WorldWideScience

Sample records for asylum physician scientific

  1. Medical care of asylum seekers: a descriptive study of the appropriateness of nurse practitioners' care compared to traditional physician-based care in a gatekeeping system

    Directory of Open Access Journals (Sweden)

    Pécoud Alain

    2007-10-01

    Full Text Available Abstract Background Medical care for asylum seekers is a complex and critical issue worldwide. It is influenced by social, political, and economic pressures, as well as premigration conditions, the process of migration, and postmigration conditions in the host country. Increasing needs and healthcare costs have led public health authorities to put nurse practitioners in charge of the management of a gatekeeping system for asylum seekers. The quality of this system has never been evaluated. We assessed the competencies of nurses and physicians in identifying the medical needs of asylum seekers and providing them with appropriate treatment that reflects good clinical practice. Methods This cross-sectional descriptive study evaluated the appropriateness of care provided to asylum seekers by trained nurse practitioners in nursing healthcare centers and by physicians in private practices, an academic medical outpatient clinic, and the emergency unit of the university hospital in Lausanne, Switzerland. From 1687 asylum seeking patients who had consulted each setting between June and December 2003, 450 were randomly selected to participate. A panel of experts reviewed their medical records and assessed the appropriateness of medical care received according to three parameters: 1 use of appropriate procedures to identify medical needs (medical history, clinical examination, complementary investigations, and referral, 2 provision of access to treatment meeting medical needs, and 3 absence of unnecessary medical procedures. Results In the nurse practitioner group, the procedures used to identify medical needs were less often appropriate (79% of reports vs. 92.4% of reports; p Conclusion Although the nursing gatekeeping system provides appropriate treatment to asylum seekers, it might be improved with further training in recording medical history and performing targeted clinical examination.

  2. Why are physicians not persuaded by scientific evidence? A grounded theory interview study

    Directory of Open Access Journals (Sweden)

    Ishizaki Tatsuro

    2006-07-01

    Full Text Available Abstract Background The government-led "evidence-based guidelines for cataract treatment" labelled pirenoxine and glutathione eye drops, which have been regarded as the standard care for cataracts in Japan, as lacking evidence of effectiveness, causing great upset among ophthalmologists and professional ophthalmology societies. This study investigated the reasons why such "scientific evidence of treatment effectiveness" is not easily accepted by physicians, and thus, why they do not change their clinical practices to reflect such evidence. Methods We conducted a qualitative study based on grounded theory to explore physicians' awareness of "scientific evidence" and evidence-supported treatment in relation to pirenoxine and glutathione eye drops, and to identify current barriers to the implementation of evidence-based policies in clinical practice. Interviews were conducted with 35 ophthalmologists and 3 general practitioners on their prescribing behaviours, perceptions of eye drop effectiveness, attitudes toward the eye drop guideline recommendations, and their perceptions of "scientific evidence." Results Although few physicians believed that eye drops are remarkably effective, the majority of participants reported that they prescribed eye drops to patients who asked for them, and that such patients accounted for a considerable proportion of those with cataracts. Physicians seldom attempted to explain to patients the limitations of effectiveness or to encourage them to stop taking the eye drops. Physicians also acknowledged the benefits of prescribing such drugs, which ultimately outweighed any uncertainty of their effectiveness. These benefits included economic incentives and a desire to be appreciated by patients. Changes in clinical practice were considered to bring little benefit to physicians or patients. Government approval, rarity of side effects, and low cost of the drops also encouraged prescription. Conclusion Physicians occasionally

  3. Eight Years of Specialist Training of Dutch Intellectual Disability Physicians: Results of Scientific Research Education

    Science.gov (United States)

    Evenhuis, Heleen M.; Penning, Corine

    2009-01-01

    Training in scientific research methods and skills is a vital part of Dutch specialist training in intellectual disability medicine. The authors evaluated results of such training at one Dutch university medical facility that had an obligatory research program involving projects conducted by the physicians-in-training (topics, teamwork, acquired…

  4. The Cultivation of Esteem and Retrieval of Scientific Knowledge in Physician Networks

    Science.gov (United States)

    Menchik, Daniel A.; Meltzer, David O.

    2016-01-01

    This paper evaluates how physicians use scientific and other forms of knowledge in different professional communities. We argue that because physicians will draw upon clinical research findings to improve their reputation with colleagues, and since the terms for accruing esteem in an academic hospital may differ depending on the dominant task structure of the organization, the form of knowledge that is therefore valued by physicians will vary with their hospital’s level of prestige. Social network and multivariate analyses are used to test this theory in six U.S. hospitals with varying levels of prestige. We find that in lower-prestige hospitals physicians can improve their reputation by reading a relatively broad range of scientific journals, whereas in higher-prestige hospitals esteem is allocated to those with a more elite medical school pedigree. Statistically significant differences also exist between hospitals in terms of whether work with patients is valued, with physicians who engage in more clinical activity in the highest-ranked hospitals receiving less esteem from their colleagues. We finish by discussing how the functioning of higher and lower prestige hospitals are interconnected in ways that sustain both the development of innovations and their widespread adoption. PMID:20617755

  5. [Public Health initiative for improved vaccination for asylum seekers].

    Science.gov (United States)

    Brockmann, Stefan O; Wjst, Stephanie; Zelmer, Ursula; Carollo, Stefanie; Schmid, Mirjam; Roller, Gottfried; Eichner, Martin

    2016-05-01

    The number of asylum seekers in Germany has increased dramatically in 2015. Their medical care includes the officially recommended vaccinations; yet, no detailed information on this is yet available in Germany. In light of the rising number of asylum seekers, we have developed a concept to facilitate their vaccination. This concept includes the coordination of different partners, the supply of vaccines and other materials through the local health office, and the cooperation with the local physicians' association. To evaluate and accelerate progress, we compared the number of vaccinations conducted by physicians independently of the vaccination concept with those conducted within the new concept. For the period of investigation, 2,256 new asylum seekers were temporarily accommodated in the facilities. The vaccination concept was applied in only some of the facilities. Twenty-eight percent of all asylum seekers (642) were vaccinated at least once; 89 % of the vaccinees (571) were vaccinated within the newly developed concept. In the facilities that were not included in this concept, only 6 % of the refugees were vaccinated, whereas in the facilities that were included up to 58 % were vaccinated. Even though the new concept has started successfully, further innovations are required to reach sufficient vaccination coverage among asylum seekers. In view of the large number of new asylum seekers expected, the adjustment and expansion of the new concept requires professional planning and coordination. Furthermore, additional resources are required. PMID:27072499

  6. Daily Occupations among asylum seekers

    DEFF Research Database (Denmark)

    Morville, Anne-Le

    2014-01-01

    Asylum seekers often find themselves in a situation where the structure and content of daily occupations have been disrupted and they might have limited access to paid work and education. Studies have shown that asylum seekers experience occupational deprivation and a change in daily occupations...... which might even influence their identity. Such deprivation can eventually lead to dissatisfaction with everyday life and to occupational dysfunction, i.e. a decline in ADL ability. Asylum seekers are a group who are more likely to suffer from health problems than the background population. Especially...... torture survivors suffer from ill health. Pain and psychological symptoms are among the most frequent health issues for both asylum seekers and torture survivors and may cause occupation-related problems. The overarching aim of this thesis was to investigate how staying in an asylum centre influenced...

  7. Impact of asylum interviews on the mental health of traumatized asylum seekers

    OpenAIRE

    Katrin Schock; Rita Rosner; Christine Knaevelsrud

    2015-01-01

    Background: Asylum interviews within the asylum procedure are associated with psychological stress for traumatized asylum seekers. This study investigates the impact of asylum interviews on the mental health in a sample of 40 traumatized asylum seekers. The comparison group consisted of refugees (N=10) that had not been invited to an asylum interview. Additionally, the moderating effects of trial-related variables such as perceived justice of the trial, stress of giving testimony, and stress ...

  8. Ethical and professional considerations providing medical evaluation and care to refugee asylum seekers.

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    Asgary, Ramin; Smith, Clyde L

    2013-01-01

    A significant number of asylum seekers who largely survived torture live in the United States. Asylum seekers have complex social and medical problems with significant barriers to health care access. When evaluating and providing care for survivors, health providers face important challenges regarding medical ethics and professional codes. We review ethical concerns in regard to accountability, the patient-physician relationship, and moral responsibilities to offer health care irrespective of patient legal status; competing professional responsibility toward society and the judiciary system; concerns about the consistency of asylum seekers' claims; ethical concerns surrounding involving trainees and researching within the evaluation setting; and the implication of broader societal views towards rights and social justice. We discuss contributing factors, including inadequate and insufficient provider training, varying and inadequate institutional commitment, asylum seekers' significant medical and social problems, and the broader health and social system issues. We review existing resources to address these concerns and offer suggestions. PMID:23767428

  9. Length of stay in asylum centres and mental health in asylum seekers

    DEFF Research Database (Denmark)

    Hallas, Peter; Hansen, Anne R; Staehr, Mia A;

    2007-01-01

    BACKGROUND: The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic...

  10. [The emergence of the Québec asylum in the 19th century.].

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    Paradis, A

    1977-01-01

    This team of five philosophers analyses the 18th and 19th century Quebec discourse on the subject of insanity. The 18th century saw the insane excluded from social contact with the state recognizing only their indigence. They were relegated either to the "Loges", designed to expiate their sins since insanity was linked to an abuse of mind and body, or to prison for appropriate punishment, since madness was considered to lead to crime. But economic pressures produced by the growing number in indigents, including the mentally ill, led to the creation of the Beauport asylum in 1845. The authors then describe how the urban insane, marginal to both the French Canadian and English Canadian communities* were placed in private institutions and subjected to a system of profit maximization controlled by bourgeois physicians. This situation increased the distance between proprietors and occupants, and accounts for the lack of original discourse on the subject of insanity. In addition, the reasoning of the alienist physicians was without scientific foundation, taking root rather in the dominant industrial capitalist ideology. As for the content of the discourse, the Beauport physicians borrowed from moral treatment and restraint system notions, giving them a certain Quebec character. PMID:17093651

  11. Refugee families during asylum seeking.

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    Sourander, Andre

    2003-01-01

    The mental health of refugee families with children during the asylum period is a neglected research area in psychiatry. The present paper describes the situation of 10 refugee families residing at an asylum centre in Finland. Case vignettes are presented to illustrate the situations of these families. The study shows a high rate of depressive and post-traumatic stress disorder-related symptoms among adult refugees. The case vignettes suggest that during the asylum period, many children and adult members of the family are not in a post-traumatic situation, but they live constantly in a distressing situation. The foremost distress amongst the asylum seekers appeared to be fear of deportation and separation from family members. Most of the adults and all children had not received any psychiatric or psychotherapeutic assessment or treatment. It is likely that current procedures for dealing with the asylum seekers contributes to the level of stress, family confusion and psychiatric problems in already traumatized refugee families. PMID:12775295

  12. Dermatological problems of asylum seekers arriving on boats: a case report from Australia and a brief review.

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    Cheng, Hui Mei; Kumarasinghe, Sujith Prasad

    2014-11-01

    Assessing the skin of asylum seekers, immigrants, migrant workers, tourists or even locals who return from abroad, can be a confronting task due to the possibility of such people having non-autochthonous diseases. Primary-care physicians and dermatologists need to have a systematic approach in the assessment of such dermatoses. This article describes an interesting case of possible kerosene-induced and diesel-induced skin injury in an asylum seeker arriving on a boat. Dermatological conditions in asylum seekers and a suggested template for skin assessment are discussed. PMID:25178452

  13. Philosophers and physicians on the scientific validity of Latin physiognomy, 1200-1500.

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    Ziegler, Joseph

    2007-01-01

    The article surveys and contextualizes the main arguments among philosophers and academic physicians surrounding the status of physiognomy as a valid science from the thirteenth to the early sixteenth centuries. It suggests that despite constant doubts, learned Latin physiognomy in the later Middle Ages was recognized by natural philosophers (William of Spain, Jean Buridan, William of Mirica) and academic physicians (Rolandus Scriptor, Michele Savonarola, Bartolomeo della Rocca [Cocles]) as a body of knowledge rooted in a sound theoretical basis. Physiognomy was characterized by stability and certainty. As a demonstrative science it was expected to provide rational explanation for every bodily sign. In this respect, learned physiognomy in the Middle Ages was dramatically different from its classical sources, from Islamic and possibly from early-modern physiognomy as well. PMID:18175464

  14. Life in dispersal : narratives of asylum, identity and community

    OpenAIRE

    Brown, Philip

    2005-01-01

    This study explores how the immigration status of the 'asylum seeker' impacts upon notions of 'identity', 'community' and 'belonging' whilst claiming asylum in the UK. By taking a narrativedialogical approach this research explores the stories that have been constructed around 'asylum' by policy, those working with 'asylum seekers' and 'asylum seekers' themselves. This research looks at how the 'official' narratives of asylum are operationalised and delivered by workers contrac...

  15. Right to asylum and its protection

    OpenAIRE

    Kuosmanen, Jaakko Niilo

    2012-01-01

    The topic of this thesis is justice and asylum. The central argument in the thesis is that citizens of all states have a moral right that entitles them to asylum in certain circumstances of deprivation. The right to asylum can be understood as a general derivative right, and it is grounded in the more fundamental entitlement to basic needs. More specifically, I argue that all persons whose basic needs are insufficiently protected in their home states have the right to asylum when they cannot ...

  16. Mental health of failed asylum seekers as compared with pending and temporarily accepted asylum seekers

    OpenAIRE

    Mueller, J; Schmidt, M.; Staeheli, A; Maier, T.

    2011-01-01

    BACKGROUND: Asylum seekers (AS) and refugees often suffer from severe psychopathology in the form of post-traumatic stress disorder (PTSD). As PTSD impacts memory functions, and as asylum applications rely on personal accounts, AS with PTSD are at more risk of being rejected than refugees. METHODS: We studied the mental health of failed asylum seekers (FAS, N = 40) and a matched sample of AS (N = 40). Participants were administered structured interviews on sociodemographics, flight, exile and...

  17. Impact of asylum interviews on the mental health of traumatized asylum seekers

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    Katrin Schock

    2015-09-01

    Full Text Available Background: Asylum interviews within the asylum procedure are associated with psychological stress for traumatized asylum seekers. This study investigates the impact of asylum interviews on the mental health in a sample of 40 traumatized asylum seekers. The comparison group consisted of refugees (N=10 that had not been invited to an asylum interview. Additionally, the moderating effects of trial-related variables such as perceived justice of the trial, stress of giving testimony, and stress of waiting for the asylum interview were examined. Method: Participants were assessed on average 10 days before (t1 and 16 days after (t2 the asylum interview. Chi-square tests for dichotomous and categorical variables were used to compare the descriptive statistics of the two groups. To investigate symptom changes from t1 to t2, paired t-tests were calculated. The magnitude of effects was measured by Cohen's effect size d within groups. Hierarchical regression analyses were conducted for demographic and trial variables predicting posttraumatic intrusions, avoidance, and hyperarousal. Results: Data showed a significant increase in posttraumatic intrusions and a significant decrease in posttraumatic avoidance and hyperarousal symptoms from t1 to t2. No significant symptom changes in the posttraumatic stress disorder subscales were found in the comparison group. The results of hierarchical regression analyses revealed perceived justice of the interview to predict the increase of intrusions and the number of experienced traumata and testimony stress to predict posttraumatic avoidance. Conclusions: The present findings underline the stressful impact of asylum interviews on traumatized refugees. They indicate that the asylum interview might decrease posttraumatic avoidance and trigger posttraumatic intrusions, thus highlight the importance of ensuring that the already vulnerable group of traumatized refugees needs to be treated with empathy during their asylum

  18. Age assessment of young asylum seekers

    DEFF Research Database (Denmark)

    Hjern, Anders; Brendler-Lindqvist, Maria; Nørredam, Marie Louise

    2012-01-01

    During 2009, 15,100 unaccompanied children sought asylum in Europe. Many of them came from 'failed states' like Somalia and Afghanistan where official documents with exact birth dates are rarely issued. This has led to requests to health care professionals in many countries to assist migration....... CONCLUSION: To improve care for young asylum seekers with undetermined age, we suggest better legal procedures for the determination of age and a more flexible approach to chronological age....

  19. Asylum for persecuted homosexuals in the Republic of Korea

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    Andrew Wolman

    2013-04-01

    Full Text Available Two recent successful claims for asylum suggest that the Republic of Korea may be prepared to serve in the future as an important country of asylum for those suffering persecution due to their sexual orientation.

