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Biomedical subjects

J Parboosingh

Publications and source records attributed to J Parboosingh.

At least 19 recordsLinked to original sources
PubMed2000

Credentialing physicians: challenges for continuing medical education.

BACKGROUND: Professionals involved in the regulation, credentialing, and certification of physicians around the world met in Chicago in June 2000 to discuss systems to ensure the competence of physicians. We learned that public demand for evidence of continuing competence in practice is driving the profession in most countries to explore new approaches to the education and assessment of physicians. Most groups have called the value of traditional continuing medical education (CME) into question and are exploring the use of self-directed CME methods, self-assessment, and quality improvement as the main instruments for maintenance of certification. It seems likely that teachers will be required to integrate assessment with enhancement of competencies, in much the same way that a coach uses an athlete's performance as a basis for continuous improvement. Recognizing the tough challenges ahead and the demand for CME to adapt to complement future plans for continuous assessment of physician competence, conference participants agreed to create a communication network that would facilitate information sharing and avoid duplication of research efforts.

Clinical Competence↗
PubMed1999

A catalyst for change in communication skills: the Canadian Breast Cancer Initiative.

A major focus of the Canadian Breast Cancer Initiative (CBCI) has been the development of the programming, partnerships and networks necessary to enhance communication skills within the physician-patient relationship. In this paper, the rationale for taking this approach and the scope of the activities that have been undertaken will be described, as well as the rationale for producing this series of papers. February has been chosen as the month of publication, as previous major activities of the CBCI in the area of physician-patient communication skills have been held in the month of February. It is hoped that February may become known as Communication Skills Month just as October is Breast Cancer Month: the gauntlet is thrown down to others to continue making February the month to reinforce the significance of physician-patient communication skills in the provision of quality health care.

Breast Neoplasms↗
PubMed1996

[Initial experience with the PCDiary: software for physicians for documenting and evaluating individual learning].

A computer diary was developed for physicians to create a portfolio of their self-directed learning. Each item of learning is recorded in the form of a question along with the stimulus, the learning resources used and the outcome planned for the learning. The records of 123 physicians which volunteered to use the diary were analyzed. Their response to the software, elicited by survey, is described. Items of learning were most often stimulated by scanning the literature and while seeking information to manage a patient. The physicians recorded their intent to change their practice as the outcome to learning most often when the learning was stimulated while managing a patient. One-half of the physicians reported that keeping the diary made them think about their patient care.

Attitude of Health Personnel↗
PubMed1995

Determining priorities for family physician education in substance abuse by the use of a survey.

As the initial stage in developing a curriculum to assist family physicians to diagnose and manage alcohol abuse in their practices, questionnaires were mailed to a selected group of family physicians. A total of 117 physicians (34%) completed the questionnaire. The majority of physicians (70.1%) reported that fewer than 10% of their caseload experienced alcohol-related problems. Most physicians (59.3%) did not use any of the standard diagnostic instruments but reported that screening and detection was the most challenging alcohol-related problem along with patient management. The questionnaire identified a number of areas that could be used in the development of educational strategies to increase the expertise of primary care physicians in the diagnosis and management of alcohol-related problems.

Canada↗
PubMed1993

"Academic" CME and the social contract.

The term academic continuing medical education (CME) is defined and explored from the perspective of forces that have made its usage necessary. These forces include the new understandings of the place, impact, and scope of CME, and, in particular, the increasing entrepreneurial interests in the field, unrelated to the improvement of physicians' competence or performance, or to health care outcomes. In addition to principles of CME provision promulgated by the Accreditation Council of CME, and those of ethical CME providers, academic CME implies the critical appraisal of the providers' activities, the creation of new knowledge about how physicians learn and change, and the dissemination of information based on such knowledge. Finally, the nature of academic CME providers is discussed, and the potential role of CME in fostering the social contract between the medical professional and society is explored.

Clinical Competence↗
PubMed1993

Presymptomatic diagnosis for neurofibromatosis 2 with chromosome 22 markers.

Neurofibromatosis 2 (NF2) is a dominantly inherited disorder characterized by multiple tumors of the central nervous system, predominantly bilateral vestibular schwannomas. The gene for NF2 is located in the chromosomal region 22q12 between the loci D22S1 and D22S28. We have performed genetic linkage analysis on 13 NF2 families with a total of nine polymorphic DNA markers, including five which we have recently mapped to this region. Two loci, D22S32 and NEFH, are linked to the NF2 locus at 0% recombination (lod scores of 6.03 and 4.28, respectively). By multipoint linkage analysis, we assign the NF2 gene to an interval of 7 cM, between the loci D22S212 and D22S28. We have used this set of nine markers to construct chromosome 22 haplotypes for the 82 at-risk individuals in this pedigree set. It has been possible to determine, with a high degree of certainty, the carrier status of 70 (85%) of these at-risk individuals. Risk prediction was possible in every case where DNA was available from both parents. Fifty-three of the 70 (76%) informative individuals were assigned decreased risks of being carriers. The use of chromosome 22 probes for risk assessment should result in a greatly reduced number of individuals who require periodic screening for NF2.

