PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Medicine--changes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Is there a role for general practitioners in future medicine?].

Changes in the type and frequency of diseases towards the end of the century will result in a larger number of elderly and chronically ill patients. At the same time, functional changes in the health services will lead to greater centralisation of complicated medical services. The general practitioner offers continuity, care and security in the patient's local environment. In the years to come the growing number of patients will put new pressures on the organisation of public health services. It is to be expected that general practitioners will have to take care of a larger number of more seriously ill patients than they do today. Therefore, general practitioners must examine the possibility of saying no to some of the many tasks they have accepted since the 1960s. Moreover, the hospitals must give priority to making their services more accessible and to improving the cooperation with the general practitioners so that the latter can use the specialists to a greater extent as advisers, and the hospitals as centers of expertise.

Family Practice↗
PubMed1983

France, the fundament, and the rise of surgery.

This article describes events in 17th and 18th century France that resulted in the elevation of surgery from a lowly status to one of parity with medicine. Changes in the education and organization of surgeons are described, and the nature and significance of the successful operation for fistula-in-ano on Louis XIV is considered in some detail.

Colorectal Surgery↗
PubMed1996

Epidural and subarachnoid administration of opioids for nonmalignant pain: technical issues, current approaches and novel treatments.

As intraspinal opioid infusions are being offered to an increasing number of patients with chronic noncancer pain, technical considerations and complications have become important. For these technical considerations, there are points that are unclear and controversial and others that appear to be "minor" but, if missed, can lead to disastrous pump complications. Among the controversial areas are type of testing for a spinal infusion, method for needle placement in the spine, and type of pump. For the apparently minor considerations, important areas are attention to the method of puncture of the paraspinal fascia, anchoring of catheter, pump placement, and initial filling of the pump. As experience with these infusions is accumulated, and as the financial climate in medicine changes, the approaches to these techniques appear to be changing toward a general consensus. Recent scientific advances, both in newer analgesic substances and in innovative methods for intraspinal delivery of these substances, also are affecting these approaches.

Analgesia, Epidural↗
PubMedDate not supplied

The child between nature and culture.

Medicine changes: some diseases disappear and "new" ones arise. New therapies also pose new problems, some of which even have bioethical traits. Progress often produces diseases. In any case - for good or for worse - culture, the foundation of progress, deeply interferes with the natural environment in which the child lives, and constantly modifies it, especially, or indeed, in industrial societies. For a better quality and longer duration of life, the hope should be to put culture as extensively as possible in the service of nature so as to not contaminate or deteriorate it and so as to prevent progress from turning against man. Especially in industrial societies, the family too has furthermore changed and has provided the child with different living conditions. New pediatrics and the new pediatrician are committed to a better management of the problems posed by changing medicine as well as by the changes undergone by the environment as a function of culture and progress.

Bioethics↗
PubMed1994

The patient-centred case presentation.

The presentation of case histories is an important part of medical education, socialization and research. The traditional format of presentation, developed at the beginning of the century and based on disease-centred nosologies, has been criticized as minimizing the patient's story and subjective experience. It results in a separation of biological processes from the person. With the development of a patient-centred clinical method, it is desirable to have a patient-centred case presentation format that places the patient's subjective experience in the forefront, without sacrificing traditional biomedical aspects. This paper describes such a method and presents an example. This method is especially useful in the education of senior residents in family medicine, as it can serve to reinforce an attitude of 'patient-centredness'. The method can also serve as a useful bridge between the passive learning inherent in much of the education in medical schools and the active, adult learning necessary for graduate practitioners. By placing an emphasis on the person's subjective experience of illness, rather than solely on the disease, this way of presenting a case history readily suggests new questions and directions in research. The presentation of case histories is an underrecognized tool in family medicine. Changing the format of such presentations to be more consistent with the family medicine world view has implications for education and research.

Adult↗
PubMed1988

Career plans and debt levels of graduating U.S. medical students, 1981-1986.

Trends in students' responses to the annual graduation questionnaire of the Association of American Medical Colleges from 1981 to 1986 were examined. Since 1981 the percentage of students choosing primary care specialties dropped from 43.6 percent to 36.6 percent. The decline of interest in primary care specialties occurred mainly in general internal medicine. Changes in career activity since 1981 reflected increasing interest by the students in full-time academic appointments and decreasing interest in solo, private practices. Changes in the size of a city in which students planned to practice reflected an increasing interest in large cities or suburbs. The students' preferences for certain geographic regions of the country for practice locations changed very little. Finally, total postsecondary educational debt increased from an average of +19,697 in 1981 to an average of +33,499 in 1986. This difference represents a 70 percent increase as measured by 1987 dollars and a 37 percent increase in constant dollars.

Career Choice↗
PubMed1995

The effect of a required third-year family medicine clerkship on medical students' attitudes: value indoctrination and value clarification.

BACKGROUND: The effect of a required six-week third-year family medicine clerkship was examined within a framework of professional socialization. Socialization was considered to consist of an institutional process, i.e., value indoctrination, and a learner process, i.e., value clarification. METHOD: Pre- and postclerkship data from 1,095 students (classes of 1981-1993) at the University of Arizona College of Medicine were analyzed. In addition, specialty match data were obtained. Factor analysis of 19 items on the pre- and postclerkship questionnaires was used to derive four scales measuring attitudes related to family medicine. The students were first grouped into four groups: those who preferred family medicine before and after the clerkship, those who preferred other specialties both times, those who switched to family medicine, and those who switched away from family medicine. Then the students were grouped into eight groups by dividing each of the specialty-preference groups into two sections: those who matched to family medicine and those who did not. Statistical comparisons involved the use of the t and F statistics. RESULTS: Usable data were available for a maximum of 997 students (91%). The students' attitudes about family medicine changed during the clerkship to become more consistent with their postclerkship specialty preferences. In addition, more students preferred family medicine after the clerkship than before it. When each group was further divided into those matching and not matching into family medicine, no significant difference in attitudes was found between those matching and those not matching. CONCLUSION: These results reflect both a value clarification process and a value indoctrination effect. The discrepancy between postclerkship specialty preferences and later match data indicates that the indoctrination effect and clarification process continue into the fourth year.

Arizona↗
PubMed1996

Influence of the interview on the evaluation of applicants to medical school.

PURPOSE: To determine whether medical school admission interviewers change their evaluations and impressions of applicants as a direct result of the interview. METHOD: In 1991-92, 419 applicants to the University of Virginia School of Medicine were interviewed by members of the admission committee in two separate half-hour sessions. After reviewing each applicant's folder, interviewers rated the applicant before the interview on six objective scales. After the interview, ratings were again made on the same six scales, on the same form, below the ratings made before the interview. Data were examined using paired t-tests, Pearson correlations, and stepwise multiple-regression analysis. RESULTS: Of the six scales, only the ratings of Commitment to Serve Others were not significantly changed by the interview; the ratings of Familiarity with Issues in Medicine changed the most (p < .01 by paired t-test). The ratings of Overall Impression increased for accepted applicants and decreased for rejected applicants. CONCLUSION: The interview did influence interviewers' ratings made before the interview, and in the direction consistent with admission decisions, which supports the continued use of the interview. Although the magnitude of the changes was not large, the changes validate the conviction that the interview aids in the selection of individuals for medical school.

Humans↗
PubMed1983

Medical education meeting community needs.

As the scientific foundation of clinical practice has expanded the caring aspect of medicine has been given less emphasis. The development of a paradigm of medicine based on achieving a diagnosis has resulted in neglect of this caring aspect of medicine in education programmes. This has contributed to the current failing of doctors to meet community needs in terms of caring as opposed to curing in medicine. Change in the structure and emphasis of clinical training is necessary in order that graduates meet community needs.

Attitude of Health Personnel↗
PubMed1991

Connecting healthcare providers. An effective computer network can create durable relationships.

Physician networks are computerized systems that link primary care physicians and specialists to one another and to hospitals and other providers. The networks have four key components: communication, practice management, practice marketing, and diagnostic testing capabilities. Advantages of physician networks for hospitals include increased physician loyalty and increased market share through additional admissions and outpatient registrations. From physicians' perspective, networks can help them expand their patient bases and increase revenue, provide additional services for existing patients, automate their offices, and improve their administrative efficiency. Networks also affect the way physicians practice medicine. Changes in practice patterns improve patient care, speed test results, and improve physicians' relationships with each other and their patients. They also save time for physicians and their staff. In deciding whether to develop a network, executives must examine the architectural framework and components they need, their commitment to physician relations, how reliant they are on primary care referrals, the competitive environment, the resources they are willing to commit, legal issues, and the physicians' role in planning.

Catholicism↗
PubMed1986

Efficiently-run practices--ways to keep costs in line.

Containment of health care costs is a serious concern today for everyone, including the local, state and federal governments, industry and the private sector. Physicians are looked at as the "bad guys" in the cost containment battle as publicity focuses on the high cost of office visits, procedures, tests and hospital charges. When you add to that the additional image of the "rich doctor," it is easy to understand why so much attention is paid to the doctor as the perceived reason for the high costs of care. Medical practices are also guilty of fostering that image as patients perceive an inefficient approach about the business side of medicine. And, as an inefficient office usually adds to a practice's overhead, someone must be expected to cover that extra cost. That someone, unfortunately, is the patient--either by a direct payment of increased fees or by the added cost of the insurance premium. What follows are some basic items of good business management that should help cut your practice expenses, whether you are solo or part of a group practice. The streamlining of your practice should enable you to keep your costs--and your fees--in line. And, as medicine changes with health maintenance organizations and preferred provider organizations becoming more of a factor, it will be essential for your practice to be cost efficient to compete.

