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PubMed1986

Traditional medicine and the modern medical curriculum.

Experience in Sokoto suggests that traditional medicine can be successfully introduced as a distinct academic discipline into the curriculum of a modern African medical school. The importance of such a step lies in two facts. Firstly, for the foreseeable future most people in developing countries will turn to traditional medicine at times of sickness, so modern doctors should be acquainted with its principles and methods. Secondly, within traditional medicine there is a body of important knowledge that needs to be explored and studied. If exposed early and gradually to the subject, medical students are likely to become more effective both as health workers and as contributors to medical science.

Curriculum↗
PubMed1999

Emergency medicine in Singapore: past, present, and future.

What began in 1948 as a "Casualty and Outpatient Service" at the Singapore General Hospital grew into the first 24-hour emergency unit in 1964 and has since expanded to the current emergency departments of the 6 public hospitals providing acute 24-hour accident and emergency services with an annual patient load of up to 540,000. In 1984, emergency medicine was recognized as a distinct medical specialty by the Ministry of Health. Five years later, structured academic postgraduate training programs were introduced. In 1990, a specialist training committee for emergency medicine was appointed to oversee the development of advanced training in emergency medicine locally. Seven areas of subspecialization have since been identified and are in various stages of development: emergency cardiac care, emergency trauma care, emergency toxicology, prehospital emergency care, pediatric emergency medicine, disaster medicine, and observation medicine. The achievements in emergency medicine in Singapore can help to provide a model for the future development of emergency medicine in other similar environments.

Emergency Medical Services↗
PubMed2006

Surgical practice in Hong Kong.

Surgery in Hong Kong has undergone a significant evolution over the past century. The quality of surgical care, medical education, surgical training and academic research has improved significantly through the joint efforts of the two universities, the government and the surgical colleges over these years. Surgical practice in Hong Kong continues to change also with the development of specialties/subspecialties, the changing pattern of disease and the development of new and effective treatments. Areas of clinical excellence in oesophageal cancer, hepatocellular carcinoma (HCC) and nasopharyngeal cancer (NPC) have gradually developed in these areas in Hong Kong. With the ongoing Westernisation and continued economic development in Hong Kong, some previously uncommon diseases will become more common. The surgical service in Hong Kong will need to continue to change to meet the new challenges in the future

Benchmarking↗
PubMed2003

Perceptions of physicians on infection control activities in Turkish hospitals: a cross-sectional survey.

BACKGROUND: Most countries practice some form of infection control (IC) to minimize hospital-acquired infections. There is still considerable diversity in IC activities in Turkey. Little is known about practical issues and perceptions of physicians regarding IC in Turkey. METHODS: The authors developed an 11-item questionnaire addressing questions on IC activities. Physicians attending a national infection control meeting (n = 285) were asked to participate. RESULTS: The response rate was 86%. Respondents from nonuniversity teaching hospitals stated a higher involvement in IC. Physicians from university hospitals were in greater need of IC training. CONCLUSIONS: Academic hospitals are particularly concerned with IC. Domains such as surveillance of endemic hospital infections, specific preventive protocols, antibiotics policy, and staff education should be addressed by IC committees. IC is well established in Turkey, but there is still a long way to go to reach the standards found in developed countries.

Attitude of Health Personnel↗
PubMed1981

Primary health care in the People's Republic of China.

In scarcely more than 30 years, the People's Republic of China has progressed from limited health care available only to a privileged few to a countrywide system providing basic services to one fifth of the world's population. The author gives his impressions of the current situation, based on a recent visit.

Acupuncture Therapy↗
PubMed2006

Practicing HIV/AIDS community-based research.

Although community-based research (CBR) is gaining popularity, especially within the field of HIV/AIDS research, there is a paucity of practical models or frameworks designed to guide researchers and community members. Within the present paper the author presents a ten-stage model of conducting CBR that emerged from two HIV/AIDS CBR studies that were conducted in Alberta, Canada. The main strengths and challenges to conducting HIV/AIDS CBR are also explored. Living a life with HIV has changed dramatically over the past few decades. There have been notable improvements in medical technology and treatment, resulting in increased quality and duration of life (Volberding, 1998; Wong-Staal, 1997) as well as improvements in psychosocial interventions leading to improved mental health services (Grinstead & Van Der Straten, 2000; Hoffman, 1996; Sarwer & Crawford, 1994; Schaffner, 1994). Perhaps most significant has been the astonishing community rallying and social support networks that have occurred among individuals living with HIV and AIDS (Roy & Cain, 2001). People living with HIV and AIDS have demonstrated their resilience and positive outlooks through developing a multitude of community connections and projects. These organizational groups have engaged in HIV peer counselling at community-based organizations, fund raising programs, board involvement in community agency organizations and HIV/AIDS national committees, as well as volunteer work in many settings. There has also been a recent focus on CBR, which includes having individuals living with HIV and AIDS, people vulnerable to HIV infection or other stakeholders in HIV/AIDS issues become partners in research projects with academic or trained researchers (Health Canada, 2002).