Adolescent↗
PubMed1993

Multicultural issues in medical curriculum: implications for Canadian physicians.

This descriptive study explored multicultural issues in medical education which should be included in the curricula of both the undergraduate and residency programs of the Faculty of Medicine, The University of Calgary. Face-to-face interviews were conducted with 21 male and female ethnic patients to determine their expectations of and experiences with the health care they had received in Canada. Telephone interviews were conducted with ten primary care physicians to determine their experiences of providing care to new immigrants from cultures other than their own. Content analyses and comparison of the two sets of interview data revealed barriers to satisfaction, diagnosis and treatment. Some barriers were perceived both by the physicians and the ethnic patients, e.g. language, and attitudes towards medical technology and treatment. Others were perceived just by the physicians, e.g. patients' belief in traditional practices. Still others were perceived just by the ethnic patient, e.g. perceived racial discrimination. Based on the data from the interviews, two simulated patients were developed and presented to the students of medicine, both undergraduate and resident, to teach them about multicultural health care. This study demonstrates how local data about multicultural health issues can be used to develop simulated patients for inclusion in the medical curriculum.

Adult↗
PubMed1993

A breast-ovarian cancer susceptibility gene maps to chromosome 17q21.

Nineteen North American Caucasian families that contain a minimum of four confirmed cases of breast or ovarian cancer have been studied. Four polymorphisms (cLB17.1, D17S579, D17S588, and D17S74), which span a region of approximately 15 cM on chromosome 17q12, were typed. Our data confirm the location of a dominant gene conferring susceptibility to breast and ovarian cancer (maximum lod = 9.78) and suggest that the breast-ovarian cancer syndrome is genetically heterogeneous. Two recombinants in one large family suggest that the breast-ovarian cancer locus lies between D17S588 and D17S579.

Adult↗
PubMed1992

Neurofibromatosis type 2 appears to be a genetically homogeneous disease.

Neurofibromatosis type 2 (NF2) is an autosomal dominant syndrome characterized by the development of vestibular schwannomas and other tumors of the nervous system, including cranial and spinal meningiomas, schwannomas, and ependymomas. The presence of bilateral vestibular schwannomas is sufficient for the diagnosis. Skin manifestations are less common than in neurofibromatosis type 1 (NF1; von Recklinghausen disease). The apparent clinical distinction between NF1 and NF2 has been confirmed at the level of the gene locus by linkage studies; the gene for NF1 maps to chromosome 17, whereas the gene for NF2 has been assigned (in a single family) to chromosome 22. To increase the precision of the genetic mapping of NF2 and to determine whether additional susceptibility loci exist, we have performed linkage analysis on 12 families with NF2 by using four polymorphic markers from chromosome 22 and a marker at the NF1 locus on chromosome 17. Our results confirm the assignment of the gene for NF2 to chromosome 22 and do not support the hypothesis of genetic heterogeneity. We believe that chromosome 22 markers can now be used for presymptomatic diagnosis in selected families. The NF2 gene is tightly linked to the D22S32 locus (maximum lod score 4.12; recombination fraction 0). A CA-repeat polymorphism at the CRYB2 locus was the most informative marker in our families (lod score 5.99), but because the observed recombination fraction between NF2 and CRYB2 was 10 cM, predictions using this marker will need to be interpreted with caution.

Chromosomes, Human, Pair 17↗
PubMed1990

Treatment of an aggressive non-Hodgkin's lymphoma during pregnancy with MACOP-B chemotherapy.

Non-Hodgkin's lymphoma occurring during pregnancy is a rare event. A young woman at 18 weeks gestation with twins presented with a B-cell immunoblastic lymphoma. Combination chemotherapy with methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B) was instituted after limited staging. There was excellent response and the 12 weekly chemotherapy protocol was completed in 13 weeks. Twin male infants were born at 28 weeks gestation by cesarean section for premature labor. There was no evidence of any congenital malformations or hematologic suppressions. We believe this to be the first report of aggressive weekly chemotherapy during pregnancy; this approach to treatment in aggressive non-Hodgkin's lymphoma is both efficacious and safe.

Adult↗