Journal articles on the topic 'Physicians (General practice) Victoria History'
To see the other types of publications on this topic, follow the link: Physicians (General practice) Victoria History.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Physicians (General practice) Victoria History.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Clayton, Alison. "Malaria therapy for general paralysis of the insane at the Sunbury Hospital for the Insane in Australia, 1925–6." History of Psychiatry 33, no. 4 (November 19, 2022): 377–93. http://dx.doi.org/10.1177/0957154x221120757.
Full textAbstract:
This paper, drawing on the published medical literature and unpublished medical record archives, provides an in-depth account of the introduction of malaria therapy for general paralysis of the insane into Australia in 1925–6, at Victoria’s Sunbury Hospital for the Insane. This study reveals a complex and ambiguous picture of the practice and therapeutic impact of malaria therapy in this local setting. This research highlights a number of factors which may have contributed to some physicians overestimating malaria therapy’s effectiveness. It also shows that other physicians of the era held a more sceptical attitude towards malaria therapy. Finally, this paper discusses the relevance of this history to contemporary psychiatry.
2
Temple-Smith, M. J., G. Mulvey, and L. Keogh. "Attitudes to taking a sexual history in general practice in Victoria, Australia." Sexually Transmitted Infections 75, no. 1 (February 1, 1999): 41–44. http://dx.doi.org/10.1136/sti.75.1.41.
Full text
3
Hallinan, Christine Mary, Jane Maree Gunn, and Yvonne Ann Bonomo. "Implementation of medicinal cannabis in Australia: innovation or upheaval? Perspectives from physicians as key informants, a qualitative analysis." BMJ Open 11, no. 10 (October 2021): e054044. http://dx.doi.org/10.1136/bmjopen-2021-054044.
Full textAbstract:
Objective We sought to explore physician perspectives on the prescribing of cannabinoids to patients to gain a deeper understanding of the issues faced by prescriber and public health advisors in the rollout of medicinal cannabis. Design A thematic qualitative analysis of 21 in-depth interviews was undertaken to explore the narrative on the policy and practice of medicinal cannabis prescribing. The analysis used the Diffusion of Innovations (DoI) theoretical framework to model the conceptualisation of the rollout of medicinal cannabis in the Australian context. Setting Informants from the states and territories of Victoria, New South Wales, Tasmania, Australian Capital Territory, and Queensland in Australia were invited to participate in interviews to explore the policy and practice of medicinal cannabis prescribing. Participants Participants included 21 prescribing and non-prescribing key informants working in the area of neurology, rheumatology, oncology, pain medicine, psychiatry, public health, and general practice. Results There was an agreement among many informants that medicinal cannabis is, indeed, a pharmaceutical innovation. From the analysis of the informant interviews, the factors that facilitate the diffusion of medicinal cannabis into clincal practice include the adoption of appropriate regulation, the use of data to evaluate safety and efficacy, improved prescriber education, and the continuous monitoring of product quality and cost. Most informants asserted the widespread assimilation of medicinal cannabis into practice is impeded by a lack of health system antecedents that are required to facilitate safe, effective, and equitable access to medicinal cannabis as a therapeutic. Conclusions This research highlights the tensions that arise and the factors that influence the rollout of cannabis as an unregistered medicine. Addressing these factors is essential for the safe and effective prescribing in contemporary medical practice. The findings from this research provides important evidence on medicinal cannabis as a therapeutic, and also informs the rollout of potential novel therapeutics in the future.
4
McVaugh, Michael. "The "Experience-Based Medicine" of the Thirteenth Century." Early Science and Medicine 14, no. 1-3 (2009): 105–30. http://dx.doi.org/10.1163/157338209x425524.
Full textAbstract:
AbstractWe should not assume that medieval physicians did not take pains to found their practice upon evidence. Academic physicians at Montpellier ca. 1300 were cautious about accepting textbook claims for the powers of drugs, and tried to verify each drug's physiological effects before using it; yet they were also flexible, ready to believe that powerful new medicines might be discovered empirically that were unknown to their authorities or superficially inconsistent with existing knowledge. Likewise, physicians were careful to observe their patients closely and to try to identify the condition from which each was suffering, and when they were unsure of the nature of an illness, they feared to administer medicines lest their known effects might be harmful to the patient. Anticipating today's "evidence-based medicine," the physician's practice involved the conscientious use of current best evidence.
5
Barry, Jonathan. "Educating physicians in seventeenth-century England." Science in Context 32, no. 2 (June 2019): 137–54. http://dx.doi.org/10.1017/s0269889719000188.
Full textAbstract:
ArgumentThe tension between theoretical and practical knowledge was particularly problematic for trainee physicians. Unlike civic apprenticeships in surgery and pharmacy, in early modern England there was no standard procedure for obtaining education in the practical aspects of the physician’s role, a very uncertain process of certification, and little regulation to ensure a suitable reward for their educational investment. For all the emphasis on academic learning and international travel, the majority of provincial physicians returned to practice in their home area, because establishing a practice owed more to networks of kinship, patronage and credit than to formal qualifications. Only when (and where) practitioners had to rely solely on their professional qualification to establish their status as young practitioners that the community could trust would proposals to reform medical education, such as those put forward to address a crisis of medicine in Restoration London, which are examined here, be converted into national regulation of medical education in the early nineteenth century, although these proposals prefigured many informal developments in medical training in the eighteenth century.
6
Lahham, Aroub, Angela T. Burge, Christine F. McDonald, and Anne E. Holland. "How do healthcare professionals perceive physical activity prescription for community-dwelling people with COPD in Australia? A qualitative study." BMJ Open 10, no. 8 (August 2020): e035524. http://dx.doi.org/10.1136/bmjopen-2019-035524.
Full textAbstract:
ObjectivesClinical practice guidelines recommend that people with chronic obstructive pulmonary disease (COPD) should be encouraged to increase their physical activity levels. However, it is not clear how these guidelines are applied in clinical practice. This study aimed to understand the perspectives of respiratory healthcare professionals on the provision of physical activity advice to people with COPD. These perspectives may shed light on the translation of physical activity recommendations into clinical practice.DesignA qualitative study using thematic analysis.SettingHealthcare professionals who provided care for people with COPD at two major tertiary referral hospitals in Victoria, Australia.Participants30 respiratory healthcare professionals including 12 physicians, 10 physical therapists, 4 nurses and 4 exercise physiologists.InterventionsSemistructured voice-recorded interviews were conducted, transcribed verbatim and analysed by two independent researchers using an inductive thematic analysis approach.ResultsHealthcare professionals acknowledged the importance of physical activity for people with COPD. They were conscious of low physical activity levels among such patients; however, few specifically addressed this in consultations. Physicians described limitations including time constraints, treatment prioritisation and perceived lack of expertise; they often preferred that physical therapists provide more comprehensive assessment and advice regarding physical activity. Healthcare professionals perceived that there were few evidence-based strategies to enhance physical activity. Physical activity was poorly differentiated from the prescription of structured exercise training. Although healthcare professionals were aware of physical activity guidelines, few were able to recall specific recommendations for people with COPD.ConclusionPractical strategies to enhance physical activity prescription may be required to encourage physical activity promotion in COPD care.
7
Khan, Asaduzzaman, David Plummer, Rafat Hussain, and Victor Minichiello. "Sexual risk assessment in general practice: evidence from a New South Wales survey." Sexual Health 4, no. 1 (2007): 1. http://dx.doi.org/10.1071/sh06012.
Full textAbstract:
Background: Physicians’ inadequate involvement in sexual risk assessment has the potential to miss many asymptomatic cases. The present study was conducted to explore sexual risk assessment by physicians in clinical practice and to identify barriers in eliciting sexual histories from patients. Methods: A stratified random sample of 15% of general practitioners (GP) from New South Wales was surveyed to assess their management of sexually transmissible infections (STI). In total, 409 GP participated in the survey with a response rate of 45.4%. Results: Although nearly 70% of GP regularly elicited a sexual history from commercial sex workers whose presenting complaint was not an STI, this history taking was much lower (<10%) among GP for patients who were young or heterosexual. About 23% never took a sexual history from Indigenous patients and 19% never elicited this history from lesbian patients. Lack of time was the most commonly cited barrier in sexual history taking (55%), followed by a concern that patients might feel uncomfortable if a sexual history was taken (49%). Other constraints were presence of another person (39%) and physician’s embarrassment (15%). About 19% of GP indicated that further training in sexual history taking could improve their practice. Conclusions: The present study identifies inconsistent involvement by GP in taking sexual histories, which can result in missed opportunities for early detection of many STI. Options for overcoming barriers to taking sexual histories by GP are discussed.