  20. Morbidity of asylum seekers in a medium-sized German city.

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    Führer, Amand; Eichner, Friederike; Stang, Andreas

    2016-07-01

    Asylum seekers constitute a particularly vulnerable group. Not only is their physical and mental health exposed to multiple stresses, but also their access to health care in Germany is legally restricted. Up to now, there is very limited scientific literature investigating the health-outcomes of asylum seekers in Germany. The aim of this study was to provide prevalence data on the morbidity and vaccination status of asylum seekers in a medium-sized German city. We used a structured questionnaire in a cross-sectional study on 214 adult asylum seekers (182 males, 24 females, 8 unknown) in Halle, Germany, 2015. The questionnaire inquired about the respondent's self-reported physical health and vaccination status and assessed their mental health using the Hopkins-Symptom-Checklist-25 and the Harvard Trauma Questionnaire. Pain (37.9 %) and psychological illness (depression: 54.7 %, anxiety disorder: 40.2 %; post-traumatic stress disorder: 18.2 %) were the most prevalent complaints. Among asylum seekers with psychological complaints, co-morbidity was high (64.2 % had more than one psychological disease). 5.6 % of the respondents mentioned suicidal thoughts. The prevalence of chronic diseases was low. We suggest interventions to improve asylum seekers' health on two levels: first, the obligatory initial medical examination after the refugees' arrival at the reception centre should be complemented with questions related to the vaccination status and the most common complaints including pain and psychological diseases. Second, medical infrastructure should be expanded to better serve the needs of culturally and linguistically diverse patient populations, so that those screened positive can be referred for early diagnosis and treatment. PMID:27068422

  1. EU asylum procedures and the right to an effective remedy

    OpenAIRE

    Reneman, Anne Marcelle

    2013-01-01

    Adequate and fair asylum procedures are a precondition for the effective exercise of rights granted to asylum applicants, in particular the right not be expelled to a country where they face the risk of being subjected to human rights violations. In 1999 the EU Member States decided to work towards a Common European Asylum System. In this context the Procedures Directive was adopted in 2005. This directive provides for important procedural guarantees for asylum applicants, but also leaves muc...

  2. European Asylum Law : and its Relation to International Law

    NARCIS (Netherlands)

    Battjes, H.

    2006-01-01

    In Chapter 1 I introduce the question of enquiry, the relation between Community and international law on asylum. Further, I sketch the content of the Refugee Convention, other relevant international law, the historical background of current Community asylum law (i.e. the asylum acquis from before 2

  3. Occupational deprivation in an asylum centre:

    DEFF Research Database (Denmark)

    Morville, Anne-Le; Erlandsson, Lena-Karin

    2013-01-01

    This article presents a study of three asylum-seeking men from Iran and Afghanistan. It aimed to explore how and if they experienced occupations as occupations in a Danish asylum centre and how their life experience shaped their choice and value of current occupations. In-depth narrative interviews...... explored the participants’ occupational history and its influence on their occupations in the asylum centre. A thematic analysis showed that the participants had been subjected to occupational disruption and deprivation by politically oppressive systems even before their flight. Their occupations in...... Denmark were to a certain extent influenced by their earlier occupations and the current occupational deprivation they all experienced was due to limited possibilities in the centre. Although they tried their best to fill their days and create structure, there was a loss of valued occupations and a...

  4. Haitian Refugees Need Asylum: A Briefing Paper.

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    National Council of the Churches of Christ of the United States of America, New York, NY. Church World Service.

    Haitian refugees who are seeking political asylum in the United States are finding themselves unwelcome. Although various reports attest to continuing persecution in Haiti under the repressive Duvalier regime, the U.S. Immigration and Naturalization Service claims that the Haitians seek only greater economic opportunity and are not genuine…

  5. Bogus refugees? The determinants of asylum migration to Western Europe

    OpenAIRE

    Neumayer, Eric

    2005-01-01

    This article analyses the determinants of asylum migration to Western Europe. Potential asylum seekers balance the costs of staying versus the costs of migrating. Estimation results confirm that economic hardship and economic discrimination against ethnic minorities lead to higher flows of asylum seekers. However, political oppression, human rights abuse, violent conflict and state failure are also important determinants. Migration networks and geographical proximity are important facilitator...

  6. The externalisation of the asylum function in the European Union

    OpenAIRE

    Morgades Gil, S??lvia

    2010-01-01

    This paper aims to identify and assess the main items in the strategy followed by the EU and its member states on the externalisation of their asylum function. First, it analyses the European harmonisation of the return to safe third countries and to countries of first asylum, which is carried out by means of readmission agreements. Second, it refers to the strategies defined by the Hague and the Stockholm programs concerning the External Aspects of the European Union Asylum Policy, on the de...

  7. The association between acculturation patterns and mental health symptoms among Eritrean and Sudanese asylum seekers in Israel.

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    Nakash, Ora; Nagar, Maayan; Shoshani, Anat; Lurie, Ido

    2015-07-01

    Past research has documented the role acculturation plays in the process of adjustment to new cultures among migrants. Yet little attention has been paid thus far to the role of acculturation in the context of forced migration. In this study we examined the association between acculturation patterns and mental health symptoms among a convenience sample of Eritrean and Sudanese asylum seekers (n = 118) who accessed health services at the Physicians for Human Rights Open-Clinic in Israel. Participants completed measures on sociodemographic information as well as detention history, mental health symptoms, exposure to traumatic events, and acculturation pattern, in their native language upon accessing services. Consistent with our predictions, findings showed that acculturation predicted depressive symptoms among asylum seekers beyond the effect of history of detention and reports of experiences of traumatic events. Assimilated compared with integrated asylum seekers reported higher depressive symptoms. Findings draw attention to the paradox of assimilation, and the mental health risks it poses among those wishing to integrate into the new culture at the expanse of their original culture. Asylum seekers may be particularly vulnerable to the risks of assimilation in the restrictive policies that characterize many industrial countries in recent years. PMID:25090150

  8. LGBTI asylum claims: the Central and Eastern European perspective

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    Krzysztof Śmiszek

    2013-04-01

    Full Text Available Recent research indicates that CEE countries still lag far behind therest of Europe in their asylum practices in relation to LGBTI asylumclaims. Low levels of awareness, lack of guidance and cultural hostility are jeopardising asylum seekers’ prospects for fair treatment.

  9. Outcomes among Asylum Seekers in Atlanta, Georgia, 2003--2012.

    Science.gov (United States)

    Evans, Dabney P; Donato, Caitlin E; Malewezi, Bridget A; Li, Anyie J; Corea, Mario J; Mitchell, Andrew B

    2015-10-01

    INTRODUCTION Asylum seekers face a wide array of challenges, including the need for a fair and just adjudication process. In the state of Georgia, the Atlanta Asylum Network addresses the needs of such individuals by providing them physical, psychological and gynecological assessments, the results of which are presented to the courts in the asylum appeal process. OBJECTIVE As a component of the Network's program evaluation, assess outcomes among asylum seekers using its services, as well as relation of outcomes to type of service provided, the individual's geographic origin and English language proficiency. METHODS A retrospective examination was conducted of program data gathered by the Network between 2003 and 2012. Subjects included asylum seekers who received assessments by the Network during this period. The primary variable of interest was the final case outcome, defined as determination of asylum status: granted, withholding of removal, administrative closure and prosecutorial discretion, denied or voluntary departure. Outcomes were subsequently collapsed into a single positive or negative outcome variable. Positive outcomes included asylum granted, removal withheld, administrative closure and prosecutorial discretion. Negative outcomes included asylum denied and voluntary departure. We conducted bivariate and multivariate analyses, relating final case outcomes to Network services, geographic origin and English language proficiency, among the key variables. RESULTS A total of 69 of 120 asylum seekers in the study had a known final case outcome, and of those, 63.8% (44) had a positive outcome; or 37% of the total number of asylum seekers (n = 120). Among the 20 who received 2 of the 3 types of assessment (physical, psychological, gynecological), 16 (80%) received a positive case outcome. Most persons with a known final outcome came from Africa (41), where 78% (32) of cases resulted positive. Asylum seekers not proficient in English were 2.4 times more likely

  10. Problems Faced by Mexican Asylum Seekers in the United States

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    J. Anna Cabot

    2014-12-01

    Full Text Available Violence in Mexico rose sharply in response to President Felipe Calderón’s military campaign against drug cartels which began in late 2006. As a consequence, the number of Mexicans who have sought asylum in the United States has grown significantly. In 2013, Mexicans made up the second largest group of defensive asylum seekers (those in removal proceedings in the United States, behind only China (EOIR 2014b. Yet between 2008 and 2013, the grant rate for Mexican asylum seekers in immigration court fell from 23 percent to nine percent (EOIR 2013, 2014b. This paper examines—from the perspective of an attorney who represented Mexican asylum seekers on the US-Mexico border in El Paso, Texas—the reasons for low asylum approval rates for Mexicans despite high levels of violence in and flight from Mexico from 2008 to 2013. It details the obstacles faced by Mexican asylum seekers along the US-Mexico border, including placement in removal proceedings, detention, evidentiary issues, narrow legal standards, and (effectively judicial notice of country conditions in Mexico. The paper recommends that asylum seekers at the border be placed in affirmative proceedings (before immigration officials, making them eligible for bond. It also proposes increased oversight of immigration judges.

  11. The leprosy asylum in India: 1886-1947.

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    Robertson, Jo

    2009-10-01

    Writing against a historical practice that situates the leprosy asylum exclusively within prison-like institutions, this article seeks to show the variation in leprosy asylums, the contingencies of their evolution, and the complexity of their designs, by devoting attention to the characteristics of the leprosy asylum in India from 1886 to 1947, in particular to the model agricultural colony. Drawing upon the travel narratives of Wellesley Bailey, the founder of the Mission to Lepers in India, for three separate periods in 1886, 1890-91, and 1895-96, it argues that leprosy asylums were formed in response to a complex conjunction of impulses: missionary, medical, and political. At the center of these endeavors was the provision of shelter for persons with leprosy that accorded with principles of good stewardship and took the form of judicious use of donations provided by benefactors. As the Mission to Lepers began to bring about improvements and restructuring to asylums, pleasant surroundings, shady trees, sound accommodation, and good ventilation became desirable conditions that would confer physical and psychological benefits on those living there. At the same time, the architecture of the asylum responded to economic imperatives, in addition to religious and medical aspirations, and asylums moved towards the regeneration of a labor force. Leprosy-affected people were increasingly employed in occupations that contributed to their sustenance and self-sufficiency, symbolically reincorporating the body damaged by leprosy into the economic world of productive relations. PMID:19531547

  12. United States refugee and asylum policy: history and current approaches.

    Science.gov (United States)

    Stein, B N

    1986-01-01

    For most of the 4 decades since World War II, US refugee and asylum policy has been generous but ad hoc, discretionary, and highly variable favoring some refugee groups and discriminating against or ignoring others. This paper: 1) tries to clarify some of the terminology of the refugee field and explains the distinctions between asylum and resettlement, 2) provides some of the historical background that has brought the US to its present condition and chronicles the US overseas refugee admission policy, and 3) examines some asylum issues and other refugee issues. Asylum is far more difficult to control than refugee resettlement. As a result of what is perceived to be abuse of the asylum system, the US has joined the growing tendency of states to treat asylum-seekers as illegal migrants. The greatest problem with American asylum policy is its lack of fairness of application; many critics believe that foreign policy factors dominate asylum hearings rather than the individual merits of the case. The 3 classic solutions to this problem are resettlement, voluntary repatriation, and settlement in a country of 1st asylum. Only in the Indochinese refugee crisis has resettlement been widely used as a solution for 3rd World refugees. Nationalism and nation-building conflicts are at the root of many refugee movements; hosts are often no less nationalistic than source countries, thus many non-integrated refugees live in peril. Developed country political will and statesmanship are needed to revive resettlement as a durable solution. Resettlement may be difficult and costly, but the pluralistic western societies do offer an integrated new life. PMID:12178938

  13. Detention in Kenya: risks for refugees and asylum seekers

    Directory of Open Access Journals (Sweden)

    Lucy Kiama

    2013-09-01

    Full Text Available Refugees and asylum seekers detained in Kenya risk multiple convictions and protracted detention due to poor coordination between immigration officials, police and prison officers, coupled with lack of interpreters and low levels of knowledge among government officers.

  14. Usage of psychiatric emergency services by asylum seekers

    DEFF Research Database (Denmark)

    Reko, Amra; Bech, Per; Wohlert, Cathrine;

    2015-01-01

    given at the initial evaluation was ICD-10 F43.9 "reaction to severe stress, unspecified" (50%). Evaluations were made primarily by non-psychiatrists. No standardized screening or diagnostic instrument was used. CONCLUSION: This first description of the use of an acute psychiatric emergency service by......BACKGROUND: Asylum seekers are found to be at high risk of mental health problems. Little is known about the use of acute psychiatric emergency services by asylum seekers. AIM: To describe the usage of an inpatient/outpatient psychiatric emergency service in Denmark by adult asylum seekers, and...... predominantly male and married. The group consisted primarily (61%) of failed asylum seekers. Most patients (81%) presented with relevant mental health problems. The main reasons for presenting to the acute psychiatric emergency service were suicidal ideation and/or behaviour (60%). The most frequent diagnosis...

  15. Adult Asylum Seekers from the Middle East Including Syria in Central Europe: What Are Their Health Care Problems?

    Directory of Open Access Journals (Sweden)

    Carmen Andrea Pfortmueller

    Full Text Available Forced displacement related to persecution and violent conflict has reached a new peak in recent years. The primary aim of this study is to provide an initial overview of the acute and chronic health care problems of asylum seekers from the Middle East, with special emphasis on asylum seekers from Syria.Our retrospective data analysis comprised adult patients presenting to our emergency department between 01.11.2011 and 30.06.2014 with the official resident status of an "asylum seeker" or "refugee" from the Middle East.In total, 880 patients were included in the study. Of these, 625 (71.0% were male and 255 (29.0% female. The median age was 34 (range 16-84. 222 (25.2% of our patients were from Syria. The most common reason for presentation was surgical (381, 43.3%, followed by medical (321, 36.5% and psychiatric (137, 15.6%. In patients with surgical presentations, trauma-related problems were most common (n = 196, 50.6%. Within the group of patients with medical presentation, acute infectious diseases were most common (n = 141, 43.9%, followed by neurological problems (n = 70, 21.8% and gastrointestinal problems (n = 47, 14.6%. There were no differences between Syrian and non-Syrian refugees concerning surgical or medical admissions. The most common chronic disorder of unclear significance was chronic gastrointestinal problems (n = 132, 15%, followed by chronic musculoskeletal problems (n = 108, 12.3% and chronic headaches (n = 78, 8.9%. Patients from Syria were significantly younger and more often suffered from a post-traumatic stress disorder than patients of other nationalities (p<0.0001, and p = 0.05, respectively.Overall a remarkable number of our very young group of patients suffered from psychiatric disorders and unspecified somatic symptoms. Asylum seekers should be carefully evaluated when presenting to a medical facility and physicians should be aware of the high incidence of unspecified somatic symptoms in this patient population

  16. The psychiatric profession and the Australian government: the debate over collective depression syndrome among asylum-seeking detainees

    Directory of Open Access Journals (Sweden)

    William W Bostock

    2009-11-01

    Full Text Available William W BostockSchool of Government, University of Tasmania, Hobart, Tasmania, AustraliaAbstract: Psychiatrists have long had involvement with the political process, both individually and as a profession. They have made valuable contributions to debate over such issues as war, conflict, terrorism, torture, human rights abuse, drug abuse, suicide and other public health issues. However, they have also been complicit in some gross atrocities. Over several years there has been debate over the Australian Government’s treatment of asylum seekers, and the Royal Australian and New Zealand College of Psychiatrists took the unusual step of publicly criticizing the Australian Government’s policy on grounds of its toxicity leading to a diagnosis of collective depression syndrome, particularly among child detainees, but also adult detainees. The official Ministerial response was to deny that collective depression exists and to assert that the concept is meaningless. Can this intervention by psychiatrists be interpreted as a product of earlier political behaviors by psychiatrists? The willingness of psychiatrists to cooperate with other professions, notably psychologists, pediatricians, physicians and lawyers, is noted, as is presence of minority voices within the Australian psychiatric profession. The significance of the debate over the mental condition of asylum-seeking detainees is that its outcome has implications for how Australia sees itself and is seen by the rest of the world, that is, its national identity.Keywords: collective depression syndrome, psychiatric profession, political intervention, asylum seeker, Australian national identity

  17. Strategic asylum law making in Europe: institutional locus

    OpenAIRE

    Monheim, Jenny

    2007-01-01

    Given the background of changing institutional competencies in the European Union, we analyze the choice of asylum law standards of national and European parliaments, the Council of the European Union and codecision between the Council and the European Parliament. In a two country model we nd that the European arrangements maximize neither the welfare of the Member Countries nor the welfare of refugees. For the latter, there has been an improvement in the institutional location of asylum law ...

  18. Setting policy on asylum: Has the EU got it right?

    OpenAIRE

    Hatton, Tim

    2015-01-01

    Policy toward asylum-seekers has been controversial. Since the late 1990s, the EU has been developing a Common European Asylum System, but without clearly identifying the basis for cooperation. Providing a safe haven for refugees can be seen as a public good and this provides the rationale for policy coordination between governments. But where the volume of applications differs widely across countries, policy harmonization is not sufficient. Burden-sharing measures are needed as well, in orde...

