa K.; Chan, Benjamin T.B.

    2005-01-01

    OBJECTIVE To document the proliferation of rural family medicine residency programs and to note differences in design as they affect rural recruitment. DESIGN Descriptive study using semistructured telephone interviews. SETTING All family medicine residency programs in Canada in 2002. PARTICIPANTS Directors of Canadian family medicine residency programs. MAIN OUTCOME MEASURES Number of rural training programs and positions; months of rural exposure, degree of remoteness, and specialist support of rural communities within rural training programs. RESULTS The number of rural training programs rose from one in 1973 to 12 in 2002. Most medical schools now offer dedicated rural training streams. From 1989 to 2002, the number of rural residency positions quadrupled from 36 to 144; large jumps in capacity occurred from 1989 to 1991 and then from 1999 to 2001. Rural positions now represent 20% of all family medicine residency positions. Among rural programs, minimum rural exposure ranged from 4 to 12 months, and the median distance between rural training communities and referral sites ranged from 50 to 440 km (median 187 km). Rotations in communities with no hospital were mandatory in five of 12 rural programs, optional in five, and unavailable in two. The proportion of training communities used by rural programs that had family physicians only (ie, no immediate specialty backup) ranged from 0 to 78% (mean 44%). Most training communities (78%) used by rural programs had fewer than 10 000 residents. Four of 12 rural programs offered various specialty medicine rotations in small communities. CONCLUSION Rural residency programs have proliferated in Canada. The percentage of residency positions that are rural now equals the proportion of the general population in Canada living in rural areas. National guidelines for rural programs recommend at least 6 months of rural rotations and at least some training in communities without hospitals. Major variations among programs exist

  17. [Theory and practice of bionic cultivation of traditional Chinese medicine].

    PubMed

    Liu, Dahui; Huang, Luqi; Guo, Lanping; Shao, Aijuan; Chen, Meilan

    2009-03-01

    The bionic cultivation of medicinal plant is an ecological cultivation pattern, which is adopting ecological engineering and modern agricultural techniques to simulate the natural ecosystem of wild medicinal plant community, and has been given greater attention on the agriculture of traditional Chinese medicine (TCM). It is also the cross subject that combines Chinese traditional medicine, agronomy, horticulture, ecology, agricultural engineering and management. Moreover, it has significant technology advantages of promoting the sustainable utilization of medicinal plant resources, improving the ecological environment and harmonizing man and nature. So it's important to develop the bionic cultivation of TCM.

  18. Validation of an instrument to measure patients’ experiences of medicine use: the Living with Medicines Questionnaire

    PubMed Central

    Krska, Janet; Katusiime, Barbra; Corlett, Sarah A

    2017-01-01

    Background Medicine-related burden is an increasingly recognized concept, stemming from the rising tide of polypharmacy, which may impact on patient behaviors, including nonadherence. No instruments currently exist which specifically measure medicine-related burden. The Living with Medicines Questionnaire (LMQ) was developed for this purpose. Objective This study validated the LMQ in a sample of adults using regular prescription medicines in the UK. Methods Questionnaires were distributed in community pharmacies and public places in southeast England or online through UK health websites and social media. A total of 1,177 were returned: 507 (43.1%) from pharmacy distribution and 670 (56.9%) online. Construct validity was assessed by principal components analysis and item reduction undertaken on the original 60-item pool. Known-groups analysis assessed differences in mean total scores between participants using different numbers of medicines and between those who did or did not require assistance with medicine use. Internal consistency was assessed by Cronbach’s alpha. Free-text comments were analyzed thematically to substantiate underlying dimensions. Results A 42-item, eight-factor structure comprising intercorrelated dimensions (patient–doctor relationships and communication about medicines, patient–pharmacist communication about medicines, interferences with daily life, practical difficulties, effectiveness, acceptance of medicine use, autonomy/control over medicines and concerns about medicine use) was derived, which explained 57.4% of the total variation. Six of the eight subscales had acceptable internal consistency (α>0.7). More positive experiences were observed among patients using eight or fewer medicines compared to nine or more, and those independent with managing/using their medicines versus those requiring assistance. Free-text comments, provided by almost a third of the respondents, supported the domains identified. Conclusion The resultant LMQ

  19. Validation of an instrument to measure patients' experiences of medicine use: the Living with Medicines Questionnaire.

