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Integrating complementary medicine and health care services into practice.

LaValley, J W; Verhoef, M J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 01/07/1995 Português
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Complementary medicine and health care services constitute a significant proportion of the use of health care services in Canada, despite a history of limited acceptance of these therapies by the medical profession. However, physician attitudes appear to be changing. A survey of a random sample of general practitioners in Quebec (see page 29 of this issue) shows that four out of five general practitioners perceive at least one of three complementary health care services to be useful. Similar surveys of samples in Alberta and Ontario suggest that physicians there, although somewhat less enthusiastic than their counterparts in Quebec, have also begun to be more open-minded about these types of therapies. However, physicians have reported little understanding of complementary health care services, which suggests the need for more research on and education about these services. The Medical Society of Nova Scotia has responded to this need by establishing a Section of Complementary Medicine. The authors believe that fair, accountable, scientific and rigorous research on complementary therapies will benefit physicians and patients. The problems inherent in applying reductionist analysis to a holistic approach to care can be largely circumvented by focusing on outcomes research. In light of the popularity of these therapies...

Biological Basis of Determinants of Health

Bortz, Walter M.
Fonte: © American Journal of Public Health 2005 Publicador: © American Journal of Public Health 2005
Tipo: Artigo de Revista Científica
Publicado em /03/2005 Português
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Clinical medicine and health policy planning find common cause as they seek to define the determinants of health. There is substantial recent interest in the social ecology in which health is embedded. However, biology is where these contributing environmental factors are translated.

Ethical Challenges of Medicine and Health on the Internet: A Review

Dyer, Kirsti A
Fonte: Gunther Eysenbach Publicador: Gunther Eysenbach
Tipo: Artigo de Revista Científica
Publicado em 28/06/2001 Português
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66.871123%
Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet raises many questions involving what sort of ethical conduct should be expected by practitioners and developers of the medical Internet. Some of the early pioneers in medical and healthcare Web sites pushed the ethical boundaries with questionable, even unethical, practices. Many involved with the medical Internet are now working to reestablish patient and consumer trust by establishing guidelines to determine how the fundamentals of the medical code of ethical conduct can best be adapted for the medical/healthcare Internet. Ultimately, all those involved in the creation, maintenance, and marketing of medical and healthcare Web sites should be required to adhere to a strict code of ethical conduct, one that has been fairly determined by an impartial international organization with reasonable power to regulate the code. This code could also serve as a desirable, recognizable label-of-distinction for ethical Web sites within the medical and healthcare Internet community. One challenge for those involved with the medical and healthcare Internet will be to determine what constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics...

Manual of Travel Medicine and Health

Posey, Drew L.
Fonte: Centers for Disease Control and Prevention Publicador: Centers for Disease Control and Prevention
Tipo: Artigo de Revista Científica
Publicado em /07/2004 Português
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76.635605%
Manual of Travel Medicine and Health

Training Physician Investigators in Medicine and Public Health Research

Gourevitch, Marc N.; Jay, Melanie R.; Goldfrank, Lewis R.; Mendelsohn, Alan L.; Dreyer, Benard P.; Foltin, George L.; Lipkin, Mack; Schwartz, Mark D.
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Português
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Objectives. We have described and evaluated the impact of a unique fellowship program designed to train postdoctoral, physician fellows in research at the interface of medicine and public health.

Public Health, Academic Medicine, and the Alcohol Industry’s Corporate Social Responsibility Activities

Babor, Thomas F.; Robaina, Katherine
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Português
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66.796357%
We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives.

Modeling of Novel Diagnostic Strategies for Active Tuberculosis – A Systematic Review: Current Practices and Recommendations

Zwerling, Alice; White, Richard G.; Vassall, Anna; Cohen, Ted; Dowdy, David W.; Houben, Rein M. G. J.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Português
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Introduction: The field of diagnostics for active tuberculosis (TB) is rapidly developing. TB diagnostic modeling can help to inform policy makers and support complicated decisions on diagnostic strategy, with important budgetary implications. Demand for TB diagnostic modeling is likely to increase, and an evaluation of current practice is important. We aimed to systematically review all studies employing mathematical modeling to evaluate cost-effectiveness or epidemiological impact of novel diagnostic strategies for active TB. Methods: Pubmed, personal libraries and reference lists were searched to identify eligible papers. We extracted data on a wide variety of model structure, parameter choices, sensitivity analyses and study conclusions, which were discussed during a meeting of content experts. Results & Discussion From 5619 records a total of 36 papers were included in the analysis. Sixteen papers included population impact/transmission modeling, 5 were health systems models, and 24 included estimates of cost-effectiveness. Transmission and health systems models included specific structure to explore the importance of the diagnostic pathway (n = 4), key determinants of diagnostic delay (n = 5), operational context (n = 5), and the pre-diagnostic infectious period (n = 1). The majority of models implemented sensitivity analysis...