8
Barry, Jonathan. "Educating physicians in seventeenth-century England - ADDENDUM." Science in Context 32, no. 3 (August 27, 2019): 353. http://dx.doi.org/10.1017/s026988971900022x.
Full textAbstract:
ArgumentThe tension between theoretical and practical knowledge was particularly problematic for trainee physicians. Unlike civic apprenticeships in surgery and pharmacy, in early modern England there was no standard procedure for obtaining education in the practical aspects of the physician’s role, a very uncertain process of certification, and little regulation to ensure a suitable reward for their educational investment. For all the emphasis on academic learning and international travel, the majority of provincial physicians returned to practice in their home area, because establishing a practice owed more to networks of kinship, patronage and credit than to formal qualifications. Only when (and where) practitioners had to rely solely on their professional qualification to establish their status as young practitioners that the community could trust would proposals to reform medical education, such as those put forward to address a crisis of medicine in Restoration London, which are examined here, be converted into national regulation of medical education in the early nineteenth century, although these proposals prefigured many informal developments in medical training in the eighteenth century.
9
Rosner, Lisa M. "Book Review: Physicians, Surgeons, and Apothecaries: Medical Practice in Seventeenth-Century Edinburgh." Bulletin of the History of Medicine 71, no. 1 (1997): 152–53. http://dx.doi.org/10.1353/bhm.1997.0014.
Full text
10
DIACONU, Camelia, Giorgiana DEDIU, Mădălina ILIE, and Mihaela Adela IANCU. "Treatment with new oral anticoagulants in the family medicine practice." Romanian Journal of Medical Practice 10, no. 4 (December 31, 2015): 329–32. http://dx.doi.org/10.37897/rjmp.2015.4.4.
Full textAbstract:
Vitamin K antagonists represented for more than 50 years the only oral anticoagulant treatment option, though encumbered by numerous food and drug interactions, with direct impact on the safety and efficacy of this treatment. The frequent complications of anticoagulant treatment with vitamin K antagonists led to the need for the emergence of new oral anticoagulants (NOAC). The main NOACs used today are dabigatran, rivaroxaban and apixaban. NOAC have a number of advantages over antivitamin K anticoagulants: fewer drug interactions, no food interactions, rapid onset of the anticoagulant action, rapid clearance, no need for INR monitoring. NOAC therapy must be individualized according to patient age, comorbidities and medical history, renal function, concomitant medications. Given that clinical experience with NOAC is still limited in practice, physicians (including family physicians) must monitor these patients and need to pay attention and report any side effects.
11
Stolberg, Michael. "Empiricism in Sixteenth-Century Medical Practice." Early Science and Medicine 18, no. 6 (2013): 487–516. http://dx.doi.org/10.1163/15733823-0186p0001.
Full textAbstract:
Based on an analysis of some 4.000 pages of manuscript notes on ordinary medical practice which the little-known Bohemian physician Georg Handsch (1529–1578?) wrote from the late 1540s, this article traces the central place which empiricist attitudes and approaches held in mid-sixteenth-century learned medical practice. While explicit epistemological statements are rare, the very effort which Handsch put into recording thousands of observations he and other physicians around him had made, and the value they attributed to the experiences of ordinary lay persons and even “empirics” reflects a profound belief in the value of sensory experience and personal observation. The paper traces the uses of empiricist key terms like “experientia,” “historia” and “observatio,” it highlights the epistemic effects of personal observation, from confirming and challenging established notions to the creation of new general knowledge from particulars, and it suggests, in conclusion, that such brief notes on ordinary medical practice played an important role in the history of “facts.”
12
Oikonomou-Koutsiari, Anastasia, Georgios Zografos, Epameinondas Koutsiaris, Evangelos Menenakos, and Effie Poulakou-Rebelakou. "Milestones in the History of Pediatric Surgery During the Byzantine Times." Acta medico-historica Adriatica 18, no. 1 (2020): 115–28. http://dx.doi.org/10.31952/amha.18.1.7.
Full textAbstract:
During the Byzantine Times, medicine and surgery developed as Greek physicians continued to practice in Constantinople. Healing methods were common for both adults and children, and pediatrics as a medical specialty did not exist. Already Byzantine hospitals became institutions to dispense medical services, rather than shelters for the homeless, which included doctors and nurses for those who suffered from the disease. A major improvement in the status of hospitals as medical centers took place in this period, and physicians were called archiatroi. Several sources prove that archiatroi were still functioning in the late sixth century and long afterward, but now as xenon doctors. Patients were averse to surgery due to the incidence of complications. The hagiographical literature repeated allusions to doctors. Concerns about children with a surgical disease often led parents to seek miraculous healings achieved by Christian Protectors – Saints. This paper is focused on three eminent Byzantine physicians and surgeons, Oribasius, Aetius of Amida, Paul of Aegina, who dealt with pediatric operations and influenced the European Medicine for centuries to come. We studied historical and theological sources in order to present a comprehensive picture of the curative techniques used for pediatric surgical diseases during the Byzantine Times.
13
Jeremic, Marko, Ana Vukovic, Dejan Markovic, Rade Vukovic, and Ninoslav Stanojlovic. "History of Dentistry in Central Serbia." Balkan Journal of Dental Medicine 20, no. 3 (November 1, 2016): 138–42. http://dx.doi.org/10.1515/bjdm-2016-0022.
Full textAbstract:
Summary History of dentistry in the Central Serbian District of Jagodina has been influenced by traditional medicine for centuries. Development of dentistry in the region of Jagodina was slow, the level of oral and general hygiene was low and the sanitary prevention was absent. Trained physicians started to practice medicine and dentistry in the first half of the nineteenth century and they were educated in abroad universities. However, common people used to address to these physicians only when the traditional medicine were unable to help. Until the end of the World War II, common, mostly rural people, with the urgent dental treatment need were usually referred to the barbers, healers or empirics in the nearby villages rather than the dentists. Medications used for the urgent dental treatment were balsams and solutions made of herbs. After the World War II, the dental technicians who finished special courses started to practice dentistry. In 1947 the Regional Dental Office in Jagodina was opened and in 1955 the first Doctor of Dental Medicine who graduated from the School of Dental Medicine of University of Belgrade was employed. Nowadays, the Department of Dentistry represents is an important and independent part of the Health Care Centre in Jagodina.
14
Liebrenz, Boris. "The Social History of Surgery in Ottoman Syria." Turkish Historical Review 5, no. 1 (April 30, 2014): 32–58. http://dx.doi.org/10.1163/18775462-00501006.
Full textAbstract:
Little is known about the role of surgery in pre-modern medical practice in general, and in the lands under Muslim dominance in particular. There is an acknowledged gap between theoretical knowledge and medical practice, but evidence of the latter is difficult to find. Many fundamental questions therefore remain unanswered. For example, was there a division of labour between surgeons and physicians? We are also mostly ignorant about who practiced surgery, the legal context surrounding this practice, and its financial aspects. This article offers an analytical edition of two documents from the Syrian town Hamah dating from 1212/1798, which can help answer some of these questions. They concern a respected and learned physician who also personally performed the removal of bladder stones and was paid well for his services.
15
Appajigol, Jayaprakash S., and Manjunath Somappa Somannavar. "Assessment of Knowledge, Attitude and Practices of Medical Officers in Primary Health Centres Regarding Type 2 Diabetes Mellitus." Journal of Medicine 20, no. 2 (June 27, 2019): 63–67. http://dx.doi.org/10.3329/jom.v20i2.42004.
Full textAbstract:
Background: Health education is an integral part of Type 2 diabetes mellitus (T2DM) management, as it can be prevented and controlled by the implication of appropriate interventions. The aim of the study was to assess the knowledge, attitude, and practice (KAP) of medical officers (MOs) in primary health centres (PHC) regarding T2DM.
Materials and methods: The 104 medical officers (MOs) with an experience of £2 years of medical practice were included in the study. A self-completion questionnaire, designed to be completed within 10-15 minutes, was developed to analyse the KAP of the MOs regarding T2DM.
Results: Among the 104 MOs, 14 had knowledge about the prevalence of T2DM in India. Among the risk factors, obesity (71), physical inactivity (31), family history (43), and hypertension (15) were identified by the MOs. The microvascular complications, including retinopathy (77), nephropathy (63), and neuropathy (49) were stated by the physicians. However, the physicians were less aware about the macrovascular complications. As few as 23 physicians included HbA1c test as one of the diagnostic methods, 43 physicians included HbA1c to monitor the glycemic levels. More than half (55) of the physicians prescribed appropriate medications for the treatment of T2DM.
