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Family medecine

Nick Busing, Jay Rosenfield, Kamal Rungta, Matt Raegele, Andrew Warren, Bruce Wright, Mark Walton, Ivy Oandasan, Anthony Sanfilippo, Anurag Saxena
In 2010 the Association of Faculties of Medicine of Canada, Collège des médecins du Québec, College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada launched The Future of Medical Education in Canada Postgraduate (FMEC PG) Project to examine postgraduate medical education (PGME) in Canada and make recommendations for improvement. One recommendation that emerged concerns the transitions learners experience across the undergraduate medical education-PGME-practice continuum...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
M Bernier, E Varlet
Hyperthyroidism and sub-hyperthyroidism are common illnesses. Their diagnosis and their treatment are accessible to the general practitioner in the any great majority of the cases. A careful clinical examination already allows to direct the diagnosis. The development is simple and consists of a blood dosage, an ultrasound and sometimes a scintigraphy. Rare cases and severe forms are to be recognized and to refer to specialized centre. The treatment of first intention are betablockers. The comorbidities are cardiovascular (atrial fibrillation mostly) and skeletal (osteoporosis)...
2017: Revue Médicale de Bruxelles
N Kacenelenbogen
CONTEXT: in Belgium 70 % of the children aged 0 - 14 years have at least one annual contact with their family doctor, while for the same period, only 6 - 12 % of them will see a neuropaediatrician and/or a child psychiatrist, despite the fact that a diagnostic of Externalizing behavior before the age of 6 to 7 years, such as various ways of aggressiveness, of anger or of stealing will very often alert the family, the staff of creches or nursery as well as the teachers. Other children are showing signs of Internalizing behavior, very often together with depression or other forms of anxiety...
2017: Revue Médicale de Bruxelles
Adrianna Murphy, Michel Biringanine, Bayard Roberts, Beverley Stringer, Pablo Perel, Kiran Jobanputra
BACKGROUND: Evidence is urgently needed from complex emergency settings to support efforts to respond to the increasing burden of diabetes mellitus (DM). We conducted a qualitative study of a new model of DM health care (Integrated Diabetic Clinic within an Outpatient Department [IDC-OPD]) implemented by Médecins Sans Frontières (MSF) in Mweso Hospital in eastern Democratic Republic of Congo (DRC). We aimed to explore patient and provider perspectives on the model in order to identify factors that may support or impede it...
June 23, 2017: BMC Health Services Research
Venkiteswaran Muralidhar, Md Faizul Ahasan, Ahad Mahmud Khan, Mohammad Shariful Alam
The Médecins Sans Frontiérs (MSF) established basic occupational health services to diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families in one of the more polluted areas of the world populated by 600 000 people. In spite of project limitations, an analysis of the 6-month data showed that of the original cohort of 5000, 3200 (64%) came for at least 1 consultation. Among them, 468 (14.6%) were diagnosed with suspected work-related diseases as per defined protocols...
March 20, 2017: BMJ Case Reports
R Douglas Wilson, Sylvie Langlois
OBJECTIF: Offrir aux médecins un survol des troubles génétiques courants qui devraient être pris en considération dans le cadre de l'examen gynécologique annuel d'une patiente, et ce, afin de déterminer le risque que court celle-ci ou d'en venir à procéder à des examens particuliers ou à orienter la patiente vers un autre service de sous-spécialité, en fonction de ses antécédents personnels ou familiaux. OPTIONS: Ces renseignements d'ordre génétique peuvent être utilisés aux fins de la sensibilisation des patientes et du dépistage ou du diagnostic de possibles maladies et/ou mutations...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Isabelle Gaboury, Noémie Johnson, Christine Robin, Mireille Luc, Daniel O'Connor, Johane Patenaude, Luce Pélissier-Simard, Marianne Xhignesse
OBJECTIVE: To determine whether medical training prepares FPs to meet the requirements of the Collège des médecins du Québec for their role in advising patients on the use of complementary and alternative medicine (CAM). DESIGN: Secondary analysis of survey results. SETTING: Quebec. PARTICIPANTS: Family physicians and GPs in active practice. MAIN OUTCOME MEASURES: Perceptions of the role of the physician as an advisor on CAM; level of comfort responding to questions and advising patients on CAM; frequency with which patients ask their physicians about CAM; personal position on CAM; and desire for training on CAM...
