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PubMed2000

[Death versus feelings: a reality in the world of medical students].

The purpose of this investigation was to unveil the feelings of medical students while facing the phenomena of death, and also the meaning of these experiences on their lived-world and its implications to their academic training. The investigation was carried out with 10 students who are regularly registered in the Medical School of the Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil, attending between the 3rd and the 6th year. The qualitative approach, with phenomenological basis, along with theoretical assumptions of Merleau-Ponty and the information analysis method proposed by Giorgi (1988) and Comiotto (1992), disclosed five phenomenological essences: The meanings of death; Conflict between life and death; Feelings experienced on the interfaces of death; Medical training; Personal transformation as a path to professional transformation. The findings of this study evidence the feelings and their implications to the process of personal and professional development of the students as primordial and undeniable phenomenon. Considering this relevance, a psycho-pedagogical proposal is presented to educate feelings.

Death↗
PubMed2002

[Popular medicine versus university medicine during the reign of João V of Portugal (1706-1750)].

This paper endeavours to contribute to an understanding of the coexistence and complementarity between popular and university medicine in the Portugal of the first half of the 18th century. It begins by outlining the academic training of physicians and the publishing of medical books, concentrating on the study of advertisements published in the Gazeta de Lisboa from 1715 to 1750. These draw attention to the more frequent diseases in the population and the large number of remedies offered to treat them, and represents an example of the pluralism of medical practices exercised by qualified and qualified practitioners, Portuguese or otherwise.

Education, Medical↗
PubMed2003

[Compendium of the history of veterinary anatomy of Rumania: for the 100th birthday of one of their most famous anatomists, Vasile Ghetie].

The lessons of veterinary anatomy, firstly it was called "Zootomie", began in Rumania in 1853 and took place at educational establishments for ambulances and at schools for human medicine. The first veterinary school of the country was opened at the 16th of May 1861. The academically trained anatomy began with Prof. Constantin Gavrilescu. The most famous representative of anatomy was Prof. Vasile Ghetie (1903-1990). His act of life positions him beside the great anatomists of the gone century Schmaltz, Barone and Grau.

Anatomy, Veterinary↗
PubMed2003

[Evidence-based pharmacology in community and hospital pharmacies--a vision of the future?].

Pharmacists are academically trained drug and medication specialists. Also in the eyes of the law, pharmacists are more than just specialised sales people for medication. As laid out in the regulations governing pharmacies, pharmacists see patients and experts in the fields of medicine, dentistry and veterinary science to whom they have to offer advice. The pharmacist's advisory activities, though, must not interfere with an existing doctor-patient relationship. All pharmaceutical activities in community and hospital pharmacies should therefore be based--similar to the medical faculty--on an evidence-based practice in the sense of an evidence-based pharmacy adopting all principles of Evidence-based Medicine. The challenge for pharmacists and doctors should therefore be to work together to increasingly develop common strategies in order to achieve optimal treatment for the benefit of the patient. Especially in the treatment of chronically ill patients, synergistic effects could be reached through open exchange and a closer linkage between medical and pharmaceutical activities. Such closer contacts between the two disciplines could be made at interdisciplinary colloquia or special subject-specific round table discussions. Pharmaceutical Care (PhC), i.e. the optimisation of medicational therapy of chronically ill patients through accompanying intensive pharmaceutical advice is desirable from the patient's point of view and could take some load off medical practitioners. Any questions as to the use of medication, potential side-effects or undesirable interaction with other medications, but also regarding additional preventive measures can be posed to qualified personnel by the patient collecting his/her medication in the pharmacy. Also, as community pharmacists see themselves as active medication specialists and valuable qualified advisors to the patient with regard of self-medication, increased investment in internal communication between colleagues and external communication with patients is desirable. In the hospital setting, the pharmacy is to be regarded as the central medication information office and should participate in interdisciplinary working groups for the development of clinical guidelines and substitution possibilities. Furthermore, hospital pharmacy should be consulted on pharmaco-economic questions and on planning and conducting clinical studies.

Evidence-Based Medicine↗
PubMedDate not supplied

[On the origins of modern science].