Conclusions: The MOs had considerable knowledge and attitude about T2DM, however due to lack of facilities at the PHCs, the practice of MOs in the management of T2DM is poor. Education programmes to expand the understanding of the MOs regarding T2DM and initiatives to advance the facilities at PHCs are essential to manage T2DM in India. Keywords: Type 2 Diabetes Mellitus
J MEDICINE JUL 2019; 20 (2) : 63-67
16
Barry, Jonathan. "The ‘Compleat Physician’ and Experimentation in Medicines: Everard Maynwaring (c.1629–1713) and the Restoration Debate on Medical Practice in London." Medical History 62, no. 2 (March 19, 2018): 155–76. http://dx.doi.org/10.1017/mdh.2018.2.
Full textAbstract:
Restoration London saw a wave of publications by physicians advocating that the ‘compleat physician’ should be one who experimented and produced his own medicines. Only thus, they argued, could the medical hierarchy be restored and medical authority re-established on a defensible basis. This article seeks to explain the context for this unusual approach, and why it failed to attract mainstream physicians by the end of the century, by considering the sixty-year career of one of its leading advocates, Everard Maynwaring (c.1629–1713), a prolific medical author, and what his own failure to enter the medical establishment may show about the problems inherent in this model for the physician. A university-trained gentleman physician who converted to chymical medicinec.1660, Maynwaring published learned and relatively unpolemical texts to persuade both medical and lay audiences of the superiority of experimental medicine as a mode of learned practice, yet could not easily reconcile this with the advocacy and sale of his own chymical medicines (especially as he focused increasingly on a small group of ‘universal medicines’) without being branded an ‘empirick’. Fragmentary evidence regarding his career suggests he became increasingly marginalised, and as an old man was reduced to advertising his cures like the ‘empiricks’ from whom he had sought to distance both himself and physicians in general.
17
Hwalla, N., and M. Koleilat. "Dietetic practice: the past, present and future." Eastern Mediterranean Health Journal 10, no. 6 (June 13, 2004): 716–30. http://dx.doi.org/10.26719/2004.10.6.716.
Full textAbstract:
The history of dietetics can be traced as far back as the writings of Homer, Plato and Hippocrates in ancient Greece. Although diet and nutrition continued to be judged important for health, dietetics did not progress much till the 19th century with the advances in chemistry. Early research focused focuses on vitamin deficiency diseases while later workers proposed daily requirements for protein, fat and carbohydrates. Dietetics as a profession was given a boost during the Second World War when its importance was recognized by the military. Today, professional dietetic associations can be found on every continent, and registered dietitians are involved in health promotion and treatment, and work alongside physicians. The growing need for dietetics professionals is driven by a growing public interest in nutrition and the potential of functional foods to prevent a variety of diet-related conditions
18
Maraqa, Beesan, Zaher Nazzal, Jurouh Jabareen, and Kamal Al-Shakhra. "Smoking cessation counseling: Attitude in the background of poor practice compliance among Palestinian primary health care physicians: a cross-sectional study." International Journal of Healthcare 7, no. 1 (November 27, 2020): 37. http://dx.doi.org/10.5430/ijh.v7n1p37.
Full textAbstract:
Objectives: Healthcare systems have primary responsibility for treating tobacco dependence. Despite its proven effectiveness, international studies have shown that smoking cessation advice to patients in primary health care is suboptimal. This study aimed at assessing Palestinian PHC physicians’ compliance and attitude towards smoking cessation counseling and their determinants.Methods: The study utilized a cross-sectional study design using a self-reported questionnaire targeted general practitioners, family medicine doctors, obstetrics & gynecologists, and dentists working at PHC Centers in Palestine from April to September 2019. A proportional stratified random sampling method was used. Socio-demographic, medical experience, if received any training in smoking cessation counseling, smoking history, practice compliance, knowledge, confidence, and attitude, were assessed.Results: Two-hundred ninety-four PHC physicians participated in the study with a high response rate. More than half (53%) were between 31-45 years of age. Most of them (76.5%) were general practitioners seeing more than 30 patients per day (66%), and only 15% (n = 40) get training about smoking cessation counseling. Practice compliance was low; only 39 (13.3%) reported adherence to smoking cessation practice. The participant physicians’ attitude level was good as the overall attitude score mean 75.1 ± 9.6. A positive attitude, assigned as any score ≥ 65, was observed in 87.7% (n = 258) of physicians. Job title, experience, and knowledge are predictors of a positive attitude towards smoking cessation counseling.Conclusions: Building a supportive environment, improving physicians’ capabilities will reflect on their self-efficacy and their confidence level and enhance their practice in smoking cessation counseling.
19
Tipton, Charles M. "The history of “Exercise Is Medicine” in ancient civilizations." Advances in Physiology Education 38, no. 2 (June 2014): 109–17. http://dx.doi.org/10.1152/advan.00136.2013.
Full textAbstract:
In 2007, the American College of Sports Medicine, with endorsement from the American Medical Association and the Office of the Surgeon General, launched a global initiative to mobilize physicians, healthcare professionals and providers, and educators to promote exercise in their practice or activities to prevent, reduce, manage, or treat diseases that impact health and the quality of life in humans. Emerging from this initiative, termed Exercise Is Medicine, has been an extensively documented position stand by the American College of Sports Medicine that recommended healthy adults perform 150 min of moderate dynamic exercise per week. The purpose of this article is to demonstrate the foundation for this global initiative and its exercise prescription for health and disease prevention has roots that began in antiquity more than two millennia ago. Individuals and concepts to remember are that Susruta of India was the first “recorded” physician to prescribe moderate daily exercise, Hippocrates of Greece was the first “recorded” physician to provide a written exercise prescription for a patient suffering from consumption, and the global influence of Galen from Rome combined with his recommendation on the use of exercise for patients in the management of disease prevailed until the 16th century. Historically intertwined with these concepts was exercise being advocated by select physicians to minimize the health problems associated with obesity, diabetes, and inactivity.
20
Kušeliauskaitė, Irma, and Aistis Žalnora. "The museum of the History of Medicine of Vilnius University." Papers on Anthropology 30, no. 1 (September 29, 2021): 53–61. http://dx.doi.org/10.12697/poa.2021.30.1.04.
Full textAbstract:
The museum of medicine of Vilnius university is one of the unique museums devoted to the issues of medicine in Lithuania. It was created out of the clinical practice by Vilnius university physicians. Early museum served as a curiosity cabinet as well as a teaching museum. After the closure of Vilnius university in the mid of 19th century the museum was destroyed by Tsar’s government. In the early 20th century museum was reestablished by the Polish government. The modern collections were added with craniological and osteological specimens as well as pathology exhibition. The contemporary museum was created in the last decade of 20th century. In the last period museum servers both academic and public interest. Museum includes interwar, soviet exhibits and collection of medical books.
21
Klaas, Philipp. "Cäsar Adolf Bloesch – ein Geburtshelfer? Einblicke in seine ärztliche Praxis zwischen 1832 und 1850." Gesnerus 69, no. 1 (November 11, 2012): 110–25. http://dx.doi.org/10.1163/22977953-06901007.
Full textAbstract:
This article contributes to the history of obstetrics as it was performed in the context of general practice during the 19th century. It focuses on the Swiss physician Cäsar Adolf Bloesch (1804–1863) from the town of Biel, Canton Bern. Drawing upon Bloesch’s extensive practice records, it raises the question whether this physician participated in the local market for obstetrical activities. Furthermore, the paper tries to make an estimate about the importance this field of action took for Bloesch’s practice. To achieve this, results of a smaller study about obstetrical cases within the practice records during the years 1832 to 1850 are being presented. I will argue that physicians like Bloesch were aware of the problems obstetrics brought with it, and as a consequence, he tried to limit it in favor of his general practice.
22
Choksi, Palak, Brittany L. Gay, David Reyes-Gastelum, Megan R. Haymart, and Maria Papaleontiou. "UNDERSTANDING OSTEOPOROSIS SCREENING PRACTICES IN MEN: A NATIONWIDE PHYSICIAN SURVEY." Endocrine Practice 26, no. 11 (November 2020): 1237–43. http://dx.doi.org/10.4158/ep-2020-0123.
