PubMed Health⌕ Search

Biomedical subjects

J T Rourke

Publications and source records attributed to J T Rourke.

At least 19 recordsLinked to original sources
PubMed2000

Postgraduate medical education for rural family practice in Canada.

Canada is a large country with a diverse and spread-out rural population. Compared to their urban counterparts, rural Canadians have fewer family doctors and dramatically fewer specialists, and they face other significant geographic barriers to accessing health care. This paper describes the milieu of the rural physician in Canada and reports on efforts to develop a postgraduate medical education model for rural family practice that will produce more physicians with the knowledge, skills and interest to practice in small and mid-sized communities. Key recommendations of the College of Family Physicians of Canada include: providing earlier and more extensive rural medicine experience for all undergraduate medical students, developing rural postgraduate training programs, providing third-year optional special and advanced rural family medicine skills training and making advanced family medicine skills training competency-based and nationally accredited.

Canada↗
PubMed1998

Evidence-based well-baby care. Part 1: Overview of the next generation of the Rourke Baby Record.

PROBLEM BEING ADDRESSED: Well baby and child care in the primary care setting has not always been based on evidence that has been shown to be effective in preventing and detecting disease and injury. OBJECTIVE OF THE PROGRAM: To help physicians and nurses provide care that is more effective than a routine complete examination, the Rourke Baby Record has been revised to include evidence-based recommendations for preventive care for infants and young children. The revision incorporates the approach and recommendations of the Canadian Task Force on the Periodic Health Examination. The updated record is now called the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance Guide (Rourke Baby Record: EB). MAIN COMPONENTS OF PROGRAM: Part 1 of this two-part article briefly describes the background for development and presents an overview of the revised record. Part 2 discusses in detail the evidence that exists for maneuvers included in the education and advice section of the revised record. CONCLUSION: Using the Rourke Baby Record: EB and incorporating it into their office record systems as a working guide will help increase the effectiveness of the primary preventive care physicians provide to infants and young children.

Child↗
PubMed1998

Evidence-based well-baby care. Part 2: Education and advice section of the next generation of the Rourke Baby Record.

PROBLEM BEING ADDRESSED: Well baby and child care in the primary care setting has not always been based on evidence that has been shown to be effective in preventing and detecting disease and injury. OBJECTIVE OF THE PROGRAM: To help physicians and nurses provide care that is more effective than a routine complete examination, the Rourke Baby Record has been revised to include evidence-based recommendations for preventive care for infants and young children. The revision incorporates the approach and recommendations of the Canadian Task Force on the Periodic Health Examination. The updated record is now called the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance Guide (Rourke Baby Record: EB). MAIN COMPONENT OF PROGRAM: Part 2 of this two-part article discusses the maneuvers included in the education and advice section of the record. These maneuvers are discussed under the subheadings safety, behaviour, family coping, high-risk children, and other. CONCLUSION: Using the Rourke Baby Record: EB and incorporating it into their office record systems as a working guide will help increase the effectiveness of the primary preventive care physicians provide to infants and young children.

Child↗
PubMed1998

Trends in small hospital medical services in Ontario.

OBJECTIVE: To compare the medical services provided in small hospitals in Ontario in 1995 with those provided in 1988. DESIGN: Mailed survey questionnaire. SETTING: Small hospitals in Ontario. PARTICIPANTS: Chiefs of Staff of the hospitals. MAIN OUTCOME MEASURES: Hospital size and location; numbers of physicians; availability of obstetric, anesthesia, and general surgery services; and other medical services available. The 1995 questionnaire was identical to the 1988 one, except for addition of questions on midwives and deletion of the detailed emergency medicine section. RESULTS: Sixty hospitals responded in both years. In these hospitals, there were significantly fewer acute care beds and births in 1995 than in 1988. Availability of general anesthesia and general surgery was significantly reduced, although general anesthesia was administered and general surgeries were performed more often. There were significantly fewer GP anesthetists and significantly fewer family physicians who attended births, although there were slightly more family physicians overall. There were fewer specialists. CONCLUSION: These are negative trends, particularly for women giving birth and patients needing emergency surgery in rural Ontario.

Anesthesiology↗
PubMed1998

Trends in small hospital obstetric services in Ontario.

OBJECTIVE: To compare obstetric services provided in small Ontario hospitals in 1995 with those provided in 1988. DESIGN: Mailed survey questionnaire. SETTING: Small hospitals in Ontario. PARTICIPANTS: Chiefs of Staff of the hospitals. MAIN OUTCOME MEASURES: Hospital size and location; numbers of physicians; availability of obstetric, anesthesia, and general surgery services; and other medical services. The 1995 questionnaire was identical to the 1988 one, except for addition of questions on midwives and deletion of the detailed emergency medicine section. RESULTS: A study group of 35 hospitals that provided active obstetric care in both years had significantly fewer births, fewer family physicians attending births, and fewer GP anesthetists in 1995 than in 1988. There were fewer cesarean births, but a similar number of epidural anesthetics. Availability of anesthetic, epidural, and cesarean services was significantly lower in 1995 than in 1988 in these 35 hospitals. Also, 11 other hospitals that had provided active obstetric care (defined as more than 25 births yearly) in 1988 no longer did so in 1995. CONCLUSION: By almost all measures, obstetric services in these rural Ontario hospitals were less available in 1995 than they had been in 1988.

