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Medical model of inquiry

Katherine Rouleau, Monique Bourget, Patrick Chege, Francois Couturier, Paula Godoy-Ruiz, Paul H Grand'Maison, Melanie Henry, Kerling Israel, Videsh Kapoor, Hendra Kurniawan, Louella Lobo, Mahamane Maiga, Samantha Pereira Franca, Lynda Redwood-Campbell, Jamie Rodas, Raman Sohal, Dawit Wondimagegn, Robert Woolard
BACKGROUND AND OBJECTIVES: There is a limited evidentiary base on the development of family medicine in different contexts and countries. The lack of evidence impedes our ability to compare and characterize family medicine models and identify areas of success that have led to the effective provision of care. This paper offers a comparative compilation and analysis of the development of family medicine training programs in seven countries: Brazil, Canada, Ethiopia, Haiti, Indonesia, Kenya, and Mali...
March 8, 2018: Family Medicine
Aine Marie Kelly, Patricia B Mullan
Teaching and assessing trainees' professionalism now represents an explicit expectation for Accreditation Council Graduate Medical Education-accredited radiology programs. Challenges to meeting this expectation include variability in defining the construct of professionalism; limits of traditional teaching and assessment methods, used for competencies historically more prominent in medical education, for professionalism; and emerging expectations for credible and feasible professionalism teaching and assessment practices in the current context of health-care training and practice...
February 22, 2018: Academic Radiology
E N Leonova, Yu P Shakir'yanova, S V Leonov, A S Mosoyan, Yu I Pigolkin
Forensic medical expertise carried out with a view to reconstruction of an event is a time-consuming procedure because it requires collection of a large amounts of various materials for the institution of a criminal investigation including physical evidence, photoboards of the site of an occurrence, etc. A forensic medical expert may encounter difficulties when reconstructing and scrutinizing the scene of action at a single computer monitor in order to analyze the behaviour of each participant of the event...
2018: Sudebno-meditsinskaia Ekspertiza
Katie Lutz, Stefan R Rowniak, Prabjot Sandhu
In the 25 years since advance care planning first drew the attention of the national healthcare and legal systems, gains in the rate of advance care directive completion have been negligible despite the effort of researchers, ethicists, and lawmakers. With the benefit of sophisticated healthcare technology, patients are living longer. Despite the benefits of increased longevity, it is widely acknowledged that enough has not been done to adequately address end-of-life care decisions at the crossroads between medical futility and quality of life...
December 29, 2017: Journal of Religion and Health
Lil Deverell, Denny Meyer, Bee Theng Lau, Abdullah Al Mahmud, Suku Sukunesan, Jahar Bhowmik, Almon Chai, Chris McCarthy, Pan Zheng, Andrew Pipingas, Fakir M Amirul Islam
INTRODUCTION: Orientation and mobility (O&M) specialists assess the functional vision and O&M skills of people with mobility problems, usually relating to low vision or blindness. There are numerous O&M assessment checklists but no measures that reduce qualitative assessment data to a single comparable score suitable for assessing any O&M client, of any age or ability, in any location. Functional measures are needed internationally to align O&M assessment practices, guide referrals, profile O&M clients, plan appropriate services and evaluate outcomes from O&M programmes (eg, long cane training), assistive technology (eg, hazard sensors) and medical interventions (eg, retinal implants)...
December 21, 2017: BMJ Open
Prasanna Ananth, Clement Ma, Hasan Al-Sayegh, Leah Kroon, Victoria Klein, Claire Wharton, Elise Hallez, Ilana Braun, Kelly Michelson, Abby R Rosenberg, Wendy London, Joanne Wolfe
BACKGROUND: Although medical marijuana (MM) may have utility in the supportive care of children with serious illness, it remains controversial. We investigated interdisciplinary provider perspectives on legal MM use in children with cancer. METHODS: We sent a 32-item, cross-sectional survey to 654 pediatric oncology providers in Illinois, Massachusetts, and Washington characterizing MM practices, knowledge, attitudes, and barriers. Forty-eight percent responded; 44% (n = 288) were included in analyses...
December 12, 2017: Pediatrics
Amanda W Harrist, Glade L Topham, Laura Hubbs-Tait, Lenka H Shriver, Taren M Swindle
In recent years, researchers and policymakers have recognized that obesity in childhood is not simply a medical problem, but is a complex social and psychological phenomenon. Our research team used an interpersonal and intrapersonal risk model to examine the psychosocial aspects of obesity among rural children. In this article, we describe how the global study of children's obesity has broadened over the last 10 to 15 years, and we present our model of interpersonal and intrapersonal risk factors, which includes complex pathways with many psychosocial variables...
December 2017: Child Development Perspectives
Catherine Panter-Brick, Mark Eggerman
Conceptually and methodologically, medical anthropology is well-positioned to support a "big-tent" research agenda on health and society. It fosters approaches to social and structural models of health and wellbeing in ways that are critically reflective, cross-cultural, people-centered, and transdisciplinary. In this review article, we showcase these four main characteristics of the field, as featured in Social Science & Medicine over the last fifty years, highlighting their relevance for an international and interdisciplinary readership...
October 31, 2017: Social Science & Medicine
Shabnam Javdani, Sukhmani Singh, Corianna E Sichel
In this article, we describe ethical tensions we have faced in the context of our work as intervention scientists, where we aim to promote social justice and change systems that impact girls involved in the juvenile legal system. These ethical tensions are, at their core, about resisting collusion with systems of control while simultaneously collaborating with them. Over the course of designing and implementing a randomized controlled trial (RCT) of an ecological advocacy intervention for girls, called ROSES, ethical paradoxes crystalized and prompted us to engage in critical reflection and action toward the aim of moving away from conducting research on legal-system-involved girls and moving toward a more democratic, participatory process of inquiry with girls...
October 13, 2017: American Journal of Community Psychology
Eliza Zamor, Munashe Chigerwe, Karen A Boudreaux, Jan E Ilkiw
The objective of this study was to determine if a revised, recently implemented curriculum, embracing an integrated block design with a focus on student-centered, inquiry-based learning, had a different effect on veterinary medical students' approaches to studying than the previous curriculum. A total of 577 students completed a questionnaire consisting of the short version of the Approaches and Study Skills Inventory for Students (ASSIST). It included questions relating to conceptions about learning, approaches to studying, and preferences for different types of courses and teaching...
December 0: Journal of Veterinary Medical Education
Ninnie Borendal Wodlin
INTRODUCTION: The objectives were to establish the prevalence of persistent vaginal bleeding following subtotal hysterectomy, to analyze the effect of intraoperative cervical treatment on the occurrence of persistent vaginal bleeding, and to evaluate the impact of persistent vaginal bleeding on the patient-reported opinion concerning result of surgery and medical condition. MATERIAL AND METHODS: Retrospective study with data from the Swedish National Register for Gynecological Surgery including 5240 women undergoing subtotal hysterectomy for benign conditions between January 2004 and June 2016...
December 2017: Acta Obstetricia et Gynecologica Scandinavica
Yu Yang, Xiaofeng Zhou, Shuangqing Gao, Hongbo Lin, Yanming Xie, Yuji Feng, Kui Huang, Siyan Zhan
INTRODUCTION: Electronic healthcare databases (EHDs) are used increasingly for post-marketing drug safety surveillance and pharmacoepidemiology in Europe and North America. However, few studies have examined the potential of these data sources in China. METHODS: Three major types of EHDs in China (i.e., a regional community-based database, a national claims database, and an electronic medical records [EMR] database) were selected for evaluation. Forty core variables were derived based on the US Mini-Sentinel (MS) Common Data Model (CDM) as well as the data features in China that would be desirable to support drug safety surveillance...
August 16, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Mark Honigsbaum
Reflecting on his scientific career toward the end of his life, the French-educated medical researcher René Dubos presented his flowering as an ecological thinker as a story of linear progression-the inevitable product of the intellectual seeds planted in his youth. But how much store should we set by Dubos's account of his ecological journey? Resisting retrospective biographical readings, this paper seeks to relate the development of Dubos's ecological ideas to his experimental practices and his career as a laboratory researcher...
