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At least 19 recordsLinked to original sources
PubMed1979

On education and research in ecological medicine (Psychosomatic medicine). Psychosomatic medicine of the year 2000.

Because advances in our field have increased the complexity of our work, I feel that the name of this discipline should be changed. I suggest a more pragmatic term, namely, Ecological Medicine. Ecological Medicine is a science relating to physiological, biological, genetic, socioeconomic, cultural, etc., changes now taking place in our cosmos. It is concerned with disease and health processes of several components of the living organism. Its task is to recognize, evaluate, prevent, and treat all the above variables which are in integral part of the disease process. I should like to stress here that the central thinking must be a strategic one: to devise and apply means, ways, and methods for the exchange of information between those working in clinical and humanistic disciplines and of those in laboratories. In other words, I, personally, believe that the research scientists, who are working in any laboratory, cannot afford to ignore the psychological, socioeconomic and cultural factors affecting people's health. Consequently, they must, on one hand, orient themselves in accordance with the above-mentioned demands, and collaborate with the scientists of the humanistic disciplines, on the other. Thus, in this way, only the anthropos can be thoroughly and completely investigated as a unique psychophysiological, socioeconomic, and cultural ecologic entity.

Education, Medical, Undergraduate↗
PubMed1992

Academic emergency medicine: a national profile with and without emergency medicine residency programs.

STUDY OBJECTIVE: Formal data are lacking regarding emergency departments in academic medical centers, particularly those without an emergency medicine residency program. The Education Committee of the Society for Academic Emergency Medicine conducted a survey to define a national profile of academic emergency medicine. DESIGN: Prospective survey with telephone follow-up. SETTING: Academic medical centers. PARTICIPANTS: One hundred twenty-three academic medical centers as defined by the Association of American Medical Colleges. RESULTS: Results were obtained from 94 (78%) institutions: 27 (29%) had an emergency medicine residency program and 67 (71%) had no emergency medicine residency program. Significant differences were found between those with and without emergency medicine residency programs regarding 24-hour attending coverage (96% versus 73%), mean weekly clinical faculty hours (26 versus 33), the number of emergency medicine board-certified faculty, faculty recruitment difficulties (25% versus 75%), and the presence of a curriculum for housestaff (96% versus 38%). No significant differences were noted regarding the presence of a curriculum for medical students (78% versus 64%). Of the 67 institutions with no emergency medicine residency programs, 42% were actively planning a program, and 42% would consider future development of a program. CONCLUSION: This article provides the first comprehensive profile of emergency medicine in the Association of American Medical Colleges academic medical centers. Programs with emergency medicine residency programs provided more 24-hour attending coverage, had more emergency medicine board-certified faculty, and reported less difficulty recruiting additional faculty than institutions with no emergency medicine residency program. Both need to expand their undergraduate educational activities. Many institutions with no emergency medicine residency program are attempting to develop emergency medicine residency programs.

Academic Medical Centers↗
PubMed1992

Some epidemiological observations on medicinal and non-medicinal poisoning in preschool children.