    PubMed

    Krska, Janet; Katusiime, Barbra; Corlett, Sarah A

    2017-01-01

    Medicine-related burden is an increasingly recognized concept, stemming from the rising tide of polypharmacy, which may impact on patient behaviors, including nonadherence. No instruments currently exist which specifically measure medicine-related burden. The Living with Medicines Questionnaire (LMQ) was developed for this purpose. This study validated the LMQ in a sample of adults using regular prescription medicines in the UK. Questionnaires were distributed in community pharmacies and public places in southeast England or online through UK health websites and social media. A total of 1,177 were returned: 507 (43.1%) from pharmacy distribution and 670 (56.9%) online. Construct validity was assessed by principal components analysis and item reduction undertaken on the original 60-item pool. Known-groups analysis assessed differences in mean total scores between participants using different numbers of medicines and between those who did or did not require assistance with medicine use. Internal consistency was assessed by Cronbach's alpha. Free-text comments were analyzed thematically to substantiate underlying dimensions. A 42-item, eight-factor structure comprising intercorrelated dimensions (patient-doctor relationships and communication about medicines, patient-pharmacist communication about medicines, interferences with daily life, practical difficulties, effectiveness, acceptance of medicine use, autonomy/control over medicines and concerns about medicine use) was derived, which explained 57.4% of the total variation. Six of the eight subscales had acceptable internal consistency (α>0.7). More positive experiences were observed among patients using eight or fewer medicines compared to nine or more, and those independent with managing/using their medicines versus those requiring assistance. Free-text comments, provided by almost a third of the respondents, supported the domains identified. The resultant LMQ-2 is a valid and reliable multidimensional measure of

  20. Regenerative Medicine Build-Out

    PubMed Central

    Pfenning, Michael A.; Gores, Gregory J.; Harper, C. Michel

    2015-01-01

    Summary Regenerative technologies strive to boost innate repair processes and restitute normative impact. Deployment of regenerative principles into practice is poised to usher in a new era in health care, driving radical innovation in patient management to address the needs of an aging population challenged by escalating chronic diseases. There is urgency to design, execute, and validate viable paradigms for translating and implementing the science of regenerative medicine into tangible health benefits that provide value to stakeholders. A regenerative medicine model of care would entail scalable production and standardized application of clinical grade biotherapies supported by comprehensive supply chain capabilities that integrate sourcing and manufacturing with care delivery. Mayo Clinic has rolled out a blueprint for discovery, translation, and application of regenerative medicine therapies for accelerated adoption into the standard of care. To establish regenerative medical and surgical service lines, the Mayo Clinic model incorporates patient access, enabling platforms and delivery. Access is coordinated through a designated portal, the Regenerative Medicine Consult Service, serving to facilitate patient/provider education, procurement of biomaterials, referral to specialty services, and/or regenerative interventions, often in clinical trials. Platforms include the Regenerative Medicine Biotrust and Good Manufacturing Practice facilities for manufacture of clinical grade products for cell-based, acellular, and/or biomaterial applications. Care delivery leverages dedicated interventional suites for provision of regenerative services. Performance is tracked using a scorecard system to inform decision making. The Mayo Clinic roadmap exemplifies an integrated organization in the discovery, development, and delivery of regenerative medicine within a growing community of practice at the core of modern health care. Significance Regenerative medicine is at the