Cost Control↗
PubMed1989

Traditional and evolving concepts in medical ethics.

Modern developments in science, technology and medicine have resulted in an unprecedented interest in ethical and moral issues in the practice of medicine. Changes threaten to erode the traditional ethos of practice and to transform medicine into a marketable commodity. The challenge of a new medical ethic and suggestions for a future course are discussed.

Africa, Southern↗
PubMed1996

[What did hormonal contraception change for women?].

A major date and a major change for our society, hormonal contraception had to battle against law and against medicine. Changing women's status, it gave them a new freedom. But what of the traditional role models, man and woman's relationship to each other, what of their approach to love and sexuality? That is the question...

Contraceptives, Oral, Hormonal↗
PubMedDate not supplied

[Bibliometric repercussions of adopting English as the sole language for publication].

OBJECTIVE: To determine the effect that the change from French to English had on the impact of the Annales de l' Institut Pasteur. THEORETICAL REFERENCE: The Pasteur Institute journals have a prestige of over 100 years of existence and eight Nobel Prize winners in Physiology and Medicine. Changes through time on the impact of these journals can be monitored as they are included in databases of the ISI (Institute for Scientific Information). METHODS: A year by year analysis from 1974 to 1992 was done using simple regression between percentage of articles published in English and: a) their impact factor; b) their ranking among journals of the same field. RESULTS: The determination coefficient (r2) between the percentage in English and the impact factor was 0.108, and that between percentage in English and the journal's rank in similar publications was 0.178 for the Ann Microbiol, 0.045 for the Ann Immunol and 0.122 for the Ann Virol. CONCLUSIONS: The change of language did not increase the impact factor of the French journals.

Academies and Institutes↗
PubMed1998

[Long-term administration study of propiverine hydrochloride (BUP-4 tablets) in pollakiuria and urinary incontinence].

The safety and efficacy of one-year administration of propiverine hydrochloride (BUP-4 tablets) were assessed in facilities affiliated with the Department of Urology of Yokohama City University School of Medicine. Changes in subjective symptoms showed significant improvement in mean frequency of urination in the daytime from 10.3 +/- 4.0 times before administration to 7.1 +/- 2.9 times 1 year after the start of administration, in mean frequency of voiding at night from 4.2 +/- 1.7 times to 2.1 +/- 1.1 times and in mean incidence of urinary incontinence from 2.9 +/- 2.1 times to 0.7 +/- 1.0 times. The final degree of overall improvement rate was 82.0% (41/50 cases). Adverse effects were observed 26 times in 22 patients, the incidence being 15.6% (22/141 cases). They consisted of digestive symptoms in 9.9% (6 events of dry mouth, 4 of constipation, 2 of abdominal discomfort, 2 of diarrhea and 1 of gastritis), urinary tract symptoms in 3.5% (4 of dysuria and 1 of residual urine), abnormal laboratory findings in 1.4% (increase in glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase or lactate dehydrogenase levels) and others (1.4%). These results provide further evidence of the safety and efficacy of propiverine hydrochloride (BUP-4 tablets) even when administered for a long-term in the treatment of patients with pollakiuria and urinary incontinence.

Administration, Oral↗
PubMed2025

Acoustic ejection mass spectrometry: the potential for personalized medicine.

INTRODUCTION: The emergence of personalized medicine (PM) has shifted the focus of healthcare from the traditional 'one-size-fits-all' approach to strategies tailored to individual patients, accounting for genetic, environmental, and lifestyle factors. Acoustic ejection mass spectrometry (AEMS) is a novel technology that offers a robust and scalable platform for high-throughput MS readout. AEMS achieves analytical speeds of one sample per second while maintaining high data quality, broad compound coverage, and minimal sample preparation, making it an invaluable tool for PM. AREAS COVERED: This article explores the potential of AEMS in critical PM applications, including therapeutic drug monitoring (TDM), proteomics, metabolomics, and mass spectrometry imaging. AEMS simplifies conventional workflows by minimizing sample preparation, enhancing automation compatibility, and enabling direct analysis of complex biological matrices. EXPERT OPINION: Integrating AEMS with orthogonal separation techniques such as differential mobility spectrometry (DMS) further addresses challenges in isomer discrimination, expanding the platform's analytical capabilities. Additionally, the development of high-throughput data processing tools could further enable AEMS to accelerate the development of personalized medicine.

Humans↗
PubMed1985

Probable future funding priorities in maternal and child health: a modified Delphi National Survey.

Recent enactment of program consolidation block grants proposed by the Reagan administration has left many observers of public health services wondering about the impact of such a change on categorical programs in maternal and child health (MCH). This study first presents predictions about the future of 23 specific MCH services, derived from a modified Delphi Survey of MCH experts, and then examines the implications of these predictions for future public health.

Adult↗