Knowledge In Medical Practice Research Articles

Analysis of the implementation of the medical boarding school in a medical course derived from the mais médicos program

The mandatory curriculum internship corresponds to an essential period for medical education in which the apprentice, through supervised training in the health service, develops and improves competencies and knowledge of medical practice. In 2014, the new National Curriculum Guidelines (DCN) were instituted that guide medical education activities according to the scenario observed in the Unified Health System (SUS), aiming to qualify professionals so that the demands of citizens, families and communities are served. In this context, through the Mais Médicos Program (PMM) and the initiatives for the expansion of medical schools in Brazil, the medical course analyzed in this study, started its activities in 2015, starting to compose the set of courses guided by the new DCN. This article proposed to analyze the process of implementing the medical boarding school of the course, from the perspective of the students. This is a qualitative study, in which the data were collected through a questionnaire sent to the students of the course, with a total of 29 participants. The analysis of the data produced was performed by the dialectical hermeneutic technique. The categories of analysis were health care, health management and health education, which addressed topics about a) operational techniques, such as the correct filling of medical records, learning maneuvers and physical examination techniques and the communication of established hypotheses and sharing the therapeutic process with the patient; b) Integration between service, teaching and community, discussing the adaptation of the structure of health services to receive academics, perceptions about the number and quality of practice scenarios, students' performance in the health service and incentive to contribute actions in the context SUS; c) Structuring the boarding school, discussing the total workload of the stages, pointing out which casters demonstrated the largest and lower organization and what their evaluative methods were; d) Preceptoria, deepening about the performance of preceptors in the practical scenarios, the quality of preceptoria and communication between preceptors and students. It was concluded that the process of implementation of the medical boarding school analyzed is in line with the new DCN, but it demands improvements to fully achieve the learning objectives specified in the course regulation.

Efficacy of human resource development program for young industry personnel who will be involved in future medical device development

BackgroundTraining next-generation personnel from small/medium enterprises (SMEs) is an urgent issue in promoting medical device research and development (R&D). Since 2014 we have engaged in governmentally funded human resource development program for medical/non-medical SMEs, and have assessed its effectiveness by analyzing self-evaluation of achievement level (SEAL) data obtained before and after the training course.MethodsHuman resource development experts interviewed 34 key opinion leaders with deep knowledge of medical device R&D from industry, government, and academia. The skills required for R&D personnel were written down, and a set of skills was created by making a greatest common measure in the list of common elements among them. Using that skill sets, skill evaluations were conducted on trainees at “Osaka University Training Course,” twice before participation and after completion of the entire program using SEAL assessment.ResultsThere were 97 men and 25 women, with one-third in the’30 s. Among them, 61 participants (50%) were from R&D divisions, and 32 (26%) were from business/sales divisions. 94 (77%) were from medical SMEs, and 28 (23%) were from non-medical SMEs (new entry). After completing the training course, significant growth was observed in every item of both Soft and Hard skill sets. Especially in new entry SME members, a striking improvement was observed in practical medical knowledge to enhance communication with medical doctors (p < 0.0001).ConclusionOur training course, though 7-day-short in total, showed that both Soft and Hard skills could be improved in young medical/non-medical SME members. Further assessment is needed to establish the necessary skill sets for our future partners from industries, to foster the creation of innovative medical devices through med-tech collaboration.

Medical discourse as a social activity: formation, priorities, dynamics (based on the material of the Russian popular science magazine «Zdorovie»)