December 2016: Canadian Family Physician Médecin de Famille Canadien
Kamalini Lokuge, Meggy Verputten, Maryanne Ajakali, Bianca Tolboom, Grace Joshy, Katherine A Thurber, Daisy Plana, Steven Howes, Anastasia Wakon, Emily Banks
BACKGROUND: Levels of gender-based violence in Papua New Guinea (PNG) are high; health services for survivors are limited. Evidence from the few existing health services for survivors can inform improvements in care in this and similar settings. METHODS: Médecins Sans Frontières supported health services for survivors in Lae, PNG from 2008-2013. Routine monitoring data from August 2010-April 2013 were used to describe patient and service characteristics. RESULTS: 5,892 individuals received care over 6,860 presentations, the majority self-referred or referred by friends and family...
2016: PloS One
Doris Burtscher, Rafael Van den Bergh, Ulan Toktosunov, Nilza Angmo, Nazgul Samieva, Eva P Rocillo Arechaga
OBJECTIVES: Kyrgyzstan is one of the 27 high multidrug-resistant tuberculosis (MDR-TB) burden countries listed by the WHO. In 2012, Médecins Sans Frontières (MSF) started a drug-resistant tuberculosis (DR-TB) project in Kara Suu District. A qualitative study was undertaken to understand the perception of TB and DR-TB in order to improve the effectiveness and acceptance of the MSF intervention and to support advocacy strategies for an ambulatory model of care. METHODS: This paper reports findings from 63 interviews with patients, caregivers, health care providers and members of communities...
2016: PloS One
Dhruvin H Hirpara, Michelle C Cleghorn, Sanjeev Sockalingam, Fayez A Quereshy
BACKGROUND: Decisions leading up to surgery are fraught with uncertainty owing to trade-offs between treatment effectiveness and quality of life. Past studies on shared decision-making (SDM) have focused on the physician-patient encounter, with little emphasis on familial and cultural factors. The literature is scarce in surgical oncology, with few studies using qualitative interviews. Our objective was to explore the complexities of SDM within the setting of colorectal cancer (CRC) surgery...
June 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Andrew Brittlebank, Marc Hermans, Dinesh Bhugra, Mariana Pinto da Costa, Martina Rojnic-Kuzman, Andrea Fiorillo, Tamas Kurimay, Cecile Hanon, Danuta Wasserman, Rutger Jan van der Gaag
Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Européenne des Médecins Spécialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an additional European Framework for Competencies in Psychiatry in 2009. Yet these have not been implemented throughout Europe. In this paper, the diversity in training throughout Europe is approached from different angles: the cultural differences between countries with regards to how mental health care is considered and founded on, the cultural differences between people throughout Europe in all states...
March 2016: European Archives of Psychiatry and Clinical Neuroscience
Stella Benbaba, Petros Isaakidis, Mrinalini Das, Sonakshi Jadhav, Tony Reid, Jennifer Furin
INTRODUCTION: Directly-observed therapy (DOT) is recommended for drug-resistant tuberculosis (DR-TB) patients during their entire treatment duration. However, there is limited published evidence on implementation of direct observation (DO) in the field. This study aims to detail whether DO was followed with DR-TB patients in a Médecins Sans Frontières (MSF) tuberculosis program in Mumbai, India. METHODS: This was a cross-sectional, mixed-methods study. Existing qualitative data from a purposively-selected subset of 12 patients, 5 DOT-providers and 5 family members, were assessed in order to determine how DO was implemented...
2015: PloS One
E Mohr, J Hughes, L Snyman, B Beko, X Harmans, J Caldwell, H Duvivier, L Wilkinson, V Cox
In response to the growing burden of drug-resistant tuberculosis (DR-TB) in South Africa (SA), Médecins Sans Frontières (MSF), with local government health departments, piloted a decentralised model of DR-TB care in Khayelitsha, Western Cape Province, in 2007. The model takes a patient-centred approach to DR-TB treatment that is integrated into existing TB and HIV primary care programmes. One essential component of the model is individual and family counselling to support adherence to and completion of treatment...