Using Health Care Utilization and Publication Patterns to Characterize the Research Portfolio and to Plan Future Research Investments

Katz, Luba; Fink, Rebecca V.; Bozeman, Samuel R.; McNeil, Barbara J.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Português
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66.94265%
Objective: Government funders of biomedical research are under increasing pressure to demonstrate societal benefits of their investments. A number of published studies attempted to correlate research funding levels with the societal burden for various diseases, with mixed results. We examined whether research funded by the Department of Veterans Affairs (VA) is well aligned with current and projected veterans’ health needs. The organizational structure of the VA makes it a particularly suitable setting for examining these questions. Methods: We used the publication patterns and dollar expenditures of VA-funded researchers to characterize the VA research portfolio by disease. We used health care utilization data from the VA for the same diseases to define veterans’ health needs. We then measured the level of correlation between the two and identified disease groups that were under- or over-represented in the research portfolio relative to disease expenditures. Finally, we used historic health care utilization trends combined with demographic projections to identify diseases and conditions that are increasing in costs and/or patient volume and consequently represent potential targets for future research investments. Results: We found a significant correlation between research volume/expenditures and health utilization. Some disease groups were slightly under- or over-represented...

Florida International University School of Medicine Initiative: Board of Governors Presentation Draft

School of Medicine
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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Annotated draft of a presentation for the Board of Governors on the Florida International University School of Medicine Initiative. Presentation provides an overview of the proposed outcomes resulting from the establishmend of a School of Medicine at Florida International University and the impact on the physician shortage and health care in South Florida.

Impact of a Comprehensive Nutrition and Lifestyle Education Intervention on Body Weight and Health-Related Outcomes in Morbidly-Obese Hispanic-Americans Following Laparoscopic Roux-En Y Gastric Bypass

Petasne Nijamkin, Monica
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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76.529277%
As morbid obesity increasingly affects Hispanic-Americans, the incidence of Roux-en-Y gastric bypass procedures (RYGB) among this population rises. Prospective research on the impact of postoperative educational interventions focused on Hispanic-Americans is needed to prevent premature weight loss plateau, weight regain, nutritional deficiencies, and relapse of obesity-related comorbidities. This randomized-controlled study evaluated the impact of a comprehensive nutrition and lifestyle education intervention (6 biweekly postoperative sessions that incorporated motivational strategies for behavioral change) as compared to a non-comprehensive approach (printed guidelines for healthy lifestyle). The variables to consider are body weight, obesity-related comorbidities (depression, diabetes, dyslipidemia, and others), nutrient status, physical activity, and eating habits in 144 morbidly-obese adult Hispanic-Americans 6 to 12 months following RYGB. Patients were randomly assigned to either the comprehensive intervention (n=72) or the comparison group (n=72). Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born females (83.3%). Intervention sessions attendance was 64%. At 12 months, both groups lost weight significantly, but those in the comprehensive intervention experienced greater excess weight loss than those in the comparison group (80% vs. 64% from preoperative excess weight...

Attitudes of teachers to evidence based medicine

Kljakovic, Marjan; Love, Tom; Gilbert, Amanda
Fonte: Royal Australian College of General Practitioners; http://www.racgp.org.au/ Publicador: Royal Australian College of General Practitioners; http://www.racgp.org.au/
Tipo: Journal article; Published Version Formato: 3 pages
Português
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AIM: To describe the attitudes of general practitioners and specialist clinical teachers toward teaching evidence based medicine (EBM). PARTICIPANTS AND METHODS: Questionnaire survey of 114 general practitioner and 162 specialist university teachers teaching EBM. RESULTS: Two hundred and six (80%) teachers responded; 196 regularly consulted with patients, 21% had received training, and 40% taught EBM. Those with formal training (68%) taught more often than without (32%) (p=0.0001), 27% had taught EBM for over 5 years. More GPs (57%) than specialists (40%) asked students to assist in finding evidence (p=0.036). Most welcomed EBM and were confident in teaching it. Barriers included antagonism to EBM philosophy, shortage of time, and a need for training in teaching EBM. DISCUSSION: Although not all trained, GPs and specialists teach EBM, enjoy doing so, and want to increase their ability to teach it.; At time of writing, Marjan Kljakovic affiliated with University of Otago, Wellington School of Medicine and Health Sciences, General Practice, Convenor of Evidence Based Medicine Teaching