Full textAbstract:
Objective: To understand osteoporosis screening practices, particularly in men, by a diverse cohort of physicians, including primary care physicians, endocrinologists, and geriatricians. Methods: We surveyed randomly selected members of the American Academy of Family Practice, Endocrine Society, and American Geriatrics Society. Respondents were asked to rate how often they would screen for osteoporosis in four different clinical scenarios by ordering a bone density scan. Multivariable logistic regression analyses were conducted to determine factors associated with offering osteoporosis screening in men in each clinical scenario. Physicians were also asked to note factors that would lead to osteoporosis screening in men. Results: Response rate was 63% (359/566). While 90% respondents reported that they would always or frequently screen for osteoporosis in a 65-year-old post-menopausal woman, only 22% reported they would screen a 74-year-old man with no significant past medical history. Endocrinologists were more likely to screen a 74-year-old man compared to primary care physicians (odds ratio, 2.32; 95% confidence interval, 1.10 to 4.88). In addition to chronic steroid use (94%), history of nontraumatic fractures (88%), and androgen-deprivation therapy for prostate cancer (82%), more than half the physicians reported suppressive doses of thyroid hormone (64%) and history of falls (52%) as factors leading to screening for osteoporosis in men. Conclusion: Our survey results highlight heterogeneity in osteoporosis screening in men, with underscreening in some scenarios compared to women, and identify factors that lead to screening in men. These findings can help design interventions to improve osteoporosis screening in men. Abbreviation: CI = confidence interval
23
Leroy, Victoire, Yaohua Chen, Naiara Demnitz, Florence Pasquier, Pierre Krolak-Salmon, Bertrand Fougère, and Françcois Puisieux. "Is Fall Risk Systematically Evaluated in Memory Clinics? A National Survey of Practice in France." Journal of Alzheimer's Disease 81, no. 4 (June 15, 2021): 1483–91. http://dx.doi.org/10.3233/jad-201585.
Full textAbstract:
Background: Falls are a major health problem in older persons but are still under-diagnosed and challenging to prevent. Current guidelines do not target high-risk populations, especially people living with dementia. In France, people with neurocognitive disorders are mainly referred to memory clinics (MCs). Objective: We aimed to survey the routine practice of physicians working in MCs regarding fall risk assessment. Methods: We conducted a cross-sectional survey in France from January to May 2019 among physicians working in MCs, through an anonymous online questionnaire: twenty-seven questions about the physician’s background and their practice of fall risk assessment, especially use of clinical and paraclinical tools. We compared the results according to the age and the specialty of the physician. Results: We obtained 171 responses with a majority of women (60%) and geriatricians (78%). All age classes and all French regions were represented. Most of respondents (98.8%) stated that they address gait and/or falls in outpatient clinic and 95.9%in day hospitals. When asked about how they assess fall risk, fall history (83%) and gait examination (68.4%) were the most widely used, while orthostatic hypotension (24%) and clinical standardized tests (25.7%) were less common. Among standardized tests, One-leg Balance, Timed Up and Go Test, and gait speed measurements were the most used. Geriatricians had more complete fall risk assessment than neurologists (e.g., 56%versus 13%for use of standardized tests, p < 0.0001). Conclusion: Almost all physicians addressed the question of fall in MC, but practices are widely heterogeneous. Further investigations are needed to standardize fall risk assessment in MCs.
24
Ali, Mohd Akhtar, Mohd Khalid, Hamiduddin, Zaigham, and Mohammad Aslam. "History of Ilmul Saidala (Unani Pharmacy) Through Ages: A Critical Appraisal and Current Scenario." Bangladesh Journal of Medical Science 21, no. 1 (January 1, 2022): 24–36. http://dx.doi.org/10.3329/bjms.v21i1.56324.
Full textAbstract:
Ilmul Saidala (Unani pharmacy) is an important pharmaceutical branch of Unani System of Medicine, also known as Greco-Arabic medicine. Its historical evolution is intricately related with that of human’s disease and sufferings. The earlier records about the Ilmul Saidala reveal that the Greco-Roman civilization is credited with its origin and development. Then, the Arabs preserved their medical legacy, and enriched it with their pharmaceutical experiments, innovations, and newer formulations. Most of the physicians rendered voluminous compendium known as “Al-Qarābādhīn” (pharmacopoeia) on the pharmacy including pharmaceutical as well as cosmeceutical preparations. After the fifth century, the development in Unani Pharmacy has been greatly contributed by Arab physicians and the world acclaimed piece of knowledge from this period is Avicenna’s ‘Canon of Medicine’. The medical influences of the Arabs helped in further development, regulation, and advancement of pharmaceutical sciences in the European soil and evolved it as a distinctive institution of respect and public welfare. The vastness of knowledge of Greco-Arabic period can be judged from the fact that the contemporary innovations and developments in the pharmaceutical industry is primarily owed to the original contributions of Greek, Egyptian, and Arab philosophers and physicians, such as Hippocrates, Pedanios Dioscorides, Galen of Pergamon, Avicenna, Rhazes, Geber etc. In India, Mughals, especially emperor Akbar was very instrumental in the propagation of Unani medicine and had appointed Unani physicians in different cities of his territory. Later on, Khandan Shareefi (Shareefi family) and Khandan Azizi (Azizi family) played important roles in the promotion of Unani Pharmacy. In post-independence India , Hạkīm ‘Abd al-Hạmeed established Unani pharmacies on the lines of the modern pharmaceutical industry for the mass production of Unani formulations in compliance with Good Manufacturing Practice (GMP) guidelines. At present, Unani System of Medicine and its pharmacies enjoys the patronage of Government in India and other South-East Asian countries, such as Pakistan and Bangladesh along with post graduate education in Unani pharmacy. The present work is a sincere attempt of authors to critically appraise the Unani Pharmaceutical potentials from the past, the current waves of developments and issues, and their possible ways forward. Bangladesh Journal of Medical Science Vol. Vol. 21(1) 2022 Page : 24-36
25
van ’t Land, Karine. "Long Life, Natural Death." Early Science and Medicine 19, no. 6 (December 2, 2014): 558–83. http://dx.doi.org/10.1163/15733823-00196p03.
Full textAbstract:
Within late medieval learned medicine, natural death functioned both as a theoretical concept and as a goal for practice. Late medieval commentaries on Avicenna’s Canon are used as source material in this study, in order to investigate the ways in which these learned medical authors envisaged natural death. The findings are compared to descriptions of natural death by natural philosophers, and to ideals of dying in broader medieval culture. According to the physicians, natural death was caused by the extinction of innate heat, due to a lack of innate moisture. They discussed natural death in relation to regimen, as the right regimen protected the body’s heat and moisture, and thus helped a patient to keep natural death aloof. So, in order to think about natural death, the physicians turned to the whole of life, during which heat dried out moisture and regimens ought to be followed. By contrast, natural philosophers tended to focus on the moment of death itself. The comparison of natural death with the Good Death in broad medieval culture highlights the amoral nature of the natural death.
26
Hadley, Elizabeth Harrison. "Nurses and Prescriptive Authority: A Legal and Economic Analysis." American Journal of Law & Medicine 15, no. 2-3 (1989): 245–99. http://dx.doi.org/10.1017/s0098858800009849.
Full textAbstract:
This article identifies twenty-six jurisdictions where nurses have been granted legal authority to prescribe drugs. The jurisdictions are divided into two groups: those where nurses have authority to prescribe without the supervision of a physician and can therefore function as substitutes for physicians; and those where nurses may prescribe only in collaboration with a supervising physician, and are thereby limited to functioning in a complementary role.The issue of prescriptive authority is discussed within the context of regulating the practice of nursing, and more generally, the health care professions. The article reviews the history of Nurse Practice Acts, focusing upon the Connecticut statute and the economic implications of this statutory approach. It is argued that the law should promote the use of nurses as substitutes for physicians whenever appropriate.The article concludes with a two-part proposal for reform: an “authorized prescriber” statute requiring health care professionals desiring to prescribe drugs to pass an examination testing their knowledge of pharmacology and drug therapy; and the elimination of the “unauthorized practice” provisions of the statutes regulating all health care professions. The proposal promotes economic efficiency by eliminating artificial constraints on the substitutability of labor in the provision of health services.
27
Girard, Donald E., Patrick Brunett, Andrea Cedfeldt, Elizabeth A. Bower, Christine Flores, Uma Rajhbeharrysingh, and Dongseok Choi. "Plug the Leak: Align Public Spending With Public Need." Journal of Graduate Medical Education 4, no. 3 (September 1, 2012): 293–95. http://dx.doi.org/10.4300/jgme-d-11-00199.1.
Full textAbstract:
Abstract We explore the history behind the current structure of graduate medical education funding and the problems with continuing along the current funding path. We then offer suggestions for change that could potentially manage this health care spill. Some of these changes include attracting more students into primary care, aligning federal graduate medical education spending with future workforce needs, and training physicians with skills they will require to practice in systems of the future.
28
Mola, Ernesto, and Cristina Melgiovanni. "Cross sectional study on arterial hypertension in a general practice setting." Italian Journal of Medicine 10, no. 2 (June 23, 2016): 128. http://dx.doi.org/10.4081/itjm.2016.581.