Increasing interest in society in topics related to medicine and health is due to the current trend to consider physical, mental and social well-being as a basic human need. In the context of modern life, health is perceived as one of the most important values of an individual and society as a whole, therefore, medical discourse today plays a special role in culture, covering not only the professional expert and scientific community, but also the widest audience - the audience of the media. The media play a key role as a source of medical information and its targeted and targeted distribution. In this article, the medical discourse is analyzed in terms of its formation as a social activity and the role of modern mass media in it. The aim of the study is to analyze the demand for medical discourse in society and the features of its mediatization, which is the most important factor in the value-semantic dynamics of society and its way of life. The main empirical material is publications in the magazine "Zdorovie", the most popular Russian publication about a healthy lifestyle, medicine, practices for the treatment and prevention of diseases, the art of preserving beauty and vitality. The discourse of the popular scientific magazine "Zdorovie" as a very important segment of the value-semantic space of modern media is represented by a set of genres aimed at disseminating theoretical and practical medical knowledge, experience and providing medical services, taking into account the characteristics of medical subjects. dis-course, their information needs and problem-thematic requests, goal-setting attitudes, the degree and nature of interest, as well as the level of professional, general cultural and communicative competencies.

Ethnopharmacological survey on medicinal plants utilization in Freetown, Sierra Leone

Abstract Objectives Ethnopharmacological survey of medicinal plants utilized in Freetown Sierra Leone in the management and treatment of diseases. Methods The study utilized a cross-sectional descriptive study and face-to-face interviews with a pre-checklist of 20 Traditional Herbal Medicine Practitioners in Freetown. The survey included socio-segment information, data on the kinds of herbal medication, their constituents, wellsprings of the plants, diseases managed and details on preparation. Twenty traditional medicine practitioners consented to this study. Key findings The results showed that 15 (75%) were men and 5 (25%) were women, while all of them are above the age of 30 years. Some of the respondents have some level of formal education, ranging from twelve (12) with primary/secondary education to three (3) with tertiary education while five (5) do not have any formal education at all. Thirty percent practice herbal medicine as a family trade (inherited), 10% got involved in it through training, or both, while 10% claimed the knowledge as a natural gift. Traditional Herbal Medicine Practitioners (THMPs) in the study area updated their knowledge of medical practice through a wide range of choices such as by intuition (70%), participation at health talks or meetings (20%), while 10% of them adopted various forms of a combination of these and other choices. However, there was the problem of plant misidentification with some practitioners. According to our data, Freetown, Sierra Leone has a rich wellspring of restorative plants and an enormous part of the populace actually depends on customary plant drugs which are plentifully and promptly accessible. Conclusions Traditional Herbal Medicine Practitioners (THMPs) in this research updated their knowledge of medical practice through intuition, participation at health talks or meetings and also via various forms of a combination of these and other choices. The involvement of certified Plant Taxonomists is important, in order to avoid the consequences which may arise through misidentification.

Domestic Medicine in an Early Eighteenth-Century Manuscript, GUL, Ferguson MS 43

This article delves into Early Modern English1 manuscript domestic medicine with special attention to a recipe compilation, Glasgow, University Library, Ferguson MS 43. Household recipe books were an important repository of practical medical knowledge for families. Recipe collections were often brought by women to their new households upon marriage, and were subsequently passed down through generations, highlighting the significant role that women played in the production and dissemination of household practical knowledge. Ferguson MS 43, attributed to Lady Stanhope, showcases the female recipe collections’ ability to provide valuable information regarding eighteenth-century domestic medical practice and, more specifically, women’s contribution to it. The manuscript physical characteristics and its contents are analysed to place the text in its proper social, cultural and linguistic context as a representative instance of the recipe genre.

OPTIMIZATION OF TEACHING THE DISCIPLINE “MEDICAL PRACTICE IN FAMILY MEDICINE” AT THE FIFTH COURSE OF MEDICAL FACULTY OF IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY

This article shows details of educational program for 5-year students education in discipline “Medical practice in family medicine”. There are results for realisation of the competence-based approach in medical education with introduction of educational interactive technologies, new forms and methods of educational process. Described a role of Ivano-Frankivsk national medical university teaching-practical centre “Medicine” in improving teaching quality according to standards of Higher Education, regulation on the organization of the teaching and learning process, which promote qualitative mastery of knowledge to provide medical care.&#x0D; In this article is shown, that the main question by realisation of modern education tendentious is qualitative training of healthcare professionals. Successful using of optimal model of combination by traditional and innovative educational methods is directed to professional skills assimilation by students, formation of clinical thinking and development of future doctors’ personality.This combination promotes the use of knowledge in medical practice, teaches the students to take new information adequately. The main factors influence on students’ interest are teacher’s effective work and skilful using of teaching technologies. Modern educational technologies give new opportunities, interest in studying, discipline. The main conception of practical classes is cooperation between the head of practice and students. Extra individual lessons can promote this.&#x0D; 5- year students study the discipline “Medical practice in family medicine” during the whole academic year, to get knowledge and skills in Department of General Medicine №2 and Nursing, Department of Surgery №2 and cardiac surgery, Department of Pediatry and Department of Midwifery and Gynaecology.&#x0D; Mixed teaching model according to EURACT recommendations gives the best results. It provides a combination of individual work of future doctors with using electronic sources, media services and traditional work in auditoriums with interactive methods of teamwork.&#x0D; The use of active teaching methods should be not a practical addition to theoretical questions, but other way round, starting point to help teachers and students during the studying – these are common actions to deal successful those or others questions. Specifics of medical speciality has influence on choice of different studying technologies in medical education where both theoretical and practical components are clearly noticeable. Among the most common objection to expediency using of different technologies in education one thesis need to be highlighted: it only can be defined by patient whether doctor has necessary knowledge, practice and skills. Nowadays teaching is based on creating “virtual patient”. Instead there are active technologies and teaching methods which allow us to teach specialists effectively. Practical skills improving takes place at clinical departments and teaching-practical centres.&#x0D; Nowadays distance education helps students to develop such traits as independence, adaptability and responsibility, develops self-educational skills. All of these qualities are highly valued.&#x0D; Consequently new discipline “Medical practice in family medicine” helps students to master and consolidate practical skills, make own decisions in diagnostics and treatment of patients, considering medical ethics rules.

The Feasibility and Efficacy of a Multi-Institutional Urology Boot Camp for Incoming Urology Residents

To determine the feasibility and perceived usefulness of a pre-residency urology boot camp for first and second year urology residents. First and second year urology residents attended a multi-institutional boot camp in July 2019, which consisted of lectures, a hands-on practical, patient simulation session, and networking social event. Attendees completed a pre-course survey where they rated their comfort level in managing interpersonal, post-operative, and urology-specific scenarios on a Likert scale of 0-5. Participants completed follow-up surveys immediately and 6 months after the course regarding confidence in managing the same scenarios and the impact of boot camp on their training. 6 urology PGY1s (55%) and 5 PGY2s (45%) from 4 institutions attended the boot camp. On the precourse survey, PGY2s had higher average comfort scores compared to PGY1s for all post-operative scenarios besides hypotension but just 2 urology-specific scenarios, difficult Foley troubleshooting (4 vs 3, P < .01) and obstructing urolithiasis with urosepsis (3.6 vs 2.2, P = .05). Immediately after the course, 10 of 11 (91%) residents reported feeling better prepared to handle all scenarios. All participants reported they would recommend this training to other urology residents. Six months later, the majority of respondents reported using knowledge learned in boot camp on a daily basis. All agreed that it was a useful networking experience, and 63% had since contacted other residents they met at the course. A pre-residency boot camp is both feasible and valuable for first- and second-year urology residents for gaining practical medical knowledge and professional networking.

The Silk Road (丝绸之路) and Sources of Chinese Medicine Expansion: Part III – Histories

Medicine and knowledge of medical practice have been exchanged along the Silk Road since antiquity. Medical texts provide the vast majority of information about the drugs, techniques, and ideas that passed from foreign lands into China and became part of Chinese medicine. In addition to the medical corpus, historical works provide the backdrop for how, when, and from where these ideas and medicines entered and influenced Chinese medical practice. Examining the historical texts and the information pertaining to medical exchange can allow us to better understand how foreign cultures and practices of medicine along the Silk Road entered and influenced Chinese Medicine.

