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At least 397 records · Page 22Linked to original sources
PubMed1998

Hepatitis B vaccination rates among medical personnel at Ain Shams University Hospital and obstacles to vaccine uptake.

The current study included 1426 medical personnel working at Ain Shams University hospitals selected randomly; 354 staff members, 679 junior doctors (residents and internships) and 393 nurses. The overall vaccination coverage with at least one dose of HB vaccine was 40.6%. The overall coverage with 3 doses of HB vaccine was 29.1%. The mean number of working years was higher among the vaccinated group. More than 55% of personnel who had direct exposure or contact with blood were not vaccinated. HB vaccine uptake was conducted at the work place by 65.6% of vaccinated personnel and about 50% received the vaccine recently, i.e. less than one year. The side effects experienced by vaccinated subjects were local pain (5.4%) and headache (0.7%). About 38% of included personnel were not sure about the effectiveness of HB vaccine, and 47% do not know exactly the duration of vaccine validity. The current price of the vaccine was unaffordable as stated by 60.9% of subjects and 95.2% concluded that the vaccine should be funded. It was recommended that the work place is the best place for HB vaccine uptake by 80.9% of subjects and the vaccine should be obligatory for all medical personnel by 84.3% of subjects.

Attitude of Health Personnel↗
PubMed1991

Physical activity from rehabilitation to independent community function: the role of physical activity in handicapping conditions.

All ingredients are there--philosophies and principles, models and examples, competent and committed professionals, ready and willing agencies and organizations, and anxious-to-get-involved persons with handicapping conditions. The time has never been so right to go forward and onward to the heights with sport, recreation, and physical activity to produce lives worth living by persons with handicapping conditions. George Washington warned: "We ought not to look back unless it is to derive useful lessons from past errors, and for the purpose of profiting by dearly bought experience." In this case some might advise not to look back at all, because pessimists and disbelievers may be trying to overtake optimists and believers. As Henry David Thoreau stated: "If you build castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them." Physical activity, recreation, and sport are important in physical, mental, emotional, and social adjustment of individuals with handicapping conditions. In many cases, active participation in such activities provides more effective and efficient rehabilitation and therapy than formal rehabilitation and therapeutic modalities and approaches. Throughout history some pioneers striving to introduce and use such techniques and approaches have been rebuffed and rejected by many facets of the medical establishment. Often, progress has come from highly committed advocates from various professional specializations with interests in activity programs for their populations. Although progress continues to be made, much greater recognition by and involvement of the medical profession are needed from the classrooms in medical schools, through all internships and residencies, to hospitals and clinics of all types, and among all medical branches and specialties.

Activities of Daily Living↗
PubMed1990

The pull toward the vacuum: osteopathic medical education in the 1980s.

During the 1980s, the two major influences in osteopathic medical education were the increasingly large number of new DOs seeking internships and residencies and the loss of training sites as a result of the shrinking osteopathic hospital network. Owing mainly to a declining interest in primary care by young MDs, allopathic postdoctoral program directors, particularly in primary care specialties, began to actively recruit osteopathic physicians. An oversupply of positions on the allopathic postdoctoral side and an undersupply of residency positions in osteopathic postdoctoral programs contributed to a crossover trend. The programs approved by the Accreditation Council for Graduate Medical Education have made significant inroads in attracting DOs. It has reached the point where two out of every three DOs currently training in a primary care residency can be found in an allopathic program. If it continues, this pattern will have a significant impact on the character of osteopathic medical education.

Accreditation↗
PubMedDate not supplied

A statistically based method for identifying hospital classification criteria.

The development of valid classification criteria for U.S. hospitals. A number of bills recently introduced in the U.S. Congress call for the linkage of classification criteria to cost limits for hospitals. Such proposals have not indicated how the classification criteria should be validated or tested.A research project was therefore undertaken to determine whether 87 large community hospitals could be classified into interpretable and reproducible homogenous groups. By means of an automatic interaction detector (AID), a set of unique classification criteria were identified. These included residency and internship education programs, medical school affiliation, renal dialysis, and organ bank facilities. Application of the criteria to 1970 and 1971 data for the 87 hospitals resulted in five reproducible and stable groups of hospitals. The criteria were validated by several tests involving different types of cost comparisons and ratios.The research results indicate that an AID-based classification structure is a feasible model for grouping or classifying large hospitals for comparative purposes. Only a small number of variables are necessary to classify large hospitals, and the criteria do not need to be overly complex. Many of the variables traditionally used may be omitted.

Economics, Hospital↗
PubMed1993

[General practice: a theme in search of clarity].

Specialization is a consequence of the progress in knowledge and technology, and is essential to increase medical knowledge. Culturally, the population increasingly aspires to be attended by a specialist. On the other hand, generalism is necessary to protect the unitary focus on the sick patient, to mitigate the increasing cost of medicine and to avoid the increasing dehumanization of medical practice. The condition of generalist is not synonym of general practitioner and may be applied to internists or pediatricians with ample knowledge and diagnostic skills based more in medical interview and physical examination than in the sophisticated laboratory. Specialties have clearly defined fields of knowledge and action, have well established training programs and are culturally accepted, not so general medicine. In Chile, a significant number of trained general practitioners has not been attained, in spite of the existence of training programs since more than 20 years. Outpatient care (primary care in the language of health planners) may be undertaken by general practitioners but also, and perhaps with better efficiency, by general internists and pediatricians. The use of ones or others will depend on the geographic location (urban, suburban or rural), on the available physicians and the communication facilities with better developed medical centers. Within this line of thinking, the Faculty of Medicine of the University of Chile is studying a reform of medical curriculum, rotating internship and residency programs.

Education, Medical↗
PubMed1996

Family practice training in Estonia.

BACKGROUND AND OBJECTIVES: The collapse of the Communist regime has required many newly independent countries to reform their health care systems. This article presents the unique experience of Estonia's development of family practice training and the introduction of this specialty to the existing health care system. Family practice training programs began in 1991 and include several pathways to certification in family practice. For physicians currently working as district doctors, pediatricians, gynecologists, or emergency doctors, there is the possibility of part-time retraining while continuing their work as primary care physicians. For new graduates of the medical school, there is an internship and residency in family practice or the option of part-time or in-service vocational training while maintaining a clinical practice. An important aim of the programs is to develop the identity of family physicians. The success and the failures of the Estonian experience in launching this project may be useful to other countries facing health care reform.

Education, Medical, Continuing↗
PubMed1996

Management of the early and late presentations of rheumatoid arthritis: a survey of Ontario primary care physicians.

OBJECTIVE: To examine primary care physicians' management of rheumatoid arthritis, ascertain the determinants of management and compare management with that recommended by a current practice panel. DESIGN: Mail survey (self-administered questionnaire). SETTING: Ontario. PARTICIPANTS: A stratified computer-generated random sample of 798 members of the College of Family Physicians of Canada. OUTCOME MEASURES: Proportions of respondents who chose various items in the management of two hypothetical patients, one with early rheumatoid arthritis and one with late rheumatoid arthritis. Scores for investigations, interventions and referrals for each scenario were generated by summing the recommended items chosen by respondents and then dividing by the total number of items recommended in that category. The scores were examined for their association with physician and practice characteristics and physician attitudes. RESULTS: The response rate was 68.3% (529/775 eligible physicians). Recommended investigations were chosen by more than two thirds of the respondents for both scenarios. Referrals to physiotherapy, occupational therapy and rheumatology, all recommended by the panel, were chosen by 206 (38.9%), 72 (13.6%) and 309 (58.4%) physicians respectively for early rheumatoid arthritis. These proportions were significantly higher for late rheumatoid arthritis (p < 0.01). In multiple regression analysis, for early rheumatoid arthritis, internship or residency training in rheumatology was associated with higher investigation and intervention scores, for late rheumatoid arthritis, older physicians had higher intervention scores and female physicians had higher referral scores. CONCLUSIONS: Primary care physicians' investigation of rheumatoid arthritis was in accord with panel recommendations. However, rates of referral to rheumatologists and other health care professionals were very low, especially for the early presentation of rheumatoid arthritis. More exposure to rheumatology and to the role of physiotherapy, occupational therapy and social work during primary care training is strongly recommended.

Adult↗
PubMed1996

Interdisciplinary multiinstitutional alliances in support of educational programs for health sciences librarians.

This project responds to the need to identify the knowledge, skills, and expertise required by health sciences librarians in the future and to devise mechanisms for providing this requisite training. The approach involves interdisciplinary multiinstitutional alliances with collaborators drawn from two graduate schools of library and information science (University of Illinois at Urbana-Champaign and Indiana University) and two medical schools (University of Illinois at Chicago and Washington University). The project encompasses six specific aims: (1) investigate the evolving role of the health sciences librarian; (2) analyze existing programs of study in library and information science at all levels at Illinois and Indiana; (3) develop opportunities for practicums, internships, and residencies; (4) explore the possibilities of computing and communication technologies to enhance instruction; (5) identify mechanisms to encourage faculty and graduate students to participate in medical informatics research projects; and (6) create recruitment strategies to achieve better representation of currently underrepresented groups. The project can serve as a model for other institutions interested in regional collaboration to enhance graduate education for health sciences librarianship.

Cooperative Behavior↗