Full textAbstract:
An observational study on arterial hypertension (AH) in the setting of general practice takes advantages of reaching easily the involved population and of getting information from data recorded in the physicians’ databases. Their results could be different from data obtained in specialist settings. The aim of the study is to obtain some prevalence indexes regarding AH and verify if they are consistent with literature. Researchers administered a questionnaire and measured the blood pressure to 478 individuals, randomly selected from the patients’ lists of 17 general practitioners (GPs). Patients with high value of AH but not acknowledged as hypertensive patients (HP) were invited to come back for two new measurements. Some obtained indexes are not consistent with literature, particularly: i) 97.34% of the acknowledged hypertensive patients receive a drug treatment; ii) the percentage of HPs not identified by GP is very low (5.05%); iii) the prevalence of acknowledged HPs at target is higher compared to literature (64.89%). The study shows that the knowledge of clinical history of patients recorded by GPs enhances the rigor of the scientific methodology.
29
Brokman, Aleksandra. "Sterility and suggestion: Minor psychotherapy in the Soviet Union, 1956–1985." History of the Human Sciences 31, no. 4 (October 2018): 83–106. http://dx.doi.org/10.1177/0952695118773962.
Full textAbstract:
This article explores the concept of minor or general psychotherapy championed by physicians seeking to popularise psychotherapy in the post-Stalin Soviet Union. Understood as a set of skills and principles meant to guide behaviour towards and around patients, this form of psychotherapy was portrayed as indispensable for physicians of all specialities as well as for all personnel of medical institutions. This article shows how, as a result of Soviet teaching on the power of suggestion to influence human organisms, every interaction with patients was conceptualised as a form of psychotherapy, leading to the embrace of placebo as a legitimate form of therapy, and to the blurring of the boundary between therapy and other activities in the clinic. The principles of minor psychotherapy reveal a concept of psychotherapy that is much wider, and rooted in different priorities, than the dominant understanding of this type of treatment found in Western Europe and North America. This article addresses the ethical principles implicit in the Soviet perspective, demonstrating that despite fighting against the uncaring and dismissive attitude of other physicians, Soviet psychotherapists remained rooted in the paternalistic tradition. Finally, it traces the efforts to establish minor psychotherapy as standard practice in medical institutions, which, like many other plans and ambitions of Soviet psychotherapists, were constrained by a lack of resources in the healthcare system.
30
Quaranta, Alessandra. "The Consilia by Learned Physicians Pietro Andrea Mattioli and Francesco Partini: Dialectic Relations between Doctrine, Empirical Knowledge and Use of the Senses in Sixteenth-century Europe." Social History of Medicine 35, no. 1 (November 29, 2021): 20–48. http://dx.doi.org/10.1093/shm/hkab118.
Full textAbstract:
Summary The present article focuses on the medical practice of Pietro Andrea Mattioli from Siena and Francesco Partini from Rovereto (Trent), learned physicians who worked for the Habsburg courts in the second half of the sixteenth century. They paid particular attention to the body signs of disease and described them in detail through the senses of sight, touch, smell and taste. Such a method allowed them to formulate a plausible diagnosis, which concerned not only a general humoral imbalance but also often a specific organ. Furthermore, the empirical data they observed were interpreted in the light of Galenic medicine, a fluid and adaptable system, capable of including relatively new elements. Partini and Mattioli’s medical consultations reveal peculiar aspects of body examination and offer the opportunity both to seize the inventiveness of Galenic medicine and to explore the complex relationship between learned physicians and the written medical tradition.
31
Meinke, William B. "A Portrait of Arts Medicine as a Young Discipline." Medical Problems of Performing Artists 19, no. 2 (June 1, 2004): 51–53. http://dx.doi.org/10.21091/mppa.2004.2008.
Full textAbstract:
In late 1992 and knowing of my interest in the arts, a colleague gave me a copy of the November 30 issue of Physicians Financial News, in which he had circled the title of an article by Sidney Stevens called “Spotting Trends, Savvy Doctors Carve Out Practice Niches.” The gist of the article was that so-called niche specialties, such as arts or travel medicine, should be considered useful marketing tools rather than true specialties or subspecialties....Although I am certain that I chuckled on reading this at the time, my attention was drawn more to Mr. Stevens’ mention of the (incorrectly named) “Physicians Arts Medicine Association headed by Dr. Richard Lederman at the Cleveland Clinic.” I wrote a short letter to Dr. Lederman asking for more information about the group, and within a matter of weeks I was a bona fide member of the Performing Arts Medicine Association (PAMA).
32
Armstrong, David, Farouk Kazim, Marcel Gervais, and Myron Pyzyk. "Early Relief of Upper Gastrointestinal Dyspeptic Symptoms: A Survey of Empirical Therapy with Pantoprazole in Canadian Clinical Practice." Canadian Journal of Gastroenterology 16, no. 7 (2002): 439–50. http://dx.doi.org/10.1155/2002/567684.
Full textAbstract:
BACKGROUND: Upper gastrointestinal symptoms attributable to gastroesophageal reflux disease or peptic ulcer are common, but the outcome of proton pump inhibitor therapy in clinical practice is not well documented.AIM: To assess the range of upper gastrointestinal acid-related symptoms in clinical practice and the rapidity of their response to pantoprazole (40 mg daily), after seven days of therapy.METHODS: A total of 726 Canadian physicians (65.3% family physicians) recorded a working diagnosis and alarm features in eligible patients, who then recorded the severity of eight upper gastrointestinal symptoms in a daily symptom diary during the first week of therapy.RESULTS: Complete data were obtained from 2273 (37.3% male) of 3261 patients; physicians diagnosed reflux esophagitis alone (66.9%), peptic ulcer (9.7%), other upper gastrointestinal disorders (12.3%) and reflux esophagitis with another diagnosis (11.1%). Alarm features were common (29.6%), but a history of gastrointestinal blood loss was rare (less than 1%). Mean daytime heartburn scores decreased from 2.59 to 1.40, and epigastric pain scores decreased from 2.54 to 1.56 over the first week (P<0.00001); the proportions of patients who became symptom-free were 68.1% and 55.4%, respectively. Decreased mean symptom scores were also observed for acid regurgitation (2.21 to 1.35), bloating (2.47 to 1.57), nausea (2.03 to 1.36), slow digestion (2.51 to 1.56) and burping (2.56 to 1.69). The percentage of patients with severe or very severe symptoms decreased from 53.5% to 13.8% at day 7. The physician’s initial diagnosis was not predictive of outcome.CONCLUSIONS: In a predominantly primary care population with upper gastrointestinal acid-related symptoms, proton pump inhibitor therapy produces prompt symptomatic relief in most patients. Potential alarm symptoms are common, and further research is required to determine the absolute risk of alarm symptoms and their implications for empirical therapy.
33
Nisselle, Amy, Emily A. King, Belinda McClaren, Monika Janinski, Sylvia Metcalfe, and Clara Gaff. "Measuring physician practice, preparedness and preferences for genomic medicine: a national survey." BMJ Open 11, no. 7 (July 2021): e044408. http://dx.doi.org/10.1136/bmjopen-2020-044408.
Full textAbstract:
ObjectiveEven as genomic medicine is implemented globally, there remains a lack of rigorous, national assessments of physicians’ current genomic practice and continuing genomics education needs. The aim of this study was to address this gap.DesignA cross-sectional survey, informed by qualitative data and behaviour change theory, to assess the current landscape of Australian physicians’ genomic medicine practice, perceptions of proximity and individual preparedness, and preferred models of practice and continuing education. The survey was advertised nationally through 10 medical colleges, 24 societies, 62 hospitals, social media, professional networks and snowballing.Results409 medical specialists across Australia responded, representing 30 specialties (majority paediatricians, 20%), from mainly public hospitals (70%) in metropolitan areas (75%). Half (53%) had contacted their local genetics services and half (54%) had ordered or referred for a gene panel or exome/genome sequencing test in the last year. Two-thirds (67%) think genomics will soon impact their practice, with a significant preference for models that involved genetics services (p<0.0001). Currently, respondents mainly perform tasks associated with pretest family history taking and counselling, but more respondents expect to perform tasks at all stages of testing in the future, including tasks related to the test itself, and reporting results. While one-third (34%) recently completed education in genomics, only a quarter (25%) felt prepared to practise. Specialists would like (more) education, particularly on genomic technologies and clinical utility, and prefer this to be through varied educational strategies.ConclusionsThis survey provides data from a breadth of physician specialties that can inform models of genetic service delivery and genomics education. The findings support education providers designing and delivering education that best meet learner needs to build a competent, genomic-literate workforce. Further analyses are underway to characterise early adopters of genomic medicine to inform strategies to increase engagement.
34
Jacob, Carl GA, and Daniel Lagacé-Roy. "Unsung Heroes: Gay Physicians’ Lived Journeys During the HIV/AIDS Pandemic." SAGE Open 9, no. 1 (January 2019): 215824401982771. http://dx.doi.org/10.1177/2158244019827717.