A Call for Medical Pluralism in America: Integrating Traditional Chinese Medicine and Western Medicine

Kong, Jiayi
Fonte: Rice University Publicador: Rice University
Tipo: articles
Português
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Submission to the Friends of Fondren Library Undergraduate Research Awards, 2012; China has adopted a unique policy of medical pluralism, whereby traditional Chinese medicine (TCM) and western biomedicine (WM) are both widely used in the health care system to provide optimal health outcomes to patients. Indeed, this fusion of traditional and western principles may seem contradictory, as there are fundamental differences in philosophy between TCM and WM. For example, TCM emphasizes the concepts of “Qi, Zang”, the “Yin-Yang” theory, “Shen”, and “Bianzheng lunzhi”. To the Chinese, health is viewed holistically, encompassing psychology, activity and diet. On the other hand, WM is much more concerned with intervention, focusing on the biological determinants of illness, and viewing health simply as the absence of disease. Despite these differences in theory, there are great advantages to combining TCM and WM, as illustrated in the successful integration seen in China since the 1950s. This integration improves health outcomes in chronic diseases. Furthermore, it also increases cost-effectiveness of health care. Finally, it meets an increasing demand for complementary medicine and cultural sensitivity. Indeed, research shows that the application of both TCM and WM in many cases would be more efficacious than the use of just one method alone. In the future...

Services and support for IU School of Medicine and Clinical Affairs Schools by the UITS/PTI Advanced Biomedical Information Technology Core and Research Technologies Division in FY 2013 - Extended Version

Stewart, Craig A.; Barnett, William K.; Link, Matt R.; Shankar, Ganesh; Miller, Therese; Michael, Scott; Henschel, Robert; Boyles, Mike J.; Wernert, Eric; Quick, Robert
Fonte: Indiana University: UITS/PTI ABITC and RT Division Publicador: Indiana University: UITS/PTI ABITC and RT Division
Tipo: Relatório
Português
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The report presents information on services delivered in FY 2013 by ABITC and RT to the IU School of Medicine and the other Clinical Affairs schools that include the Schools of Nursing, Dentistry, Health and Rehabilitation Sciences, and Optometry; the Fairbanks School of Public Health at IUPUI; the School of Public Health at IU Bloomington; and the School of Social Work.

Percepções discentes sobre a Estratégia de Saúde da Família e a escolha pela especialidade de Medicina de Família e Comunidade; Students' perceptions of the Family Health Strategy and Choose the Specialty of Family Medicine and Community

Issa, Afonso Henrique Teixeira Magalhaes
Fonte: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Ensino na Saúde (FM); Faculdade de Medicina - FM (RG) Publicador: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Ensino na Saúde (FM); Faculdade de Medicina - FM (RG)
Tipo: Dissertação Formato: application/pdf
Português
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67.073394%
Objective: To analyze the perceptions of undergraduates in medicine in relation to the work of the Family Health Strategy (FHS) and the influencing factors in choosing the specialty of Family Medicine and Community (FM). Materials and Methods: An exploratory and qualitative study of a cross-sectional nature involving undergraduates in the 11th period of the medical school of the University Center of Anápolis (UniEVANGÉLICA) which is located in the Central-West region of Brazil. The study involved the examination of data collected from the body of students involved in a course of study who have been selected after approval by the Ethics and Research Committee. In the research, two instruments for collecting data and information were used: Firstly a questionnaire and secondly a roadmap for semi-structured interviews. This approach was taken in order to Identify Socioeconomic Characterization along with the Identification of Occupational Aspirations and analysis of factors that influence their choice of FM by using the technique of content analysis. Results and Discussion: None of the interviewed graduates opted to specialize in FM. The low social status, low wages, lack of labor rights, the experience of little contact with medical specialists during the course...

Do Ask, Do Tell: High Levels of Acceptability by Patients of Routine Collection of Sexual Orientation and Gender Identity Data in Four Diverse American Community Health Centers

Cahill, Sean; Singal, Robbie; Grasso, Chris; King, Dana; Mayer, Kenneth; Baker, Kellan; Makadon, Harvey
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Português
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Background: The Institute of Medicine and The Joint Commission have recommended asking sexual orientation and gender identity (SOGI) questions in clinical settings and including such data in Electronic Health Records (EHRs). This is increasingly viewed as a critical step toward systematically documenting and addressing health disparities affecting lesbian, gay, bisexual, and transgender (LGBT) people. The U.S. government is currently considering whether to include SOGI data collection in the Stage 3 guidelines for the incentive program promoting meaningful use of EHR. However, some have questioned whether acceptable standard measures to collect SOGI data in clinical settings exist. Methods: In order to better understand how a diverse group of patients would respond if SOGI questions were asked in primary care settings, 301 randomly selected patients receiving primary care at four health centers across the U.S. were asked SOGI questions and then asked follow-up questions. This sample was mainly heterosexual, racially diverse, and geographically and regionally broad. Results: There was a strong consensus among patients surveyed about the importance of asking SOGI questions. Most of the LGBT respondents thought that the questions presented on the survey allowed them to accurately document their SOGI. Most respondents—heterosexual and LGBT—answered the questions...

