PubMed Health⌕ Search

Biomedical subjects

M Kamien

Publications and source records attributed to M Kamien.

At least 19 recordsLinked to original sources
PubMed1991

Are departments of general practice in medical schools really needed?

Few medical schools appear aware of modern developments in general practice and of its educational potential in helping provide balance to a predominantly teaching hospital approach to the diagnosis and treatment of disease. Contributing to the problem are a lack of clarity about the term "undifferentiated doctor", failure to understand the different purposes of undergraduate and vocational training and the erroneous view that general practice is not a "proper" university discipline because it lacks an intellectual basis.

Accreditation↗
PubMed1991

Academic general practice in Australian medical schools.

This paper reports on a survey of the current state of academic general practice in the ten Australian medical schools. Despite its lack of resources, low profile and ambivalent acceptance in Australian medical schools, academic general practice has survived. Its problems and potential contribution for producing better doctors are outlined and discussed.

Adult↗
PubMed1991

Distance learning in a local setting: a structured learning course for the introduction of general practice to undergraduate students.

This paper describes the development and evaluation of a structured introductory course in general practice. Following some of the principles developed in distance education, the Department provides everything the student needs for the formal learning requirement as well as detailed assistance in how best to tackle the selected topics. The course was reported to be demanding, relevant and enjoyable. The major areas requiring attention were in reducing the amount of reading required, more help in learning to work in small student-run groups and more one-to-one supervision of physical examination skills. With further refinement the course should be applicable to other medical schools in developed countries.

Curriculum↗
PubMed1990

Can first-year medical students contribute to better care for patients with a chronic disease?

First-year medical students at the University of Western Australia are attached to a patient with a chronic illness in order to begin to understand the world of the chronically ill and their families. The patients are recruited by general practitioner preceptors who have been reticent in accepting first-year students because of their perceived immaturity and lack of medical knowledge. Not only have the preceptors' reservations proven groundless, but the teaching exercise has produced an unintended and positive side in that 35% of students discovered new information which was judged by the patients' general practitioners to be of significant help in the total management of patients' illness. Since these were only first-year medical students, the effect should be much greater with more mature students. Doctors often have incomplete records and act on incomplete information. Medical students are a means of correcting some of these deficits. In return they develop better psychosocial and communication skills and achieve considerable personal development by demonstrating to patients, their preceptors and themselves that they can be useful in contributing to more effective patient care.

Chronic Disease↗
PubMed1990

Change in aboriginal childhood morbidity and mortality in Bourke 1971-84.

In the early 1970s, the Aboriginal community of Bourke attempted to improve its socioeconomic and health status through a number of community development activities. As a result, markers of nutrition in early childhood, housing conditions and access to health care all improved, in spite of a deterioration in employment opportunities and adult health. Coincidentally, most markers of the health of Aboriginal children in Bourke improved over the period 1971-84. In particular, Aboriginal child admissions due to gastroenteritis, eye and ear infections and accidents, and the community prevalence of trachoma, middle ear disease and pneumonia among Aboriginal children, decreased. Skin infections were an exception to this general picture, becoming more prevalent over the period.

Adolescent↗
PubMed1990

A rational management of tennis elbow.

Tennis elbow is due to a torque injury or sudden overstretching of tendons which insert into the epicondyles of the humerus. The predominant lesion is an enthesopathy--a pathological lesion at the insertion of tendon into bone. The most common site is at the lateral epicondyle and this is 3 times as frequent as at the medial epicondyle. Approximately 50% of tennis players can expect to get a tennis elbow at some time during their playing lifetime. In one-third of the players this will be severe enough to interfere with their tasks of daily living. The major unresolved question about the aetiology of tennis elbow is why it has its peak incidence between the ages of 40 and 50 years and why 90% of players then have no further recurrence. Making sense of the literature on the treatment of tennis elbow is difficult because there are few studies that have used the acceptable epidemiological techniques of the prospective randomised controlled trial or case-controlled study. Most papers are based on a collection of highly selected cases which represent the more intractable end of the tennis elbow spectrum and their reported results have been inconsistent. Tennis elbow is largely a self-limiting condition. The prime aim of treatment should be based on Hippocrates' first tenet of medicine--first do no harm. Therapy should start with the simple and conservative before progressing to the more complex and invasive therapies. It should be acceptable to the patient, cost-effective and where invasive therapy is recommended, the potential benefits should clearly outweigh the risks. The principles of therapy for tennis elbow are to relieve pain, microbleeding and inflammation, promote healing, rehabilitate the injured arm and try to prevent recurrence. The most effective modalities of treatment are found to be cryotherapy in the acute stage then nonsteroidal anti-inflammatory drugs and heat in its various modalities including ultrasound. This is combined with rest which is best defined as the absence of painful activity. Injection of a depot preparation of cortisone is effective although patient reports are not as flattering as those of doctors. There is no advantage and in fact considerable disadvantage in using more than 2 such injections. Therapies such as acupuncture and chiropractic have not been evaluated. Nevertheless they cause no harm, may result in good and should be tried before resorting to more invasive therapy. Rehabilitation should run parallel to treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1987

The secret bread tests: selective primary health care or experimentation on human-beings?

This is a case history which describes an attempt to fortify the bread of Australian Aborigines in an isolated area of New South Wales. The medically successful intervention was accomplished by the publication of scientific enquiry and by attention to the culture of Aborigines. Paradoxically the long-term failure of the project was also due to the power of the written word and the neglect of the culture of the more densely populated and politically dominant white community. The need for doctors to be aware of the different approaches of primary health care and selective primary health care is stressed so that a general practitioner who provides health care for minority groups of the Fourth World can better define his role and relevance.

Australia↗