August 2015: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Caris E Grimes, Michael L Billingsley, Anna J Dare, Nigel Day, Imogen Mabey, Sara Naraghi, Peter M George, Michael Murowa, Thaim B Kamara, Nyengo C Mkandawire, Andy Leather, Christopher B D Lavy
BACKGROUND: Awareness is growing of both the importance of surgical disease as a major cause of death and disability in low-income and middle-income countries (LMICs) and the cost-effectiveness of fairly simple surgical interventions. We hypothesised that surgical disease predominantly affects young adults and is therefore significant in both the macroeconomic effect of untreated disease and the microeconomic effects on patients and families in low-resource settings. METHODS: We retrospectively reviewed all admission data from two rural government district hospitals, Bo District Hospital in Sierra Leone and Thyolo District Hospital in Malawi...
April 27, 2015: Lancet
Harvey Levin
This paper comments on the report by a committee of La Société Française de Médecine Physique et de Réadaptation (SOFMER) in response to the Haute Autorité de santé in France concerning the classification and clinical management of disorders of comportment following moderate to severe traumatic brain injury (TBI). In view of the large number of patients and families affected by these disorders, there is a strong rationale for these guidelines to ensure that clinical assessment and treatment is evidence-based...
February 2016: Annals of Physical and Rehabilitation Medicine
Nick Busing, Ken Harris, Anne-Marie MacLellan, Geneviève Moineau, Ivy Oandasan, James Rourke, Anurag Saxena
The Future of Medical Education in Canada Postgraduate (FMEC PG) Project was launched in 2010 by a consortium of four organizations: the Association of Faculties of Medicine of Canada, the Collège des Médecins du Québec, the College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada. The FMEC PG study set out to review the state of the Canadian postgraduate medical education (PGME) system and make recommendations for improvements and changes. The extensive process included literature reviews, commissioned papers, stakeholder interviews, international consultations, and dialogue with the public and learners...
September 2015: Academic Medicine: Journal of the Association of American Medical Colleges
Morgan Houguet
The association Médecins du Monde, through its Missions France programmes, works to improve the state of health of marginalised populations in France. For these people, it seeks to favour access to care, rights and prevention. One such project has been set up in Nantes, aimed at Roma families. A young hospital nurse shares his experience of his voluntary work promoting oral health.
June 2015: Revue de L'infirmière
Sakib Burza, Raman Mahajan, Elisa Marino, Temmy Sunyoto, Chandra Shandilya, Mohammad Tabrez, Kabita Kumari, Prince Mathew, Amar Jha, Nuria Salse, Kripa Nath Mishra
BACKGROUND: An estimated one-third of the world's children who are wasted live in India. In Bihar state, of children <5 y old, 27.1% are wasted and 8.3% have severe acute malnutrition (SAM). In 2009, Médecins Sans Frontières (MSF) initiated a community-based management of acute malnutrition (CMAM) program for children aged 6-59 mo with SAM. OBJECTIVE: In this report, we describe the characteristics and outcomes of 8274 children treated between February 2009 and September 2011...
April 2015: American Journal of Clinical Nutrition
Doris Burtscher, Sakib Burza
OBJECTIVE: Since 2009, Médecins Sans Frontières has implemented a community management of acute malnutrition (CMAM) programme in rural Biraul block, Bihar State, India that has admitted over 10 000 severely malnourished children but has struggled with poor coverage and default rates. With the aim of improving programme outcomes we undertook a qualitative study to understand community perceptions of childhood undernutrition, the CMAM programme and how these affected health-seeking behaviour...
December 2015: Public Health Nutrition
Julita Gil Cuesta, Narcisse Mukembe, Palle Valentiner-Branth, Pawel Stefanoff, Annick Lenglet
The Democratic Republic of Congo (DRC) has committed to eliminate measles by 2020. In 2013, in response to a large outbreak, Médecins Sans Frontières conducted a mass vaccination campaign (MVC) in Moba, Katanga, DRC. We estimated the measles vaccination coverage for the MVC, the Expanded Programme on Immunization routine measles vaccination (EPI) and assessed reasons for non-vaccination. We conducted a household-based survey among caretakers of children aged 6 months-15 years in Moba from November to December 2013...
2015: PLoS Currents
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