September 2017: History and Philosophy of the Life Sciences
Rajesh Vedanthan, Jemima H Kamano, Hana Lee, Benjamin Andama, Gerald S Bloomfield, Allison K DeLong, David Edelman, Eric A Finkelstein, Joseph W Hogan, Carol R Horowitz, Simon Manyara, Diana Menya, Violet Naanyu, Sonak D Pastakia, Thomas W Valente, Cleophas C Wanyonyi, Valentin Fuster
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality worldwide, with >80% of CVD deaths occurring in low and middle income countries (LMICs). Diabetes mellitus and pre-diabetes are risk factors for CVD, and CVD is the major cause of morbidity and mortality among individuals with DM. There is a critical period now during which reducing CVD risk among individuals with diabetes and pre-diabetes may have a major impact. Cost-effective, culturally appropriate, and context-specific approaches are required...
June 2017: American Heart Journal
Ferdinand C Mukumbang, Sara Van Belle, Bruno Marchal, Brian van Wyk
BACKGROUND: Poor retention in care and non-adherence to antiretroviral therapy (ART) continue to undermine the success of HIV treatment and care programmes across the world. There is a growing recognition that multifaceted interventions - application of two or more adherence-enhancing strategies - may be useful to improve ART adherence and retention in care among people living with HIV/AIDS. Empirical evidence shows that multifaceted interventions produce better results than interventions based on a singular perspective...
May 4, 2017: BMC Public Health
Ezra Gabbay, Matthew W McCarthy, Joseph J Fins
The Ultra-Orthodox Jewish community embraces a system of values and a rigorous behavioral code that are deeply rooted in religious tradition and history. Here we describe some of the unique challenges that stem from the encounter between modern medical practice and the Ultra-Orthodox world. Through examples of clinical and ethical scenarios ranging from prenatal care to end-of-life decisions, we illustrate problems related to observance of age-old practices in a modern hospital setting, balancing acceptance of Divine will with standard risk assessment, reconciliation of patient autonomy with deference to rabbinic authority and fear of stigma associated with mental illness in a traditional society...
April 2017: Journal of Religion and Health
Sara C Keller, Ayse P Gurses, Nicole Werner, Dawn Hohl, Ashley Hughes, Bruce Leff, Alicia I Arbaje
Medical devices, or instruments or tools to manage disease, are increasingly used in the home, yet there have been limited evaluations of how older adults and caregivers safely use these devices. This study concerns a qualitative evaluation of (1) barriers and facilitators of appropriate use, and (2) outcomes of inappropriate use, among older adults at the transition from hospital to home with skilled home health care (SHHC). Guided by a human factors engineering work system model, the authors (1) conducted direct observations with contextual inquiry of the start-of-care or resumption-of-care SHHC provider visit, and (2) semi-structured interviews with 24 older adults and their informal caregivers, and 39 SHHC providers and administrators...
August 2017: Population Health Management
Lynette Reid
Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration (conceptual, practical, and ethical) call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries (the concept of medical need) and on the normative questions raised by complex models of funding and delivery of care, where patients, providers, and services cross system boundaries...
June 2017: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
Nanda C de Knegt, Frank Lobbezoo, Carlo Schuengel, Heleen M Evenhuis, Erik J A Scherder
Objective: The aim of the present study was to examine whether cognitive functioning (i.e., memory and executive functioning) is related to self-reported presence of pain (i.e., affirmative answer to the question whether the individual feels pain) and experience of pain (i.e., intensity and affect) in adults with Down syndrome (DS). Design, Setting, and Subjects: Cross-sectional study of 224 adults with DS (mean age = 38.1 years, mild-severe intellectual disabilities) in the Netherlands...
July 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Alexandra C Sundermann, Troy D Abell, Lisa C Baker, Mark B Mengel, Kathryn E Reilly, Michael A Bonow, Gregory E Hoy, Richard D Clover
BACKGROUND: The specialization of human fat deposits is an inquiry of special importance in the study of fetal growth. It has been theorized that maternal lower-body fat is designated specifically for lactation and not for the growth of the fetus. OBJECTIVE: Our goal was to compare the contributions of maternal upper-body versus lower-body adiposity to infant birth weight. We hypothesized that upper-body adiposity would be strongly associated with infant birth weight and that lower-body adiposity would be weakly or negligibly associated with infant birth weight-after adjusting for known determinants...
November 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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