The Renaissance savants essentially repelled the scholastic translations and commentaries of the ancient writings. Nevertheless, they did not reach a modern vision of experimental science. Moreover, education at the universities was not credited for the development of science. In fact, academic training of students was rather precarious. The first professional associations, such as the "Royal College of Physicians" of London, were not any better. Regarding the hermetic influence on Renaissance thought, the cultured and philosophical reformed magic (so-called white magic) was the equivalent of science at the time. Once the animistic universe, operated by magic, was transformed into the mathematical universe operated by mechanics, the era of science came into being. This movement began during the post-Renaissance age and gradually progressed following the physical-mathematical orientation of Galileo and his pupils: Borelli; Fabrizi; Santorio; Harvey, etc. They initiated physiological studies and introduced the quantitative method into the research field. Harvey's doctrine was the first adequate explanation of an organic phenomenon and a starting point for the way toward experimental physiology. However, the English physician did not completely leave the pre-scientific era, as can be inferred from his monography on animals reproduction. In this work, some points suggesting the birth of modern scientific reasoning alternate with confused, vague, and capricious assertions. In fact, modern science did not arise suddenly, but was elaborated and sustained slowly starting in the XVII century: Galileo's century.

History, 16th Century↗
PubMed1992

The nuts and bolts of implementing large-scale longitudinal studies.

Studies that assess large numbers of subjects for longitudinal research, for epidemiological purposes, or for the evaluation of prevention and intervention efforts, are very costly and should be undertaken with the greatest care to ensure their success. The success of a study, apart from its scientific merit, depends largely on the ability of the researcher to plan and set up a smoothly running operation. However, the skills required for such a task are often not acquired in academic training, nor do scientific journals abound with information on the practical aspects of running a large study. This paper summarizes the experience gained in executing a longitudinal study and covers aspects of planning, hiring of staff, training and supervision of interviewers, data collection and data entry and management. The importance of the use of the computer as a management tool is stressed.

Adolescent↗
PubMedDate not supplied

[Information technology and communication applied to continuous medical education].

Continuous medical education (CME) with credit is the challenge we are facing in Latinamerica. The appearance of new information and communication technologies bring to us important tools to carry out this teaching/learning process that targets the healthcare team. The distances that separate many professionals from centers of academic training exhort us to join efforts to take knowledge updates to far-reaching areas through postgraduate institutions. Only equality in opportunities to access continuous education will improve our societies. Display of projects done 1995-2004.

Communication↗
PubMedDate not supplied

[Home parenteral nutrition, question mark in pediatrics].

Home parenteral nutrition (HPN) is a necessary but under-used therapy in Spain as compared to other European countries. This problem has been studied at the 1st Discussion Forum of the Spanish Society for Parenteral and Enteral Nutrition. One of its recommendations has been "to design studies in order to analyze the problems detected in HPN practice". Our study attempts to assess pediatric professionals knowledge and opinion about this concern, because children are important recipients of this therapy. A multidisciplinary team prepared a questionnaire to be distributed among 136 health professionals (70 physicians and 66 nurses) working in 4 public hospitals (H) and 8 Primary Health Care Centers (PHC) from Asturias and Salamanca (Spain). Answers show that few professionals have appropriated theoretical and practical knowledge about HPN. Most of them have received neither academic training education nor information over the last year on this matter. The ability to solve patient and caregiver doubts in daily management (handling, storage, compatibility and nutrition stability, parenteral infusion equipment problems, etc) is only 10% in PHC and 50% in H. Only 6 physicians (4.4%) from H group know about the existence of NADYA expert group despite its website and handbooks providing a wide information about HPN. The advantage of HPN to improve life quality, its economic efficacy and the need of cooperation to this respect between H and PHC are matters with a high level of agreement. An important number of pediatric professionals does not have enough knowledge about HPN in PHC. The awareness of HPN must be promoted among clinical services dealing with patients able to benefit from this therapy. All available resources must be used to improved this issue. Specific protocols developed by multidisciplinary teams would promote H and PHC collaboration to help patients, who are the aim of our activity.

Child↗
PubMed2006

[Hospitals in Hesse in the view of enlightened travellers].