STUDY OBJECTIVE: The aim was to identify and compare rates of admission to hospital of preschool children for medicinal and non-medicinal poisoning in a defined population. DESIGN: The study was an analysis of computerised abstracts of hospital inpatient records for poisoning. SETTING: Six districts in southern England covered by the Oxford record linkage study. SUBJECTS: The subjects were children under six years of age residing in the six districts from 1975 to 1986. MEASUREMENTS AND MAIN RESULTS: 6152 children, drawn from an average annual resident population of 164,000 children in 1975-1986, experienced 6562 hospital admissions for poisoning before six years; 3702 (56.4%) were attributed to medicinal and 2860 (43.6%) to non-medicinal agents. Of the latter, 646 (9.8% of the total) were recorded under the International classification of diseases code, described as "noxious food" (almost exclusively plant material). Average annual admission rates in children under six were 1.88 per 1000 for medicinal agents and 1.45 for non-medicinal substances. Analgesics accounted for 28.1% of the admissions for medicinal poisoning; berries and mushrooms for 97.4% of the plant materials; and corrosive aromatics, acids and alkalis for 22.0% of the other non-medicinals. Admission rates were higher in males than females in each category of poisoning. In children aged 1-4 years there was a significant decrease in admission rates between 1975 and 1986, averaging per annum 5.8% for medicinal poisoning, 6.9% for non-medicinal poisoning (excluding plant material), and 12.8% for plant material poisoning. Significant seasonal variation was found for each class of poisoning. CONCLUSIONS: Admission rates for medicinal and non-medicinal poisoning in preschool children declined between 1975 and 1986. The decline could reflect a change in thresholds for admission although, if so, this would be against the general trend in paediatric medical admissions, which is upward. An alternative explanation is a decline in the incidence of poisoning.

Child, Preschool↗
PubMed1992

General internal medicine in internal medicine: at the core or on the periphery?

In the past decade, faculty in sections of general internal medicine have assumed responsibility for training residents, for staffing clinical practices, and for developing new domains of health services and effectiveness research. These activities form the core of internal medicine: They are integral to the role of internal medicine as an academic and patient care discipline, and they complement the activities of the internal medicine subspecialties. The effect of general internal medicine on internal medicine, therefore, has been to shift the focus away from the subspecialty services--which compartmentalize a patient's medical problems--and back to the concept of the patient as a "whole" person. The role and territory of the general internist are changing as a result of this shift in focus, and general internal medicine is emerging as the new core discipline in internal medicine. These changes have allowed for an expanded capacity of internal medicine to provide new services, modified curricula, and innovative research.

Holistic Health↗
PubMed1992

General internal medicine and general internists: recognizing a national need. Federated Council for Internal Medicine.

The Federated Council for Internal Medicine (FCIM) comprises the American Board of Internal Medicine, American College of Physicians, American Society of Internal Medicine, Association of Professors of Medicine, Association of Program Directors in Internal Medicine, and the Society of General Internal Medicine. The Council was established in 1975 to speak with a collective voice for the specialty of internal medicine. In 1992, the Council developed the following statement in conjunction with its endorsement of a target of 50% of internal medicine residency graduates entering the practice of general internal medicine.

Career Choice↗
PubMed1992

Inpatient resource use: a comparison of family medicine and internal medicine physicians.

BACKGROUND: It is not known whether differences exist between the use of inpatient resources by family medicine and internal medicine physicians when patient demographic and complexity variables are statistically controlled. METHODS: The study population was all patients in 13 higher volume diagnosis-related groups (DRGs) discharged from the family medicine (n = 306) and internal medicine services (n = 2374) of the University of Cincinnati Hospital during 1985 and 1986. The dependent variables were length of stay and inpatient readmission within 2 weeks. Stratification by DRGs was used to control for the effects of age and case mix on these variables. RESULTS: With the exception of findings regarding one DRG, the results do not indicate that differences exist in average length of stay between patients of family medicine and internal medicine physicians after adjustment for other variables. Furthermore, almost all of the explained variance in length of stay was attributed to patient complexity and not to physician specialty or patient race or sex. For all discharges, the proportion of patients readmitted within 2 weeks was about 4% higher for the internal medicine service. However, multivariate analysis did not support the importance of physician specialty (family medicine or internal medicine) as a predictor of whether readmission occurred within 2 weeks. CONCLUSIONS: General indicators of resource use (such as length of stay or readmission occurrence) without adjustment for patient case mix, demographics, and complexity are inadequate for comparison of health care providers. Further research regarding interspecialty differences should use longitudinal data from large populations, which would permit more detailed examination of resource utilization.

Family Practice↗
PubMed2026

Genomic Medicine Sweden: Advancing precision medicine at the national level.

