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PubMed1999

End-of-life care in medical textbooks.

Improvement in end-of-life care has become a demand of the public and a priority for health care professionals. Medical textbooks could support this improvement by functioning as educational resources and as reference material. In this paper, four widely used general medical textbooks are assessed for their coverage of nine content domains for 12 illnesses that often cause death; each domain in each disease and in each text was graded for presence and helpfulness of advice. Helpful information was rare, and only prognostication and medical treatments to alter the course of the disease were usually mentioned. Harrison's Textbook of Medicine, The Merck Manual, and Scientific American Medicine often mentioned at least a few of the domains in each disease, although not often in a way that would guide a clinician. Manual of Medical Therapeutics (The Washington Manual) includes little information about end-of-life care. Improvement seems possible. Short additions of information on end-of-life care would probably be effective. Many chapters discussed at length certain topics that are clearly optional; other textbooks addressed these topics only briefly. When dealing with end-of-life care, physicians should seek guidance from other sources and textbook authors and editors should improve the utility and completeness of their texts.

Advance Care Planning↗
PubMed2003

Secular trend in medical education regarding infectious disease.

OBJECTIVE: The paradigm of global medical health has been re-characterised by a shift in its major focus from infectious disease to chronic illness. Opinions vary as to the declining emphasis on infectious disease. This paper provides clinicians with an understanding of a secular trend in medical education regarding the topic of infectious diseases over a period of 26 years. METHODS: A survey was carried out to evaluate coverage of infectious disease topics within recent general medicine textbooks and journals. RESULTS: The percentage of content dedicated to infectious disease has remained static in 2 major medical textbooks, whereas a trend towards decreasing coverage was shown in 4 major medical journals. Of 901 original articles published in 2000, 16.4% covered certain aspects of infectious disease, as compared with 20.9% of 790 articles published in 1985. Increasing rates of infectious disease mortality in developing countries were not consistently matched with the trend in coverage of infectious disease topics in either medical textbooks or journals. CONCLUSIONS: Our data demonstrate that coverage of infectious disease topics in publications issued in developed countries was more indicative of global trends in disease mortality rather than those of developing countries. Medical education and knowledge, which are usually delivered by the rich nations where influential medical textbooks and journals are published, place less emphasis on infectious disease relative to the burden infectious disease places on the developing world.

Bibliometrics↗
PubMed1994

The reading habits of RACGP Training Program doctors.

AIM: To describe the reading habits of a cohort of Western Australian RACGP Training Program doctors undertaking general practice terms in 1992. METHOD: A questionnaire that included a list of journals and books relevant to general practice was distributed to trainees. Information obtained included demographic data, the frequency of journal reading and the number of books read. RESULTS: There were 68 respondents from a total of 100. Time spent in medical reading ranged from one to 12 hours per week, with a mean of 3.3. The number of journal titles read in the past six months ranged from three to 16. The number of books actually read (from the 39 titles presented) ranged from zero to 17. The most frequently read were the reference type books. Very few of the 'core' books about the nature, scope and philosophy of general practice had been read. CONCLUSIONS: RACGPTP doctors read mainly for information. To produce educated doctors knowledgeable about their chosen discipline, the Training Program will need to place greater emphasis on introducing their vocational trainees to the writings of the thinkers and philosophers of general practice and family medicine.

Adult↗
PubMed1999

Kidney disease in Byzantine medical texts.

The most significant contribution of the great Byzantine physicians to the evolution of medicine is their effort to summarize all the medical knowledge of the Greco-Roman world, which included earlier sources in antiquity, lost forever in our days. The transition from ancient to medieval medicine included the adoption of Christian spiritual values, which took place in the early Byzantine period (4th to 7th century). In the field of nephrology, under the influence of Hippocratic and Galenic doctrines, the most prominent medical personalities, Oribasius of Pergamum, Aetius of Amida, Alexander of Tralles and Paul of Aegina, performed the role of the researcher and healer, as well as that of the encyclopedist. Their works on kidney disease are presented in this paper.

Byzantium↗
PubMed2006

The value of an evidence based practice module to skill development.