The "Hohen Hospitäler", hospitals founded by landgrave Philipp dem Grossmütigen during the years 1533-1542, were seen as an expression of greatest caritas in Early Modern times. These protestant institutions for the poor and sick underlings of Hesse were appreciated as charitable shelters by noblemen and commoners. This situation changed dramatically at the end of the 18th century. The first critics were travelling philosophers of the Enlightenment, who visited the "mad houses" of Hesse as well as other oddities. They published their experiences in travel reports. Although the hospitals as integrated institutions still cared for both psychiatric and somatic patients, these authors only concentrated on the mad inmates. The fact that these were kept in "dark and dirty cloistral corridors" was the central point of criticism. This negative situation was confronted by the travellers not only with a demand for more hygiene but also with a call for an academically trained physician. Furthermore, they claimed for dissecting deceased patients in order to explore the nature of madness. A comparison of these travel reports with the first psychiatric publications of the early 19th century discloses a literary discourse. It leads from the reports of travellers with a general interest to specialist literature of early psychiatry. Obviously it had a formative influence on the self-conception of this new medical field, which benefited from the criticism concerning the allegedly inhumane conditions in the old hospitals. Three questions follow from this statement: 1. Which were the images produced or reproduced by the travellers in their reports? 2. Which were the standards against which the critics measured their reports? 3. In how far were the philanthropic aims of the enlightened travellers related to the self-conception of the hospitals and their inmates? Travelling reports are compared with the circumstances in the hospitals. This comparison throws light in the "invention" of the genre psychiatry. Furthermore, it makes clear how ambiguous the charitableness of the travelling philosophers of the Enlightenment was.

Germany↗
PubMed1991

A reassessment of risk factors for neonatal tetanus.

A hospital-based case-control study was conducted to further examine the risk factors for neonatal tetanus (NNT) in the North-west Frontier Province of Pakistan. Three control infants were concurrently evaluated for each of 102 consecutively diagnosed NNT cases hospitalized over an 8-week period. Application of clarified butter (ghee) during the first few days of life was shown to be a significant risk factor, confirming our previously reported finding. However, the risk appeared to be limited to ghee made in the home from cow's milk. The tool used to cut the umbilical cord was again refuted to be a risk factor; application of topical antibiotics conferred significant protection. Multivariate analysis of the matched data showed that delivery by persons with academic training (physicians, nurses, and lady health visitors) was also protective. Mothers with a past history of NNT babies were shown to have a significantly increased risk, and accounted for more than one-third of all cases in the present study. The findings suggest possible ways to augment the effectiveness of NNT elimination programmes.

Butter↗
PubMed1991

Survey: pay raises growing for ambulatory care executives.

A new survey by the American Hospital Association finds ambulatory care professionals earning higher pay raises than they did three years ago. Among the factors in ambulatory care professionals' raises: the sizes of the budgets for which they are responsible, their job titles and their academic training.

Ambulatory Care↗
PubMed1977

[Education: a theme in gerontology (author's transl)].

The paper presents a review of the history of educational gerontology ("andragogy" or "gerontagogy") which has a special role within the field of gerontology. Whereas gerontological sciences such as biology, medicine, psychology, and sociology in (frequently interdisciplinary) approaches study the process of aging, educational gerontology makes use of the findings of these research areas, intending to influence the process of aging. There is a need for education in old age - provided this is not restricted to the acquisition of knowledge and skills or the extension of academic training into old age. It is stressed that an offer of "education for the aged" or even of "help for the life in age" very ofter is rejected by old people as they are induced to feel incompetent when invited to school and training courses of that kind. Future "gerontagogy" will have to notice and to respect resistance of that kind and will have to endeavour to increase the motivation to learn in old age in adequate ways. A first goal of educational gerontology should be to develop programs going beyond those developed for children and realized in traditional institutions of pedagogy. Referring to results of differential gerontology programs for "educating" and "stimulating" aged persons will have to be rather variable to fit individual goals and motivations of the old. The differential approach necessary to meet individual and rather specific demands will require a more thorough "training of trainers" than is realized today in the Federal Republic of Germany.

Age Factors↗
PubMed1990

The Century Club: a model for staff-supported medical education.

