Group Of Medical Practitioners Research Articles

Infant and childhood death in the medical profession. Evidence from nineteenth- and early twentieth-century Netherlands

AbstractThis paper shows the effect that the medical expertise of medical practitioners had on the life chances of their children. We focus on infant and early childhood mortality. We reconstructed the life histories of the offspring of a group of around 2800 medical practitioners who were practicing in a high-mortality region in the Netherlands between 1850 and 1922, the period during which infant and child mortality in the Netherlands underwent the largest changes. The survival of their offspring is compared with that of a random sample of children from the Historical Sample of the Netherlands. Multilevel hazard analysis, using Cox proportional hazards models with shared frailty, is applied to study the effect of belonging to the medical profession on survival, in relation to the level of infant mortality in the regions where children were born. Within the group of medical practitioners, attention is paid to differences in children’s survival according to the level of medical knowledge of the fathers. Our statistical analyses show that the offspring of medical practitioners as a whole did have better survival prospects than children born to families without a father with a medical background. When medical practitioners had effective medical knowledge, measured by the period of graduation and the highest level of medical training reached, the positive effects on the survival of their children were even stronger.

Medical practitioner's legal regulations in the practice from urban-rural development perspective

The role of medical practitioners in community safety area is huge. Especially huge responsibility medical practitioners have in medical treatment process from the point of view of treatment quality and legal liability. Medical practitioners are professionals regardless of territoriality. The mission and functions they perform do not depend on practice place. The responsibility is equal in both urban and rural level. To protect community safety from the medical practitioners' perspectives they should know their own rights, as well as patient's rights in healthcare. From the particular legal regulations arise duties and responsibilities of medical practitioners, which are described in the paper. The aim of the research is to study legislation that regulates medical practitioner‘s rights and duties in Latvia. The task of the paper is to study the characteristics of rights of medical practitioners in Latvia and the medical practitioner's knowledge of patients' rights in Latvia. In the research, the author has used general scientific methods such as analysis, synthesis, modelling, comparative method, inductive and deductive method, methods of interpretation of legal norms – grammatical, teleological, historical, as well as empirical method – survey. The paper describes the most important legal regulations in medical practitioner's activity, as well as defines problems and provides potential solutions that are necessary to protect community's safety. The results of the paper show that the regulatory framework exists in the field of healthcare of Latvia. Also in the field of professional activity, legal regulations exist, which govern the professional activity of medical practitioners. They are included in various law sectors (civil rights, labour rights, criminal rights, etc.). Apart from that, there exist a large number of legislative regulations of national level, which govern the professional activities of medical practitioners (special laws and Cabinet Regulations). It should be noted, that the competences of medical practitioners are not consolidated, but stipulated in separate legislative provision for each group of medical practitioners (for a doctor, doctor's assistant, nurse, etc.). The medical practitioner's knowledge of patients' rights is not good enough, especially in rural areas of Latvia.

Post-mortem external examination: competence, education and accuracy of general practitioners in a metropolitan area.

In several countries, general practitioners conduct post-mortem external examination (PMEE) and certify death in out-of-hospital cases. A possible lack of accuracy has been repeatedly criticised, although data on everyday practice of PMEE on outpatients are scarce. To evaluate medical practitioner's competence, education and accuracy regarding PMEE, we conducted a fax-survey among 1343 medical doctors in the metropolitan area of Hamburg, Germany. The results indicate considerable shortcomings in up to 63% regarding the inspection of body orifices and hidden areas, palpation of osseous structures, ectropionisation of the eyelids and use of aids. More than 5% of respondents reported to fill in a death certificate without performing a complete PMEE in the majority of cases. While theoretical teaching on PMEE was reported quite frequently (up to 78%), a considerably smaller group received practical training (32% during undergraduate and 13% during postgraduate education). To estimate the effects of training on PMEE, an individual "accuracy score" was calculated (range 1-5). Mean score was 3.63 (SD 0.81), and results differed significantly (p<0.001) among groups of medical practitioners with or without education on PMEE and was highest among doctors who received practical training (p<0.005). The results indicate that there are major shortcomings in a relevant portion of PMEE performed on out-of-hospital deaths that might lead to misdiagnosis of non-natural causes of deaths and homicides. Practical pre- and postgraduate education appears to positively impact accuracy and therefore quality of the procedure. Consequently, corresponding practical training should be mandatory during academic studies and ongoing education programs.