Anesthesia, Obstetrical↗
PubMed1996

Education for rural practice in Canada and Australia.

Better education, recruitment, and retention of rural doctors are priorities in Canada and Australia. All medical schools in both countries offer some training in rural areas. In Canada, postgraduate training is provided by university medical schools, which have produced a variety of rural educational initiatives in response to regional needs and resources. In Australia, postgraduate training is provided by the Royal Australian College of General Practitioners (RACGP) and specialty colleges, and the RACGP's Faculty of Rural Medicine has established a national training program for rural medicine. In both countries, a wide variety of continuing medical education (CME) courses are being developed for rural doctors, and funding resources and local programs are offered to make it easier for rural doctors to attend CME courses. Both countries continue to struggle to ensure high-quality, accessible medical care for rural populations. Although the two countries differ both in their health and in medical education systems, Canada and Australia are similar geographically and in their population distributions, and can benefit from and build on each other's experiences and advances.

Australia↗
PubMed1996

Postgraduate training for rural family practice. Goals and opportunities.

PROBLEM BEING ADDRESSED: The continuing shortage of rural family physicians in Canada. PURPOSE OF PROGRAM: To further develop training for rural family practice so that adequate numbers of rural family physicians will be appropriately prepared. MAIN COMPONENTS OF PROGRAM: All family medicine residents should have the opportunity to experience the joys and challenges of rural family practice. Rural family medicine training streams provide the best education for family medicine residents who are planning a career in rural family medicine. Integrated training for rural family practice should be high-quality, academically sound, needs-driven, evidence-based, learner-centered, and outcome-measured. This involves comprehensive development of curricula that provide specific skills and appropriate core subjects in rural practice as well as a solid family medicine foundation. contextual and experiential learning in areas similar to or in actual areas where there is a need for rural physicians, and appropriate hospital rotations to learn skills for the hospital role of many rural family doctors, are important components of rural family medicine training. CONCLUSIONS: Postgraduate rural family medicine training programs can be further focused and developed to train more physicians with the knowledge, skills, and attitudes required for rural practice.

Canada↗
PubMed1995

Rural family medicine training in Canada.

OBJECTIVE: To examine the status of postgraduate family medicine training that occurs in rural family practice settings in Canada and to identify problems and how they are addressed. DESIGN: A retrospective questionnaire sent to all 18 Canadian family medicine training programs followed by a focus group discussion of results. SETTING: Canadian university family medicine training programs. PARTICIPANTS: Chairs or program directors of all 18 Canadian family medicine training programs and people attending a workshop at the Section of Teachers of Family Medicine annual meeting. MAIN OUTCOME MEASURES: Extent of training offered, educational models used, common problems for residents and teachers. RESULTS: Nine of 18 programs offer some family medicine training in a rural practice setting to some or all of their first-year family medicine residents, and 99 of 684 first-year family medicine residents did some training in a rural practice. All programs offer some training in a rural practice to some or all of the second-year residents, and 567 of 702 second-year residents did some training in a rural setting. In 12 of 18 programs, a rural family medicine block is compulsory. Education models for training for rural family practice vary widely. Isolation, accommodation, and supervision are common problems for rural family medicine residents. Isolation and faculty development are common problems for rural physician-teachers. Programs use various approaches to address these problems. CONCLUSIONS: The variety of postgraduate training models for rural family practice used in the 18 training programs reflects different regional health care needs and resources. There is no common rural family medicine curriculum. Networking through a rural physician-teachers group or a faculty of rural medicine could further the development of education for rural family practice.

Canada↗
PubMed1993

Politics of rural health care: recruitment and retention of physicians.

The shortage of physicians in underserviced areas has been defined, and the causative recruitment and retention factors have been identified. The CMA report provides a framework for understanding these factors. Many can be modified, but this requires cooperation between physicians, communities, hospitals, medical schools, medical associations and governments. The development of a rural-practice master plan in each province would facilitate this process.

Canada↗
PubMed1993

Patients, friends, and relationship boundaries.

When patient and physician are close friends, both professional and personal relationships can suffer. Jointly exploring and setting explicit boundaries can help avoid conflict and maintain these valuable relationships. This is particularly important when the physician practises in a small community where such concurrent relationships are unavoidable.

Adaptation, Psychological↗
PubMed1977

The role of heparin on platelet retention by acrylonitrile co-polymer dialysis membranes.

The role of heparin on platelet--foreign surface interactions was examined by platelet retention studies on acrylonitrile--dimethylaminoethyl methacrylate (AN-DMAEMA) dialysis membranes both with and without the bonding of heparin onto their surfaces. Heparin bonding significantly reduced platelet retention. Heparin in solution (4 units/ml.) increased platelet retention when the surface of the membranes was modified by ethylene oxide but had no significant effect on the platelet-retaining properties of unmodified membranes. Studies using heparin 99mTc demonstrated that unmodified membranes took up heparin from solution whereas ethylene oxide-modified membranes had little such affinity. The heparin bonding process greatly increased the heparin uptake achieved by simple soaking in heparin solution, and the leaching rate was less than 1% at 70 hours. The results indicate that heparin has two antagonistic effects in this platelet-foreign surface interaction: it acts directly on platelets to increase adhesiveness while acting on the foreign surface to reduce platelet retention.

Acrylates↗