Osteopathic teaching hospitals are frequently criticized by house staff officers for not being sufficiently didactic or academically oriented. A model for providing academic training for students, interns, and residents as well as continuing medical education for attending staff physicians is described. This model may be administered by a department of medical education at community hospitals. Tax-deductible financial contributions from medical staff physicians and grants from pharmaceutical companies will be adequate to support this model. Benefits include enhancement of teaching rounds, increased medical staff support, improved compliance with CME requirements, and development of a useful recruitment tool.

Education, Medical↗
PubMed1987

Pharmacy practice in the United States Air Force.

The current status of pharmaceutical services in the United States Air Force Medical Service is described. The mission of the USAF Medical Service is to provide medical support to combat forces and to deliver health care to active duty and retired military members and their dependents. The USAF operates 121 medical treatment facilities (MTFs) worldwide. Pharmaceutical services in these MTFs are governed by federal law, recognized standards of professional practice, Department of Defense directives, and Air Force regulations. Ambulatory-care services are emphasized, and clinical services are provided in many MTFs. Pharmaceutical services are supported by the TRIPHARM computer system. In addition to other professional opportunities, USAF pharmacists have the opportunity to pursue graduate-level academic training or residency training under Air Force Institute of Technology sponsorship. The USAF Medical Service will continue to ensure that contemporary pharmaceutical services are available in all MTFs by providing graduate-level training to pharmacists, encouraging the adoption of new technologies, and facilitating the exchange of information among MTFs.

Aerospace Medicine↗
PubMed1966

Some thoughts on interdisciplinary science.

The development of the "new biology" is largely a story of developments in interdisciplinary science. This paper considers a few of these of special interest to the author and active at the University of Rochester; namely, dental research, biophysics, radiation biology, health physics, biomedical engineering, and space biology. Rochester pioneered advanced academic training in radiation biology, a field which, despite some earlier tendencies to become associated with techniques rather than scientific problems, is now clearly a substantive discipline. Using biophysics as an example, the paper points to the futility of trying to define in detail the exact nature of each new "interdisciplinary discipline," yet it also decries the coining of new names without due cause. Health physics and its related field, radiological health, are described as centered on problems of radiation protection and as professional in their overtones. The interrelationships between engineering and bioscience are seen most clearly in biomedical engineering and the growing programs in space biology which require complete cooperation and mutual understanding between engineers and bioscientists for their ultimate success. After presenting some implications for medical libraries, the paper closes with a plea that the developers of new interdisciplinary fields and their powerful tools maintain historical perspective, simplicity of approach, and respect for nature's infinite resourcefulness.

Education, Dental, Graduate↗
PubMed1984

An outline history of ophthalmology in Australia.

The first ophthalmologists came to Australia from Great Britain in the early 1860s and founded charitable eye hospitals on the British pattern. For many years, during which Australian States remained colonies of Great Britain, all specialist medical training was obtained overseas. World War II greatly accelerated Australian independence and stimulated Australian technology, science, education, culture and economics. Australian ophthalmologists met the challenge with tight organization, home-based training, academic responsibilities and research.

Academies and Institutes↗
PubMed1981

The community health advocate.

This article reviews the development of an academic training program for rural and urban community health workers. A needs assessment and job task inventory are described. The organizational and cost factors involved in the design of a decentralized training model are presented along with an outline of the formal curriculum established after pilot testing. The one-year curriculum includes three to four days per month of classroom work with equal attention paid to assessment of common medical problems and to health education and counseling. Integrated with the didactic work is a full year of practical community health training under the guidance of a licensed practitioner (physician, physician assistant, or nurse practitioner). Three program goals are identified: establishment of health career entry level training, service to minority populations, and certification for career mobility. These goals are discussed and evaluated in relation to current progress of the program.

Career Mobility↗
PubMedDate not supplied

Nursing and technology.

Nursing began as an effort to provide care and comfort to the sick and injured. As our society developed, technological change began to increasingly affect the practice of nursing. Nurses found themselves caring for machines in addition to, or instead of, patients. All areas of nursing were affected by the technological explosion of the past 25 years. But nursing education and agency orientation programs have not prepared the nurse to work closely with sophisticated equipment. Conventional sex-role sterotyping contributes to the problem. Changes in academic training, employer practices, and nurses themselves are necessary. Nurses are the chief users of health care technology. They should have the skills to manage that technology.

Education, Nursing↗