  19. Mad Kings, Proper Houses, and an Asylum in Rural Ireland

    OpenAIRE

    Saris, A. Jamie

    1996-01-01

    WHAT IF THEY built an asylum and nobody showed up? By asking this question, I mean to forefront the problem of what sort of a structure it is to which people are committed or present themselves. In the extensive literature on asylums that has developed over the course of the last three decades, most authors assume a needy or dominated population to exist around such buildings who eventually give over their unfortunates to fill them up. Few theorists, moreover, look ser...

  20. Unaccompanied minor asylum seekers and participation in everyday life

    OpenAIRE

    Rajšter, Tina

    2011-01-01

    Unaccompanied minor asylum seekers receive little attention by the media and the general public, which is why I decided to look into and clarify their situation in Slovenia. In the theoretical part legal issues concerning refugee policy, the origin, numbers and vulnerability of asylum seekers in Slovenia and the rest of the world are explained. Furthermore the topic of participation is presented from different points of view. The second, empirical part of the thesis is aimed to find out ...

  1. Toward a Common Asylum Policy for the European Union

    OpenAIRE

    Toni Lluch

    2001-01-01

    In the process of harmonizing EU members states’ asylum policies, as a result of the lack of a common asylum policy, save for the limited Dublin Agreement, we are witnessing a wide variety of non-binding political declarations, at times more the product of fear than of considerations of human rights, that are setting the trend for countries’ actions. This article focuses on an analysis of the Dublin Agreement in terms of its achievements and failures over the years of its implementation.

  2. Haiti, insecurity, and the politics of asylum.

    Science.gov (United States)

    James, Erica Caple

    2011-09-01

    In this article, I seek to show how states of insecurity provoked by ongoing social, economic, and political ruptures in Haiti can disorder individual subjectivity and generate the flight of individuals seeking asylum within and across borders. Nongovernmental actors working in Haiti and with Haitians in the diaspora frequently managed the long-term psychosocial effects of insecurity. Their interventions can range from repressive to compassionate and influence the formation of identity and the embodied experiences of trauma for vulnerable Haitians. The case of a young Haitian refugee who was repatriated to Haiti from the United States in the 1990s demonstrates how insecurity is both an existential state reflecting the disordering of embodied experience, as well as a collective sociopolitical condition the effects of which cannot be managed or contained within national borders. The case is emblematic of the plight of thousands of Haitians affected by the January 12, 2010, earthquake. PMID:22007562

  3. Physician Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in...

  4. Suffering and the struggle for recognition : lived experiences of the U.S. political asylum process

    OpenAIRE

    Haas, Bridget Marie

    2012-01-01

    This dissertation is an ethnographic study of seeking political asylum in the United States. With the implementation of restrictive immigration measures, particularly following September 11, 2001, seeking asylum in the U.S. has become increasingly onerous and protracted. From an institutional standpoint, the goal of the asylum process is to discern 'deserving' migrants ('authentic' refugees) from 'undeserving' migrants ('bogus' asylum seekers, economic migrants), and the process is undergirde...

  5. Refugeeship - A project of justification : Claiming asylum in England and Sweden

    OpenAIRE

    Magnusson, Nicola

    2011-01-01

    The aim of this thesis is to explore the asylum process from an experiential perspective, starting in the country of origin, fleeing, claiming asylum and being granted refugee status. The theoretical interest is to contribute with an understanding of how this asylum process impacts on personal meaning-making, focusing on identification and positioning work of the person forced to flee and make an asylum claim. With this purpose in mind, I have remained close to the experiences of the particip...

  6. 32 CFR 700.939 - Granting of asylum and temporary refuge.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Granting of asylum and temporary refuge. 700.939... Officer Present Contents § 700.939 Granting of asylum and temporary refuge. (a) If an official of the Department of the Navy is requested to provide asylum or temporary refuge, the following procedures...

  7. Neomodern insecurity in Haiti and the politics of asylum.

    Science.gov (United States)

    James, Erica Caple

    2009-03-01

    The term 'asylum' has a dual connotation that generates opposing but related forms of intervention: providing sanctuary and protection vs. imposing confinement and quarantine. The proliferation of "neomodern insecurity"--intrastate violence and the specter of transnational terrorism, arising within many postcolonial, postauthoritarian and postsocialist states--generates intervention practices that reflect the dual connotations of asylum. In fragile states like Haiti, national insecurity (ensekirite) often results in the flight of traumatized populations across and within national borders. For these individuals, 'asylum' connotes the attainment of political recognition and inclusion outside Haiti's space of ensekirite. Ironically, these vulnerable persons may be viewed as threats to the nations they seek to enter. In so-called secure states like the United States, the threat of insecurity often engenders interventions to contain, manage and rehabilitate states of disorder, as well as their disordered subjects. By chronicling the case of a young Haitian refugee who sought asylum in the United States, was detained and then repatriated after manifesting the disordered signs of insecurity, I argue that the Haitian trope of ensekirite captures and prefigures the subjective experience of neomodernity, one for which there is no asylum. PMID:19116780

  8. THE ASYLUM, BETWEEN HUMANITARIAN RESPONSE AND POLITICAL INSTRUMENT

    Directory of Open Access Journals (Sweden)

    Catrinel BRUMAR

    2012-06-01

    Full Text Available At 9 November 2010, the European Court of Justice, in a preliminary ruling, decided to depart from the interpretation promoted by the United Nations High Commissioner for Refugees, in the matter of the application of the exclusion clauses. The European Court considered that no proportionality test between human rights protection and gravity of a crime is to be applied in the case of a person suspected of having committed an act contrary to the principles and purposes of the United Nations. By eliminating this test, the Court is sending a signal on rethinking the asylum institution, from a humanitarian tool that it became, to a political instrument. This decision could not be read alone; corroborated to the concerns already raised on the suitable use of the asylum instrument to address massive humanitarian needs, it would indicate a reorientation in the interpretation of international norms governing the refugee law. Still, the human rights organs and the European Court of Human Rights continue to refer to the asylum as a situation where a humanitarian perspective, reflected in the proportionality test, or for those mechanisms the risk of human rights violation probability test, is still valid. The two apparently divergent directions will need to converge in the implementation of the European Union regulations on asylum. This paper is exploring the possible reinterpretation of the European norms, trying to identify the new trends in the political perspective of asylum and the limitations to these trends that the respect for human rights is establishing.

  9. [Asylum for curing or securing? The confinement of forensic patients as a challenge of asylum psychiatry in Imperial Germany].

    Science.gov (United States)

    Müller, Christian

    2006-01-01

    Asylum for curing or securing? The confinement of forensic patients as a challenge of asylum psychiatry in Imperial Germany. In Imperial Germany psychiatrists sought to give their asylums the character of modern medical hospitals. Due to the increase of insanity defence these efforts were obstructed by the high number of inmates with a criminal background. Special departments for mentally ill criminals were founded both in asylums and in prisons. But the clientele was not welcome in any of these institutions. Thus, there was a high fluctuation between prisons and asylums. A new definition of criminal responsibility was needed. In order to keep criminals out of their hospitals psychiatrists developed the medical concept of psychopathy referring to a mental defect without lack of responsibility. On the other hand penal law reformers plead to introduce preventive measures, such as security confinement, into the criminal law book. Since the resolution of the 'law against habitual criminals' in November 1933 judges are allowed to sentence mentally ill offenders to indefinite confinement in psychiatric institutions. PMID:17144371

  10. Psychological evaluation of asylum seekers as a therapeutic process.

    Science.gov (United States)

    Gangsei, David; Deutsch, Anna C

    2007-01-01

    Torture survivors are often reluctant to tell their stories. They typically make every effort to forget this painful, traumatic experience. Often they do not share with family, friends or healthcare professionals the fact that they have been beaten, raped or subjected to electrical shocks and other terrors. Talking means retrieving memories, triggering the feelings and emotions that accompanied the torture itself. Furthermore, refugee torture survivors feel that people won't understand or believe their experiences. However, survivors who escape their country may need to reveal their torture experience as they apply for asylum in the host country. When they prepare for the asylum process, it may well be the first time that they talk about the torture. Mental health professionals are often called upon to evaluate survivors and prepare affidavits for the asylum process, documenting the effects of torture. This creates a unique and priviliged opportunity to help survivors to address the devastating consequences of torture. Winning asylum is essential to recovery for a torture survivor in a country of refuge. Psychological evaluations of the consequences of torture can present information and evidence to asylum adjudicators which significantly increases understanding of the survivors' background and experiences as well as their manner of self-presentation in the courtroom or interview. They can empower the torture survivor to present his/her experiences more fully and confidently. Even apart from winning asylum, the process of the evaluation has many potential benefits for the survivor's emotional well-being. This includes helping the survivor understand the necessity of telling the story, illuminating the often poorly perceived link between current emotional suffering and past torture, facilitating the development of cognitive and emotional control, and healing the wounds of mistrust, humiliation, marginalization and fear. PMID:17728485

  11. American College of Emergency Physicians

    Science.gov (United States)

    ... EMBRS) Workshop Reimbursement & Coding Research Forum Simulation-based Immersive Medical (SIM) Training Course Teaching Fellowship Scientific Assembly ... Read More More Than 850 Hours of Online Education Log In Now > Physicians Podcasts and Apps Reimbursement ...

  12. Church Asylum - new strategies, alliances and modes of resistance

    DEFF Research Database (Denmark)

    Jørgensen, Martin Bak

    2013-01-01

    This article discusses the possibilities for democratic transformation in a landscape of political closure. Taking the case of Church Asylum [Kirkeasyl] as an example of new ways of resistance and participation in contemporary Denmark the articles argues that although the established political...... channels are characterised by closure alternatives may be formulated outside the parliamentarian system. Using contemporary perspectives on social critique and mobilization the article looks back at Church Asylum in 2009 and discuss the alliances, strategies and modes of resistance used during the event....... The article draws on a framework derived from political sociology and critical theory....

  13. Australian health policy on access to medical care for refugees and asylum seekers

    OpenAIRE

    Correa-Velez, Ignacio; Gifford, Sandra M; Bice, Sara J

    2005-01-01

    Since the tightening of Australian policy for protection visa applicants began in the 1990s, access to health care has been increasingly restricted to asylum seekers on a range of different visa types. This paper summarises those legislative changes and discusses their implications for health policy relating to refugees and asylum seekers in Australia. Of particular concern are asylum seekers on Bridging Visas with no work rights and no access to Medicare. The paper examines several key quest...

  14. Asylum Seekers in Europe: The Warm Glow of a Hot Potato

    OpenAIRE

    Giovanni Facchini; Oliver Lorz; Gerald Willmann

    2005-01-01

    The Common European Asylum System calls for increased coordination of the EU countries’ policies towards asylum seekers and refugees. In this paper, we provide a formal analysis of the effects of coordination, explicitly modelling the democratic process through which policy is determined. In a symmetric, two-country citizen-candidate setup, in which accepting asylum seekers in one country generates a cross-border externality in the other, we show that coordination is desirable. Internalizing ...

  15. Tradable Refugee-admission Quotas: a Policy Proposal to Reform the EU Asylum Policy

    OpenAIRE

    Hillel Rapoport; Jesús Fernández-Huertas Moraga

    2014-01-01

    he current EU Asylum policy is widely seen as ineffective and unfair. We propose an EU-wide market for tradable quotas on both refugees and asylum-seekers coupled with a matching mechanism linking countries' and migrants' preferences. We show that the proposed system can go a long way towards addressing the shortcomings of the existing system. We illustrate this claim using the recent problems regarding relocation faced by the European Asylum Support Office (EASO) in Malta.

  16. Experiences of asylum seeking women on housing and health care services in Bradford

    OpenAIRE

    Fuseini, Sulemana

    2009-01-01

    The purpose of this study was to look at housing and health care services provided for asylum seeking women in Bradford, and whether service delivery meets their needs and expectations. This study used a qualitative research approach; the method of data collection was focused group interviews. The participants were selected from the Bradford Ecumenical Asylum Concern (BEACON) project. 10 women seeking asylum were interviewed and the interview data was analysed through the method of conten...

  17. Gender Variation in Asylum Experiences in the UK: The Role of Patriarchy and Coping Strategies

    OpenAIRE

    Ruth L Healey

    2010-01-01

    Previous work suggests that female asylum seekers and refugees have more constraints on their actions than their male counterparts, as structural forces from the country of origin are reproduced in the host country. This paper explores the use of structuration theory in interpreting the impact of gender upon asylum seeker and refugee experiences in the UK. The experiences of, and coping strategies used by 8 male and 10 female asylum seekers and refugees from two different cities are analysed....

  18. A Study of Asylum Seeker/Refugee Advocacy: Paradoxes of Helping in a Climate of Hostility.

    OpenAIRE

    Wroe, Lauren

    2013-01-01

    This thesis is concerned with the extent to which hostility towards asylum seekers/refugees frames advocacy talk. Using a dialogical approach, I analyse how the identities of asylum claimants are dealt with by refugee advocates, in order to counter this hostility. My analysis is based on the collection of publicity materials from four refugee organisations, and from Narrative Biographical Interviews conducted with their staff, volunteers and asylum-seeking clients. Using the notion of dialogi...

  19. Narratives of Service Provision: A Dialogical Perspective on the ‘Support’ of Asylum Seekers

    OpenAIRE

    Brown, Philip

    2005-01-01

    This chapter focuses upon some of the narratives of housing and ‘support’ service provision set against the backdrop of the support of asylum seekers in the United Kingdom. Since 1999 specific asylum seeker support teams have been established within a number of local authorities throughout the UK contracted to the Home Office to provide housing and social support to destitute asylum seekers. Currently, the regions of the UK, operate within a national legislative arena led by...

  20. Asylum seekers and refugees in Indonesia: Problems and potentials

    Directory of Open Access Journals (Sweden)

    Muzafar Ali

    2016-07-01

    Full Text Available In the Indonesian West Java town of Cisarua, asylum seekers and refugees face prolonged periods of waiting in limbo. Australian government policies have contributed to the lengthy waiting times, particularly Operation Sovereign Borders. Those in protracted situations have found ways to ensure that during their time in Cisarua their basic needs are met and they demonstrate creativity and resilience in difficult circumstances. Education for children is a priority for asylum seeker and refugee communities and a learning centre developed by the community has provided hope for children and their families. The paper draws on the experiences of Author One during his waiting time in Cisarua and research conducted by Authors Two and Three in late 2013.

  1. [Asylum in Switzerland. Some aspects of refugee migration].

    Science.gov (United States)

    Bolzman, C; Musillo, I

    1987-06-01

    "Switzerland is the European country which, after Sweden, has received the highest number of refugees (30,000) in proportion to its population. Asylum seekers have increased considerably since 1979. They are coming mostly from Third World, politically unsettled countries. The essay presents the results of a survey conducted in Geneva on a sample of 549 asylum seekers assisted by public welfare agencies from 1974 to 1983. These refugees belong to the younger age bracket of the active population. About half of them have completed their secondary or tertiary education. But their professional, social and cultural adjustment poses some problems. The vast majority of them, in fact, are employed in unqualified occupations in the tertiary sectors." (SUMMARY IN ENG) PMID:12315256

  2. Impact of September 11 on refugees and those seeking asylum.

    Science.gov (United States)

    Piwowarczyk, Linda A; Keane, Terence M

    2007-12-01

    September 11, 2001 profoundly affected the American public. We share the views of a cohort of refugees and those seeking asylum from the Boston Center for Refugee Health and Human Rights. Of the 63 individuals from 18 countries interviewed, many had concerns about their personal safety following September 11, as well as fears related to deportation, arrest, detention, imprisonment, discrimination, physical violence and the destruction of property, and war. Asylum seekers were more likely than refugees to have concerns about their safety before their departure and during flight, as well as fear deportation and arrest after September 11. In the wake of September 11, most common coping strategies utilized included prayer (77.8%), speaking with friends from their own social group (47.6%), family (44.4%), and belief in fate (42.9%). PMID:18089639

  3. Asylum seekers and refugees in Indonesia: Problems and potentials

    OpenAIRE

    Ali, Muzafar; Briskman, Linda Ruth; Fiske, Lucy Imogen

    2016-01-01

     Asylum seekers and refugees in Indonesia increasingly experience protracted waiting times for permanent settlement in other countries. They have few, if any, legal rights, coupled with extremely limited financial resources and no access to government provided services. In response to the prospect of living for many years in this difficult and liminal space, a small community of refugees in the West Java town of Cisarua has built relationships, skills and confidence among themselves and with ...

  4. Credibility assessments as "normative leakage": asylum applications, gender and class

    OpenAIRE

    Hanna Wikström; Thomas Johansson

    2013-01-01

    Based on the assumption that credibility assessments function as 'normative leak­age' within the asylum process, we analyse how narratives of gender and class are articulated, rendered meaningful, or silenced in credibility assessments. Two cases concerning male applic­ants are selected in order to illustrate these processes. In relation to the existing concepts of internal/external credibility, we wish to introduce the concept of social credibility, which focuses on how the assessors read ...

