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Screening in liver disease

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World Journal of Gastroenterology 2006年第33期12卷 5272-5280页

作者： Paolo Del Poggio Marzio Mazzoleni Hepatology Unit Treviglio Hospital Treviglio (Bergamo) Italy General practitioner Italian Society of Family Physicians (SIMG) Italy

A disease is suitable for screening if it is common, if the target population can be identifi ed and reached and if both a good screening test and an effective therapy are available. Of the most common liver diseases only viral hepatitis and genetic hemochromatosis partially satisfy these conditions. Hepatitis C is common, the screening test is good and the therapy eliminates the virus in half of the cases, but problems arise in the definition of the target population. In fact generalized population screening is not endorsed by international guidelines, although some recommend screening immigrants from high prevalence countries. Opportunistic screening (case finding) of individuals with classic risk factors, such as transfusion before 1992 and drug addiction, is the most frequently used strategy, but there is disagreement whether prison inmates, individuals with a history of promiscuous or traumatic sex and health care workers should be screened. In a real practice setting the performance of opportunistic screening by general practitioners is low but can be ameliorated by training programs. Screening targeted to segments of the population or mass campaigns are expensive and therefore interventions should be aimed to improve opportunistic screening and the detection skills of general practitioners. Regarding genetic hemochromatosis there is insufficient evidence for population screening, but individual physicians can decide to screen racial groups with a high prevalence of the disease, such as people in early middle age and of northern European origin. In the other cases opportunistic screening of high risk individu-als should be performed, with a high level of suspicion in case of unexplained liver disease, diabetes, juvenile artropathy, sexual dysfunction and skin pigmentation.

关键词： Screening Risk factors Hepatitis C Hepatitis B Genetic hernochromatosis

Acute Stress Symptoms in Families of Patients Admitted to the Intensive Care Unit during the First 24 Hours Following Admission in Japan

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Open Journal of Nursing 2015年第4期5卷 325-335页

作者： Miyuki Komachi Kiyoko Kamibeppu Department of Nurse practitioner Training Division of Healthcare Graduate School of Medical Welfare International University of Health and Welfare Tokyo Japan Department of family Nursing Division of Health Sciences & Nursing Graduate School of Medicine University of Tokyo Tokyo Japan

Families of patients in the intensive care unit often experience sever stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of patients admitted to the intensive care unit (ICU). To evaluate the prevalence and factors associated with acute stress symptoms among families of patients admitted to the ICU, we carried out a cross-sectional study at a teaching and advanced treatment hospital. The mean total Impact of Event Scale-Revised (IES-R) score differed significantly between planned and unplanned ICU admissions (t = 4.03, p family members more than did getting support from nurses, being the patient’s spouse, or the severity of illness of the patient.

关键词： Intensive Care Unit Families within 24 Hours Acute Stress Symptoms Post-Traumatic Stress Disorder

Problems of Contraception in Commune IV of the District of Bamako about 109 Cases

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Advances in Breast Cancer Research 2023年第3期12卷 77-96页

作者： Sirama Diarra Birama Traore Yacouba Dembele Brahima Dembele Salif Diarra Dessé Diarra Amaguiré Saye Gynecology and Obstetrics Department at the District Hospital of Commune IV Bamako Mali Gynecology and Obstetrics Department of the CSREF of San Bamako Mali Hospital practitioner at the CSREF of Sikasso Bamako Mali Hospital practitioner at the CSREF of Commune I Bamako Mali

In Mali, the low utilization of reproductive health services in general and family planning (FP) in particular contributes strongly to illnesses or deaths of women during and/or after childbirth and of children under the age of one year. This situation is, among other things, the logical consequence of harmful practices, including closely spaced pregnancies, early pregnancies, clandestine abortions, access difficulties and the lack of adequate obstetric and neonatal care. Objective: The objective of our study was to study the difficulties of access to contraception in the health district of commune IV. Methodology: This was a descriptive and multicenter prospective cross-sectional study, carried out in the reference health center of commune IV in the district of Bamako, in the ten (10) CSCOMs and the RENEE CISSE maternity hospital (MRC). Study appalled from June 1 to December 30, 2019. Two subgroups of the study population were involved in the study: Service providers;Users (clients) made up of women of childbearing age (13 - 45 years old). The premises of the FP units, the service providers, the clients who answered our questionnaires constituted our sample;the interviewed providers were also evaluated for their capacity in Counseling with the different methods used. The variables retained for the analysis concerned: the provision of contraceptive products;as well as user files and their characteristics. Results: The result of our survey reveals that the method most used at the time of our survey was Norplant 49.5% and the least used is the pill 1.8;some products, such as the diaphragm, cervical cap, female condom and spermicide, are not available in the various FP units. Side effects were the cause of discontinuation for 17.9% of our clients;50% against the husband;10.7% for no reason;21.4% for desire for children. 87.2% of clients are satisfied with the service delivery compared to 12.8%. 79.8% of clients say that the cost of contraceptive products is affordable

关键词： Problem Contraception Bamako (Mali)

Ten Rules Preventing COVID-19

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Advances in Infectious Diseases 2020年第3期10卷 123-128页

作者： Iraj Salehi-Abari Shabnam Khazaeli Rheumatology Research Center Faculty of Medicine Tehran University of Medical Sciences Tehran Iran General practitioner Genetic Consultant Toronto Canada

The new Coronavirus disease or COVID-19 is a contagious viral/immunological systemic disorder with predominantly respiratory features caused by human infection with SARS-CoV-2, which is rapidly spreading from person-to-person all around the world as a pandemic. As long as there is no effective vaccine available to prevent this disease and no definitive treatment is provided to cure it, it is better to prevent this disease by following a series of principles, which are: home quarantine of asymptomatic to mild COVID-19 patients and hospitalization of severe cases, physical distancing, staying at home, handwashing, cleaning and disinfecting high-touch surfaces, face-mask using, cough and sneeze covering, healthy nutritious diet along with the routine life activities and daily exercise, video communication by phone/online with family, and finally practice to relieve stress/anxiety.

关键词： Quarantine Telemedicine Physical Distancing Prevention COVID-19 Face-Mask Handwashing High-Touch Surfaces

Integration of traditional Chinese medicine and Western medicine in a Chinese community health center

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family Medicine and Community Health 2015年第2期3卷 79-83页

作者： Kenneth Kushner Shuang Yu Department of family Medicine University of WisconsinMadisonWIUSA Yuetan Community HealthServices BeijingChina

Objective:Although the literature is abundant on traditional Chinese medicine(TCM)in the West,there is limited information on how TCM is integrated with Western medicine(WM).We describe how one Chinese Community Health Service(CHS)system located in Beijing integrates WM and ***:Our information is based on the authors’observations,interviews with center TCM practitioners,and discussions with center ***:We summarize our observations according to the following themes:selection of type of practitioner;frequent diagnoses of patients seen by TCM clinicians;types of TCM ser-vices provided;economic factors;challenges;and future *** age,nature of the problem,and cost may determine whether or not Chinese patients initially consult TCM or WM *** of referral pathways between the WM and TCM practitioners,up to one-third of the patients receive integrated *** physicians see more patients per day than do their WM counterparts;TCM physicians also earn higher *** there are clearly close collaborative relationships between the TCM and WM practitioners,a few TCM providers report that lack of respect between the two fields may be a barrier towards further ***:Given governmental policies and the cost differentials between WM and TCM,the future for the integration of the two medical traditions within the CHS system appears to be favorable;however,issues of mutual respect and workforce issues may challenge success-ful *** impressions are limited by the fact that we observed practices in only one community in one district of Beijing.

关键词： Traditional Chinese medicine integrative medicine community health centers China

Motivations and Training Needs of General practitioner Preceptors

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Chinese Medical Journal 2017年第14期130卷 1689-1693页

作者： Wen Ren Nulanbieke Hasenbieke Ying Liu Yan Qiu Zhao-Nong Zhou Xiao-Yan Mao Jing-Jing Ren Department of General Practice The First Affiliated Hospital College of Medicine Zhejiang University Hangzhou Zhejiang 310003 China Training Center of the National Population and family Planning Commission Beijing 100024 China Department of Comprehensive Training School of Continuing Education Zhejiang University Hangzhou Zhejiang 310003 China

Background：General practitioner （GP） preceptors play an important role in the cultivation of *** problems exist in the training of GP *** study aimed to explore the willingness and training needs of GP preceptors and compare the differences between preceptors from general practice and other ***：A total of 375 questionnaire forms were sent to 375 GP preceptors from 11 different provinces,and 344 completed forms were *** main outcome included general information,teaching motivations,and training needs of GP ***：The study showed that about 89.2% of GP preceptors were willing to be *** majority of respondents strongly agreed that the motivation for becoming a GP supervisor was to learn from *** most important capability they should master was clinical teaching （92.2%）,followed by lecture （83.1%） and doctor-patient communication （83.1%）.The top three preferred methods of GP preceptors training were case discussion （78.8%）,workshop （57.6%）,and classroom teaching （56.4%）.The domains in which most GP preceptors wanted to acquire knowledge and skill were mental health （59.3%）,rehabilitation （47.1%）,pediatrics （41.0%）,and obstetrics （37.5%）.No significant differences were found in the willingness to train GPs （x2 =3.34,P 〉 0.05） and whether they would become or continue to become a GP supervisor after the training （x2 =l.106,P 〉 0.05）.Conclusions：Although most preceptors were under on-the-job training,they were glad to train *** be qualified,preceptors should be trained according to the actual needs of GP preceptors.

关键词： General practitioner Health Educator: Motivation: Needs Assessment

A complaint that changed my practice

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英国医学杂志中文版 2006年第3期9卷 188-188页

作者： Antonio Munno general practitioner King Street Surgery Kempston Bedford

The family asked to meet me. Their daughter had recovered from meningococcal septicaemia, and they wanted to know why I hadn't diagnosed it when they saw me that morning six weeks ago at the GP surgery. A few hours after I had treated her for an upper respiratory tract infection, her parents noticed a rash on her legs and took her straight to the accident and emergency department, where the seriousness of her condition was recognised.

关键词：医生病人诊断治疗临床医学

针刺作为辅助手段治疗精神分裂症的探索性病例研究(英文)

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中西医结合学报 2011年第5期9卷 503-514页

作者： Patricia Ronan Nicola Robinson Dominic Harbinson Douglas MacInnes Health Wellbeing and the family Beckett HouseCanterbury Christ Church University Allied Health Sciences Department Faculty of Health and Social CareLondon South Bank University Canterbury Complementary Health Clinic Centre for Health and Social Care Research Canterbury Christ Church University

目的:探索个体针刺疗法作为常规治疗的辅助手段在精神分裂症患者中的效果;采用探索性病例研究的方法,使用定量和定性评价工具,以便能够对针刺治疗此类患者的确切疗效作出科学评价,并对未来采用针刺治疗此类患者的试验设计提供方法学建... 详细信息

目的:探索个体针刺疗法作为常规治疗的辅助手段在精神分裂症患者中的效果;采用探索性病例研究的方法,使用定量和定性评价工具,以便能够对针刺治疗此类患者的确切疗效作出科学评价,并对未来采用针刺治疗此类患者的试验设计提供方法学建议。方法:共纳入11例精神分裂症患者,在予以10周的针刺治疗前,治疗过程中及治疗后分别采用多种有效的定量和定性评价工具对患者进行多方面的评价。这些评价手段包括对针刺治疗、全科医生及精神科医生病历的整理回顾。分析定性资料以评价受试者向研究者及其临床医生和护理人员报告的内容的可靠性。结果:11名受试者中共有8名完成了1个疗程的针刺治疗,全部11名受试者都报告了针刺治疗的积极作用,包括精神分裂症症状的改善,缓解药物的副作用,对精力、内在动机、睡眠、成瘾症状及其他身体机能的促进作用。但是,受试者向研究者和针刺医生报告的信息在不同治疗阶段有一定差别,且往往不一致;在研究结束后,受试者向研究者报告了更多的信息。结论:本研究表明,在常规疗法之外辅以针刺治疗能够给精神分裂症病人带来一定益处。对数据的三角测量表明了受试者报告内容的某些不一致性,而这些可以通过多种研究方法的混合使用得以克服。通过对数据的比较,推荐在将来的研究设计中使用阳性与阴性症状量表、针刺临床试验干预措施报告标准以及在问卷中增加对药物副作用、运动、睡眠以及日常作息的调查。在将来的研究中还应充分考虑到,恢复期患者容易复发,应该让他们可以方便地获得帮助。

关键词：精神分裂症针刺阳性与阴性症状量表 STRICTA 研究设计

Forward from the Editor-in-Chief

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family Medicine and Community Health 2024年第S03期12卷 1-1页

作者： Li Li Department of family Medicine University of Virginia School of MedicineCharlottesvilleVirginiaUSA UVA Comprehensive Cancer Center University of VirginiaCharlottesvilleVirginiaUSA

family medicine in the USA,born out of the timeless and universally needed role of the general practitioner,has enjoyed tremendous growth since its founding in *** is now one of the largest medical specialties with an active workforce of approximately 118000 board-certified family *** of the 165 Departments of family Medicine at US academic institutions celebrated their 50th anniversary in the past few *** are currently over 750 residency programmes in the USA and this number continues to grow,driven by the widespread shortage and inequitable geographical distribution of primary care physicians nationwide.

关键词： founding nationwide family