  1. Regenerative Medicine Build-Out.

    PubMed

    Terzic, Andre; Pfenning, Michael A; Gores, Gregory J; Harper, C Michel

    2015-12-01

    Regenerative technologies strive to boost innate repair processes and restitute normative impact. Deployment of regenerative principles into practice is poised to usher in a new era in health care, driving radical innovation in patient management to address the needs of an aging population challenged by escalating chronic diseases. There is urgency to design, execute, and validate viable paradigms for translating and implementing the science of regenerative medicine into tangible health benefits that provide value to stakeholders. A regenerative medicine model of care would entail scalable production and standardized application of clinical grade biotherapies supported by comprehensive supply chain capabilities that integrate sourcing and manufacturing with care delivery. Mayo Clinic has rolled out a blueprint for discovery, translation, and application of regenerative medicine therapies for accelerated adoption into the standard of care. To establish regenerative medical and surgical service lines, the Mayo Clinic model incorporates patient access, enabling platforms and delivery. Access is coordinated through a designated portal, the Regenerative Medicine Consult Service, serving to facilitate patient/provider education, procurement of biomaterials, referral to specialty services, and/or regenerative interventions, often in clinical trials. Platforms include the Regenerative Medicine Biotrust and Good Manufacturing Practice facilities for manufacture of clinical grade products for cell-based, acellular, and/or biomaterial applications. Care delivery leverages dedicated interventional suites for provision of regenerative services. Performance is tracked using a scorecard system to inform decision making. The Mayo Clinic roadmap exemplifies an integrated organization in the discovery, development, and delivery of regenerative medicine within a growing community of practice at the core of modern health care. Regenerative medicine is at the vanguard of health care

  2. 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

  3. [Improved medicine lists with multi-dose packaging?].

    PubMed

    Bakken, Toril; Straand, Jørund

    2003-12-23

    In a part of Oslo, Norway, the community care services use multi-dose packed medicines for some of their clients. We wanted to investigate whether this improved quality as compared to manually dispensed medicines. We included 20 patients who received multi-dose packaged medicines, and 33 patients in two other districts who received manually dispensed medicines, and recorded disagreements between what daily medicines the general practitioner had prescribed and those that were dispensed by the community care service or the multi-dose packager. The 53 patients received a total of 324 daily medicines. Disagreements were found in 23% of all daily medicines, involving 58% of patients. In addition, deficiencies in the information on medication were found in 6% of all daily doses. For patients who received multi-dose packaged medicines, disagreements were found in relation to 21 % of the drugs. For patients who received manually dispensed medicines, disagreements were found in 17% and 33% of the medicines lists in the two districts. The disagreements found between the medication prescribed by doctors and what was dispensed were unacceptable regardless of dispensing method (manual or automatic). It is important to clarify who should be responsible for maintaining accurate records for patients who receive community care.

  4. How Do Asthma Medicines Work?

    MedlinePlus

    ... Lifesaver Kids Talk About: Coaches How Do Asthma Medicines Work? KidsHealth > For Kids > How Do Asthma Medicines ... long-term control medicines . What Are Quick-Relief Medicines? Quick-relief medicines (also called rescue or fast- ...

  5. How Do Asthma Medicines Work?

    MedlinePlus

    ... Happens in the Operating Room? How Do Asthma Medicines Work? KidsHealth > For Kids > How Do Asthma Medicines ... of medicines for treating asthma: 1. Quick-relief Medicines Quick-relief medicines (also called rescue or fast- ...

  6. "Evaluating normative epistemic frameworks in medicine: EBM and casuistic medicine".

    PubMed

    Bingeman, Emily

    2016-08-01

    Since its inception in the early 1990s, evidence-based medicine (EBM) has become the dominant epistemic framework for Western medical practice. However, in light of powerful criticisms against EBM, alternatives such as casuistic medicine have been gaining support in both the medical and philosophical community. In the absence of empirical evidence in support of the claim that EBM improves patient outcomes, and in light of considerations that it is unlikely that such evidence will be forthcoming, another standard is needed to assess EBM against its alternatives. In this paper, I propose a set of criteria for this purpose based on Helen Longino's criteria for assessing the objectivity of a knowledge productive community. I then apply these criteria to assess EBM against a casuistic framework for medical knowledge. I argue that EBM's strict adherence to a hierarchical organization of knowledge can reasonably be expected to block it from fulfilling a high level of objectivity. A casuistic framework, on the other hand, because it emphasizes critical evaluation in conjunction with the flexibility of a case-based approach, could be expected to better facilitate a more optimal epistemic community. © 2016 John Wiley & Sons, Ltd.

  7. [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.

  8. 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

  9. Occupational medicine in ancient Egypt.

    PubMed

    Ziskind, Bernard; Halioua, Bruno

    2007-01-01

    Only the remarkable organisation of Egyptian society, based on an economy of redistribution and allocation of tasks, enabled the erection of the pyramids and the construction of the great temples. Medicine naturally found its place in this organisation as illness was part of the afflictions the pharaoh had to fight against. This particular task was delegated to doctors. The organisation of a medical group could be witnessed on the banks of the Nile almost 5000 years ago and Hesy-Re "the greatest of doctors" (1750 BC), doctor to pharaoh Djoser, is one of the oldest known to mankind. Some doctors were assigned by Egyptian administration to deal with the health problems of communities of workers carrying out the same duties. We consider these doctors to be the pioneers of medicine in the workplace.

  10. The Wounded Bear: A Modern Day Medicine Story.

    ERIC Educational Resources Information Center

    Eagleheart, Shianne

    2002-01-01

    In Native American culture, medicine stories are used to teach important lessons that have healing effects on the listener. Following is an excerpt from "The Wounded Bear", a modern day medicine story. The story offers a blueprint for healing the heartbreak and violence in our communities. (Author)

  11. A Review of the Clinical Education in Podiatric Medicine.

    ERIC Educational Resources Information Center

    Baerg, Richard H.

    1979-01-01

    Contemporary clinical educational programs at five colleges of podiatric medicine are reviewed. Both classroom contact hours and clinical experience are examined and compared among institutions. Course offerings in podiatric medicine, radiology, surgery, othopedics, community health, etc., are listed by college. (MLW)

  12. A Review of the Clinical Education in Podiatric Medicine.

    ERIC Educational Resources Information Center

    Baerg, Richard H.

    1979-01-01

    Contemporary clinical educational programs at five colleges of podiatric medicine are reviewed. Both classroom contact hours and clinical experience are examined and compared among institutions. Course offerings in podiatric medicine, radiology, surgery, othopedics, community health, etc., are listed by college. (MLW)

  13. The Wounded Bear: A Modern Day Medicine Story.

    ERIC Educational Resources Information Center

    Eagleheart, Shianne

    2002-01-01

    In Native American culture, medicine stories are used to teach important lessons that have healing effects on the listener. Following is an excerpt from "The Wounded Bear", a modern day medicine story. The story offers a blueprint for healing the heartbreak and violence in our communities. (Author)

  14. Chemical bases for medicinal plant use in Oaxaca, Mexico.

    PubMed

    Ortiz de Montellano, B R; Browner, C H

    1985-03-01

    Fifty-eight medicinal plants used for the management of reproduction and the treatment of women's reproductive health problems in an indigenous community in southern Mexico are described. The efficacy of these plants is assessed according to both community members' understandings of the therapeutic effects they seek and the standards of conventional Western medicine. The majority of the plants contain chemicals which would appear to enable them to accomplish their intended effects in either or both the popular and the conventional medical systems.

  15. Reflections on preventive medicine.

    PubMed

    Miettinen, Olli S

    2014-10-01

    Having thought much about medicine in my career-long effort to understand it and the research for its advancement, I have come to views rather different form the now-prevailing ones in respect to what preventive medicine is about; what epidemiology is in relation to preventive medicine; what distinguishes preventive medicine in preventive healthcare at large; the relation of preventive medicine to public health; the concept of health promotion; and also the core principles of preventive medicine. All of these views I set forth in this article, for the readers' critical reflection. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Mapuche medicinal plants: Proposition in their propagation

    Treesearch

    Paz Ovalle; Zoia Neira; Patricio Nunez

    2002-01-01

    The Mapuche (native indians from Chile) population is one of the largest populations of native indians left in America (approximately 1 million). As many of the other Native communities, they continuously struggle to maintain their rituals and customs. One of the most valuable customs for the Mapuche is the use of medicinal plants. All these plants are native plants...

  17. Some Medicinal Plants Used in Chinese Medicine.

    DTIC Science & Technology

    1960-09-27

    consisting of the following^plants: Panax ginseng C.A.ivio, Lycium chinense Mill«, Cornus officinalis Sieb, et Zucc, Rehmannia glutinosa (Gaertn.) Libosch...medicine. As an example of combined therapy with drugs from modern and Chinese popular medicine we might cite the use of ginseng as a factor which

  18. [Counterfeit medicines--Japan and the world].

    PubMed

    Sato, Daisaku

    2014-01-01

    Health, Labour and Welfare (MHLW) has been actively involved in prevention and educational activities such as public awareness campaign. MHLW started anti-counterfeit medicines and new psychoactive substance project from February 2013, which centrally collects information about counterfeit medicines, in particular, and provides the risk information more effectively to the public. Japanese Government will work together with international community and contribute to combating counterfeiting through public and private partnership.

  19. Community Links

    ERIC Educational Resources Information Center

    Nelson, Mary

    1975-01-01

    At Moraine Valley Community College (Illinois), a chain of events, programs, activities, and services has linked the college and community in such areas as fine arts, ethnic groups, public services, community action, community service, and community education. (Author/NHM)

  20. Advancing the science of medicines regulation: the role of the 21st-century medicines regulator.

    PubMed

    Lumpkin, M M; Eichler, H-G; Breckenridge, A; Hamburg, M A; Lönngren, T; Woods, K

    2012-10-01

    The history of medicines regulation is punctuated with sudden swings in focus mandated by a public injured by medicines and skeptical of regulators' abilities to protect them. As stakeholder communities and the science that undergirds medicines have both grown more sophisticated, seemingly conflicting mission equities, such as public health protection vs. promotion or population vs. individual patient product development focus, have created new challenges to defining the mission and role of twenty-first-century medicines regulators. The role of medicines regulators as a nationally focused, retrospective assessor of data is rapidly shifting to that of a prospective generator of public data and tools to help drive what has now become a global product development and regulatory enterprise that is fast gaining recognition as an integral part of any truly effective twenty-first-century health-care system. This article discusses this evolution and describes how regulatory science will help to both drive and define it.

  1. Herbal medicinal oils in traditional Persian medicine.

    PubMed

    Hamedi, Azadeh; Zarshenas, Mohammad M; Sohrabpour, Maryam; Zargaran, Arman

    2013-09-01

    In Iran, conventional production methods of herbal oils are widely used by local practitioners. Administration of oils is rooted in traditional knowledge with a history of more than 3000 years. Scientific evaluation of these historical documents can be valuable for finding new potential use in current medicine. The current study (i) compiled an inventory of herbal oils used in ancient and medieval Persia and (ii) compared the preparation methods and therapeutic applications of ancient times to current findings of medicinal properties in the same plant species. Information on oils, preparation methods and related clinical administration was obtained from ancient Persian documents and selected manuscripts describing traditional Persian medicine. Moreover, we investigated the efficacy of medicinal plant species used for herbal oils through a search of the PubMed, Scopus and Google Scholar databases. In Iran, the application of medicinal oils date back to ancient times. In medieval Persian documents, 51 medicinal oils produced from 31 plant species, along with specific preparation methods, were identified. Flowers, fruits and leaves were most often used. Herbal oils have been traditionally administered via oral, topical and nasal routes for gastrointestinal, musculoskeletal, and neural diseases, respectively. According to current investigations, most of the cited medicinal plant species were used for their anti-inflammatory and analgesic properties. Medicinal oils are currently available in Iranian medicinal plant markets and are prepared using traditional procedures for desirable clinical outcomes. Other than historical clarification, the present study provides data on clinical applications of the oils that should lead to future opportunities to investigate their potential medicinal use.

  2. [The practice of Internal Medicine in Andalusia follows the evidence-based medicine basic principles].