Not Guilty, but Guilty

In 1882, an accused, elderly African-Canadian woman—a former slave and known midwife, healer, and abortionist in the town of Woodstock, Ontario—was implicated in the death of a younger White woman, allegedly from a botched abortion. The article focuses on the ways the accused was viewed by the local media, specifically references to her race, age, and “suspect” knowledge of medical practices. Tried in a court of law and found not guilty, the press nevertheless declared themselves “morally certain” of her guilt and attempted to sway public opinion in a way that brought race to the forefront. The trial and its aftermath raise a number of important questions regarding socially-constructed configurations of race, gender, justice, rumour, and respectability in a nineteenth-century Ontario town chiefly populated by Anglo-Celtic Protestants.

Partnership as a legal form of exercising the profession of midwife

Abstract Introduction. The profession of midwife belongs to the medical ones. In the Polish legal system, the definition it is not of a legislative nature. It refers to liberal professions associated with practical medical knowledge. However, the profession of midwife has also been included in the catalog of liberal professions under the commercial law, and the legislature allows the practice of midwife in the form of a partnership. Nevertheless, the majority of midwives working in Poland is employed on the basis of an employment relationship and a civil law agreement, while exercising practice in the form of partnership is not a frequent choice. Aim. The purpose of this article is to profile the midwife partnership, including the approximation of its essence and purpose, as well as the rights and obligations of the partner, and discussion of the terms and conditions of the company's medical business. Summary. Compared to other commercial companies, a limited liability partnership company is an attractive legal form for exercising the profession of midwife, primarily because of the partner's liability for the company's obligations. At the same time, the midwife partnership company, by combining both a reduction of personal responsibility, transparent representation with the use of possibility of appointing a board, and the possibility of accumulating financial and intellectual capital, meets the demands of the free services market and growing competition, thereby fostering service quality.

Global Mental Health and systems of diagnostic classification: clinical and cultural perspectives

Historical and conceptual aspects of Global Health and Global Mental Health are examined and topics such as resources, professional and social attitudes toward mental disorders, the multidimensional experience of getting ill and the presence of world systems of psychiatric diagnosis and classification, are reviewed. The application of these areas of knowledge in medical practice require the integrated use of clinical and socio-cultural perspectives whose precise alignment is an essential component of accurate diagnoses, successful treatments and a consistent improvement of mental health as a component of public health. The latter includes preventive measures applicable to general populations, communities and health care proper. Management of socio-cultural aspects of diagnosis and treatment is imperative as is that of the growing relationship between mental health and neurosciences. The operationalization of this series of interactive processes must be part of legislations which, in turn, can make training, research and dissemination of the resulting data, possible.

The Quebec rural emergency department project: a cross-sectional study of a potential two-pronged strategy in the knowledge transfer process.

IntroductionHealth services research generates useful knowledge. Promotion of implementation of this knowledge in medical practice is essential. Prior to initiation of a major study on rural emergency departments (EDs), we deployed two knowledge transfer strategies designed to generate interest and engagement from potential knowledge users. The objective of this paper was to review: 1) a combined project launch and media press release strategy, and 2) a pre-study survey designed to survey potential knowledge users’ opinions on the proposed study variables.Materials and MethodsWe evaluated the impact of the project launch (presentation at two conferences hosted by key stakeholders) and media press release via a survey of participants/stakeholders and by calculating the number of media interview requests and reports generated. We used a pre-study survey to collect potential key stakeholder’ opinions on the study variables.ResultsTwenty-one of Quebec’s 26 rural EDs participated in the pre-study survey (81% participation rate). The press release about the study generated 51 press articles and 20 media request for interviews, and contributed to public awareness of a major rural research initiative. In the pre-study survey, thirteen participants (46%) mentioned prior knowledge of the research project. Results from the pre-study survey revealed that all of the potential study variables were considered to be relevant for inclusion in the research project. Respondents also proposed additional variables of interest, including factors promoting retention of human resources.ConclusionsThe present study demonstrated the potential utility of a two-pronged knowledge transfer strategy, including a combined formal launch and press release, and a pre-study survey designed to ensure that the included variables were of interest to participants and stakeholders.

Decisions about knowledge in medical practice: the effect of temporal features of a task.

A classic question of social science is how knowledge informs practice. Research on physicians' decisions about medical knowledge has focused on doctors' personal capabilities and features of the knowledge corpus, producing divergent findings. This study asks, instead, How is decision making about the use of knowledge influenced by features of work? From observations of one team's decisions in multiple clinical and administrative contexts, the author argues that making decisions is contingent upon temporal features of physicians' tasks. Physicians receive feedback at different speeds, and they must account for these speeds when judging what they can prioritize. This finding explains doctors' perceived uncertainty in other studies as a product of the long feedback loop in tasks, and their certainty or pragmatism as a product of shorter feedback loops. In these latter scenario's, physicians consider and deploy scientific knowledge after--and not before, as is usually assumed--determining a fruitful plan of action.

Mediators between Theoretical and Practical Medieval Knowledge: Medical Notebooks from the Cairo Genizah and their Significance

AbstractThis article presents a plethora of fragments from the medical notebooks found in the Cairo Genizah that comprise a unique source of historical data for scholarly study and for a better understanding of the ways in which medieval medical knowledge in Egypt was transferred from theory to practice and vice versa. These documents provide the most direct evidence we have for preferred practical medical recipes because they record the choices of medical practitioners in medieval Cairo. Since the language most commonly used in them was Judaeo-Arabic, they were evidently written by Jews. The medical genre in the notebooks was primarily pharmacopoeic, consisting of apparently original recipes for the treatment of various diseases. There are also a few notebooks onmateria medica. The subject matter of the Genizah medical notebooks shows that they were mostly of an eclectic nature, i.e. the writers had probably learnt about these treatments and recipes from their teachers, applied them at the hospitals where they worked or copied them from the books they read. Foremost among the subjects dealt with were eye diseases, followed by skin diseases, coughs and colds, dentistry and oral hygiene, and gynaecological conditions. The writers of the Genizah notebooks apparently recorded the practical medical knowledge they wished to preserve for their future use as amateur physicians, students, traditional healers or professional practitioners.

Évolution de la mortalité, de la morbidité et de la prise en charge des grands prématurés dans un centre de niveau III : comparaison des années 2000, 2005 et 2010

The very preterm birth rate has increased in the past few years. Despite advances in neonatal medicine, neurodevelopmental sequelae have not decreased, despite a perinatal plan published in France in 1994. We conducted an epidemiological comparative survey at Rouen University Hospital in order to analyze morbidity, mortality, and care of very of premature infants by comparing the years 2000, 2005, and 2010. This hospital draws on an area of 17,000 births per year. Our survey was a single-center prospective, descriptive, and comparative study. The three cohorts had the same characteristics and the mortality rate was constant for 11 years. Use of medically assisted procreation and maternal age increased over this period. Chorioamnionitis halved, whereas duration of intrapartum antibiotic therapy increased. Neonatal morbidity was stable for hyaline membrane disease, bronchopulmonary dysplasia, maternofetal or nosocomial infections, and necrotizing enterocolitis. Regarding neurological complications, intraventricular hemorrhages decreased and white matter lesions remained constant. The rate of severe retinopathy remained low. The duration of parenteral nutrition and assisted ventilation, use of postnatal corticosteroids, and length of hospitalization decreased. The breastfeeding rate has increased since 2000 in parallel with postnatal growth restriction : 39% of the premature infants had a weight under the 10th percentile at hospital discharge. Our study allowed us to follow up the changes in neonatal epidemiological characteristics, the mortality and morbidity of extreme premature infants over a period of 11 years and showed few significant changes. Knowledge of medical practices is essential to improve the short- and long-term outcome of premature infants.

Functional Realism: A Defense of Narrative Medicine

In this paper we (1) define and describe the practice of narrative medicine, (2) reveal the need for narrative medicine by exposing the presuppositions that give rise to its discounting, including a reductive empiricism and a strict dichotomy between scientific fact and narrative value, (3) show evidence of the effects of education in narrative competence in the medical clinic, and (4) present Peircean realism as the proper conceptual model for our argument that the medical school curriculum committees should give space to the employment of the scientific and literary knowledge in medical practice. On account of our argument, we contend that the medical community should tend to latitude and openness with regard to the tools we use to resolve medical problems. These tools include both biomedical and narrative knowledge.