Feasibility of Large Scale Implementation of Personalized Medicine in the Current Scenario

Personalized Medicine (PM) is an emerging concept in the modern healthcare system and can play a vital role in modern healthcare management. If this concept can be adopted and implemented in a proper manner, the entire healthcare system will attain an elevated dimension. However, there exist many difficulties in adopting personalized healthcare system. An attempt has been made in this paper to present the data obtained through survey that has been conducted amongst a group of medical practitioners and a group of patients. The data collected have then been analysed by resorting to statistical techniques. The study shows that despite many personalized medicines have been discovered for use, it is difficult to adopt the personalized medicare system due to lack of adequate infrastructures, healthcare record system, communication among the medical doctors and genomic researchers, awareness and encouragement of common people, proper training of medical doctors, and confidentiality of the patients.

26th International Conference of the Society for Medical Innovation and Technology (SMIT).

The Society for Medical Innovation and Technology is an international society, formed in 1989 under the name ‘‘Society for Minimally Invasive Therapy’’ by an innovative group of medical practitioners led by John Wickham. The society is dedicated to the multidisciplinary advancement of minimally invasive therapy in an attempt to reduce patient trauma arising from traditional surgical operations or radiological interventions. This is the first time for this conference to be hold in China. Shanghai is one of the most developed cities in China, and at the same time, it is also an important economy center. The conference was co-chaired by Dr. Chengli Song from China and Dr. William Meng from Hong Kong. The main theme this year was ‘‘Emerging for Impacting.’’ Speakers and guests came from different parts of the world shared their experience on the innovation in the techniques, surgical instruments, new materials, computer-assisted surgeries and robots, 3D printing techniques in surgical use, new technologies in endoscopy and cardiovascular disease, and finally research, training, and education. During the conference, Prof. Chan Hak-Kim from University of Sydney shared his new technology on the translational pulmonary drug delivery, while Prof. Yinghao Sun introduced his Sun’s flexible tip semirigid ureteroscope. Prof. George Hanna from Imperial College of London and Prof. Izumi Shin Ichi from Tohoku University both discussed about medical education, auditing and assessment, especially on the objective assessment of the quality of laparoscopic surgical performance. On the other hand, Prof. Arthur Erdman concentrated on how the physical and virtual medical device prototyping will solve our healthcare dilemma. Finally, both Prof. Richard M. Satava from University of Washington and Dr. Paul Alan Wetter stressed on the importance of the innovation in medical technology. Representatives from our society were also actively involved in the meeting (Fig. 1). Dr. Dennis Ng shared his experience on the endoscopic submucosal dissection (ESD) in the treatment of early colorectal tumor, with tips and tricks on how to perform a good colorectal ESD. From March 2009 to December 2013, there were total 71 patients who underwent ESD North District Hospital. The median operation time was 101 min, while the median postoperative hospital stay was 1 day. The median polyp size was 400 mm (25–1600 mm). Majority of them were adenomas (62/71), while only 12.7 % (9/71) were malignant lesions. Perforation was reported in 12 patients (16.9 %); only one patient required laparotomy, and all others were managed successfully with endoscopic methods. Recurrence was reported in 6.3 % of cases. The authors concluded that ESD is safe and feasible in the treatment of selected patients with colorectal polyps and early colorectal cancer. On the other hand, Dr. Irene Lo educated us on how the APACHE II score can be used in predicting mortality in laparotomy patients above 90 years old. A total of 70 patients aged 90 and above underwent emergency laparotomy over the 4-year period. Overall mortality within the & D. C. K. Ng dennis_ckng@yahoo.com.hk

Collaborative Networked Virtual Surgical Simulators (CNVSS): Factors Affecting Collaborative Performance