  5. Gender-Based Persecution and the (inadequate) use of the Concept of Gender - A textual analysis of the construction of women's gender-based asylum claims in the Swedish asylum determination system

    OpenAIRE

    Johansson, Lovisa Viktoria Maria

    2013-01-01

    Abstract Asylum determination has, historically, not been sensitive to women's gender-based claims. Rather, male experiences and governmental persecution have been held as preferences in asylum determination. There have been international calls to assess gender-based claims in relation to a social constructivist approach towards gender, in order to eradicate the misinterpretations of women's asylum claims. This dissertation analyses the constructions of women's gender-based asylum claims...

  6. Asylum Doctor Extraordinaire: Dr. Thomas Drapes (1847-1919).

    Science.gov (United States)

    Kelly, B D

    2015-09-01

    Dr. Thomas Drapes (1847-1919) was resident medical superintendent of Enniscorthy District Asylum in County Wexford, Ireland from 1883 to 1919, and one of the leading figures in Irish asylum medicine for several decades. Drapes' career was as complex as it was remarkable. Drapes was elected president of the Medico-Psychological Association for the term 1911-12 but had to decline on health grounds. In 1912, however, he was unanimously elected as co-editor of the Journal of Mental Science, to which he devoted his considerable energies and intellect. Drapes published widely, opposing Emil Kraepelin's proposed division of "functional" psychosis into manic-depressive illness and dementia praecox; openly examining the use of "punitive measures" in asylums (Enniscorthy had notably low rates of restraint and seclusion); and publicly bemoaning the folly of "psychophysical parallelism", or the spurious division between mental and physical symptoms in medicine. Although not immune to passing trends in medical thought (e.g. regarding sterilisation of the mentally ill to prevent further mental disorder), Drapes was generally independent-minded, insightful and incisive, and his legacy was to help shape Irish mental health care for many decades. PMID:25833354

  7. Should physicians fake diagnoses to help their patients?

    Science.gov (United States)

    Helgesson, G; Lynöe, N

    2008-03-01

    Are fake diagnoses and false or misleading certificates permissible means of helping patients? This question is examined in relation to four examples from Swedish health care: the sterilisation case, the asylum case, the virginity case, and the adoption case. We argue that both consequentialist and deontological ethical theories, to be reasonable, need to balance values, principles, and interests such as wellbeing, truthfulness, autonomy, personal integrity, trust in the medical profession, and abidance by national legislation. We conclude that it can be justifiable for physicians to fake diagnoses and write false or misleading certificates in order to help patients when not doing so has dire consequences. However, physicians must also consider the long-term effects of making exceptions to honest, non-deceitful behaviour based on the best empirical evidence available. Otherwise valuable social practices might erode and public confidence in physicians be threatened. PMID:18316450

  8. The American College of nuclear physicians 18th annual meeting and scientific sessions DOE day: Substance abuse and nuclear medicine abstracts

    Energy Technology Data Exchange (ETDEWEB)

    1992-02-01

    Despite the enormous personal and social cost Of substance abuse, there is very little knowledge with respect to the mechanisms by which these drugs produce addiction as well as to the mechanisms of toxicity. Similarly, there is a lack of effective therapeutic intervention to treat the drug abusers. In this respect, nuclear medicine could contribute significantly by helping to gather information using brain imaging techniques about mechanisms of drug addiction which, in turn, could help design better therapeutic interventions, and by helping in the evaluation and diagnosis of organ toxicity from the use of drugs of abuse. This volume contains six short descriptions of presentations made at the 18th Meeting of the American College of Nuclear Physicians -- DOE Day: Substance Abuse and Nuclear Medicine.

  9. The American College of nuclear physicians 18th annual meeting and scientific sessions DOE day: Substance abuse and nuclear medicine abstracts

    International Nuclear Information System (INIS)

    Despite the enormous personal and social cost Of substance abuse, there is very little knowledge with respect to the mechanisms by which these drugs produce addiction as well as to the mechanisms of toxicity. Similarly, there is a lack of effective therapeutic intervention to treat the drug abusers. In this respect, nuclear medicine could contribute significantly by helping to gather information using brain imaging techniques about mechanisms of drug addiction which, in turn, could help design better therapeutic interventions, and by helping in the evaluation and diagnosis of organ toxicity from the use of drugs of abuse. This volume contains six short descriptions of presentations made at the 18th Meeting of the American College of Nuclear Physicians -- DOE Day: Substance Abuse and Nuclear Medicine

  10. An Overview of Pending Asylum and Refugee Legislation in the US Congress

    Directory of Open Access Journals (Sweden)

    Melanie Nezer

    2014-05-01

    Full Text Available There has been no significant legislation related to the asylum process enacted in Congress in nearly a decade.  In 1996, the Illegal Immigration Reform and Immigration Responsibility Act (IIRIRA became law, rolling back protections for asylum seekers by including a one-year deadline for filing asylum applications, subjecting asylum seekers to “expedited removal” procedures, and expanding the detention of asylum seekers. In 2005, Congress enacted the REAL ID Act, which created additional legal barriers to asylum, including new requirements for proving an asylum claim. During the past several sessions of Congress, bills have been introduced that would make significant changes to the country’s asylum laws and refugee admissions program. This paper provides an overview of the pending legislation and the changes proposed.  This overview is instructive in understanding (1 which members of Congress have demonstrated interest and leadership in refugee and asylum issues; (2 which refugee and asylum reform issues have been of most interest to members of Congress in recent years; (3 the different approaches to refugee and asylum issues by members of Congress who have shown leadership on these issues; and (4 which provisions have been enacted, which have gained traction, and which remain pending without significant movement through the legislative process.While it is difficult to imagine in the current partisan climate how any asylum or refugee legislation could be enacted into law, some legislative provisions have been reintroduced over a number of sessions of Congress and some have a history of bipartisan support.  Legislation focused on a group of particular interest or concern to members of Congress could gain traction.  A more comprehensive legislative approach framed by the need generally to improve the system could be less effective, particularly in the context of the years-long stalemate on comprehensive immigration reform

  11. Quality in Dutch asylum law : from ‘strict but fair’, to ‘fast but good’?

    NARCIS (Netherlands)

    Winter, Heinrich; Bolt, Korine

    2007-01-01

    The Aliens Act 2000 aimed to speed up and improve decision-making in asylum cases. To what extent were these objectives attained and what can be said on the basis of the available data about the factors which determine the quality of asylum decisions? Acceleration of the asylum procedure has certain

  12. [Some unedited scientific letters to the Physicians' and Naturalists' Society of Iaşi, in the period of 1830-1860].

    Science.gov (United States)

    Brodel, E G; Constantinescu, R; Ionescu, Cristina

    2010-01-01

    The princely Moldavian Society of Natural Sciences and Medicine in Jassy received many foreign letters from correspondent members during the period of 1830 through to 1860. Most of the letters received were from German speaking countries and were addressed to one of the most famous members of the mentioned society in Jassy, Dr. Jacob von Czihak. He was born in Aschaffenburg in Bavaria to Czech parents and was educated in German schools. He went on to the University of Heidelberg. The multiplicities of letters that arrived in Jassy and that were found in the Romanian state archive in our time make it impossible to mention in detail, in a singe article. Therefore, I have chosen only three of them to analyze now. They are the letters from Mr. Prof. J.J. Berzelius (Stockholm), Mr. Dr. P. J. Cretzschmar (Frankfurt am Main) and Mr. Prof. J.B. Wilbrand (Giessen). The full list of correspondent members to the society in Jassy can be read in the who-is-who of the scientific world of there time. The reason I have chosen to mention these letters in my article was that they were exemplary to most I found and analyzed. They helped the members of the society in Jassy to keep contact with the scientific people during the beginning of the scientific awakening of the western European world. PMID:20509319

  13. 8 CFR 209.2 - Adjustment of status of alien granted asylum.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Adjustment of status of alien granted asylum. 209.2 Section 209.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 209.2 Adjustment of status of...

  14. 8 CFR 1209.2 - Adjustment of status of alien granted asylum.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Adjustment of status of alien granted asylum. 1209.2 Section 1209.2 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM §...

  15. Occult Genres and the Certification of Madness in a 19th-Century Lunatic Asylum

    Science.gov (United States)

    Berkenkotter, Carol; Hanganu-Bresch, Cristina

    2011-01-01

    Using archival admissions records and case histories of patients at a British asylum from the 1860s to the 1870s, the authors examine the medical certification process leading to the asylum confinement of individuals judged to be "of unsound mind." These institutional texts are, the authors suggest, "occult genres" that function as complex acts of…

  16. Disciplinary power and the role of the subject at a nineteenth-century Danish asylum

    DEFF Research Database (Denmark)

    Hamre, Bjørn

    2010-01-01

    This article reports on the ways in which psychiatric practice and power were constituted in a Danish asylum at the beginning of the nineteenth century. The point of departure will be a complaint by a former patient questioning the practice at the asylum in 1829. In an analysis of this narrative...

  17. 77 FR 76352 - Adjustment of Status of Refugees and Aliens Granted Asylum

    Science.gov (United States)

    2012-12-28

    ... SECURITY 8 CFR Part 209 Adjustment of Status of Refugees and Aliens Granted Asylum CFR Correction In Title..., reinstate paragraphs (b) through (f) to read as follows: Sec. 209.2 Adjustment of status of alien granted asylum. * * * * * ] (b) Inadmissible alien. An applicant who is not admissible to the United States...

  18. Child Poverty as Public Policy: Direct Provision and Asylum Seeker Children in the Republic of Ireland

    Science.gov (United States)

    Fanning, Bryan; Veale, Angela

    2004-01-01

    This paper evaluates responses to asylum seeker children in Ireland from a child poverty perspective and from that of the United Nations Convention on the Rights of the Child. It draws upon research undertaken in early 2001 on behalf of the Irish Refugee Council among asylum seeker families with children in Cork, Limerick and Ennis on their…

  19. Family Support through Childcare Services: Meeting the Needs of Asylum-Seeking and Refugee Families

    Science.gov (United States)

    Dolan, Nicola; Sherlock, Catherine

    2010-01-01

    This article is a summary of the research carried out in relation to the experiences of asylum-seeking and refugee families regarding access and participation in local childcare services. Focus groups and interviews were carried out with 16 refugee and asylum-seeking parents, five childcare practitioners, and two support and development staff in a…

  20. Gender stereotyping in the Dutch asylum procedure: ‘independent’ men versus ‘dependent’ women

    NARCIS (Netherlands)

    P. Mascini; M. van Bochove

    2009-01-01

    Attention for discrimination against women in asylum law has grown considerably during the last few decades. Yet it is male claimants who have had smaller success Rates in the asylum procedures of different countries. Using administrative data from the Dutch INS, we show this difference is caused by

  1. Discursive Representations of Asylum Seekers and Illegal Immigrants in Ireland

    Directory of Open Access Journals (Sweden)

    Elaine Burroughs

    2013-12-01

    Full Text Available Migrants are often referred to as an all encompassing group of people and the “many faces of migration”, the variety of people, legalities and complexities involved, can be overlooked. The same can be said for non-EU migrants in the Irish context. Non-EU migrants (or those that are not Caucasian are generally viewed to be a distinct cohort of comparable migrants. Indeed, these migrants are often portrayed in a broadly negative way by key Irish institutions (such as the parliament or the media, and these representations impact upon how Irish society views non-EU migration and indeed migration in general. While Ireland is by no means the only European country in which this type of practice occurs, this paper aims to draw attention to generalized, inaccurate and misleading representations of non-EU migrants in Ireland, by specifically examining representations of asylum seekers and illegal immigrants. There can be an overlap in how these “types” of migrants are conceptualized and this paper therefore aims to develop an understanding of the implications involved for migrants categorized as an “asylum seeker” or an “illegal immigrant.” Furthermore, these topics are under-researched within the Irish context, yet they receive much political and public attention. At the same time however, this paper aims to challenge the labels assigned to non-EU migrants and the terminology that is used to define their identity so concretely. In the Irish context there is much confusion in relation to the multiple “faces” of non-EU migration, as a range of terminology is used to refer to them. This terminology is often used in an interchangeable manner, in an array of societal contexts. There is a consistent (whether this happens intentionally or unintentionally is debatable misuse of categories and migration terminology in Irish institutional discourses. Quite often those seeking asylum are referred to as illegal immigrants and vice versa

  2. Refugee and asylum law in a time of crisis

    OpenAIRE

    Hills, Hannah Ruth

    2016-01-01

    2015 saw the arrival of over one million asylum seekers in the EU, sparking what is now known as the European refugee crisis. The majority of those coming into the EU were doing so by boat from Turkey to Greece and then heading North, mainly to EU States such as Germany and Sweden. In order to deal with this so-called crisis, from September 2015 to March 2016 a number of EU and non-EU States along the Western Balkans route began to implement deterrence and prevention measures in order to redu...

  3. Activity of daily living performance amongst Danish asylum seekers

    DEFF Research Database (Denmark)

    Morville, Anne-Le; Erlandsson, Lena-Karin; Eklund, Mona; Danneskiold-Samsøe, Bente; Christensen, Robin; Amris, Kirstine

    2014-01-01

    OBJECTIVE: The aim of this study was to evaluate the extent of Activities of Daily Living (ADL) ability impairment in newly arrived Danish asylum seekers. It was hypothesized that exposure to trauma and torture would negatively influence ADL performance and that measures of ADL ability would be...... and Process Skills (AMPS). Interviews were based on questionnaires about torture exposure, WHO-5 Wellbeing Index, Major Depression Inventory and Pain Detect Questionnaire. All participants were interviewed and tested using a linguistic interpreter. RESULTS: Thirty three (77%) participants reported...

  4. A longitudinal study of change in asylum seekers Activities of Daily Living ability while in asylum centre

    DEFF Research Database (Denmark)

    Morville, Anne-Le; Amris, Kirstine; Eklund, Mona;

    2014-01-01

    questionnaire about exposure to torture and trauma. Ten months later, 17 participants were accessible for re-assessment, based on the same instruments as above. The participants took part in the usual activities in a centre during the time between baseline and follow-up. Results: At entrance, the asylum seekers...... impairment that increased during time spent in a centre, and that the increase may be associated with exposure to number of applied torture methods. Contribution to practice/evidence base of occupational therapy: The knowledge contributes to the planning and execution of preventive and rehabilitation...

  5. European Asylum Law and Policy: The EU and Slovak Perspectives The EU and Slovak Perspectives

    OpenAIRE

    Ferguson Sidorenko, O.

    2006-01-01

    textabstractThe right of asylum is rooted in the history of mankind (religious right of asylum (sanctuary)) and since the beginning of the modern State it has been rooted in the sovereignty of the State itself (the right of territorial asylum). The State retains the right to grant its protection to certain non-nationals or stateless persons, as a consequence of its territorial sovereignty, once the conditions laid down by the State have been complied with. In principle, it is the sovereign St...

  6. Asylum support for children and young people living in Kirklees: Stories of mothers

    OpenAIRE

    Smith, Kate; Lockwood, Kelly

    2015-01-01

    The report is based on a one-year pilot study by academic practitioners at WomenCentre, Kirklees, funded by the Nationwide Children’s Research Centre. This study has taken a localised approach to the Parliamentary Inquiry (2013) into asylum support for children and young people. We have placed the views of mothers of children who live or have lived in receipt of asylum support in Kirklees at the heart of the study. All of the mothers interviewed said that asylum support (accommodation and/or ...

  7. [Sherlock Holmes as amateur physician].

    Science.gov (United States)

    Madsen, S

    1998-03-30

    The medical literature contains numerous articles dealing with Sherlock Holmes and his companion Dr. Watson. Some of the articles are concerned with the medical and scientific aspects of his cases. Other articles adopt a more philosophical view: They compare the methods of the master detective with those of the physician--the ideal clinician should be as astute in his profession as the detective must be in his. It this article the author briefly reviews the abilities of Sherlock Holmes as an amateur physician. Often Holmes was brilliant, but sometimes he made serious mistakes. In one of his cases (The Adventure of the Lion's Mane) he misinterpreted common medical signs. PMID:9599503

  8. Violence against women: the physician's role.

    Science.gov (United States)

    Schmuel, E; Schenker, J G

    1998-10-01

    Violence against women is one reflection of the unequal power relationship between men and women in societies. Reflections of this inequality include marriage at a very young age, lack of information or choice about fertility control and forced pregnancy within marriage. The different forms of violence against women are: domestic violence and rape, genital mutilation or, gender-based violence by police and security forces, gender-based violence against women during armed conflict, gender-based violence against women refugees and asylum-seekers, violence associated with prostitution and pornography, violence in the workplace, including sexual harassment. Violence against women is condemned, whether it occurs in a societal setting or a domestic setting. It is not a private or family matter. The FIGO Committee for the Study of Ethical Aspects of Human Reproduction released statements to physicians treating women on this issue. Physicians are ethically obliged to inform themselves about the manifestations of violence and recognize cases, to treat the physical and psychological results of violence, to affirm to their patients that violent acts toward them are not acceptable and to advocate for social infrastructures to provide women the choice of seeking secure refuge and ongoing counselling. PMID:9846677

  9. Asylum applications in the European Union: patterns and trends and the effects of policy measures.

    Science.gov (United States)

    Bocker, A; Havinga, T

    1998-09-01

    "Statistics on asylum applications have been used in a highly selective way in the debates on refugees and asylum policies in Western Europe, to justify restrictive measures. This paper provides a more systematic analysis of these statistics. It focuses on the pattern of origins and destinations for asylum seekers in the European Union in the period 1985-1994.... When the patterns of origin and destinations are compared for separate years, it becomes clear that the destinations of asylum movements have been constantly changing. Though some of the more remarkable shifts were clearly related to policy measures in the relevant countries, many measures produced only limited effects or failed to have any effect at all." PMID:12295700

  10. Moral architecture: the influence of the York Retreat on asylum design.

    Science.gov (United States)

    Edginton, B

    1997-06-01

    Institutional and architectural history places the asylum alongside the prison and other institutional types whose architectural characteristics emphasized confinement and control. This history obfuscates important differences in how ideas about treatment were represented in the particular design of these institutions; in other words, how the structure of a place became part of its discourse. What becomes obvious in nineteenth-century, asylum architecture is the influence of a small Yorkshire private asylum built by a Quaker, William Tuke, in 1796. The York Retreat, in form, solidified the ideas of 'moral treatment' in design and in turn assumed an exalted character in the design of late nineteenth-century asylums. Every researcher working in the field of the history of insanity acknowledges the importance of this event and its impact on the discourse of insanity for the century to follow. Few however talk about how its unique design was incorporated as part of this discourse. PMID:10671006

  11. [Beyond the asylum -An other view on the history of psychiatry in the modern age].

    Science.gov (United States)

    Fauvel, Aude

    2015-07-01

    If one thinks medicine, madness and the past, one image immediately pops into mind: that of the mental asylum. Following the famous work by Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason, many historians have thus considered that the medicalization of insanity in the modern age had mostly led to a "great confinement" and a greater segregation of all individuals deemed mentally unfit during the "asylum era': However, new research demonstrates that this classic narrative of the psychiatric past needs to be revised. It discloses that, ever since the 191h century, a whole other medical culture existed as a challenge to asylums, a culture that advocated the integration of the mad and fought to disassociate psychiatry from the dominant model of confinement all throughout the occidental world. This article aims at presenting the results of these historical works that depict another aspect of the psychiatric history, exploring "boarding out" practices, instead of asylum ones. PMID:26111838

  12. [Psychopathology of asylum seekers in Europe, trauma and defensive functioning].

    Science.gov (United States)

    Mazur, V M-L; Chahraoui, K; Bissler, L

    2015-06-01

    Refugees seeking asylum are a particularly vulnerable population. It has been observed that among the most commonly-occurring disorders exhibited in this population, there is a high incidence of post-traumatic stress disorder, generalized anxiety disorder, and depression. These disorders may be linked to the difficult paths that refugees are forced to undertake, as well as to different traumatic events which are particularly destructive psychologically (deliberate physical, sexual and/or psychological violence, traumatic bereavements in the context of war, or social and political instability, socio-economic, familial or administrative difficulties), which compromise their view of their short-term futures. In the face of the weight of these life events, the question of the psychological resources of the individual is at the forefront of our understanding of mental health and the capacity to adjust to trauma. Our study aims to apprehend in a dynamic way, the different strategies used by asylum seekers in our western countries to adjust psychologically to traumatic and stressful events. The aim of this research is to study the links between mental health and anxious and depressive psychopathologies as well as the defensive modalities of these subjects. One hundred and twenty adult asylum seekers, living in refugee centres in Slovakia, France and Norway have agreed to participate in this study. We tried to assess the psychopathological disorders manifesting in these populations, notably PTSD, major depression and generalized anxiety disorder. Using the DSQ-60 we also tried to establish the links between the psychopathologies observed in this population and the defence mechanisms employed. Our results reveal that 60% of subjects do indeed suffer from psychopathological disorders with an important comorbidity of PTSB and depression (64.2%). Furthermore, the seriousness of the symptoms is correlated with less adaptive defence mechanisms (a higher incidence of defence

  13. Punished for Persecution: An Analysis of the Criminalization of the Asylum Seeker in the United Kingdom

    OpenAIRE

    Haglund, Molly Grace

    2012-01-01

    Far from a welcoming and humane reception, those seeking asylum within the United Kingdom are confronted with obstacles at all levels of their search for protection. Rather than fulfill their responsibilities to refugees, the UK has sought to avoid its international legal obligations through the implementation of deterrence policies—practices that seek to evade and deny the offering of protection at various levels of the asylum process. These policies not only actively oppose the best inter...

  14. From commitment to compliance? Norway's international human rights obligations and practice towards asylum seekers

    OpenAIRE

    Hermansen, Tonje Falstad

    2015-01-01

    This dissertation examines what international human rights obligations Norway has towards asylum seekers through international treaties and conventions and its compliance with these obligations. The study applies case study methodology and through four cases it lays out some of the disputes between the Norwegian government and asylum authorities, and human rights advocates such as NGOs and lawyers. The theoretical framework for the dissertation is compliance theory which focuses on how states...

  15. Prejudice against and discrimination of asylum seekers: Their antecedents and consequences in a longitudinal field study

    OpenAIRE

    Geschke, Daniel

    2007-01-01

    Prejudice towards and discrimination of migrants are serious problems in our modern, globalised world. In the present doctoral thesis it was studied how negative attitudes of citizens towards asylum seekers relate to contact experiences, feelings of threat and acculturation orientations. A longitudinal field study with two measurement points was conducted with the German inhabitants (N = 70) of a neighbourhood where an asylum seekers refuge was soon to be opened. Directly before and six month...

  16. Health services for asylum seekers and refugees in Europe: consequences for policymaking.

    OpenAIRE

    Devillé, W.; Goosen, S.

    2006-01-01

    Reception and integration of asylum seekers and refugees are high on the political agenda in most European countries. Reception conditions, including the provision of health care, differ considerably between countries. The European Commission tries to harmonise the reception standards in the European countries. This is done for example by launching the EU Reception Conditions Directive (Directive 2003/9/EC), which defines minimum standards on the reception of asylum applicants. This directive...

  17. Asylum recognition rates in Western Europe : their determinants, variation, and lack of convergence

    OpenAIRE

    Neumayer, Eric

    2005-01-01

    Substantial variation in recognition rates for asylum claims from the same countries of origin and therefore prima facie equal merit subjects refugees to unfair and discriminatory treatment. This article demonstrates the extent of variation and lack of convergence over the period 1980 to 1999 across Western European destination countries. Refugee interest groups also suspect that political and economic conditions in destination countries as well as the number of past asylum claims unduly impa...

  18. Why and how there should be more Europe in asylum policies

    OpenAIRE

    Berger, Melissa; Heinemann, Friedrich

    2016-01-01

    The experiences of the ongoing refugee crisis in Europe highlight the failures of the current model of having the EU and its members states share responsibility for asylum policies. Based on standard criteria of fiscal federalism, this paper analyses the shortcomings of the status quo. We show that European asylum policies stand in sharp contradiction to the optimal assignment of tasks within a federal system. For example, the current system creates substantial incentives for free-riding and ...

  19. EU common policy on illegal immigration and asylum: adding to the copenhagen school

    OpenAIRE

    Karadağ, Sibel; Karadag, Sibel

    2012-01-01

    This study is on the common policy of the European Union on illegal immigration and asylum. It particularly explores the adaptability of the Copenhagen School's securitization theory in the context of European immigration policy. The study examines a central puzzle: although the representation of illegal immigrants and asylum seekers as an existential threat has been securitized at the discursive level, this has not contributed to extraordinary measures in the course of the European integrati...

  20. Mental Health and asylum seekers/refugees – interview based research

    OpenAIRE

    MGuiness, Rachael

    2010-01-01

    Abstract Background The number of asylum seekers, refugees and internally displaced people worldwide is continually growing. Alongside this, increasingly restrictive policies are being developed, limiting access to support and healthcare and also enforcing detention and destitution on those seeking asylum in the U.K. The adverse effects these policies have on a person’s emotional and psychological health can cause further distress to this population who have already experienced overwhe...

  1. Measuring common standards and equal responsibility-sharing in EU asylum outcome data

    OpenAIRE

    Luc Bovens; Chlump Chatkupt; Laura Smead

    2012-01-01

    We construct novel measures to assess (i) the extent to which European Union member states are using common standards in recognizing asylum seekers and (ii) the extent to which the responsibilities for asylum applications, acceptances and refugee populations are equally shared among the member states, taking into account population size, gross domestic product (GDP) and GDP expressed in purchasing power parity (GDP-PPP). We track the progression of these measures since the implementation of t...

  2. School and Community-Based Interventions for Refugee and Asylum Seeking Children: A Systematic Review

    OpenAIRE

    Tyrer, Rebecca A.; Mina Fazel

    2014-01-01

    Background Research for effective psychological interventions for refugee and asylum-seeking children has intensified. The need for interventions in environments more easily accessed by children and families is especially relevant for newly arrived populations. This paper reviews the literature on school and community-based interventions aimed at reducing psychological disorders in refugee and asylum-seeking children. Methods and Findings Comprehensive searches were conducted in seven databas...

  3. A Longitudinal Study of Changes in Asylum Seekers Ability Regarding Activities of Daily Living During Their Stay in the Asylum Center

    DEFF Research Database (Denmark)

    Morville, Anne-Le; Amris, Kirstine; Eklund, Mona; Danneskiold-Samsøe, Bente; Erlandsson, Lena-Karin

    2015-01-01

    The aim was to assess change in activities of daily living (ADL) ability amongst asylum seekers and if there were any difference between tortured and non-torture following a 10 months post-arrival period, and if self-reported health and exposure to torture were factors related to change in ADL......-ability. The study was a combined baseline, follow-up correlational study amongst individuals from Afghanistan, Iran and Syria, living in Danish asylum centers. Forty-three persons aged 20-50, were invited and participated in the baseline study. Twenty-two were still in asylum center at the follow-up and 17 of...... depression increased. Exposure to physical torture and change in ADL motor (r = 0.525) measures were associated, as well as change in current pain and change in ADL process (r = 0.525) measures. Due to preponderance of torture survivors analysis of group difference was not applicable. Health care workers...

  4. [Taking Care of Asylum Seekers: Occupational Health Aspects with a Special Focus on Vaccination].

    Science.gov (United States)

    Kolb, S; Hörmansdorfer, S; Ackermann, N; Höller, C; Brenner, B; Herr, C

    2016-04-01

    Employees and volunteers often feel insecure about the potential transmission of infectious diseases when taking care of asylum seekers. It could be shown that overall only a minor risk of infection emanates from asylum seekers. However, aspects of occupational health and vaccination should be kept in mind.Besides the standard vaccination the Standing Committee on Vaccination (STIKO) recommends for occupational indication, which is given for employees and volunteers in asylum facilities, vaccination against hepatitis A, hepatitis B, polio (if the last vaccination was more than 10 years before) as well as influenza (seasonal).According to the German Occupational Safety and Health Act taking care of the employer has to determine which exposures might occur at the workplace (risk assessment) and define necessary protection measures. Depending on task and exposure when taking care of asylum seekers different acts (e. g. biological agents regulation) and technical guidelines for the handling biological agents (e. g. TRBA 250 or TRBA 500) have to be applied.The Bavarian Health and Food Safety Authority (LGL) has published several information sheets regarding "asylum seekers and health management" for employees and volunteers from the non-medical as well as the medical area (www.lgl.bayern.de search term "Asylbewerber"). With theses publications insecurities in taking care of asylum seekers should be prevented. Furthermore the employer gets support in the implementation of legal obligations to ensure occupational safety for the employees. PMID:27078829

  5. Seroprevalence of Hepatitis B, C and HIV/AIDS in Asylum Seekers in Istanbul

    Directory of Open Access Journals (Sweden)

    Kadriye Kart Yaşar

    2014-03-01

    Full Text Available Objective:This study aimed to determine prevalence of hepatitis B, C and HIV/AIDS in asylum seekers in Istanbul, Turkey. Methods: The data about asylum seekers who applied in Istanbul between March 2008 and March 2010 were evaluated retrospectively. Demographic features and markers of blood borne infections (HBsAg, anti-HCV and anti-HIV results of asylum seekers were reviewed. Results: In total 3043 asylum seekers were included into the study. The leading origin countries of the refugees were from Afghanistan, Turkmenistan and Azerbaijan and majority of them (2328 people, 77% were male. The young adults between 25 and 45 years constituted the most crowded group. Overall prevalence of HCV, HBsAg and HIV/AIDS were 12.2%, 5.9% and 0.7%, respectively. The highest seropositivity rate for anti-HCV, HBsAg and anti-HIV were found in Georgian males (47.1%; in Moldovan males (13.2% and in Somali males (3.1%, respectively. Conclusion:Mostly asylum seekers who have migrated to our country were young adult males from Asia. The highest prevalence rate of HCV was found in Georgian males. Therefore, the increased potential of migration to our country along the recent years necessitates development of an appropriate health approach concerning asylum seekers. J Microbiol Infect Dis 2014;4(1: 20-25

  6. Book review: who is worthy of protection? Gender-based asylum and US immigration politics by Meghana Nayak

    OpenAIRE

    Kao, M. Bob

    2016-01-01

    In Who is Worthy of Protection? Gender-Based Asylum and US Immigration Politics, Meghana Nayak examines gender-based asylum in the United States, focusing on the narratives through which certain asylees are framed as being more ‘worthy’ than others. While M. Bob Kao welcomes Nayak’s recommendations regarding how feminist scholars can productively intervene in the asylum process, he nonetheless questions whether all of these arguments can be equally put into practice by lawyers navigating the ...

  7. ‚Getting Asylum Seekers into Employment‘? – Ein Allheilmittel für die Europäische Einwanderungspolitik?

    OpenAIRE

    Tausch, Arno

    2012-01-01

    The cross-national empirics of the international asylum system are in their infancy. While Hatton, 2009, and Neumayer, 2005, 2006a and 2006b provided important and valuable cross-national insights on the drivers of the asylum seeking process, as yet little is known in terms of hard-core evidence about the effects of asylum-driven migration processes on the recipient countries. But such analyses are necessary, since asylum plays such an important role in the overall South-North migration proce...

  8. After Wilberforce : an independent enquiry into the health and social needs of asylum seekers and refugees in Hull.

    OpenAIRE

    Campion, P; Brown, S. R.; Thornton-Jones, H.

    2010-01-01

    Commissioned by NHS Hull, this project has four aims: a. to gather the views of asylum seekers and refugees in Hull about their lives, and health; b. to consult with all relevant agencies in the city concerned with the health and social care of asylum seekers and refugees; c. to identify best practice in asylum seeker and refugee care in other parts of the country; d. to propose a strategy for the health and social care of asylum seekers and refugees in Hull. We car...

  9. LIFE IN A BACKPACK: THE EU’S ASYLUM POLICIES AND ITS IMPACT ON THE MACEDONIAN ASYLUM LEGISLATION

    Directory of Open Access Journals (Sweden)

    Angelina Stanojoska

    2015-09-01

    Full Text Available Starting the Arab spring in 2010 and going through the latest and ongoing Syrian conflict and crises, Balkans and Macedonian railways have been and are a place where many human destinies cross their paths walking to the Member States of the European Union. On the other side, Macedonia is struggling with an influx of refugees, finding itself in a status quo position, even looking as it does not know how to solve the situation. Migrants were killed on railways every day not being able to use any kind of public transportation; their smuggling became a normal business for organized crime groups; Macedonian citizens started to earn money on refugees’ misfortune. The paper using the comparative method and document analysis, gives an overview of the EU’s legislation in the area, its improvement and current impact on things, all of it concluded with the Macedonian legal solutions regarding asylum and authors’ recommendations.

  10. La relación médico-paciente, la medicina científica y las terapias alternativas Physician-patient relationship, scientific medicine and alternative therapies

    Directory of Open Access Journals (Sweden)

    J. a. Franco

    2003-04-01

    (p<0.00001, self-medication (p<0.0002, pain and concern during over 6 months due to disease or disability (p<0.00001, lack of confidence in scientific medicine (p<0.00001, the belief that «spiritual problems» (p<0.00001, «mental conditions» (p<0.003, and «emotional conditions» (p<0.00001, popular beliefs, particularly daño & envidia (p<0.00001, and mal de ojo (p<0.001 have triggered the disease. One third of the patients attended the hospital while undergoing an alternative therapy that may pose an interference or interaction hazard. Emphasis is placed on the importance of medical education to assess physician-patient relationship and the ability to convey trust in medical procedures and treatments, and scientific consulting for other practices.

  11. Hospital demand for physicians.

    Science.gov (United States)

    Morrisey, M A; Jensen, G A

    1990-01-01

    This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

  12. [Power and everyday life in a lunatic asylum environment - a case example from Glasgow at the beginning of the 20th century].

    Science.gov (United States)

    Gründler, Jens

    In this article the focus of analysis lies on power relations in everyday life in one of Glasgow's Pauper Lunatic Asylums at the turn of the twentieth century. Taking a sample of patient case files I examine the daily processes of negotiation between inmates and their relatives, physicians, attendants and nurses as well as the poor law administration. Some cases especially exemplify the complex relationships between the actors. They show which opportunities and boundaries existed for "power brokering" for the more powerless. At the same time these cases illustrate the formal and practical limits of enforcement by doctors and nursing staff. Without turning a blind eve to hierarchies and power imbalances the analysis shows that even in settings like "total institutions" power remains volatile. Even there the more powerful actors have to actualize, seize and prevail on a regular basis. PMID:27501547

  13. Narrative survival: personal and institutional accounts of asylum confinement.

    Science.gov (United States)

    Hanganu-Bresch, Cristina; Berkenkotter, Carol

    2012-01-01

    This essay has been conceptually eclectic in that we have integrated concepts from genre theory and discourse analysis. In our interpretation of Merivale and Marshall's narratives, we have also drawn upon Frye's Anatomy of criticism, a canonical text in literary genre theory. Such an eclectic approach seems warranted by both the contextual and textual features of Merivale's and Marshall's narratives, and in particular by Merivale's use of Mennipean satire with its encyclopedic detail. In our discussion of Merivale and Marshall's Admissions Records we have drawn on speech act theory to suggest that the Order (to admit a patient), the two medical certificates that follow, and finally, the notice to admit a patient constitute a constellation of texts, a genre suite, with a powerful illocutionary force. These texts are the prelude to and the means of confinement; they are both act and process. At the heart of our comparison of the asylum records of Merivale and Marshall with their "survivor narratives" is our analytic conclusion that the Ticehurst case histories can be said to constitute a linear "chronicle" of what Hayes Newington, the writer of the two case histories observed and inferred about his two patients. As chronicles, the Ticehurst Asylum case histories are linear representations or realistic accounts. As such, these archival documents provide a genuine insight into the "ways that that reality offers itself to perception". The institutional accounts exist in--and mark a--"flat time," equalized by each dated entry depicting the writer's mechanical act of observing/noting in brief, stereotypical sentences, e.g., "Patient is better [or, conversely, no] better today." We dubbed this metronomic time: beating regularly and evenly, flattening out the individual trajectories of each patient's illness. Metronomic time is normative. Each beat is calculated precisely to be the same as next. The dispassionate nature of clinical observations and the metronymic rhythms of

  14. No Time for Nostalgia!: Asylum-Making, Medicalized Colonialism in British Columbia (1859-97) and Artistic Praxis for Social Transformation

    Science.gov (United States)

    Roman, Leslie G.; Brown, Sheena; Noble, Steven; Wainer, Rafael; Young, Alannah Earl

    2009-01-01

    This article asks: How have disability, indigenous arts and cultural praxis transformed and challenged the historical sociological archival research into relationships among asylum-making, medicalized colonialism and eugenics in the Woodlands School, formerly the Victoria Lunatic Asylum, the Provincial Asylum for the Insane in Victoria, BC 1859-72…

  15. The common European asylum system and the rights of the child : an exploration of meaning and compliance

    NARCIS (Netherlands)

    Smyth, Ciara Mary

    2013-01-01

    This thesis addresses the question of whether the EU Common European Asylum System (CEAS) complies with the rights of the child. A significant proportion of people seeking asylum in EU countries are children. These children may be totally alone, with people who are not their customary caregivers o

  16. Credibility Assessments as 'Normative Leakage': Asylum Applications, Gender and Class

    Directory of Open Access Journals (Sweden)

    Hanna Wikström

    2013-10-01

    Full Text Available Based on the assumption that credibility assessments function as 'normative leakage' within the asylum process, we analyse how narratives of gender and class are articulated, rendered meaningful, or silenced in credibility assessments. Two cases concerning male applicants are selected in order to illustrate these processes. In relation to the existing concepts of internal/external credibility, we wish to introduce the concept of social credibility, which focuses on how the assessors read different socio-cultural narratives. While previous research has shown that the postcolonial will to protect women favours women as victims of patriarchal cultures, we wish to point out the continuity of this line of argumentation in relation to male and female applicants by adopting a theoretical generalization: male applicants instead become situated at the other end of the spectrum of postcolonial notions of modernity as non-victims, victims of other circumstances or perpetrators. We argue that these processes are accentuated in relation to credibility assessments. In order to prevent processes of social exclusion and to enhance inclusive practice, authorities need to acknowledge the 'normative leakage' associated with the assessment process.

  17. Physician Fee Schedule Search

    Data.gov (United States)

    U.S. Department of Health & Human Services — This website is designed to provide information on services covered by the Medicare Physician Fee Schedule (MPFS). It provides more than 10,000 physician services,...

  18. The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers.

    Science.gov (United States)

    Li, Susan S Y; Liddell, Belinda J; Nickerson, Angela

    2016-09-01

    Refugees demonstrate high rates of post-traumatic stress disorder (PTSD) and other psychological disorders. The recent increase in forcible displacement internationally necessitates the understanding of factors associated with refugee mental health. While pre-migration trauma is recognized as a key predictor of mental health outcomes in refugees and asylum seekers, research has increasingly focused on the psychological effects of post-migration stressors in the settlement environment. This article reviews the research evidence linking post-migration factors and mental health outcomes in refugees and asylum seekers. Findings indicate that socioeconomic, social, and interpersonal factors, as well as factors relating to the asylum process and immigration policy affect the psychological functioning of refugees. Limitations of the existing literature and future directions for research are discussed, along with implications for treatment and policy. PMID:27436307

  19. [Asylum-seekers' mental and physical health problems: practices and recommendations].

    Science.gov (United States)

    Kórász, Krisztián

    2016-01-01

    The Hungarian health care system faces new challenges with the unprecedented increased rate of migration. Asylum-seekers arriving are a heterogeneous group. Their health care needs vary depending on their country of origin and the quality of the health care they received prior to arrival, not to mention the impact of the migration process on their health. Described within this paper are the challenges an asylum seeker might face in obtaining care on arrival into the host country and the challenges clinicians face in providing that care. This review is designed to give health professionals the necessary knowledge to care for asylum-seekers in a culturally aware and clinically informed manner. PMID:26708683

  20. Will a Quota Plan for Asylum Seekers Plan Work —and Why Not?

    DEFF Research Database (Denmark)

    Seeberg, Peter

    The article describes the recent situation in the Mediterranean, where the number of asylum seekers arriving from countries south and east of the Mediterranean Sea is increasing significantly. The European Commission has suggested a plan, “A European Agenda on Migration”, which will redistribute...... idea from the EU-Commission of a mandatory quota plan for asylum seekers will not work, because too many states will pretend, that the problem does not really belong to them. They fear that accepting a system according to which each state has to accept a fixed quota of asylum seekers in a recent...... context might later on lead to a common EU migra-tion policy, which are beyond national control and would make it difficult to avoid responsibilities for internal crisis situations emerging in other parts of the Middle East or North Africa in the future....

  1. Physician-assisted death.

    OpenAIRE

    Senn, John S.

    1995-01-01

    Physician-assisted death includes both euthanasia and assistance in suicide. The CMA urges its members to adhere to the principles of palliative care. It does not support euthanasia and assisted suicide. The following policy summary includes definitions of euthanasia and assisted suicide, background information, basic ethical principles and physician concerns about legalization of physician-assisted death.

  2. The European Union and refugees: towards more restrictive asylum policies in the European Union?

    OpenAIRE

    Kaunert, Christian; L??onard, Sarah

    2011-01-01

    Several scholars have argued that European countries have decided to cooperate on asylum and migration matters at the EU level in order to develop more restrictive policies. In particular, it has been argued that European states have ???venue-shopped??? to a new policy-venue in order to escape national constraints. This paper puts this argument to the test by assessing the extent to which the development of EU cooperation on asylum matters has indeed led to the adoption of more restrictive as...

  3. Female genital mutilation, asylum seekers and refugees: the need for an integrated European Union agenda.

    Science.gov (United States)

    Powell, Richard A; Leye, Els; Jayakody, Amanda; Mwangi-Powell, Faith N; Morison, Linda

    2004-11-01

    Asylum seekers and refugees (ASRs) are a heterogeneous population with distinct physical and psychological needs. ASRs with additional health needs are girls and women who have undergone, or are at risk of undergoing, female genital mutilation (FGM). Across the European Union (EU), variation exists in Member States' anti-FGM and asylum legislation, the rigour of existing research programmes, and the operational coherence of the multiple agencies combating the practice. ASRs' needs are, consequently, not being addressed satisfactorily. This paper proposes an integrated future agenda, applicable in all EU countries, capable of meeting these girls' and women's needs. PMID:15364145

  4. The Grassroots Pro-Asylum Seeker Movement in the Republic of Ireland: A Social Movement Perspective

    OpenAIRE

    Moran, Niall

    2011-01-01

    This thesis is an in-depth analysis of the Grassroots Pro-Asylum Seeker Movement in the Republic of Ireland between 1994 and 2004. It seeks to understand and analyse this development of the Grassroots Pro-Asylum Seeker Movement in Ireland from a social movement perspective. The movement itself contains three key phases of mobilisation: 1) Radical Anti-Racism; 2) The Multicultural Support Group and; 3) The Anti-Deportation Group. Each of these phases is described in detail in th...

  5. Physician uncertainty and the art of persuasion.

    Science.gov (United States)

    Rizzo, J A

    1993-12-01

    Incomplete information is a chronic feature of medica markets. Much attention has focused on information asymmetries between physicians and their patients. In contrast, physician uncertainty has received far less attention. This is a significant omission. Physician uncertainty may be an even more important reason than consumer uncertainty for the high cost of health care. This paper reviews and evaluates major approaches for managing physician uncertainty. We argue that quantitative approaches alone, such as scientific advancement and the application of decision analysis to clinical reasoning, are insufficient for dealing with uncertainty. Qualitative approaches, such as forging consensus through expert panels, and teaching physicians to accept and cope with uncertainty, will play a valuable role in promoting more effective clinical decision-making under conditions of uncertainty. The current tensions between those who would eradicate physician uncertainty through quantitative approaches and those who favor qualitative methods has parallels in many other fields, including economics and mathematics. These tensions are unfortunate, since the most promising initiative to promote better clinical decision-making will likely need to draw upon both approaches. The recent initiative to implement medical practice guidelines is one example of a broad-based approach to improve clinical decision-making. Guidelines draw upon available scientific evidence, but typically involve consensus-building as well. They seek to persuade and educate physicians about appropriate treatments, without mandating changes in physician treatment patterns. Given the persistent uncertainties physicians will undoubtedly confront regarding appropriate clinical decision-making, this flexible approach may be the best way to mitigate market failures resulting from inappropriate clinical decisions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8303329

  6. Physicians: Requirements for Becoming a Physician

    Science.gov (United States)

    ... Us Contact Us A | A Text size Email Requirements for Becoming a Physician Note: We are not ... the doctor's knowledge and skills remain current. CME requirements vary by state, by professional organizations, and by ...

  7. Epistemological Beliefs and Knowledge among Physicians: A Questionnaire Survey

    OpenAIRE

    Pe�a, Adolfo; Paco, Ofelia; Peralta, Carlos

    2009-01-01

    Background: All sciences share a common underlying epistemological domain, which gives grounds to and characterizes their nature and actions. Insofar as physicians depend on scientific knowledge, it would be helpful to assess their knowledge regarding some theoretical foundations of science. Objectives: 1.To assess resident physicians? knowledge of concepts and principles underlying all sciences. 2. To determine, to what extent physicians? epistemological beliefs and attitudes are compatible ...

  8. EPISTEMOLOGICAL BELIEFS AND KNOWLEDGE AMONGST PHYSICIANS: A QUESTIONNAIRE SURVEY

    OpenAIRE

    Dr. Adolfo Peña.

    2002-01-01

    Background: All sciences share a common underlying epistemological domain, which gives grounds to and characterizes their nature and actions. Insofar as physicians depend on scientific knowledge, it would be helpful to assess their knowledge regarding some theoretical foundations of science. Objectives: 1.To assess resident physicians' knowledge of concepts and principles underlying all sciences. 2. To determine, to what extent physicians' epistemological beliefs and attitudes are compatible ...

  9. How do NGO's influence asylum policies in Norway? : a case study on the White paper, "Children on the run"

    OpenAIRE

    Koschnick, Katharina

    2013-01-01

    To which extent are NGO’s able to influence immigration and asylum policies in Norway? As important actors in Norway’s immigration and asylum politics, NGO’s had huge interests in a new white paper (white paper 27, “Children on the run”) that aimed to improve living situations of child asylum seekers in Norway, and thus used their resources intensively for lobbying politicians. This research paper employed a case study that analyzed NGO’s potential to influence governmental policies versus NG...

  10. Safe in our hands?: a study of suicide and self-harm in asylum seekers.

    Science.gov (United States)

    Cohen, Juliet

    2008-05-01

    This study examined the incidence of suicide and self-harm in asylum seekers in the UK, both those in detention and in the community. The investigation revealed that data recording is seriously flawed or sometimes non-existent. However, the scanty data those were available from Immigration Removal Centres, coroners' records and Prison Ombudsman's reports showed high levels of self-harm and suicide for detained asylum seekers as compared with the United Kingdom prison population. It is suggested that this could be attributed to routine failure to observe and mitigate risk factors. The author makes the following recommendations: coroners should record asylum seeker status and ethnicity of deceased, self-harm monitoring in the community should record asylum seeker status and ethnicity, health care in immigration removal centres should meet the same standards as UK prisons as a minimum, allegation of torture by immigration detainees should trigger a case management review and risk assessment for continued detention, and this process should be open to audit, and interpreters should be used for mental state examinations unless their English has been shown to the fluent. PMID:18423357

  11. Sexual and gender-based violence in the European asylum and reception sector: a perpetuum mobile?

    NARCIS (Netherlands)

    Keygnaert, I.; Dias, S.F.; Degomme, O.; Devillé, W.; Kennedy, P.; Kovats, A.; Meyer, S. de; Vettenburg, N.; Roelens, K.; Temmerman, M.

    2015-01-01

    Background: Refugees, asylum seekers and undocumented migrants are at risk of sexual and gender-based violence (SGBV) and subsequent ill-health in Europe; yet, European minimum reception standards do not address SGBV. Hence, this paper explores the nature of SGBV occurring in this sector and discuss

  12. Sexual and gender-based violence in the European asylum and reception sector: a perpetuum mobile?

    NARCIS (Netherlands)

    I. Keygnaert; S.F. Dias; O. Degomme; W. Devillé; P. Kennedy; A. Kováts; S. De Meyer; N. Vettenburg; K. Roelens; M. Temmerman

    2014-01-01

    Background: Refugees, asylum seekers and undocumented migrants are at risk of sexual and gender-based violence (SGBV) and subsequent ill-health in Europe; yet, European minimum reception standards do not address SGBV. Hence, this paper explores the nature of SGBV occurring in this sector and discuss

  13. Asylum Seekers and Resettled Refugees in Australia: Predicting Social Policy Attitude From Prejudice Versus Emotion

    Directory of Open Access Journals (Sweden)

    Lisa K. Hartley

    2015-07-01

    Full Text Available While most of the world's refugees reside in developing countries, their arrival to western countries is highly politicised, giving rise to questions about the types of entitlements and rights that should, or should not, be granted. In this study, using a mixed-methods community questionnaire (N = 185, we examined attitudes towards social policies aimed at providing assistance to two categories of new arrivals to Australia: resettled refugees (who arrive via its official refugee resettlement program and asylum seekers (who arrive via boat and then seek refugee status. Social policy attitude was examined as a consequence of feelings of anger, fear, and threat, as well as levels of prejudice. Participants felt significantly higher levels of anger, fear, threat, and prejudice towards asylum seekers compared to resettled refugees. For both resettled refugees and asylum seekers, prejudice was an independent predictor of more restrictive social policy attitudes. For resettled refugees, fear and perceived threat were independent predictors for more restrictive social policy whereas for asylum seekers anger was an independent predictor of restrictive social policy. The qualitative data reinforced the quantitative findings and extended understanding on the appraisals that underpin negative attitudes and emotional responses. Practical implications relating to challenging community attitudes are discussed.

  14. Experiences of Young (Minor) Asylum Seekers in Further Education in Malta

    Science.gov (United States)

    Spiteri, Damian

    2015-01-01

    This study appraises the particular challenges that minor asylum-seeking migrants who are in the 16-18 age category confront when pursuing their studies in a vocational college in Malta, a central Mediterranean island which is the smallest EU member state. The study explores how they exercise resilience in their desire to forge a future for…

  15. When Children Seek Asylum from Their Parents: A Canadian Case Study

    Science.gov (United States)

    Bossin, Michael; Demirdache, Laila

    2012-01-01

    When children seek asylum from alleged abuse by a custodial parent, the notion that family reunification is always in the best interests of independent child migrants is undermined. In this chapter, the authors discuss the legal tensions between the Refugee Convention, the Convention on the Civil Aspects of International Child Abduction (the…

  16. Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

    Science.gov (United States)

    Vitus, Kathrine

    2010-01-01

    This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…

  17. Unaccompanied adolescents seeking asylum : poorer mental health under a restrictive reception

    NARCIS (Netherlands)

    Reijneveld, S.A.; de Boer, J.B.; Bean, T.; Korfker, D.G.

