Technology assessment and the drug use process.
(1/70)
This activity is designed for pharmacists, physicians, physician assistants, nurses, and other healthcare team members, payers for health services, and healthcare executives. OBJECTIVES: Upon completion of this activity, the participant should be able to: 1. Describe the rationale behind, the development of, and the advantages arising from the formulary process, and discuss the health professionals involved in the creation of formularies. 2. Describe the impact of new drug development and technology on the drug use process. 3. Discuss the functions of the pharmacy and therapeutics committee. 4. Describe the impact of consumers on the drug use process. (+info)
Evaluating ethics competence in medical education.
(2/70)
We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions. (+info)
Putting suffering into perspective: implications of the patient's world view.
(3/70)
The need for suffering patients to reexamine their assumptions about life presents therapists with unique challenges and opportunities. Patients with a religious world view often struggle with whether God cares about, or has sent, their pain. Atheistic patients also search for the meaning in their lives but reject the answers offered by traditional authorities. Patients who are uncertain or ambivalent about their world view may challenge a therapist to provide an audience, insight, or direction. Using case examples, the author explores the therapist's role in helping patients with differing world views to integrate their suffering. (+info)
Acting on an environmental health disaster: the case of the Aral Sea.
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The Aral Sea area in Central Asia has been encountering one of the world's greatest environmental disasters for more than 15 years. During that time, despite many assessments and millions of dollars spent by large, multinational organizations, little has changed. The 5 million people living in this neglected and virtually unknown part of the world are suffering not only from an environmental catastrophe that has no easy solutions but also from a litany of health problems. The region is often dismissed as a chronic problem where nothing positive can be achieved. Within this complicated context, Medecins Sans Frontieres, winner of the Nobel Peace Prize in 1999, is actively trying to assess the impact of the environmental disaster on human health to help the people who live in the Aral Sea area cope with their environment. Medecins Sans Frontieres has combined a direct medical program to improve the health of the population while conducting operational research to gain a better understanding of the relationship between the environmental disaster and human health outcomes. In this paper we explore the health situation of the region and the broader policy context in which it is situated, and present some ideas that could potentially be applied to many other places in the world that are caught up in environmental and human health disasters. (+info)
Reflections on a new medical cosmology.
(5/70)
Since the nineteenth century the theory and practice of mainstream Western medicine has been grounded in the biomedical model. In the later years of the twentieth century, however, it has faced a range of serious problems, which when viewed collectively, remain unresolved despite a variety of responses. The question we now face is whether these problems can be dealt with by modifying and extending the principles underlying the biomedical model, or whether a more radical solution is required. Recent critiques of Western medicine have focused mainly on the biopsychosocial model in relation to the former approach, but it will be contended that this cannot deal adequately with the challenges that medicine currently faces, because although it addresses both the scientific and humanistic aspects of medicine it fails to harmonise them. I shall therefore argue for the necessity of a more radical approach, and suggest that what is required to accomplish this is the development of a new medical cosmology, rooted in an older and more global framework. Such a fundamental change would inevitably involve a long term process which it is not yet possible to fully comprehend let alone specify in detail. Some of the necessary features of such a new medical cosmology can, however, already be distinguished and the outline of these is described. (+info)
A necessary inhumanity?
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It is argued that the phrase "Necessary Inhumanity" more accurately describes the alienation required of doctors in some circumstances, than do modern sanitised coinages such as 'clinical detachment.' 'Detachment' and 'objectivity' imply separation, not engagement: creating distance not only from patients, but from the self: the process may well be required, but where it becomes too extreme or prolonged, it can damage everybody, including patients, family members, doctors themselves, and wider society. An awareness of the history of health care in the context of our society might assist self reflection--might help keep initiates in touch with the culture they have been induced to leave and might help them remain humane despite the bruising process of training. (+info)
Don't cry for us Argentinians: two decades of teaching medical humanities.
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Medical humanities--history, literature, anthropology, ethics and fine arts applied to medicine--play an important role in medical education. For more than 20 years an effort has been made to obtain an academic identity for such a multidisciplinary approach. A distinction between humanitarianism and humanism is attempted here, the former being associated with medical care and the latter with medical education. In order more precisely to define the relationship between the arts and medicine, an alternative term "medical kalology", as-yet-unsanctioned, coined after the rules of medical terminology, is proposed. The Department of Medical Humanities in the School of Medicine, National University La Plata, submits the following apologia: Don't cry for us Argentinians, since the teaching of medical humanities has helped our doctors to function more truly humanistically during the past two decades, as we intend to continue with this calling in the future. (+info)
Use of animals in research: a science--society controversy? The American perspective: animal welfare issues.
(8/70)
My paper will focus on those events happening within the United States during the last year. The issue of including or excluding rats, birds and mice from inclusion under the Animal Welfare Act has been a difficult battle for both those that wish to exclude them and those that wish to include these animals under this legislation. As of the writing of this abstract, the Senate, which originally intended to include rats, birds and mice under the Animal Welfare Act, has passed an amendment which will permanently exclude their listing under this Act. During the last several years it has become clear that refinement, as one of the 3Rs, has and will become the most important set of activities to add humanness to animal experimentation. It is clear that refinement approaches provide the opportunity to possibly eliminate or significantly minimize any pain or distress in animal protocol. My presentation will focus on CAAT's (http://caat.jhsph.edu) activities in this important area. Understanding potential health hazards to environmental industrial chemicals has become a major focus of activity both in the US, Europe and Japan. These programs offer the first opportunity to provide information, in the public domain, on these chemicals. One of the consequences, however, is the potential requirement for large numbers of animals. In the presentation, I will focus on two approaches to significantly including the 3Rs in these important programs. Although it is common practice in Japan to recognize contributions of laboratory animals through a day of memorialization, this has not been the case in the United States. During the last year, several activities have been initiated to begin to institutionalize memorial services for animals used in research. As the host institution of Altweb (http://altweb.jhsph.edu), the alternative web site internationally, current statistics and accomplishments will be provided on its worldwide utilization. (+info)