Addressing Health and Health-Care Disparities: The Role of a Diverse Workforce and the Social Determinants of Health

Jackson, Chazeman S.; Gracia, J. Nadine
Fonte: Association of Schools of Public Health Publicador: Association of Schools of Public Health
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
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Despite major advances in medicine and public health during the past few decades, disparities in health and health care persist. Racial/ethnic minority groups in the United States are at disproportionate risk of being uninsured, lacking access to care, and experiencing worse health outcomes from preventable and treatable conditions. As reducing these disparities has become a national priority, insight into the social determinants of health has become increasingly important. This article offers a rationale for increasing the diversity and cultural competency of the health and health-care workforce, and describes key strategies led by the U.S. Department of Health and Human Services' Office of Minority Health to promote cultural competency in the health-care system and strengthen community-level approaches to improving health and health care for all.

What is “colonial” about medieval colonial medicine? Iberian health in global context

McCleery, Iona
Fonte: Routledge Publicador: Routledge
Tipo: Artigo de Revista Científica
Português
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66.775415%
Colonial medicine is a thriving field of study in the history of nineteenth- and twentieth-century medicine. Medicine can be used as a lens to view colonialism in action and as a way to critique colonialism. This article argues that key debates and ideas from that modern field can fruitfully be applied to the Middle Ages, especially for the early empires of Spain and Portugal (mid-fourteenth to mid-sixteenth centuries). The article identifies key modern debates, explores approaches to colonization and colonialism in the Middle Ages and discusses how medieval and modern medicine and healthcare could be compared using colonial and postcolonial discourses. The article ends with three case studies of healthcare encounters in Madeira, Granada and Hispaniola at the end of the fifteenth century.

Knowledges, practices on Work and Health and the approaches on social medicine and labour medicine in Brasil: end of XIX century up to fifties-sixties of XX century; Conhecimentos, práticas em Trabalho-Saúde e as abordagens da medicina social e da medicina do trabalho no Brasil: final do século XIX até os anos 1950-60

Lacaz, Francisco Antonio de Castro
Fonte: Universidade de São Paulo. Instituto de Psicologia Publicador: Universidade de São Paulo. Instituto de Psicologia
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 01/06/2007 Português
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67.257505%
The article deals with the historic-institutional trajectory of the approaches on work and health in Brazil, from the late Nineteenth Century up to the 1960s'. It is a qualitative study, with documental analysis and interviews, in wich is adopted the approach by Foucault on social medicine, and the Archeology as methodology. The historic-institutional trajectory in the interfaces between work and health starts by the approach of urban social medicine untill medicine of work force, and discuss replacement of the public health by the work sectors in the actions of the State, at the industrialization post-1930. It points at many ways to conceive the referred relationships influenced by the paradigm of the rational organization of work, the hegemonic way of work management. It traces back the industrial hygiene, the infortunistica, the psychotecnique and the behaviourial medicine as important tools of workforce-control, emphasising the effect of the industrial hygiene and its “dispute” with the occupational health and labor medicine in the 1950-60s. During consolidation of the brazilian industrialization process, in the fifties, the medical services in the enterprises crops up, as strategy, based in the OMS/OIT concept of labor medicine...

Reproductive health and health sector reform in developing countries: establishing a framework for dialogue

Lubben,Marianne; Mayhew,Susannah H.; Collins,Charles; Green,Andrew
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2002 Português
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It is not clear how policy-making in the field of reproductive health relates to changes associated with programmes for the reform of the health sector in developing countries. There has been little communication between these two areas, yet policy on reproductive health has to be implemented in the context of structural change. This paper examines factors that limit dialogue between the two areas and proposes the following framework for encouraging it: the identification of policy groups and the development of bases for collaborative links between them; the introduction of a common understanding around relevant policy contexts; reaching agreement on compatible aims relating to reproductive health and health sector change; developing causal links between policy content in reproductive health and health sector change as a basis for evidence-based policy-making; and strengthening policy-making structures, systems, skills, and values.

Private sector, human resources and health franchising in Africa

Prata,Ndola; Montagu,Dominic; Jefferys,Emma
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2005 Português
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In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers...