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Artigo em Russo | MEDLINE | ID: mdl-32119224


The article considers historical characteristics of process of origin and formation of the health care system in Russia as process of state organizational activities. The starting point of the mentioned process is determined the period of the second half of XVI century that initiated becoming of institutional foundations of the whole health care system in Russia establishing the priority of state power initiative in becoming and development of the given processes. The significant role of foreign factor in development of medicine business in Russia during the given historical period is emphasized. The role of English medical men in popularization of European practice of medical treatment at the Tsar's court and in becoming of state institutions of health care is specially emphasized. At that, the state character of formation of health care system in Russia is stressed and is considered as national feature related to paternalistic character of the state authority itself. The specific facts of history of becoming of national health care system are considered in the context of universal historical development. On the whole, the period of governing of the Russian Tsars of second half of XVI century - Ivan VI the Terrible, Fedor Ioannovich, Boris Godunov, - is considered as unconditionally positive one in the process of becoming of the state medicine in Russia.

Assistência à Saúde , Medicina , Comércio , História do Século XX , Federação Russa , Medicina Estatal
N Engl J Med ; 382(9): 880, 2020 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-32101682
Rev Med Suisse ; 16(681): 322-323, 2020 Feb 12.
Artigo em Francês | MEDLINE | ID: mdl-32049455


Medicine is changing, and so are the causes of dissatisfaction among physicians. In a broader context characterized by the dominance of an economic rationality, in which medicine is shaped by the phenomenon of acceleration typical of modernity, we argue, in this brief article, that clinical practice is based on an engagement involving a form of suspension of the flow of time. Engagement is thereby an essential dimension of medicine, and is proposed as a lasting foundation of clinical practice.

Medicina/tendências , Médicos/psicologia , Humanos , Satisfação no Emprego
Lancet ; 395(10221): 334-335, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31986263
Lancet ; 395(10217): 24-25, 2020 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-31982047
Gesundheitswesen ; 82(1): 107-116, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31634963


BACKGROUND: In 2010, the ICF working group of Faculty II "Applied Social Medicine and Rehabilitation" of the German Society for Social Medicine and Prevention, DGSMP proposed a classification of personal factors (PF) for the German-speaking area. Meanwhile, the International Classification of Functioning, Disability and Health (ICF) and WHO's bio-psycho-social model were increasingly integrated into the German Social Code (Book IX for Rehabilitation and Participation). It was a legislative decision that the needs assessment for the rehabilitation process must be "comprehensive". AIM: This publication aims to present an updated classification of PF to support the socio-medical assessment. For this purpose other published papers proposing a classification of PF were analyzed, especially the publication of Geyh et al. METHODS: The multiprofessional working group re-examined the basic structure, consistency and selection of factors of the 2010 classification using a qualitative approach and modified them if meaningful and necessary. The principles for the selection of factors were the same as in the 2010 publication (comprehensive, manageable, universal, impartial, relevant, unambiguous, focusing on finality, not regarding causality and non-discriminatory). RESULTS: A fundamental revision was not necessary; the basic structure remained primarily unchanged. Some items were included, excluded, summarized, shifted and editorially or content-related altered. Legal expertise shows that the classification of PF and their individual use for the socio-medical assessment, if necessary for the individual rehabilitation allocation, incur no problems with regard to data-protection regulations. PERSPECTIVES: The revised classification is ready to support users to describe and document relevant influences of the life background of individuals in a structured manner. Thus, influences on functioning and participation can be described comprehensively and transparently based on the bio-psycho-social model. A justiciable allocation of benefits for persons with disabilities is facilitated.

Pessoas com Deficiência , Medicina , Medicina Social , Avaliação da Deficiência , Alemanha , Humanos , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Determinação de Necessidades de Cuidados de Saúde
Ann Otol Rhinol Laryngol ; 129(2): 115-121, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31526031


OBJECTIVE: Identify knowledge deficits about alternate airways (AAs) (tracheostomy and laryngectomy) among physicians across multiple specialties a tertiary institution and to assess the impact of an educational lecture on improving deficits. METHODS: Study Design: Cross-sectional assessment. Setting: Academic medical center. Subjects and Methods: An anonymous 10-item, multiple choice assessment was given to physicians at a tertiary care center in the departments of Otolaryngology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, and Pediatrics. An educational lecture on AAs was presented. Scores between a pre-lecture and a 3-month post-lecture assessment were compared. Data was analyzed using ANOVA and chi-squared analysis. RESULTS: Otolaryngology physicians scored an average of 97.8%, while non-otolaryngology physicians scored 58.3% (P < .05). Non-otolaryngology surgical physicians scored 68.4% while non-surgical physicians were lower at 55.1% (P < .0001). Comparing pre-lecture to post-lecture scores, all non-otolaryngology physicians improved their scores significantly from 58.3% to 86.5% (P < .005). Non-surgical physicians had significant improvement after the instructional lecture, closing the score gap with surgical physicians for the post-lecture assessment. DISCUSSION: The care of patients with AAs requires an understanding of their basic principles. Our findings identify significant knowledge deficits among non-otolaryngologists. Through an instructional lecture, we demonstrated improvement in knowledge among non-otolaryngology physicians and durability of the knowledge after 3 months. CONCLUSIONS: Through an instructional lecture, we found tracheostomy and laryngectomy knowledge deficits can be identified and improved upon. Periodic reinforcement of basic principles for non-otolaryngology physicians may be a promising strategy to ensure the proper care of patients with AAs.