    PubMed

    Zambrana García, J L; Velasco Malagón, M J; Díez García, F; Martín-Escalante, M D; Cruz-Caparrós, G

    2003-10-01

    To know the proportion of medical interventions carried out in the Services of Internal Medicine of the public hospitals of Andalusia based on randomized clinical trials. We have analyzed the primary treatments prescribed in a random sample of 326 patients admitted to these Internal Medicine services during 1998. One hundred and forty-three of the 326 treatments analyzed (43.9%) were based in clinical trials and 135 (41.4%) were interventions unanimously accepted by the medical community without being based in clinical trials. Most of the primary Andalusian treatments prescribed in the Internal Medicine services are evidence-based.

  3. Compounding practices in a Portuguese community pharmacy.

    PubMed

    Reis, Maria; Carvalho, Maria; Rodrigues, Angelo

    2014-01-01

    All Portuguese community pharmacies have a compounding laboratory and minimum equipment for the preparation of nonsterile (traditional) compounded medicines, but a few community pharmacies specialize in compounding. At Farmácia Lordelo, the most frequently dispensed compounded medicines are oral liquids for pediatrics and multi-drug, semi-solid preparations for dermatology patients. The majority of the compounded medicines is prepared in accordance with the national galenic formulary and standardized monographs, in order to guarantee the quality and safety of the compounded medicines dispensed.

  4. Veterinary medicines: product update.

    PubMed

    2014-04-05

    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.

  5. Veterinary medicines: product update.

    PubMed

    2014-03-01

    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.

  6. Veterinary medicines: product update.

    PubMed

    2014-08-02

    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.

  7. Veterinary medicines: product update.

    PubMed

    2014-11-01

    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.

  8. Veterinary medicines: product update.

    PubMed

    2014-09-06

    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.

  9. Veterinary medicines update.

    PubMed

    2017-03-11

    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.

  10. Cough & Cold Medicine Abuse

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold ... tos y el resfriado Why Do People Use Cough and Cold Medicines to Get High? There's an ...

  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. 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 ...

  14. Medicines for ADHD

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007592.htm Medicines for ADHD To use the sharing features on ... that the treatment plan is successful. TYPES OF MEDICINES Stimulants are the most commonly used type of ...

  15. Pregnancy and Medicines

    MedlinePlus

    Not all medicines are safe to take when you are pregnant. Some medicines can harm your baby. That includes over-the-counter or prescription drugs, herbs, and supplements. Always speak with your health ...

  16. Cough & Cold Medicine Abuse

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold ... Someone Quit? Avoiding DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ...

  17. Giving Medicine to Children

    MedlinePlus

    ... Products For Consumers Home For Consumers Consumer Updates Articulos en Espanol Giving Medicine to Children Share Tweet ... right medicine and the right amount More in Articulos en Espanol Alimentos y Bebidas Cosméticos Dispositivos Médicos ...

  18. Society for Vascular Medicine

    MedlinePlus

    ... Certification with this new online course from the Society for Vascular Medicine. Learn more. Looking for a ... jobs are listed right now. Copyright © 2016 The Society for Vascular Medicine. All Rights Reserved.

  19. 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)

  20. Traveling Safely with Medicines

    MedlinePlus

    ... means taking a trip. To be sure that you can stay healthy on your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you always carry a list of all the medicines ...

  1. 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

  2. Essential Medicines for Children.

    PubMed

    Kalle, Hoppu

    2017-02-09

    WHO defines Essential medicines as those that satisfy the priority health-care needs of the population (1). The right to Essential medicines has been considered an important component of the right to health. In the name of equity children should also have access to appropriate, available, affordable, and quality essential medicines they need, but children's essential medicines are too often missing. This article is protected by copyright. All rights reserved.