    2005-01-01

    We assessed the effects of a stringent reception policy on the mental health of unaccompanied adolescent asylum seekers by comparing the mental health of adolescents in a restricted campus reception setting and in a setting offering more autonomy (numbers [response rates]: 69 [93%] and 53 [69%], res

  18. Recording the many face of death at the Denbigh Asylum, 1848-1938.

    Science.gov (United States)

    Michael, Pamela; Hirst, David

    2012-03-01

    The funeral was a symbolic event in Welsh society, and members of staff and relatives of patients at the Denbigh Asylum shared cultural assumptions about the importance of a final resting place for the body. Formal procedures following the death of a patient were governed by asylum rules and regulations. A Denbigh the asylum chaplain played an important role, both in terms of ministering to the dying and I performing the funeral ceremony. During the late nineteenth century the burial ground became a conteste space as nonconformists and Roman Catholics fought against the ascendancy of the Anglican Church in Wale and demanded that patients be buried according to their religious affiliation. The lunatic asylum became a sit for advancing the case for Welsh disestablishment. By the twentieth century, infectious diseases had become a serious concern, and the need to carry out screening and conduct post-mortem examinations resulted in the appointment of a pathologist, whose main role was to conduct biological and histological examinations to identify cases of tuberculosis, syphilis, dysentery, typhoid, influenza and other bodily diseases. PMID:22701926

  19. Policies of exclusion and practices of inclusion: how municipal governments negotiate asylum policies in the Netherlands

    NARCIS (Netherlands)

    S. Kos; M. Maussen; J. Doomernik

    2015-01-01

    There is a major gap in Dutch refugee and immigration control policies between its ambitions and outcomes. It results in considerable numbers of rejected asylum seekers who, while they cannot be expelled from the country, are excluded from government support and from opportunities to work in the bel

  20. Gender Variation in Asylum Experiences in the UK: The Role of Patriarchy and Coping Strategies

    Directory of Open Access Journals (Sweden)

    Ruth L. HEALEY

    2010-11-01

    Full Text Available Previous work suggests that female asylum seekers and refugees have more constraints on their actions than their male counterparts, as structural forces from the country of origin are reproduced in the host country. This paper explores the use of structuration theory in interpreting the impact of gender upon asylum seeker and refugee experiences in the UK. The experiences of, and coping strategies used by 8 male and 10 female asylum seekers and refugees from two different cities are analysed. Their experiences are examined in relation to different patriarchal forces. In comparison to the males, differences are apparent in the level and types of agency of the female asylum seekers and refugees. Within this study certain types of patriarchy are reproduced in British society particularly at the household level, whilst individuals are also influenced by institutional patriarchy within the wider society. The variation in experiences found here suggests the need for policy to recognise the heterogeneity of these groups, so as to provide the most appropriate support for individuals.

  1. Transnational Migration, State Policy and Local Clinician Treatment of Asylum Seekers and Resettled Migrants

    OpenAIRE

    Koehn, Peter H.

    2006-01-01

    Abstract Based on interviews conducted at five Finnish reception centers and in two municipal communes during summer 2002 with 93 migrants, mainly from a variety of Southern and Eastern countries of origin, and their ethnoculturally discordant clinicians, the article compares asylum seekers and foreign-born residents in terms of health care treatment and outcome perspectives. Comparative analysis suggests t...

  2. Politicised Notions of Professional Identity and Psychosocial Practice among Practitioners Working with Asylum Seekers and Refugees

    Science.gov (United States)

    Apostolidou, Zoe

    2015-01-01

    This is the first study undertaken in the UK that investigates the notion of professional identity among practitioners who work with asylum seekers and refugees. Drawing on a social constructionist epistemology and a Foucauldian theoretical and methodological framework of power and discourse, I analysed extracts from semi-structured interviews…

  3. Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study.

    LENUS (Irish Health Repository)

    Toar, Magzoub

    2009-01-01

    BACKGROUND: Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD), depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. METHODS: Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60) and refugees (n = 28) from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36), presence of PTSD symptoms and anxiety\\/depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medications. RESULTS: Asylum seekers were significantly more likely than refugees to report symptoms of PTSD (OR 6.3, 95% CI: 2.2-17.9) and depression\\/anxiety (OR 5.8, 95% CI: 2.2-15.4), while no significant difference was found in self-reported general health. When adjusted by multivariable regression, the presence of more than one chronic disease (OR 4.0, 95%CI: 1.3-12.7; OR 3.4, 95% CI: 1.2-10.1), high levels of pre migration stressors (OR 3.6, 95% CI: 1.1-11.9; OR 3.3, 95% CI: 1.0-10.4) or post migration stressors (OR 17.3, 95% CI: 4.9-60.8; OR 3.9, 95% CI: 1.2-12.3) were independent predictors of self reported PTSD or depression\\/anxiety symptoms respectively, however, residence status was no longer significantly associated with PTSD or depression\\/anxiety. Residence status may act as a marker for other explanatory variables; our results show it has a strong relationship with post migration stressors (chi2 = 19.74, df = 1, P < 0.001).In terms of health care utilisation, asylum seekers use GP services more often than refugees, while no significant difference was found between these groups

  4. Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study

    Directory of Open Access Journals (Sweden)

    Fahey Tom

    2009-06-01

    Full Text Available Abstract Background Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD, depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. Methods Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60 and refugees (n = 28 from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36, presence of PTSD symptoms and anxiety/depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medications. Results Asylum seekers were significantly more likely than refugees to report symptoms of PTSD (OR 6.3, 95% CI: 2.2–17.9 and depression/anxiety (OR 5.8, 95% CI: 2.2–15.4, while no significant difference was found in self-reported general health. When adjusted by multivariable regression, the presence of more than one chronic disease (OR 4.0, 95%CI: 1.3–12.7; OR 3.4, 95% CI: 1.2–10.1, high levels of pre migration stressors (OR 3.6, 95% CI: 1.1–11.9; OR 3.3, 95% CI: 1.0–10.4 or post migration stressors (OR 17.3, 95% CI: 4.9–60.8; OR 3.9, 95% CI: 1.2–12.3 were independent predictors of self reported PTSD or depression/anxiety symptoms respectively, however, residence status was no longer significantly associated with PTSD or depression/anxiety. Residence status may act as a marker for other explanatory variables; our results show it has a strong relationship with post migration stressors (χ2 = 19.74, df = 1, P In terms of health care utilisation, asylum seekers use GP services more often than refugees, while no significant difference was found

  5. Physicians' adjustment to retirement.

    OpenAIRE

    Virshup, B; Coombs, R H

    1993-01-01

    We address the questions, How do physicians adjust to and enjoy their retirement? What factors contribute to the well-being of retired physicians? A 60-item questionnaire mailed to 238 retired physicians in Los Angeles County with a 41.6% response rate assessed health, standard of living, relationships, activities, emotional difficulties, and general enjoyment. Health often improved after retirement, as did relationships with spouses and children. Standard of living was comfortable or better ...

  6. Burnout among physicians

    OpenAIRE

    Romani, Maya; Ashkar, Khalil

    2014-01-01

    Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work; it includes emotional exhaustion, depersonalization, and low personal accomplishment. Burnout among physicians has garnered significant attention because of the negative impact it renders on patient care and medical personnel. Physicians who had high burnout levels reportedly committed more medical errors. Stress management programs that range from relaxation to ...

  7. Asylum migration and the construction of the European Common Foreign and Security Policy: evidence from the Greek case

    Directory of Open Access Journals (Sweden)

    Silvia Lucía Forero Castañeda

    2015-12-01

    Full Text Available This article examines how the recent evolution of asylum migration has affected the construction of the European Common Foreign and Security Policy (EU-CFSP, taking the Greek case during the 2001-2012 period as a starting point. With this in mind, the normative progress of the EU-CFSP facing the reception of asylum seekers in Greece is analyzed, under the scope of what Barry Buzan and Ole Waever would call Securitization Process. Both legal and political frameworks on asylum migration in Greece and in the European Union are approached, in the context of the evolution of the EU-CFSP in three main areas: Neighborhood Policy, Development and Cooperation Policy, and Human Rights Protection. The conclusión points toward the partial influence of asylum migration in the configuration of the UE-CFSP during the studied period.

  8. "Their Stories Have Changed My Life": Clinicians' Reflections on Their Experience with and Their Motivation to Conduct Asylum Evaluations.

    Science.gov (United States)

    Mishori, Ranit; Hannaford, Alisse; Mujawar, Imran; Ferdowsian, Hope; Kureshi, Sarah

    2016-02-01

    Many clinicians perform asylum evaluations yet no studies describe the motivation to perform them or their perceived rewards. The number of asylum seekers in the US is increasing and more clinicians are needed as evaluators. A survey to an asylum evaluators' network asked participants to qualitatively reflect on their experience and motivation. Answers were analyzed for themes and sentiment. Respondents cited commitment to humanistic and moral values, noted personal and family experiences, having skills, expertise, and career interests as drivers. They found the experience very rewarding personally and professionally, and in their perceived benefit to asylees. Negative sentiment was less frequent and centered on emotions related to client narratives. Process-oriented frustrations were also noted. This is the first published study describing clinicians' motivation and experience with asylum evaluations. It may illuminate clinicians' drive to volunteer, and serve as a resource for organizations for recruitment and education. PMID:25527443

  9. Physician-Assisted Suicide

    Science.gov (United States)

    Module fourteen of the EPEC-O Self-Study Original Version focuses on the skills that the physician can use to respond both compassionately and confidently to a request, not on the merits of arguments for or against legalizing physician-assisted suicide (PAS) or euthanasia.

  10. Physician drug dispensing.

    Science.gov (United States)

    Lober, C W; Behlmer, S D; Penneys, N S; Shupack, J L; Thiers, B H

    1988-11-01

    We have reviewed the issue of physician drug dispensing by focusing upon quality of care, economic considerations, drug availability, patient compliance, safety, and increased governmental regulation. From a quality of care perspective, the increased use of pharmacist assistants, the tendency toward generic and therapeutic drug substitution, and the less specialized clinical education of pharmacists all pose hazards rather than safety checks upon physician prescribing. There is no evidence that pharmacists charge less than physicians. If they did, there would be no need to protect their incomes legislatively by restricting physician dispensing. Economic motivation per se is less important to a physician than providing a true convenience for his patients and thus encouraging a closer doctor-patient relationship. Physician dispensing adds to the availability of medication and may minimize the number of patients shuttling between pharmacies to obtain complex multi-ingredient preparations. Compliance is enhanced as availability increases. Prepackaged pharmaceuticals prepared under the auspices of pharmacists and dispensed by physicians are at least as safe as those prepared by the ungloved hands of a pharmacist hidden behind store counters. Thus, restricting the physician's right to dispense can negatively affect the quality of medical care, the cost of medications, safety, the availability of pharmaceuticals, and patient compliance. Such limitation is certainly not in the best interest of our patients. PMID:3056999

  11. Hospitals focus on physician relations.

    Science.gov (United States)

    Rubright, R

    1987-09-01

    Many hospital administrators are shifting their marketing focus from consumers and referral agents to the hospital's attending physicians. These new comprehensive physician relations or retention programs are much broader than those implemented in the past and are used to build mutual exchanges between hospitals and physicians, sharpen the physicians' awareness of the hospital's most appealing attributes, compete with nearby hospitals that develop their own aggressive physician relations programs, and ensure a more promising financial picture for both parties. "Cutting-edge" physician relations plans in Catholic hospitals include the following: Marketing plans for the medical staff alone or with key medical staff sections; A strong physician data base; A physician referral system; A director of medical affairs; Practice enhancement and business assistance services; A young physicians section; Continuing marketing auditing and research into physicians' opinions, attitudes, and behavior patterns; Physician inclusion in all major programs, services, policies, and events; Programs for physician office staff; Marketing committees consisting of physicians. PMID:10283486

  12. Health literacy and refugees' experiences of the health examination for asylum seekers : a Swedish cross-sectional study

    OpenAIRE

    Wångdahl, Josefin; Lytsy, Per; Mårtensson, Lena; Westerling, Ragnar

    2015-01-01

    Background The purpose of the health examination for asylum seekers in most countries is to identify poor health in order to secure the well-being of seekers of asylum and to guarantee the safety of the population in the host country. Functional health literacy is an individual’s ability to read information and instructions about health and to function effectively as a patient in the health system, and comprehensive health literacy is an individual’s competence in accessing, understanding, ap...

  13. Asylum, immigration restrictions and exploitation: hyper-precarity as a lens for understanding and tackling forced labour

    OpenAIRE

    Lewis, H; Waite, L

    2015-01-01

    The topic of forced labour is receiving a growing amount of political and policy attention across the globe. This paper makes two clear contributions to emerging debates. First, we focus on a group who are seldom explicitly considered in forced labour debates; forced migrants who interact with the asylum system. We build an argument of the production of susceptibility to forced labour through the UK’s asylum system, discussing the roles of compromised socio-legal status resulting from restric...

  14. Adult Asylum Seekers from the Middle East Including Syria in Central Europe: What Are Their Health Care Problems?

    OpenAIRE

    Pfortmüller, Carmen; Schwetlick, Miriam; Müller, Thomas; Lehmann, Beat; Exadaktylos, Aristomenis

    2016-01-01

    Background Forced displacement related to persecution and violent conflict has reached a new peak in recent years. The primary aim of this study is to provide an initial overview of the acute and chronic health care problems of asylum seekers from the Middle East, with special emphasis on asylum seekers from Syria. Methods Our retrospective data analysis comprised adult patients presenting to our emergency department between 01.11.2011 and 30.06.2014 with the official resident sta...

  15. Stool screening of Syrian refugees and asylum seekers in Germany, 2013/2014: Identification of Sabin like polioviruses.

    Science.gov (United States)

    Böttcher, Sindy; Neubauer, Katrin; Baillot, Armin; Rieder, Gabriele; Adam, Maja; Diedrich, Sabine

    2015-10-01

    Germany is a partner of the Global Polio Eradication Initiative. Assurance of polio free status is based on enterovirus surveillance, which focuses on patients with signs of acute flaccid paralysis or aseptic meningitis/encephalitis, representing the key symptoms of poliovirus infection. In response to the wild poliovirus outbreak in Syria 2013 and high number of refugees coming from Syria to Germany, stool samples from 629 Syrian refugees/asylum seekers aged refugees and asylum seekers at that time. PMID:26321005

  16. The common European asylum system and the rights of the child: an exploration of meaning and compliance

    OpenAIRE

    Smyth, Ciara Mary

    2013-01-01

    This thesis addresses the question of whether the EU Common European Asylum System (CEAS) complies with the rights of the child. A significant proportion of people seeking asylum in EU countries are children. These children may be totally alone, with people who are not their customary caregivers or with members of their immediate family. In recognition of this phenomenon, the instruments that make up the CEAS often make specific provision for children, demonstrating an awareness on the part o...

  17. Patient-Physician Communication in the 21st Century.

    Science.gov (United States)

    Friedman, Claire F; Wolchok, Jedd D

    2016-06-01

    In clinical practice, a successful patient-physician partnership can improve the outcome of treatment, especially in cases of chronic disease or cancer. To establish this partnership, physicians must explain treatment options and potential outcomes, but how to best do this when treatment is based on scientific principles and findings that the lay patient will not be familiar with? Here we present a paradigm for patient-physician communication using the immunotherapy of cancer as a model. In this context, we argue for the importance of incorporating techniques in communicating science with patients into the training of early career physicians. PMID:27156780

  18. HIV positive asylum seekers receiving the order to leave the Belgian territory

    Directory of Open Access Journals (Sweden)

    Remy Demeester

    2014-11-01

    Full Text Available Introduction: In a human rights based approach, the Parliamentary Assembly of the Council of Europe has recently released a resolution about migrants and refugees and the fight against HIV (1. It states that “an HIV positive migrant should never be expelled when it is clear that he will not receive adequate health care and assistance in the country to which he is being sent back. To do otherwise would amount to a death sentence for that person.” Nevertheless, in Belgium, for the last 2 years, none of the HIV-infected migrants in care in the AIDS Reference Centers (ARC received the right to stay in Belgium for medical reasons. Methods: We identified all HIV-infected asylum seekers in care between 1 July 2012 and 1 July 2014 in the ARC of Charleroi, Belgium, and we analyzed their medical and social files. Results: Among the 302 patients in active follow up in our ARC, 45 HIV positive asylum seekers were in care during the last 2 years. Male/female ratio was 0/96. Mean age was 35 years. Countries of origin and reasons for migration are detailed in the Table 1. 18% (8/45 knew their seropositivity before arriving in Europe. All the patients introduced an asylum request, 29 (64% have received a negative answer and an order to leave the territory, 4 (9% were regularized for non-medical reasons (see Table 1, 4 (9% are waiting for an answer and for 8 (18% outcome is unknown due to lost follow up (LFU. 31 (69% patients have also introduced a request to stay for medical reasons: 18 (58% have received a refusal, 7 (23% are still waiting for an answer, and 6 (19% are LFU. Only 23 (51% patients are still in care in our ARC on 1 July 2014 (see Table 1. The immigration office bases its decisions on availability of the treatment in the country even if accessible only to a limited number of patients. Conclusions: Decisions taken by the Belgian authorities for the last two years concerning HIV-infected asylum seekers do not guarantee the continuity of care of

  19. National encounters and institutional states of exception : the US insane asylum and the first-person reform writing of mad women, 1844-1897

    OpenAIRE

    Larson, Trina

    2012-01-01

    Following the mid-nineteenth century, every state in the expanding US founded at least one public insane asylum. Responding to the needs of those with severe cognitive and mental impairments who were poorly housed in prisons and private homes, the asylum promised enlightened management of a seemingly growing social problem. Professional discourse centered both on patients' needs for isolated and restful care and on the threat they posed to the larger community. While asylum superintendents de...