BACKGROUND: A degree level EBP module is undertaken by students on post-qualifying programmes to develop critical appraisal skills gained at diploma level. Despite training in EBP skills, there is some suggestion that health care professionals lack confidence in this area and fail to make the links between evidence and practice. The purpose of this study was to investigate this issue further. AIMS: To identify how the EBP skills developed on the module were utilised in practice, and to identify what local barriers there were in using these skills. METHODS: A survey of all students who had completed the module within the past three years (n=393) followed by interviews to explore further issues that emerged from the survey. RESULTS: One hundred and ninety one completed questionnaires (48.6% response rate). The results showed that the students perceived themselves as 'quite skilled' or 'competent' with regard to the key EBP skills, and that completion of the module had contributed 'greatly' to this skill acquisition. Results from the interviews showed that time and cultural issues were the greatest barriers to using and developing further the EBP skills gained. CONCLUSIONS: The value of the module was apparent. For skills to be developed further in the work place, cultural changes need to occur.

Attitude of Health Personnel↗
PubMed2000

Development and evaluation of a stand-alone web-based CAL program. A case study.

The use of web browser technology allows the construction of computer-aided learning programs which will have a familiar interface to dentists. This paper reports on the evaluation of a web-based CAL program which covered the topic of tooth wear with an emphasis on the rôle of erosion in its aetiology. Evaluation of the software was made by 50 dentists contacted by an electronic mailing list. They completed a questionnaire which evaluated aspects of the functionality of the program educational objectives. The average age of the dentists was 39 years (range 24-70) and 82% were male. The average time of use was 1 h 10 min (range 15 min to 3 h). A significant change in their knowledge of tooth wear before and after using the program was recorded. Both the use of patient cases and leaflets scored highly with other aspects such as treatment planning and patient advice receiving high marks. All dentists commented that they had gained greater knowledge with particular reference to treatment and advice of tooth wear problems. 34 dentists (68%) found the web interface easy to use. Negative comments were mainly attributed to the quality of the pictures (4/50) which were corrected in the final release version. Respondents were asked to compare the program to other educational media on the same subject. 80% rated this CAL program as better than video, and 14% claimed it was as good as video. 84% rated it better than books, and 14% said it was as good as books. 98% preferred it to audio tapes and 86% preferred it to journals. The average amount that they would pay for a CAL package such as "tooth wear" would be 42 ECU. It is concluded that web browser software is a suitable medium for the use of a CAL program and this is reflected in its ease of use by dentists.

Adult↗
PubMed2003

The Byrne Guide for Inclusionary Cultural Content.

This article describes the background for development of The Byrne Guide for Inclusionary Cultural Content, which may help nurse educators evaluate and create instructional materials that include diverse groups. Curricular implications of diversity, as well as six categories of instructional bias are included in the background of information that contributed to the development of this Guide.

Audiovisual Aids↗
PubMedDate not supplied

Spinal manipulation in China.

BACKGROUND: Although there is a long history of the use spinal manipulation in China, little has been formally written on this topic. OBJECTIVE: To discuss the history and status of Chinese spinal manipulation. DISCUSSION: This article describes the history of Chinese spinal manipulation as revealed through past formal textbook publications on this topic, along with journal articles describing both the basic science foundation and clinical applications of such manipulation. In addition, the current status of Chinese spinal manipulation is described. CONCLUSION: There is a long history of the use of spinal manipulation throughout China, though some basic problems of application remain. Current research may help to resolve these problems.

China↗
PubMed2005

PrimeAnswers: A practical interface for answering primary care questions.

This paper describes an institutional approach taken to build a primary care reference portal. The objective for the site is to make access to and use of clinical reference faster and easier and to facilitate the use of evidence-based answers in daily practice. Reference objects were selected and metadata applied to a core set of sources. Metadata were used to search, sort, and filter results and to define deep-linked queries and structure the interface. User feedback resulted in an expansion in the scope of reference objects to meet the broad spectrum of information needs, including patient handouts and interactive risk management tools. RESULTS of a user satisfaction survey suggest that a simple interface to customized content makes it faster and easier for primary care clinicians to find information during the clinic day and to improve care to their patients. The PrimeAnswers portal is a first step in creating a fast search of a customized set of reference objects to match a clinician's patient care questions in the clinic. The next step is developing methods to solve the problem of matching a clinician's question to a specific answer through precise retrieval from reference sources; however, lack of internal structure and Web service standards in most clinical reference sources is an unresolved problem.