Diretrizes brasileiras para pneumonia adquirida na comunidade em adultos imunocompetentes - 2009

Community-acquired pneumonia continues to be the acute infectious disease that has the greatest medical and social impact regarding morbidity and treatment costs. Children and the elderly are more susceptible to severe complications, thereby justifying the fact that the prevention measures adopted have focused on these age brackets. Despite the advances in the knowledge of etiology and physiopathology, as well as the improvement in preliminary clinical and therapeutic methods, various questions merit further investigation. This is due to the clinical, social, demographical and structural diversity, which cannot be fully predicted. Consequently, guidelines are published in order to compile the most recent knowledge in a systematic way and to promote the rational use of that knowledge in medical practice. Therefore, guidelines are not a rigid set of rules that must be followed, but first and foremost a tool to be used in a critical way, bearing in mind the variability of biological and human responses within their individual and social contexts. This document represents the conclusion of a detailed discussion among the members of the Scientific Board and Respiratory Infection Committee of the Brazilian Thoracic Association. The objective of the work group was to present relevant topics in order to update the previous guidelines. We attempted to avoid the repetition of consensual concepts. The principal objective of creating this document was to present a compilation of the recent advances published in the literature and, consequently, to contribute to improving the quality of the medical care provided to immunocompetent adult patients with community-acquired pneumonia.

Medieval Egyptian Judaeo-Arabic Prescriptions (and the edition of three medical prescriptions)

The literature on medicine in medieval Muslim countries in general and in Egypt in particular is vast and detailed. Yet study and assessment of the practical aspects of medicine in the Mediterranean society of the Middle Ages requires examination of authentic, practical medical knowledge. At present this can be extracted mainly from the prescriptions found in the Cairo Genizah; these supply a different and valuable dimension. On the importance and the potential of research into the medical aspects of the Genizah documents, mainly prescriptions, Goitein wrote in 1971 that “these prescriptions have to be examined by experts in the history of medicine”.

“Fossils” of practical medical knowledge from medieval Cairo

Aim of the study To asses the scientific value of the practical medical fragments found in the Cairo Genizah (10th century), as a useful source for ethnopharmacological purposes (in exposing rare and usually inaccessible original medieval practical knowledge of medicinal substances to present-day researchers), and to reconstruct the practical drugs and their uses. Materials and methods A methodology distinguishing between theoretical (about 1500 fragments) and practical medical knowledge (about 230 fragments) was created and used. The information regarding the practical medicinal substances was extracted from prescriptions (140), lists of drugs (70) and few letters of physicians. Results The reconstructed lists of practical (278) and theoretical (414) drugs allow us to recognize and quantify the gap between them in medieval times (136). Conclusions We propose that the data obtained from ancient prescriptions is comparable to ethno-pharmacological surveys. The finding of plants such as myrobalan, saffron, licorice, spikenard and lentisk, all of which have scientifically proven anti-microbial/bacterial and anti-fungal activity, sheds a helpful light on the medical decision-making of the medieval practitioners in respect of the plants they applied as drugs. With the wealth of information meticulously assembled from these time capsules we expect to make a significant contribution to contemporary efforts at locating modern drugs in ancient roots and gauging their feasibility.

Towards a new strategy to implement psychosomatic knowledge in medical practice

Editorial Psycho-somatic Medicine in Europe, Japan, and throughout the world must deal with similar problems such as the links between theoretical findings from different biological fields and programs in the basic sciences, and, on the other hand, progress in good clinical practice – from a psychosomatic perspective. What this means is good biopsycho-social primary care, family and internal medicine, and detection of psychosomatic mechanisms in the development of different chronic diseases such as asthma, hypertension, coronary heart disease, inflammatory bowel disease, diabetes, atopic dermatitis and chronic arthritis.