Full textAbstract:
The HIV/AIDS pandemic was a major crisis at the end of the 20th and beginning of the 21st century. Such a defining moment in the history of health-related infections led to transformations in its proponents, as well as their medical practice. This research article, using a study consisting of semi-structured interviews with six Canadian gay physicians from different Canadian HIV/AIDS treatment centers, aims to offer insights into their lived journeys, from 1981 to 2009, while they attempted to treat, care for, and cure/heal their gay HIV/AIDS patients. The results of the study, deduced from a qualitative and interpretative data analysis, suggest that through reflection on their experiences during the HIV/AIDS pandemic, they transformed their personal and professional identities, and rethought their relationship with their patients, as well as their professional, pharmaceutical, and community networks. These results are testimonies from Canadian gay physicians who fought against the HIV/AIDS pandemic and who advocated for their gay HIV/AIDS patients. In fact, these results are evidence of an untold and valuable period in medical history. For some, it will serve as a reminder. For others, it will be foreign. It was a time marked by a major crisis that mobilized gay militant physicians who were personally and professionally affected, and who were forever transformed by their response to the HIV/AIDS pandemic. This is their hereto untold lived journeys.
35
Alpina, Tommaso. "EXERCISING IMPARTIALITY TO FAVOR ARISTOTLE: AVICENNA AND “THE ACCOMPLISHED ANATOMISTS” (AṢḤĀB AL-TAŠRĪḤ AL-MUḤAṢṢILŪNA)." Arabic Sciences and Philosophy 32, no. 2 (August 17, 2022): 137–78. http://dx.doi.org/10.1017/s0957423922000017.
Full textAbstract:
AbstractThis article analyses Avicenna's Ḥayawān III, 1, which deals with the well-known disagreement between physicians and philosophers on the origination of blood vessels (arteries and veins) and nerves. However, the proposed analysis is not limited to this chapter and its main topic. The more general purpose of this article is to reconstruct the psycho-medical context in which Avicenna's exposition lies, that is, the soul's oneness and the consequent conditions for body ensoulment (i. e. the soul's need for a primary, unitary attachment to the body through the heart and the cardiac pneuma). The article then outlines the strategy through which Avicenna presents medical positions (heart, brain, and liver are all on an equal footing) that challenge his (and Aristotle's) anatomical model, which is coherent with his theory of the soul. In this connection, firstly, the article shows how Avicenna takes physicians’ arguments apart in a philosophical context (he usually points at their logical shortcomings). Then, it clarifies the contribution of anatomy to determine the conditions of body ensoulment and, ultimately, how to reconcile medical practice with philosophical truths, if need be.
36
Chazova, Irina E., Tamila V. Martynyuk, Sergey V. Gorbachevskii, Vladimir V. Gramovich, Nikolay M. Danilov, Elizaveta P. Panchenko, Aleksandr M. Chernyavskiy, Anton A. Shmalts, and Igor S. Yavelov. ""Guiding lights" for the diagnosis of chronic thromboembolic pulmonary hypertension in the flow of patients with pulmonary embolism." Terapevticheskii arkhiv 94, no. 9 (October 24, 2022): 1052–56. http://dx.doi.org/10.26442/00403660.2022.09.201836.
Full textAbstract:
On December 13, 2021, an expert council was held to determine the position of experts of different specialties regarding the reasons for the low level of diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) in real clinical practice in a pandemic of a new coronavirus infection and possible ways to improve detection in patients with pulmonary embolism (PE) ) in history. The reasons for the low level of diagnosis of CTEPH are the insufficient level of knowledge of specialists, especially primary care physicians; lack of clear regulatory documents and expert centers for the management of this category of patients. Primary diagnosis of CTEPH in a pandemic can be strengthened through the widespread use of telemedicine for consultations of primary care physicians with specialists from expert centers; to maximize the role of echocardiography and computed tomography (CT) as differential diagnostic tools for dyspnea, in particular in patients with COVID-19. To increase the detection rate of CTEPH, diagnostic vigilance is required in patients with risk factors and episodes of venous thromboembolism. To improve the screening of CTEPH, it is necessary to create an algorithm for monitoring patients who have had PE; provide educational activities, including through the media; create materials for patients with accessible information. The regulatory documents should designate the circle of responsible specialists who will be engaged in long-term monitoring of patients with PE. Educational programs are needed for primary care physicians, cardiologists, and other physicians who come into the field of view of patients with CTEPH; introduction of a program to create expert centers for monitoring and managing patients with the possibility of performing ventilation-perfusion lung scintigraphy, cardiopulmonary stress test, CT, right heart catheterization. It seems important to build cooperation with the Ministry of Health of Russia in order to create special protocols, procedures for managing patients with PE and CTEPH.
37
Bela, Zbigniew. "Who Invented 'Avicenna's Gilded Pills'?" Early Science and Medicine 11, no. 1 (2006): 1–10. http://dx.doi.org/10.1163/157338206775569763.
Full textAbstract:
AbstractThis article questions the belief expressed in various histories of pharmacy that the tenth-century Arab physician Avicenna introduced the tradition of coating pills with gold and silver. Although an examination of his Canon documents Avicenna's interest in the medicinal application of gold and silver, no mention is made of coating pills. Nor do other Islamic physicians seem to have been familiar with this practice, any more than such medieval European authors as Arnaldus of Villanova, Raymund Lull or Johannes de Rupescissa. The same is true of medicinal compendia representative of later periods, such as the Ortus sanitatis, Valerius Cordus' Dispensatorium or the Secrets of Alessio Piemontese. The earliest known mention of coating pills with precious metals occurs in a non-medical book, The Golden Fleece (London, 1626), and the earliest mention in the professional literature seems to appear only in the second half of the seventeenth century. The practice of coating pills with gold and silver was to be practiced in Europe into the first half of the twentieth century.
38
Taghavi-Shirazi, Maryam, Roshanak Ghods, Fataneh Hashem-Dabaghian, and Arman Zargaran. "Abu-Sahl al-Masihi (died circa 1010 AD): The Persian physician in the early medieval era." Journal of Medical Biography 28, no. 3 (January 26, 2018): 132–35. http://dx.doi.org/10.1177/0967772017720372.
Full textAbstract:
In the early medieval era, in the time which is called the Islamic Golden Age, medicine flourished through the practice of Persian physicians (9th to 12th century AD). Abu-Sahl al-Masihi (died circa 1010 AD) was one of the physicians in that period who had great influence on the progress of medicine by his own writings as well as his influence on great scholars like Biruni and Avicenna as their teacher. He was a polymath and had many writings in various fields of science, in particular medical sciences. Some of his manuscripts in medicine were Al-Mia fil-Tibb (Book of the Hundred), Kitab al-Teb al-Koli (The General Medicine), Ezhar al-Hekmat Allah Ta’ala fi Khalgh al-Ensan (God’s Mystery on the Creation of Man), Resalat al-Adwiya (Treatise of Drugs), Osool Elm Nabz (the Principles of Pulse), and Resala f ī Taḥqiq Amral-Wabaʾ (On the determination of the matter of infectious diseases). As a sign of his impact in Persian medicine, many later physicians (until 19th century) referred to and cited his works in their manuscripts several times.
39
Belkic, Karen, and Olesja Nedic. "Occupational medicine - then and now: Where we could go from here." Medical review 67, no. 5-6 (2014): 139–48. http://dx.doi.org/10.2298/mpns1406139b.
Full textAbstract:
Occupational medicine has a long-standing history in the region of the former Yugoslavia with seminal contributions to the theory and practice of this discipline. This tradition should be expanded to incorporate psychosocial stressors. We review the sociological work stress models and empirical evidence gleaned thereby, and then the occupational stressor index, an additive burden model developed from a cognitive ergonomics perspective. In numerous studies, the occupational stressor index is significantly associated with risk behaviors: smoking, obesity and sedentariness and clinical outcomes: hypertension, ischemic heart disease, dyslipidemia and type 2 diabetes. The occupational stressor index characterizes the work conditions of physicians including surgeons and anesthesiologists; professional drivers and other groups at elevated risk for stress-related disorders. Much of these empirical data are from this region. Work-stress related health disorders are a major public health problem, with enormous human and economic costs. A more proactive role for physicians is needed vis-?-vis our working environment and that of patients. We physicians face a heavy job stressor burden strongly implicated with adverse health outcomes. The challenge is to identify effective strategies to lower the risk of work-stressor related illness. The critical gap is the lack of evidence-based guidelines. Intervention studies are needed in which job stressors are ameliorated as a therapeutic/preventive modality; the logical starting point is within our own profession. We also suggest how the relevant clinical competence could be enhanced. Alongside clinical enhancement should be the full restoration of physician empowerment to implement work-related recommendations. A participatory action research perspective by physicians for physicians and for our patients is needed.