  3. Southeast Asian tropical medicine and parasitology network.

    PubMed

    Waikagul, Jitra

    2006-01-01

    The SEAMEO TROPMED Network is a regional cooperative network established in 1967 for education, training and research in tropical medicine and public health under the Southeast Asia Ministers of Education Organization. The Network operates through four Regional Centers with respective areas of specialization and host institutions: Community Nutrition/Tropmed Indonesia; Microbiology, Parasitology and Entomology/Tropmed Malaysia; Public Health/Tropmed Philippines; and Tropical Medicine/Tropmed Thailand. To train health workers, to support research on endemic and newly emerging diseases, and to advocate relevant health policies are the main functions of these centers. SEAMEO TROPMED Network in collaboration with the Faculty of Tropical Medicine, Mahidol University and other institutions has regularly organized the Seminar on Food-borne Parasitic Zoonoses every 3-5 years over the past 15 years. The Faculty of Tropical Medicine has organized the annual Joint International Tropical Medicine Meeting since 1996. Full papers of the presentations at these two meetings have been published as supplementary issues to the Southeast Asian Journal of Tropical Medicine and Public Health, an in-house journal of SEAMEO TROPMED Network. Recently, the Parasitology Association of ASEAN Countries has rotated the hosting of the ASEAN Congress of Parasitology and Tropical Medicine. These institutional and conference networks will enable closer links, to promote the health of people in the Southeast Asian region.

  4. 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

  5. Women Physicians: Choosing a Career in Academic Medicine

    PubMed Central

    Borges, Nicole J.; Navarro, Anita M.; Grover, Amelia C.

    2011-01-01

    Purpose Despite recent efforts to understand the complex process of physician career development, the medical education community has a poor understanding of why, how, and when women physicians embark on a career in academic medicine. Method In 2010, the authors phone-interviewed women physicians in academic medicine regarding why, how, and when they chose an academic medicine career. Project investigators first individually and then collectively analyzed transcripts to identify themes in the data. Results Through analyzing the transcripts of the 53 interviews, the investigators identified five themes related to why women choose careers in academic medicine: fit, aspects of the academic health center environment, people, exposure, and clincial medicine. They identified five themes related to how women make the decision to enter academic medicine: change in specialty, dissatisfaction with former career, emotionality, parental influence, and decision-making styles. The authors also identified four themes regarding when women decide to enter academic medicine: as a practicing phyisican, fellow, resident, or medical student. Conclusions Choosing a career in academic medicine is greatly influenced by the environment in which one trains and by people—be they faculty, mentors, role models, or family. An interest in teaching is a primary reason women choose a career in academic medicine. Many women physicians entering acadmic medicine chose this after or during fellowship, which is when they became more aware of academic medicine as a possible career. For many women, choosing academic medicine was not necessarily an active, planned decision; rather it was serendipitous or circumstantial. PMID:22104052

  6. 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…

  7. ADHD Medicines (for Kids)

    MedlinePlus

    ... Medical Words En Español What Other Kids Are Reading What to Do in a Fire CPR: A Real Lifesaver Kids Talk About: Coaches ADHD Medicines KidsHealth > For Kids > ADHD Medicines Print A A A What's in this article? About ADHD Medicine and the Mind How Therapy Can Help en español Medicamentos para ...

  8. 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.

  9. 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…

  10. Medicines to Treat Allergies

    MedlinePlus

    ... do.  Compare prices: Call or visit three different pharmacies. Give them the name of the medicine and ask how much it costs. Ask if ... you pay less for your medicine. Buy your medicine from the pharmacy that gives you the cheapest price.  Sign up ...

  11. 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…

  12. From evidence-based medicine to genomic medicine

    PubMed Central

    2007-01-01

    The concept of ‘evidence-based medicine’ dates back to mid-19th century or even earlier. It remains pivotal in planning, funding and in delivering the health care. Clinicians, public health practitioners, health commissioners/purchasers, health planners, politicians and public seek formal ‘evidence’ in approving any form of health care provision. Essentially ‘evidence-based medicine’ aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients. It is in fact the ‘personalised medicine’ in practice. Since the completion of the human genome project and the rapid accumulation of huge amount of data, scientists and physicians alike are excited on the prospect of ‘personalised health care’ based on individual’s genotype and phenotype. The first decade of the new millennium now witnesses the transition from ‘evidence-based medicine’ to the ‘genomic medicine’. The practice of medicine, including health promotion and prevention of disease, stands now at a wide-open road as the scientific and medical community embraces itself with the rapidly expanding and revolutionising field of genomic medicine. This article reviews the rapid transformation of modern medicine from the ‘evidence-based medicine’ to ‘genomic medicine’. PMID:18923934