Alberta↗
PubMed1997

Virtual reality: teaching tool of the twenty-first century?

Virtual reality (VR) is gaining recognition for its enormous educational potential. While not yet in the mainstream of academic medical training, many prototype and first-generation VR applications are emerging, with target audiences ranging from first- and second-year medical students to residents in advanced clinical training. Visualization tools that take advantage of VR technologies are being designed to provide engaging and intuitive environments for learning visually and spatially complex topics such as human anatomy, biochemistry, and molecular biology. These applications present dynamic, three-dimensional views of structures and their spatial relationships, enabling users to move beyond "real-world" experiences by interacting with or altering virtual objects in ways that would otherwise be difficult or impossible. VR-based procedural and surgical simulations, often compared with flight simulators in aviation, hold significant promise for revolutionizing medical training. Already a wide range of simulations, representing diverse content areas and utilizing a variety of implementation strategies, are either under development or in their early implementation stages. These new systems promise to make broad-based training experiences available for students at all levels, without the risks and ethical concerns typically associated with using animal and human subjects. Medical students could acquire proficiency and gain confidence in the ability to perform a wide variety of techniques long before they need to use them clinically. Surgical residents could rehearse and refine operative procedures, using an unlimited pool of virtual patients manifesting a wide range of anatomic variations, traumatic wounds, and disease states. Those simulated encounters, in combination with existing opportunities to work with real patients, could increase the depth and breadth of learners' exposure to medical problems, ensure uniformity of training experiences, and enhance the acquisition of clinical skills.

Anatomy↗
PubMed1992

Emergency radiology services at medical schools in the United States.

RATIONALE AND OBJECTIVES: Little has been published on the delivery of emergency radiologic services in academic radiology training programs. METHODS: The author surveyed 127 medical schools in the United States concerning aspects of radiology services for their emergency rooms, including who interprets images, what training in emergency radiology is provided, and problems with film retrieval. RESULTS AND CONCLUSIONS: Emergency department radiographs most often are initially interpreted by a radiology resident and subsequently reviewed by a faculty radiologist who does not have a major interest in or time commitment to emergency radiology. Most schools describe problems such as disappearance of emergency department films and a paucity of provided clinical information. Only one third of schools provide formal instruction in emergency radiology for their radiology residents.

Delivery of Health Care↗
PubMed1991

Ecobehavioural analysis of stereotypic and adaptive behaviours: activities as setting events.

The effects of activities and task demands on the rate of stereotypic and adaptive behaviour were analysed within the conceptual framework of setting events. Data on 12 mentally retarded subjects were collected in real time using portable microcomputers during six activities: leisure, pre-vocational training, gym, academic instruction, home living, and lunch. Results showed that stereotypic and adaptive responses occurred in all settings, with the two behaviours occurring simultaneously across both subjects and activities some of the time. Micro-level analysis showed that teacher covert task demand provided the setting event for most of the stereotypic and adaptive responding during each activity. The importance of ecobehavioural analysis in understanding the nature of stereotypy and adaptive behaviour, and the contribution of such an analysis to appropriate and effective intervention were highlighted.

Adaptation, Psychological↗
PubMed1986

Planning and integrating a behavioural sciences curriculum.

This paper describes methods of planning and integrating an introductory course in human behaviour for first-year medical students, from a primary care perspective. The conceptual model is based on a synthesis of the literature on stress, stress responses and human development. An experiential component integrates didactic material and clinical experience. The teaching methods are based on formats, such as grand-rounds, used by postgraduate doctors. Specific techniques are described to integrate the diverse components of the curriculum: timing of learning experiences; training of academic staff; preparation of patient volunteers; and use of student representatives.

Attitude of Health Personnel↗
PubMed1995

The changing face of radiation oncology in Australia 1950-1995: a personal view.