40
Lord, Bill, Emily Andrew, Amanda Henderson, David J. Anderson, Karen Smith, and Stephen Bernard. "Palliative care in paramedic practice: A retrospective cohort study." Palliative Medicine 33, no. 4 (February 5, 2019): 445–51. http://dx.doi.org/10.1177/0269216319828278.
Full textAbstract:
Background: Paramedics may be involved in the care of patients experiencing a health crisis associated with palliative care. However, little is known about the paramedic’s role in the care of these patients. Aim: To describe the incidence and nature of cases attended by paramedics and the care provided where the reason for attendance was associated with a history of palliative care. Design: This is a retrospective cohort study. Setting/participants: Adult patients (aged >17 years) attended by paramedics in the Australian state of Victoria between 1 July 2015 and 30 June 2016 where terms associated with palliative care or end of life were recorded in the patient care record. Secondary transfers including inter-hospital transport cases were excluded. Results: A total of 4348 cases met inclusion criteria. Median age was 74 years (interquartile range 64–83). The most common paramedic assessments were ‘respiratory’ (20.1%), ‘pain’ (15.8%) and ‘deceased’ (7.9%); 74.4% ( n = 3237) were transported, with the most common destination being a hospital (99.5%, n = 3221). Of those with pain as the primary impression, 359 (53.9%) received an analgesic, morphine, fentanyl or methoxyflurane, and 356 (99.2%) were transported following analgesic administration. Resuscitation was attempted in 98 (29.1%) of the 337 cases coded as cardiac arrest. Among non-transported cases, there were 105 (9.6%) cases where paramedics re-attended the patient within 24 h of the previous attendance. Conclusion: Paramedics have a significant role in caring for patients receiving palliative care. These results should inform the design of integrated systems of care that involve ambulance services in the planning and delivery of community-based palliative care.
41
Avdeev, Sergey N., Alexander V. Emelyanov, Zaurbek R. Aisanov, Alexander I. Sinopalnikov, Daria S. Fomina, Natalia M. Nenasheva, Igor V. Leshchenko, et al. "Problems and opportunities to improve diagnosis of asthma and chronic obstructive pulmonary disease in Russia: resolution of advisory board." Terapevticheskii arkhiv 94, no. 4 (May 26, 2022): 524–29. http://dx.doi.org/10.26442/00403660.2022.04.201487.
Full textAbstract:
Asthma and chronic obstructive pulmonary disease remain major problems of medicine, and still there is need to improve the level and quality of diagnosis of these diseases. Primary care physicians (general practitioners, therapists) should be involved widely and actively in this process. To simplify the diagnosis, special questionnaires have been developed, they can be used in a real clinical practice. Only this approach will bring statistical data closer to the true prevalence of these diseases and improve quality of their treatment.
42
Sebo, Paul, Dagmar M. Haller, Bernard Favrat, Philippe Huber, Yolanda Mueller, and Paul Vaucher. "Adherence to guidelines when evaluating fitness-to-drive in the elderly: a practice review of Swiss physicians." Swiss Medical Weekly 148, no. 2728 (July 12, 2018): w14632. http://dx.doi.org/10.57187/smw.2018.14632.
Full textAbstract:
OBJECTIVE We aimed to explore the extent to which general practitioners (GPs) in Western Switzerland adhere to Swiss recommendations when assessing fitness-to-drive in the elderly. METHODS A random sample of 500 GPs practicing in Vaud, Neuchatel and Jura, and all GPs certified to conduct fitness-to-drive assessments in Geneva (“experts”, n = 69) were invited to participate. They were asked how often they performed twenty procedures (recommended in Swiss guidelines developed by experts in traffic medicine) when assessing older drivers during the previous year, scored on a five-point Likert scale ranging from “never” to “always performed”. The GPs were considered to be adhering to the recommended procedure if they performed it often or always. We computed the proportion of GPs adhering to each procedure, and compared GPs with or without specialised expertise. RESULTS A total of 268 GPs completed the questionnaire (participation rate 47%). The most frequently reported procedures were asking for current medication (96%), cardiovascular (94%) and neurological diseases (91%), and screening for visual acuity impairment (93%), whereas the least frequently reported procedures were screening for cognitive impairment in drivers aged between 70 and 80 years (44%) and for mood disorder (31%), asking for a history of driving license withdrawal (38%), and interviewing close relatives (10%). Six procedures were statistically significantly more frequently performed by the experts than by the other GPs. In general, GPs reported using validated tools, except when screening for at-risk drinking and mood disorder (tools used by 26 and 28%, respectively). CONCLUSIONS Many Swiss GPs seem not to systematically follow the current Swiss recommendations. Although several important procedures appear to routinely be part of older drivers’ assessment, others are infrequently performed. Further research should identify how GPs select the recommended items to which they adhere and those they never apply, and how to facilitate the use of recommended procedures to help them decide if a person is fit, unfit or requiring further evaluation.
43
Konradi, Alexandra O., Nadezhda E. Zvartau, Irina E. Chazova, Juliya V. Zhernakova, Aletta E. Schutte, and Markus P. Schlaich. "Features of antihypertensive therapy and real-world prescription of selective imidazoline receptor agonists in Russia vs other countries: STRAIGHT study data analysis." Terapevticheskii arkhiv 93, no. 4 (April 15, 2021): 440–48. http://dx.doi.org/10.26442/00403660.2021.04.200818.
Full textAbstract:
Analysis of routine clinical practice of hypertensive patient management represents one of the important tools in the search for further ways to minimize hypertension-associated cardiovascular and renal adverse outcomes.
Aim. To compare the strategies for hypertension management and features of clinical use of I1-imidazoline receptor (I1-IR) agonists in the Russian Federation and other countries where the STRAIGHT (Selective imidazoline receptor agonists Treatment Recommendation and Action In Global management of HyperTension) study was conducted.
Materials and methods. It was a cross-sectional online study involving physicians of various specializations. The study was conducted from January 18 to July 1, 2019, in seven countries with a high rate of I1-IR agonist prescription, including Russia.
Results. A total of 125 (4.5%) responders filled out the survey in the Russian Federation, which was somewhat lower than in other countries (6.8%). The participants were mostly general practitioners (54.0%) and cardiologists (42.0%), while in other countries greater diversity was seen. Most Russian physicians (83.0%) seemed to rely on national clinical guidelines in their routine practice, while in other countries the US guidelines were more popular (66.0%). The majority of responders stated that they took into account the traditional risk factors of hypertension when initiating the therapy; every second responder noted if sleep apnea was present. Awareness of I1-IR agonists, their prescription rate and their preference were higher in Russia. The main reported benefits of I1-IR agonists were their efficacy, including in resistant hypertension, and their metabolic effects (in Russia). Most participants preferred I1-IR agonists as third-line therapy (65.0% in Russia vs 60.0% in other countries) and in combination with an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin II receptor blockers (ARB) (55.0% in Russia vs 54.0% in other countries). Compared to responders from other countries, Russian physicians prescribe I1-IR agonists as first-line (15.0% vs 5.0%) and second-line (48.0% vs 21.0%) therapy more often.
Conclusion. Russian physicians were the most aware of I1-IR agonists and tended to prescribe drugs of this class for hypertension management more often, and I1-IR agonist combination with ACEi was preferable compared to physician responders from other countries. Antihypertensive efficacy and metabolic effects were reported as the major benefits of I1-IR agonist therapy.
44
Martin, J., C. R. Wilson, and T. Chaplin. "P087: Cellulitis and erysipelas management at an academic emergency department: current practice vs the literature." CJEM 19, S1 (May 2017): S107—S108. http://dx.doi.org/10.1017/cem.2017.289.
Full textAbstract:
Introduction: Cellulitis and erysipelas are common presentations for the general practitioner. Antibiotic therapy targeting beta-hemolytic streptococci and Staphylococcus aureus is the mainstay of treatment for children and adults with these infections. Although evidence-based Canadian guidelines for appropriate management exist, inconsistent practices persist. Our objective was to determine the level of adherence to current evidence by emergency physicians at two academic hospitals in Kingston, Ontario. Methods: We conducted a retrospective chart review of 200 randomly selected electronic medical records. Records belonged to patients with a discharge diagnosis of cellulitis or erysipelas who were seen in the emergency departments of Kingston General Hospital or Hotel Dieu Hospital between January 1 and June 30, 2015. We manually collected data describing patient demographics, medical history, and medical management. Results: There were 707 total visits to the emergency departments in the study period for cellulitis or erysipelas. In our random sample, for those diagnosed with cellulitis, 44% received oral cephalexin alone, which was the most common form of therapy for uncomplicated infection. Of all the patients who received any antibiotics, 36% received at least one dose of parenteral antibiotics, despite only 6.7% showing systemic signs of illness. Emergency physicians chose ceftriaxone for 88% of the patients who received parenteral antibiotics. Conclusion: There was wide variation in antibiotic selection and route of administration for patients with cellulitis or erysipelas. Ceftriaxone was chosen for most patients receiving parenteral antibiotics, but it may not have been the most effective antibiotic in some cases. Overuse of antibiotics is common, and we believe medication choice should be justified based on disease severity, spectrum of activity, and regional antibiotic resistance patterns, among other factors. In conclusion, we found that emergency physicians could more closely align management plans with current guidelines to improve management of uncomplicated infection and reduce unnecessary administration of parenteral antibiotics.