  13. Dance medicine: current concepts.

    PubMed

    Miller, Clay

    2006-11-01

    Dance medicine has grown exponentially over the past 10 to 15 years and continues to grow every year as more former professional dancers and students of dance enter into the field of medicine. Dance medicine is part of the field of performing arts medicine, which specializes in evaluating and treating performing artists such as musicians, dancers, actors/actresses, and vocalists. This article reviews the literature on dance medicine for various health-related medical issues, for the types of injuries commonly found, for the common surgical and rehabilitation interventions, and for injury prevention used in this unique group of patients.

  14. 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.

  15. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training

    PubMed Central

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

    2016-01-01

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

  16. Cough and Cold Medicine Abuse

    MedlinePlus

    ... Home » Publications » DrugFacts » Cough and Cold Medicine Abuse Cough and Cold Medicine Abuse Email Facebook Twitter Revised ... syrup is sometimes diverted for abuse. How Are Cough and Cold Medicines Abused? Cough and cold medicines ...

  17. 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.

  18. Essential medicines for children.

    PubMed

    Hoppu, Kalle; Sri Ranganathan, Shalini

    2015-02-01

    Millions of children die every year before they reach the age of 5 years, of conditions largely treatable with existing medicines. The WHO Model List of Essential Medicines was launched in 1977 to make the most necessary drugs available to populations whose basic health needs could not be met by the existing supply system. During the first 30 years of the Model List of Essential Medicines, children's needs were not systematically considered. After adoption of the 'Better medicines for children' resolution by the World Health Assembly, things changed. The first WHO Model List of Essential Medicines for Children was drawn up by a Paediatric Expert Subcommittee and adopted in October 2007. The most recent, 4th Model List of Essential Medicines for Children was adopted in 2013. Data from country surveys show that access to essential medicines for children is still generally poor; much more work is needed.

  19. [Assertive medicine: a proposal against defensive medicine].

    PubMed

    Tena Tamayo, Carlos; Sánchez González, Jorge Manuel

    2005-10-01

    More than ever the physician-patient relationship is deteriorated by diverse factors, among these liability complaints stand out, and have propitiated the practice of defensive medicine, an attitude considered in many countries as inappropriate, expensive and unethical. Defensive medicine widens the distance between a physician and his patient. To revert this vice and its noxious effects which corrupt the patient-physician relationship in our country, we propose that physicians put to practice actions which permit the renewal of the essence of humanistic medicine in their daily practice and the restoration of the relationship. These changes in attitude sum up to a proposition of professional practice which we have denominated assertive medicine. This offer is resumed in four points: 1) Maintain a proper verbal and non verbal communication with each patient, 2) Keep continuously up to date skills, knowledge and abilities, 3) Respect the patient's rights and 4) Defend their own rights as physicians.

  20. [Contribution of occupational medicine to social medicine].

    PubMed

    Geraut, Christian

    2010-01-01

    Occupational medicine has always been part of social medicine, but focuses on the part of the population in paid employment. Investigations of occupational diseases have identified several toxic chemicals that can affect other sectors of society: examples include cancers due to sawdust, asbestos, benzene, as well as carcinogens, mutagens and reproductive toxins. Better knowledge of the risks posed by epoxy resins, cements, formaldehyde, lead, toluene and other chemical agents has helped to understand certain diseases in the population. Knowledge of musculoskeletal disorders due to repetitive work has been of help in other areas; gradual resumption of appropriate activity seems to be the best basic treatment. Studies of mental overload and its consequences in the workplace (suicide, depression, etc.) have implications for human relations in society as a whole. Multidisciplinary networking helps to regularly take stock of findings in occupational medicine that may be applicable to social medicine.

  1. "Medicine show." Alice in Doctorland.

    PubMed

    1987-01-01

    This is an excerpt from the script of a 1939 pla