High-throughput sequencing has transformed clinical diagnostics of rare diseases (RD), cancer and infectious diseases by enabling the identification of disease-causing genetic alterations and facilitating individualised treatment and care. In response to these advances, Genomic Medicine Sweden (GMS) was established in 2017 as a national collaborative effort to accelerate implementation of genomics-based precision medicine within Sweden's regionally organized, publicly funded healthcare system. GMS brings together the seven university healthcare regions and their associated medical faculties, in collaboration with healthcare regions across Sweden, Science for Life Laboratory, patient organizations, industry and governmental agencies. Activities are coordinated through national disease-specific expert groups, supported by cross-cutting functions in bioinformatics, health economics, ethics, education and patient engagement. At the operational level, seven Genomic Medicine Centres, embedded at university hospitals, develop and deliver harmonised genomic diagnostics nationwide. The National Genomics Platform provides secure infrastructure for large-scale data storage, analysis, and national and international data sharing. Following initial project-based funding, GMS now receives long-term governmental support. This review describes the national implementation of genomic-based precision diagnostics, discusses challenges and lessons learnt, and highlights key milestones across disease areas, including whole-genome sequencing in RD and paediatric cancer, comprehensive genomic profiling of haematological malignancies and solid tumours, pathogen genomics in microbiology, pharmacogenomic testing and emerging applications of polygenic risk scores in complex diseases. Collectively, these efforts have contributed to more than 500,000 genomic tests being performed within Swedish healthcare between 2017 and 2025. Finally, we outline future diagnostic needs and priority areas to ensure sustainable, scalable and equitable access to precision medicine.

Precision Medicine↗
PubMed1992

The influence of occupational medicine on general medicine: a look at the journals.

To assess how the occupational medicine literature may affect general medical practice, representative journals were reviewed to address (1) how frequently the specialties cite each others' literature and (2) which topics are published most commonly by the respective journals. Five general medical journals were selected to contrast with six occupational medical journals. Methods included Journal Citation Reports, which enable the tabulation of impact factor, self-citation rate, and the number of source items published by the journal. MEDLINE was used to cross reference the 11 journals with designated topics in occupational medicine. The findings indicated that occupational medical journals are nearly 50 times more likely to cite the general medical literature than the converse. The journals most likely to cite the core occupational medical literature, aside from the specialty journals themselves, were the American Review of Respiratory Diseases and the American Journal of Epidemiology. In comparing the 1976 through 1980 period with the 1986 through 1990 period, occupational medical journals published 2.5 times as many source items (letters, technical reports, and papers) compared with a decade earlier. The MEDLINE search indicated that both types of journals address the same types of occupational medicine topics with the exception of gas poisoning and toxic hepatitis, which were published much more frequently in general medical journals. Pneumoconiosis was the most frequently addressed topic by occupational medical journals. Other major categories included reproductive hazards, lead poisoning, and noise-induced hearing loss. This study indicates that occupational medicine, as reflected by its journals, is a much more active scientific discipline than it was a decade earlier.

Bibliometrics↗
PubMed1979

A national study of internal medicine and its specialties: I. An overview of the practice of internal medicine.

A nationwide study of 24 medical and surgical specialties has been conducted by the University of Southern California School of Medicine, Division of Research in Medical Education. This article is the first in a series reporting findings for general internal medicine and 10 subspecialties of internal medicine. Populations for these 11 specialties are defined and enumerated, and the specialties are compared in terms of demographic and geographic distribution. Practice comparisons are presented based on characteristics such as workload, allocation of professional time, location of encounters with patients, distribution of primary problem diagnoses, and projections of annual patient encounters. Forthcoming specialty-specific articles will present highly detailed information for general internal medicine and for the subspecialties of cardiology, gastroenterology, pulmonary disease, allergy, hematology, endocrinology, nephrology, medical oncology, rheumatology, and infectious diseases.

California↗