Consumer Behavior↗
PubMed1998

Medieval descriptions and doctrines of stroke: preliminary analysis of select sources. Part III: multiplying speculation - the high and late Middle Ages (1000-1450).

By analyzing a body of texts compiled by various medical authors from the 11th to the 15th century, four basic developments can be noted: (1) From the beginning of the eleventh century the reception, translation and assimilation of Arabian and arabicized ancient texts became the ultimate goal of Western medicine (Constantine the African, Arnad of Villanova, et al.). Concepts of stroke were consequently guided by textual tradition, not by observation. (2) Scholastic speculations about different aspects of apoplexy, especially those concerning its origins, were numerous (Johannes Platearius, Batholomaeus Salernitanus, Pietro d'Abano, Giacomo da Forli). Although most medieval physicians used the ancient doctrine of the four humors as model and explanation, opinions differed in many ways. (3) Attempts developed to present a simple outline of the etiology, the prognosis, and the treatment of the disease (Gilbertus Anglicus, Bernard of Gordon, John of Gaddesden). (4) Although lacking in originality, many of these writers nevertheless achieved a certain uniformity in presenting main topics, thus setting the standard for later practitioners.

Arab World↗
PubMed2005

Genomics in nursing education.

PURPOSE: To review international efforts to incorporate genetics content into nursing education curricula. ORGANIZING FRAMEWORK: A discussion of the progress in nursing education programs in selected countries to educate students for genomics-based health care. Information is based on review of the literature and curriculum change efforts by the authors. CONCLUSIONS: The lack of agreed-upon minimum competencies impedes efforts to educate nurses for genomics-based health care. Nationally and internationally recognized documents are useful for collaborative efforts to establish minimal competencies in knowledge, skills, and attitudes for nurses with basic and advanced education. Curriculum change that incorporates minimum competencies will require nursing faculty to improve their knowledge base in genomics-based health care. Partnerships among nurses in different countries are needed for successful genomics education programs for faculty.

Attitude of Health Personnel↗
PubMed1996

Knowledge retrieval as one type of knowledge-based decision support in medicine: results of an evaluation study.

We report on a prospective, prolective observational study, supplying information on how physicians and other health care professionals retrieve medical knowledge on-line within the Heidelberg University Hospital information system. Within this hospital information system, on-line access to medical knowledge has been realised by installing a medical knowledge server in the range of about 24 GB and by providing access to it by health care professional workstations in wards, physicians' rooms, etc. During the study, we observed about 96 accesses per working day. The main group of health care professionals retrieving medical knowledge were physicians and medical students. Primary reasons for its utilisation were identified as support for the users' scientific work (50%), own clinical cases (19%), general medical problems (14%) and current clinical problems (13%). Health care professionals had accesses to medical knowledge bases such as MEDLINE (79%), drug bases ('Rote Liste', 6%), and to electronic text books and knowledge base systems as well. Sixty-five percent of accesses to medical knowledge were judged to be successful. In our opinion, medical knowledge retrieval can serve as a first step towards knowledge processing in medicine. We point out the consequences for the management of hospital information systems in order to provide the prerequisites for such a type of knowledge retrieval.

Computer Systems↗
PubMed2002

Francisco Vallés and the Renaissance reinterpretation of Aristotle's Meteorologica IV as a medical text.

In this paper I describe the context and goals of Francisco Vallés In IV librum Meteorologicorum commentaria (1558). Vallés' work stands as a landmark because it interprets a work of Aristotle's natural philosophy specifically for medical doctors and medical theory. Vallés' commentary is representative of new understandings of Galenic-Hippocratic medicine that emerged as a result of expanding textual knowledge. These approaches are evident in a number of sixteenth-century commentaries on Meteorologica IV; in particular the works of Pietro Pomponazzi, Lodovico Boccadiferro, Jacob Schegk, and Francesco Vimercati. Vallés' conviction that Meteorologica IV is relevant to medical knowledge depends on his understanding of Aristotle's theory of homeomerous substances and their relation to composite substances. The application of Meteorologica IV to medical topics became commonplace in the following years, and this Aristotelian book became widely known as a bridge between natural philosophy and medicine.

Europe↗