Stand-alone and networked surgical simulators based on virtual reality have been proposed as a means to train surgeons in specific surgical skills with or without expert guidance and supervision. However, a surgical operation usually involves a group of medical practitioners who cooperate as team members. To this end, CNVSS have been proposed for the collaborative training of surgical procedures in which users with different surgical roles can take part in the training session. To be successful, these simulators should guarantee synchronicity, which requires (1) consistent viewing of the surgical scene and (2) a quick response time. These two variables are affected by factors such as users' machine capabilities and network conditions. As far as we know, the impact of these factors on the performance of CNVSS has not been evaluated. In this paper, we describe the development of CNVSS and a statistical factorial design of experiments (DOE) to determine the most important factors affecting collaboration in CNVSS. From the results obtained, it was concluded that delay, jitter, packet loss percentage, and processor speed have a major impact on collaboration in CNVSS.

Consultant psychiatrists' knowledge of mental health legislation in Scotland.

There has been increasing concern recently over an apparent lack of knowledge of mental health law among psychiatrists and other medical practitioners involved in its use. This has been particularly highlighted by the introduction of new and complex legislation intended to facilitate care in the community. As a result of findings from previous studies of other groups of medical practitioners in Scotland, a national survey of consultant psychiatrists working there was undertaken to determine their level of understanding of the statutory provision for the care of the mentally disordered. A purpose-designed instrument was used at interview with 72 consultants chosen at random from all psychiatric specialties. Their knowledge of even the most basic definitions and fundamental areas was limited, with only just over half being able to give the correct title of one relevant piece of legislation and only one in 10 being able to define mental disorder in terms of the Act. Otherwise knowledge was generally patchy. Greater emphasis should be placed upon training in mental health law for consultant psychiatrists in general, as the findings are unlikely to reflect purely localized patterns. Attitudes to the use of compulsory measures also need to be addressed.

MIDWIFERY TRAINING AND FEMALE CIRCUMCISION IN THE INTER-WAR ANGLO-EGYPTIAN SUDAN

Although the conventional image of the colonial medical encounter in Africa depicts a white, male, European doctor treating a black African patient, most of the actual deliverers of Western medicine in Africa during the colonial period were non-Europeans. In the Anglo-Egyptian Sudan, British doctors formed only a small minority of Western medical practitioners. Most often, it was Syrian, Egyptian and Sudanese doctors, and Sudanese assistant medical officers, mosquito men, nurses, sanitary officers and midwives who delivered sanitary and medical services on behalf of the colonial state. Understanding the cultural exchanges, technology transfer and power relations involved in the operation of colonial medicine clearly requires careful study of the training, the role and the experiences of these non-European practitioners of Western medicine.In this paper, one such group of medical practitioners is examined through a study of the Midwifery Training School or MTS, opened in Omdurman, Sudan in 1921. The MTS sought to create a class of modern, trained Sudanese midwives, out of, and in rivalry to, an entrenched class of traditional midwives, known as dayas. The analysis relies heavily on the papers of Mabel E. Wolff, founding matron of the MTS and her sister, Gertrude L. Wolff, who first arrived in Sudan to train nurses. Throughout the discussion, the name ‘Wolff’ alone designates Mabel, whose voice dominates their collective papers.

L'essor de la pratique clinique dans les armées européennes (1750-1800)

This article demonstrates that, before the 19th century and the Paris Clinical School, new medical practice and new clinical teaching based on pathological anatomy (of organs and of tissues) and surgical experience and therapeutic experimentation developed in the military milieu, specifically because of the "auspicious" conditions found there. Over time, this military clinical experience permeated civilian medical practice as military practitioners often moved into civilian practice and collaborated and exchanged experience with their civilian or ex-military colleagues. These conditions, in different forms and at different rhythms, in the great European powers, also favoured a rapprochement between the different groups of medical practitioners - physicians, apothecaries and surgeons - initially in the military milieu, and subsequently in civilian society as well. Finally, the article shows that the coercive disciplinary structure of the military, where sick or wounded soldiers were particularly constrained to act as subjects of experience, expérimentation, clinical teaching and anatomico-pathological research, was one of the conditions propitious to this growth of clinical practice.

Medical practitioners' knowledge of dysentery treatment in Bangladesh.