In 1950, orthovoltage X-rays were used to treat a wide spectrum of malignant disease but results were impaired by poor depth dose and significant reactions; radium and radon were used commonly and superficial X-ray therapy was used for a large number of skin cancers as well as many benign skin conditions. Since megavoltage X-ray therapy was introduced to Australia and with earlier diagnosis, high standards for qualification as a radiation oncologist set by the Royal Australasian College of Radiologists (RACR), improved imaging and tumour localization, improved beam characteristics, computerization and dosimetry, patients are now better treated with improved local control and less morbidity. Public facilities have been chronically underfunded by governments resulting in waiting lists for treatment, and free standing private practices are important in sharing the ever increasing workload consequent to the increasing and ageing population. The use of brachytherapy has fallen but is enjoying a resurgence of interest. Chemotherapy has emerged. Radiobiology has had some influence on radiation treatment. Health education has improved and the needs and expectations of patients better appreciated and helped. Cancer societies have made an important contribution. Statistical evaluation of treatment is better understood. Undergraduate training and academic positions remain insufficient. The formation of the Faculty of Radiation Oncology of the RACR has given fresh impetus to the specialty.

Australia↗
PubMed1990

Are health educators being prepared to provide HIV/AIDS education?: A survey of selected health education professional preparation programs.

Health education professional preparation programs were surveyed to determine the extent of HIV/AIDS education health educators are receiving. The survey also addressed content areas, skills being developed or enhanced, areas of deficiency in preparation programs, and areas in which national professional associations may assist in the preparation of AIDS educators. One hundred eight-three surveys were mailed; 114 (68%) were completed and returned. Twenty-one institutions reported planning a separate course on HIV/AIDS. Most were designing general service courses to reach a broad cross-section of students. Twenty-five institutions (23.8%) reported previously offering or currently offering a specific course on AIDS. One hundred two (89.5%) respondents reported HIV/AIDS warranted the attention and funding it had received. Thirty-seven (35.2%) respondents reported AIDS education was of sufficient importance to influence hiring of faculty members in their departments. Survey findings demonstrate that current AIDS education courses targeted to the general student population may not be adequate in meeting the professional preparation needs of health educators charged to provide AIDS education.

Acquired Immunodeficiency Syndrome↗
PubMed1990

A professional preparation course on AIDS/HIV infection.

This paper describes the conceptualization, development, planning, and implementation of a new professional preparation course entitled "AIDS/HIV Education: Issues and Strategies." The 15-week, campuswide course was offered through the Dept. of Health Science Education at the University of Florida during spring semester 1990. Though universities have been identified as providers of preservice education for future teachers and health professionals, current activities often have been deemed inadequate to meet the needs of those charged with providing AIDS/HIV education. This course was implemented to address an array of issues related to HIV education, ranging from epidemiological and biomedical information and educational strategies to examination of personal and ethical issues surrounding the disease. Delivery of a successful course and student reaction are discussed, along with recommendations for programs considering similar educational efforts. A detailed planned information packet is available from the authors.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Use of proton pump inhibitors: an exploration of the attitudes, knowledge and perceptions of general practitioners.

BACKGROUND/AIM: Proton pump inhibitor (PPI) prescribing is costly. The volume of PPI prescription is also increasing, despite little evidence that would justify the increase. General practitioners (GPs) are largely responsible for PPI prescribing, yet knowledge of their views concerning PPIs which might explain the apparent anomaly of prescribing costly drugs without justification is lacking. The aim of this study is therefore to investigate how GPs make decisions about PPI prescribing. METHOD: Qualitative study design using focus groups of 34 GPs and 15 training GPs analysed according to grounded theory principles and use of constant comparative analysis. RESULTS: The participants showed agreement about the clinical factors potentially relevant to PPI prescribing such as age of presentation and endoscopy, issues of Helicobacter pylori eradication and issues around malignancy. There was considerable controversy, however, as to how to apply those factors in real clinical consultations. GPs in training and academic GPs tended to be more conservative; service-based GPs more pragmatic. There was agreement about the need to review long-term PPI medication, but controversy about whether the conventional 'step-up step-down' approach was realistic in practice. Good agreement was apparent about the effectiveness, the cost implications, and some of the ethical issues surrounding PPIs, but considerable controversy as to how far such factors should influence prescribing of PPIs. CONCLUSION: The GPs showed good understanding and knowledge of the issues surrounding PPI prescribing. There was considerable controversy as to how such knowledge should be translated into practice.

Adult↗
PubMed1992

Primary medical care in Seychelles.

This paper describes some of the current health problems faced by a tropical country whose standard of living and lifestyle is approaching that of many countries in Western Europe. Long-term health problems such as cardiovascular diseases and diabetes have become at least as important as infectious diseases. A change in approach to a more proactive style of primary care is needed to allow the contribution of community doctors to be effective. The system of primary care in the Republic of Seychelles is based on the UK model of general practice where recent improvements in education and organization are raising standards. How some of these improvements might be transferred elsewhere is discussed.

Adult↗