45
Shishkina, E. V., T. N. Bazilevskaya, R. F. Izokhvatova, Yu V. Panfilova, I. V. Novikova, M. Yu Galaktionova, and D. A. Maiseenko. "Tolosa-Hunt syndrome in pediatric practice." Russian Journal of Woman and Child Health 3, no. 4 (2020): 336–39. http://dx.doi.org/10.32364/2618-8430-2020-3-4-336-339.
Full textAbstract:
Tolosa-Hunt syndrome (THS) is a rare disease manifested with one or more cranial nerve disorders and orbital pain. In children, THS is diagnosed very rarely due to the lack of vigilance among physicians. Careful examination including MRI or helical CT help diagnose this disease. This paper discusses case history of THS in a child in the first ten years of life who has previously experienced similar episodes of ptosis and right-sided orbital pain; however, the cause of these symptoms has remained elusive. Disease anamnesis, clinical signs, neurological status, and additional diagnostic data are described in detail. Clinical course of THS with its relapses and remissions, rapid symptom regress after corticosteroid pulse therapy, and no specific granulomatous inflammation of the lateral wall of the cavernous sinus as demonstrated by MRI suggest idiopathic THS. The importance of in-depth neurological and general examination of patients with clinical signs of THS due to a variety of the causes of this syndrome is highlighted. KEYWORDS: pediatrics, Tolosa-Hunt syndrome, ophthalmoplegia, superior orbital fissure, cavernous sinus, corticosteroids. FOR CITATION: Shishkina E.V., Bazilevskaya T.N., Izokhvatova R.F. et al. Tolosa-Hunt syndrome in pediatric practice. Russian Journal of Woman and Child Health. 2020;3(4):336–339. DOI: 10.32364/2618-8430-2020-3-4-336-339.
46
Duster, Troy. "Lessons from History: Why Race and Ethnicity Have Played a Major Role in Biomedical Research." Journal of Law, Medicine & Ethics 34, no. 3 (2006): 487–96. http://dx.doi.org/10.1111/j.1748-720x.2006.00060.x.
Full textAbstract:
Perhaps it has always been so, but certainly in the post-Enlightenment era there are inevitable linkages between the fields of law, medicine, and science. Each of these realms of activity is embedded in the social milieu of the era, with practitioners emerging from families, communities, regions, and nations bearing deep unexamined assumptions about what is natural and normal. Equally important, these fields’ theoretical accounts of natural behavior will tend to dovetail and fit each other's – most especially as they pertain to the grand social issues of the period.For the last century and a half, a conversation with a cross-section of lawyers, scientists, and physicians at any given historical juncture would produce a remarkable pattern, consistently repeated: There would be strong enthusiasm for the idea that the “current state of knowledge and practice” is both objective and transcends the current social milieu.
47
Armstrong, Patricia, and Jim Grant. "How Research Helped Us To Move From Awareness to Action and Then to Systems Development." Australian Journal of Environmental Education 20, no. 1 (2004): 13–24. http://dx.doi.org/10.1017/s0814062600002263.
Full textAbstract:
AbstractHow can an organisation move from awareness raising, in the form of natural history poster production, to the development of systems that change organisations? Through close integration of research and practice, the Gould League has achieved this transformation. It began with extensive research into best practice environmental education, going beyond the traditional boundaries of environmental education to areas that included the psychology of culture change, business management, systems thinking, governance, drug education, marketing and organisational psychology. This broad approach to research has led to the development of highly effective sustainability education programs, such as Waste Wise Schools and Sustainable Schools.The Waste Wise Schools Program, funded by EcoRecycle Victoria and managed in consultation with the Gould League, is an action-based waste education program. Originating in Victoria in 1998, it has been adopted by over a third of Victorian schools and has led to widespread outcomes, including waste reductions of up to 95%. There is strong evidence from surveys that this program is sustainable in schools over time and research confirms that the program is contributing to changes in the waste-wise thinking and behaviour of the families of the children at these schools.A model for culture change in schools, based on the experiences of the Waste Wise Schools Program, has also been developed. This model, a valuable tool in the continual improvement of Waste Wise Schools, has applications to sustainability education in general.
48
Ahn, Ducksun. "Improving the Korean Medical Association’s organizational strength and partnership for physicians." Journal of the Korean Medical Association 63, no. 6 (June 10, 2020): 304–6. http://dx.doi.org/10.5124/jkma.2020.63.6.304.
Full textAbstract:
The Korean Medical Association (KMA) was established by legal mandate. It is a statutory body for the medical profession. However, the collective dimension of professionalism is a foreign concept for Korean doctors; the KMA is perceived as a fraternity of physicians. Korea’s history of medical professionalization is different from that of Western countries where two different kinds of professional organization have developed: one for the public as a regulator and the other for doctors as a union or trade association. The KMA represents doctors nationally assembled by type of practice, geographic location, and function. Consequently, the KMA became a trade association. However, it is not easy for the KMA to serve two conflicting functions of self-regulation and trading body under one umbrella. It is time for the KMA to build up the organizational strength for the sake of doctors as well as the public. Having a sound trade association is a part of medical professionalism; it can advocate the critical value of medicine against undue influences from employers or governments in the era of industrialization and commercialization of medicine. To achieve this goal, the KMA should revamp its troublesome communication structure regarding its governance. Improving integration among key acting bodies within the KMA can streamline management by better communication. Preventing political feudalism to build consensus within the KMA requires new competencies for the leaders as well as the members of the KMA.
49
Rock, Jack P., Stephen Haines, Lawrence Recht, Mark Bernstein, Raymond Sawaya, Tom Mikkelsen, and Jay Loeffler. "Practice parameters for the management of single brain metastasis." Neurosurgical Focus 9, no. 6 (December 2000): 1–9. http://dx.doi.org/10.3171/foc.2000.9.6.12.
Full textAbstract:
Object In January 1998 the Guidelines and Outcomes Committee of the American Association of Neurological Surgeons (AANS) issued a charge for the development of evidence-based practice parameters focusing on the treatment of patients with single metastasis to the brain. The charge was imposed in response to the significant controversy surrounding questions relating to the optimal management strategies for patients with single brain metastasis. Methods A team consisting of physicians from the AANS, the American Academy of Neurology, and the American Association of Therapeutic Radiation Oncology convened and the literature was reviewed. Methodically drawing from the best of Class I, II, and III levels of available evidence, authors sought to determine how the literature addressed and disposed of the question of the optimal management for an adult with a known history of cancer and a single meta-static brain lesion. Framing the question in this specific manner allowed researchers to focus directly on treatment issues, without having to consider diagnostic issues. Conclusions The results of the evidence-based analysis demonstrated that there was insufficient information to establish standards of care. Data from the literature does, however, support a guideline stating that surgical resection accompanied by whole brain radiation therapy is associated with the best survival rate. Additional lower-quality evidence supports an option for management with radiosurgery.
50
Pomata, Gianna. "Sharing Cases: The Observationes in Early Modern Medicine." Early Science and Medicine 15, no. 3 (2010): 193–236. http://dx.doi.org/10.1163/157338210x493932.
Full textAbstract:
AbstractThis paper examines the rise of an epistemic genre, the Observationes, a new form of medical writing that emerged in Renaissance humanistic medicine. The Observationes (collections of case-histories) originated in the second half of the sixteenth century, grew rapidly over the course of the seventeenth, and had become a primary form of medical writing by the eighteenth century. The genre developed initially as a form of self-advertisement by court and town physicians, who stressed success in practice, over and above academic learning, as a core element of their professional identity. This unprecedented emphasis on practice as a source of knowledge remained a key feature of the Observationes in its subsequent development. As the genre evolved, the original emphasis on therapeutic success gave way to a new focus on the descriptive knowledge of disease through detailed observation. The authorial identity projected by the writers of Observationes was increasingly that of the learned and experienced observer, bent on comparing notes and sharing his cases with the fellow members of the res publica medica. This paper charts the development of the genre, examining how its growth contributed to the new epistemological value of observation in the age of the Scientific Revolution.