Competência Clínica , Conhecimentos, Atitudes e Prática em Saúde , Laringectomia/educação , Traqueostomia/educação , Estudos Transversais , Humanos , Medicina , Autorrelato , Centros de Atenção Terciária
Lancet ; 394(10216): 2201, 2020 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-31868612

Medicina , Aprendizagem
Med Educ ; 54(1): 13-14, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31849099

Medicina , Viés , Pensamento
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46923


Página do Conselho Federal de Medicina, é um órgão que possui atribuições constitucionais de fiscalização e normatização da prática médica.

Mayo Clin Proc ; 94(12): 2467-2475, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31806100


OBJECTIVES: To characterize public perception of physicians' conflicts of interest (COIs) across medical and surgical specialties. PATIENTS AND METHODS: A cross-sectional 6-arm randomized survey of a nonprobability sample from Amazon's Mechanical Turk occurred on December 11 to 16, 2018. Survey respondents were randomly assigned to vignettes that varied the physician specialty with COI. The primary outcome was mean difference in Mayer Trust, and the secondary outcome included the proportion who desire to discontinue care. RESULTS: There were 1729 of 1920 respondents who completed the experiment (90.1% completion rate). Respondents were male (52.5%; n=907), white (71.4%; n=1234), and between the ages of 25 and 44 years (70.9%; n=1227). Mean ± SD Mayer Trust across the 6 specialties was 3.7±.60, with the only between-specialty differences observed for psychiatry compared with the other specialties (F=5.4; P<.001). The median dollar amount that would affect respondents' trust in a physician was $5000 (interquartile range, $100-$100,000). A total of 75.1% (n=1298) of respondents desired COI information, with 41.6% (n=720) discontinuing care. Age older than 34 years (adjusted odds ratio [aOR], 0.7; 95%, CI, 0.49-0.99; P=.047), nonwhite race (aOR, 1.3; 95% CI, 1.02-1.6; P=.03), educational attainment of 4 or more years of college (aOR, 1.31; 95% CI, 1.05-1.6; P=.016), and physician specialty as a psychiatrist (aOR, 1.5; 95% CI, 1.03-2.2; P=.034) were predictors for discontinuing care. CONCLUSION: Public COI disclosure is a common method for managing financial conflicts. Although survey respondents were more likely to discontinue care with a physician with COI, they will act on this knowledge of COI differently depending on the specialty of the physician. The finding that psychiatry is an outlier may be a chance finding that warrants further confirmation. Continued efforts to ensure best practices for disclosure are required.

Conflito de Interesses , Revelação , Medicina , Opinião Pública , Especialidades Cirúrgicas , Confiança , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Inquéritos e Questionários , Adulto Jovem
Wien Klin Wochenschr ; 131(23-24): 585-586, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31832815

Medicina , Áustria
Zhonghua Yi Shi Za Zhi ; 49(5): 269-275, 2019 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-31795593


Prescription imparted by immortals is a unique type of medical prescription. Its narrative mode changed in Song Dynasty. The mode changed from non-narrative dream and lacking of plot to integration of religious dream stories and folk prescriptions, thus it had dual functions: spreading medicine and doing missionary work. This new change first appeared in the notes of the Song Dynasty, and then entered the medical books of the Song Dynasty. Taking Hong Mai's Yi Jian Zhi(, The Records of Yi Jian) as an example, by analyzing 11 prescriptions imparted by immortals in dreams, it was found that their prescriptions conformed to pharmacology and were cited by subsequent medical books. The intentions behind the divine plot of god's presence in dreams, were to emphasize the sanctity of the source of prescriptions and the magical efficacy. Some of them were first recorded in notes of the Song Dynasty, and their cultural value of medicine should be objectively evaluated in the history of Chinese medicine.

Medicina , Prescrições , Livros , China , História Medieval , Medicina Tradicional Chinesa
Medicina (B Aires) ; 79(6): 445-452, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31829946


The introduction of statistical analysis in biomedical journals should be attributed to Dunn and Greenwood in the 1930s, who reflect the concepts of statistical analysis and interpretation. The aim of this study was to analyze the use of different statistical tests and the level of accessibility analysis-dependent and article-dependent of the original articles published in the journal Medicina (B Aires) in the period 2008-2017. A bibliometric, descriptive, observational, cross-sectional study was carried out, in which the original articles were evaluated according to the scale proposed by Mora Ripoll et al. From the 301 articles in Spanish reviewed, 96% presented statistical analyses. Among the 215 articles that used some inferential statistics technique, 49.7% used the chi-square test, z tests for proportions, the Fisher exact test or the McNemar test; 29.2% used student t-tests and z-tests, including the use of these techniques or the use of confidence intervals for medium-conformance contrasts, and/or median-homogeneity (two samples), in paired or independent samples. The results indicate that a reader who knows about the tests included in Level II will have statistical access to 75% of the original articles published. It was found that it is not necessary to have advanced knowledge of statistics to access most publications, but it is important that these contents are developed with emphasis on statistical reasoning over the application and use of software or the choice of the appropriate test.

Acesso à Informação , Bibliometria , Medicina/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , Estatística como Assunto , Argentina , Pesquisa Biomédica/estatística & dados numéricos , Estudos Transversais , Interpretação Estatística de Dados , Humanos