Interviews conducted with four groups of medical practitioners in Bangladesh revealed widespread deviation from the treatment protocol for dysentery established by the World Health Organization (WHO). Questioned were 136 doctors (46 of whom had postgraduate training), 87 drug dispensers, and 50 medical students from Dhaka; also included were 150 drug dispensers from Matlab. Each respondent was presented with a hypothetical case of a 2-year-old with bloody diarrhea of 3 days' duration and asked to identify the treatment they would offer. Less than half of the medical practitioners in each group identified the WHO-approved regimen of use of oral rehydration solution and a single antibacterial drug appropriate for shigellosis (e.g., ampicillin and co-trimoxazole). Provision of the correct answer ranged from a low of 8% among urban and 11% among rural drug dispensers to a high of 46% among medical students and doctors without postgraduate training. 398 of the 423 respondents recommended use of at least one antibiotic; 155 advised use of two or more such drugs. The drug dispensers were most likely to recommend use of the antibacterial agents metronidazole or furazolidone, neither of which are appropriate choices for children with dysentery. Of particular concern is the low level of correct knowledge of dysentery management among drug dispensers given the fact that private pharmacies are the main source of acute medical care in Bangladesh.

THE PEDIATRICIAN AND THE JUNIOR COLLEGE

The staff of the American Association of Junior Colleges has recently completed a definitive study of current trends, developments, issues, and concerns in the junior colleges.1 A short summary of some of the findings and recommendations of this study is pertinent to the planning and implementation of training programs for all allied health workers. It has particular pertinence to pediatricians who, more than any other group of medical practitioners, are faced with pressures to provide health care for more and more children. If we accept, and most of us do, the premise that the nation faces an acute shortage of personnel in the service and supportive fields of health and medical care, then careful attention should be given to making the most effective use of the nation's 2-year colleges to educate many who will go into the health and medical services. The capacity for absorbing larger and larger enrollments is apparently one of the most striking features of the 2-year college of higher education. In addition to this apparently infinite capacity, the junior college is also responsive to the needs of a heterogeneous student body and provides a comprehensive program designed to meet varying needs and all ages of students, as well as a uniquely qualified staff that differs in its preparation and interest from the traditional academic staffs so long recognized as a part of the academic community. Individual junior colleges apparently have widely differing objectives, goals, organizational patterns, and procedural methods. Another characteristic is an absence of preconceived notions of what is or is not collegiate subject matter, or what is or is not college material.

PREVENTION of Infections in Hospitals

Dr. Adams is professor of clinical surgery at the Boston University School of Medicine and chief of the division of surgery at Huggins Hospital In Wolfeboro, New Hampshire. In the past few yean he has been kept more than busy In what another person might call “spare moments” in writing articles for medical journals and speaking before groups of medical practitioners.

Keratoacanthoma of the ocular adnexa.

It is our purpose to describe the occurrence on the eyelid of an important benign tumor which is often mistaken for squamous-cell carcinoma and which has not received attention in the ophthalmic literature. This tumor, keratoacanthoma, was established as a clinical entity by MacCormac and Scarff1in 1936, and since then their observations have been substantiated by others. The tumor is important because histologically it resembles a low-grade squamous-cell carcinoma and most commonly is diagnosed and treated as a malignant tumor. Judging from the available literature, the dermatologists appear to be the only group of medical practitioners who are generally aware of its existence. Yet its incidence is relatively high, as indicated by reports of as many as 76 cases in one single series.* Among other terms, the tumor has been referred to as molluscum sebaceum, because of a superficial resemblance to molluscum contagiosum, and as molluscum pseudocarcinomatosum; however,

Die Geburtsverletzungen des Kindes.

This small book on the injuries of the new-born infant sustained at birth is written by an obstetrician. It is a valuable contribution to medical literature, because this important subject is discussed from the standpoint of the one group of medical practitioners who are in a better position than any other to reduce the high infant mortality of the new-born period. The subject matter is divided into two chapters. In the first the author deals with the origin of injuries at birth and discusses measures that obstetricans may use to prevent them; in the second he describes the clinical manifestations of the various injuries and discusses methods of treatment. The subject is handled in a systematic and exhaustive manner by a clinician of wide experience. The author has not, however, made use solely of his own clinical material, but has had access to that of his colleagues in many of