  20. Developing physician leaders in academic medical centers.

    Science.gov (United States)

    Bachrach, D J

    1997-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.* PMID:10164266

  1. Physician-Owned Hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...

  2. Physician Referral Patterns

    Data.gov (United States)

    U.S. Department of Health & Human Services — The physician referral data was initially provided as a response to a Freedom of Information (FOIA) request. These files represent data from 2009 through June 2013...

  3. Physician Shared Patient Patterns

    Data.gov (United States)

    U.S. Department of Health & Human Services — The physician referral data linked below was provided as a response to a Freedom of Information Act (FOIA) request. These files represent the number of encounters a...

  4. Physician Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — This is the official dataset associated with the Medicare.gov Physician Compare Website provided by the Centers for Medicare and Medicaid Services (CMS). These data...

  5. [Psychiatric family care in the Tapiau/East Prussia Asylum (1907-1940)].

    Science.gov (United States)

    Schmidt-Michel, P O

    1992-03-01

    At the end of the so-called "Weimar Republic" in German between the two world wars, and during the time of the Nazi regime, the psychiatric hospital and asylum in Tapiau near Königsberg/Kaliningrad had the highest incidence of psychiatric patients being looked after on an out-patient basis by host families. Data on this type of psychiatric care by external families were repeatedly published in detail between 1930 and 1937 by Karl Knapp, a psychiatrist who was actively engaged there for many years. After sterilisation of mentally diseased patients had been legally enforced and finances were restricted, family care stagnated, promoting instead a type of family care that was independent of psychiatric hospitals and was carried out on a "district" basis. After 1940, when in the course of enforcement of euthanasia almost all the inmates of psychiatric hospitals and asylums in East Prussia were murdered, the traces of patients entrusted to host family care faded out. PMID:1603867

  6. Making Sense of Pain: Delusions, Syphilis, and Somatic Pain in London County Council Asylums, c. 1900

    Directory of Open Access Journals (Sweden)

    Louise Hide

    2012-12-01

    Full Text Available During the late nineteenth century, a high percentage of male deaths in asylums was attributed to various forms of tertiary syphilis, most notably General Paralysis of the Insane (GPI and tabes dorsalis. It was not unusual for patients to present symptoms of both conditions, the latter of which could be agonizingly painful. Some patients also suffered from persecutory delusions, believing that electricity was running through them or that their limbs were gnawed by lions and wolves at night. Drawing on a theory advanced by a number of key alienists and pathologists of the period, I suggest that these delusions were misinterpretations of felt sensations and, as such, illusions rather than delusions. Despite the well-known problems around using these historical sources, I contend that recorded delusions in asylum case notes can be treated as narratives of pain that provide invaluable insights into patients' subjective experiences.

  7. Pregnancy complications of physicians.

    OpenAIRE

    Katz, V L; Miller, N H; Bowes, W A

    1988-01-01

    Studies indicate an increased risk of adverse late pregnancy events, such as preterm labor and preterm delivery, for practicing physicians. These adverse pregnancy outcomes also occur among pregnant women who work long hours with high levels of psychological stress, a mechanism most likely related to catecholamine and posturally mediated alterations in uterine blood flow. Further evaluation and research into the epidemiology of physicians' pregnancies are needed because of the increasing numb...

  8. EMDR versus Stabilization in traumatized Asylum Seekers and Refugees: Results of a pilot-study

    OpenAIRE

    Heide, ter, H.; Mooren, T.M.; Kleyn, W.; de, Jongh, Petra; Kleber, R.J.

    2011-01-01

    Background: Traumatised asylum seekers and refugees are clinically considered a complex population. Discussion exists on whether with this population treatment guidelines for post-traumatic stress disorder (PTSD) should be followed and Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) or Eye Movement Desensitisation and Reprocessing (EMDR) should be applied, or whether a phased model starting with stabilisation is preferable. Some clinicians fear that trauma-focused interventions may lead...

  9. EMDR versus stabilisation in traumatised asylum seekers and refugees: results of a pilot study

    OpenAIRE

    ter Heide, F. Jackie June; Mooren, Trudy M.; Kleijn, Wim; de Jongh, Ad; Kleber, Rolf J.

    2011-01-01

    Background: Traumatised asylum seekers and refugees are clinically considered a complex population. Discussion exists on whether with this population treatment guidelines for post-traumatic stress disorder (PTSD) should be followed and Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) or Eye Movement Desensitisation and Reprocessing (EMDR) should be applied, or whether a phased model starting with stabilisation is preferable. Some clinicians fear that trauma-focused interventions may lead...

  10. Mental health of asylum seekers: a cross-sectional study of psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Heeren Martina

    2012-08-01

    Full Text Available Abstract Background Asylum procedures are known to be protracted, stretching to over ten years in many host countries. International research shows high levels of distress for asylum seekers. Little is known about actual psychiatric morbidity in this population, especially during the first few years postmigration. Methods The mental health status of two groups of asylum seekers was assessed: Group 1 (n = 43 had arrived in Switzerland 2.9 (SD 1.1 months prior to assessment, while Group 2 (n = 43 had arrived 15.5 (SD 3.2 months prior to assessment. Psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI. Symptom severity of posttraumatic stress disorder (Posttraumatic Diagnostic Scale, anxiety (Hopkins Symptom Checklist, depression (Hopkins Symptom Checklist, and pain (Verbal Rating Scale were assessed using self-report questionnaires. Postmigratory factors such as German language proficiency and social contacts were also assessed. Interviews were conducted with the assistance of trained interpreters. Results Four out of ten participants met diagnostic criteria for at least one DSM-IV disorder. Groups did not differ with respect to psychiatric morbidity or symptom levels. Major depression (31.4% and PTSD (23.3% were diagnosed most frequently. The number of experienced traumatic event types was highly correlated with psychiatric morbidity. Conclusions Psychiatric morbidity in asylum seekers in the first two years after arrival is high, with no indication of a decrease in mental distress over time. Traumatic experiences seem to play a major role in morbidity during this time. Considering the magnitude of clinically relevant distress, a short psychological screening upon arrival with a focus on traumatic experiences may be warranted.

  11. Complex posttraumatic stress disorder in traumatised asylum seekers: a pilot study

    Directory of Open Access Journals (Sweden)

    Madeleine Kissane

    2014-09-01

    Full Text Available Background and Objectives: Complex posttraumatic stress disorder (cPTSD, a construct associated with early onset and repeated interpersonal trauma, has not previously been assessed in asylum seekers who have experienced major human rights violations. The aim of this pilot study was to describe the cPTSD symptom profile in asylum seekers, and to compare this profile between three groups of people who have experienced: human trafficking, domestic violence and/or torture. Methods: Over a period of eight weeks, clinicians working at the Helen Bamber Foundation charity invited 48 patients currently receiving psychotherapy to take part in the study, of whom 30 (62.5% agreed. The structured interview for disorders of extreme stress (SIDES was used to assess cPTSD in 29 asylum seekers, as one patient withdrew during the interview. Results: Participants originated from 18 countries, 72.4% were female, the median age at trauma onset was 17 years and the duration of trauma was ten years. Eight (27.6% participants were found to have cPTSD, defined as having all six symptom clusters, and 15 (51.7% had five or more cPTSD symptom clusters. Age at trauma onset, duration of trauma, last trauma experience, gender and trauma type were not found to be associated with cPTSD presence. Conclusions: Extensive cPTSD symptoms were common in all participants, regardless of the nature of the trauma experienced. Future research is needed to enable generalisability of cPTSD symptom profile in asylum seekers.

  12. Representations of Refugees and Asylum Seekers in the Irish Print Media

    OpenAIRE

    Patterson, Maria

    2001-01-01

    This study examines media representation of asylum seekers and refugees in Ireland. The research is based on a detailed content analysis and discourse analysis of media coverage of the issues involved in immigration in five national newspapers over selected periods. The contention of this work is that much of new public opinion has originated from, and gradually gained strength through, the ideology of the Irish print media.

  13. Transcultural Spirituality: The coping mechanisms of Refugees and Asylum Seekers: A Grounded Theory Study

    OpenAIRE

    Murgatroyd, Tamaryn

    2013-01-01

    There is evidence in the literature to suggest that Spirituality and Culture are neglected in nursing care (Greenstreet, 1999, Fernando, 2004). This has been attributed to lack of understanding and knowledge of how to deliver appropriate spiritual and cultural care, possibly due to the ambiguity of the two concepts. Refugees and Asylum Seekers appear to be vulnerable to mental health problems due to the experiences that they have had, and the lack of social support that they receive in the...

  14. Health and Social Needs of Traumatized Refugees and Asylum Seekers: An Exploratory Study

    OpenAIRE

    Strijk, Patricia; van Meijel, Berno; Gamel, Claudia

    2011-01-01

    The purpose of this study was to describe the care needs of adult traumatized refugees and asylum seekers. DESIGN AND METHODS.  A mixed-methods design was used. A survey was conducted using the Camberwell Assessment of Need (CAN) among 30 patients. Semistructured in-depth interviews were subsequently conducted with eight of these patients. FINDINGS.  Key themes among refugees are loneliness and grief. Refugees are in severe psychological distress. They also encounter all kinds of practical pr...

  15. Safer UK: preventing sexual maltreatment of unaccompanied asylum seeking minors and improving services for them.

    OpenAIRE

    Lay, Margaret; Papadopoulos, Irena; Gebrehiwot, Alem

    2007-01-01

    This report looks at the experiences of sexual abuse of young unaccompanied Ethiopian, Somalian and Eritrean asylum seekers. Based on interviews with these young people and with key professionals it considers the risks of child sexual abuse occurring, the effectiveness of preventive approaches and therapeutic interventions, and issues surrounding cultural competence. It covers the relevant legislation, the culture in the countries of origin, how sexual abuse can happen, disclosure, preventio...

  16. Law, dignity & socio-economic rights: the case of asylum seekers in Europe

    OpenAIRE

    Thornton, Liam

    2014-01-01

    This paper explores the interplay of dignity, law and rights as regards the socio-economic rights of asylum seekers. It does so by posing some questions as regards the extent to which this concept of 'reception' is preferable to the issue of socio-economic rights. This paper is not going to discuss the (rather depressing) situation in different EU member states; rather, this paper considers whether systems and processes of international and European human rights law offer heighted ...

  17. When lives are put on hold: Lengthy asylum processes decrease employment among refugees.

    Science.gov (United States)

    Hainmueller, Jens; Hangartner, Dominik; Lawrence, Duncan

    2016-08-01

    European governments are struggling with the biggest refugee crisis since World War II, but there exists little evidence regarding how the management of the asylum process affects the subsequent integration of refugees in the host country. We provide new causal evidence about how one central policy parameter, the length of time that refugees wait in limbo for a decision on their asylum claim, affects their subsequent economic integration. Exploiting exogenous variation in wait times and registry panel data covering refugees who applied in Switzerland between 1994 and 2004, we find that one additional year of waiting reduces the subsequent employment rate by 4 to 5 percentage points, a 16 to 23% drop compared to the average rate. This deleterious effect is remarkably stable across different subgroups of refugees stratified by gender, origin, age at arrival, and assigned language region, a pattern consistent with the idea that waiting in limbo dampens refugee employment through psychological discouragement, rather than a skill atrophy mechanism. Overall, our results suggest that marginally reducing the asylum waiting period can help reduce public expenditures and unlock the economic potential of refugees by increasing employment among this vulnerable population. PMID:27493995

  18. When lives are put on hold: Lengthy asylum processes decrease employment among refugees

    Science.gov (United States)

    Hainmueller, Jens; Hangartner, Dominik; Lawrence, Duncan

    2016-01-01

    European governments are struggling with the biggest refugee crisis since World War II, but there exists little evidence regarding how the management of the asylum process affects the subsequent integration of refugees in the host country. We provide new causal evidence about how one central policy parameter, the length of time that refugees wait in limbo for a decision on their asylum claim, affects their subsequent economic integration. Exploiting exogenous variation in wait times and registry panel data covering refugees who applied in Switzerland between 1994 and 2004, we find that one additional year of waiting reduces the subsequent employment rate by 4 to 5 percentage points, a 16 to 23% drop compared to the average rate. This deleterious effect is remarkably stable across different subgroups of refugees stratified by gender, origin, age at arrival, and assigned language region, a pattern consistent with the idea that waiting in limbo dampens refugee employment through psychological discouragement, rather than a skill atrophy mechanism. Overall, our results suggest that marginally reducing the asylum waiting period can help reduce public expenditures and unlock the economic potential of refugees by increasing employment among this vulnerable population. PMID:27493995

  19. Between remembrance technology and the production of truth: memory and narrative in asylum politics

    Directory of Open Access Journals (Sweden)

    Elisa Mencacci

    2015-04-01

    Full Text Available In the institutional pathway for recognition of asylum right, the narrative becomes, according to current regulations, the element to be sieved in order to ascertain title to international protection. The aim of this essay is analyzing the various declensions assumed by the narrative in this institutional process. Weaving together clinical and ethnographic data, drawn from the main phases that foreigners have to pass through in this event, I would like to highlight how, in the asylum system, the narrative takes the value of a tool directed, first of all at checking the applicant’s past, and second at co-producing a subject fitting to the media and legal dominant imaginary features. In this specific context, the treatment of traumatic injuries, recognized as basis of interrupted narratives, emerges as issue played in its turn on a double register: as adherence to specific schemes of "therapeutic governance" and as further control of specific events, experienced by asylum seekers in the past.

  20. Tuberculosis screening and follow-up of asylum seekers in Norway: a cohort study

    Directory of Open Access Journals (Sweden)

    Garåsen Helge

    2009-05-01

    Full Text Available Abstract Background About 80% of new tuberculosis cases in Norway occur among immigrants from high incidence countries. On arrival to the country all asylum seekers are screened with Mantoux test and chest x-ray aimed to identify cases of active tuberculosis and, in the case of latent tuberculosis, to offer follow-up or prophylactic treatment. We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers. Methods Asylum seekers ≥ 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test ≥ 6 mm or positive x-ray findings were included in a study group for follow-up. Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care. Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis. Results The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34% of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62% had seen an internist, while 86 of 568 with Mantoux ≥ 15, but negative x-rays (16% were also seen by an internist. By December 31st 2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000 and another 11 were treated for latent infection. Conclusion The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To

  1. EPISTEMOLOGICAL BELIEFS AND KNOWLEDGE AMONGST PHYSICIANS: A QUESTIONNAIRE SURVEY

    Directory of Open Access Journals (Sweden)

    Dr. Adolfo Peña.

    2002-05-01

    Full Text Available Background: All sciences share a common underlying epistemological domain, which gives grounds to and characterizes their nature and actions. Insofar as physicians depend on scientific knowledge, it would be helpful to assess their knowledge regarding some theoretical foundations of science. Objectives: 1.To assess resident physicians' knowledge of concepts and principles underlying all sciences. 2. To determine, to what extent physicians' epistemological beliefs and attitudes are compatible with the scientific paradigm. Design: A questionnaire was administered to 161 resident physicians at three hospitals in Lima, Peru. Results: 237 resident physicians were selected, 161 (68% of whom agreed to answer the survey. 67% of respondents indicated they did not know what epistemology is, 21% were able to correctly define epistemology; 24% of the residents knew the appropriate definition of scientific theory. No respondents knew the philosophical presumptions of science; and 48% took a relativistic stand towards knowledge. Conclusions: There appear to be deficiencies in the knowledge of scientific theoretical foundations among physicians.

  2. Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study

    Directory of Open Access Journals (Sweden)

    van Oostrum Irene EA

    2011-06-01

    Full Text Available Abstract Background Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention. Methods We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+. The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization. Results The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83. No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07. The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers. Conclusions In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour

  3. [Physicians' households in the 16th century].

    Science.gov (United States)

    Walter, Tilmann

    2008-01-01

    16th-century's medicine was marked by a wave of professionalization: besides scientific influences--evident by new ambitious texts on botany, anatomy, and chemiatry--functions of medical expertise for political purposes were an important factor. Based on findings made in my DFG-funded project "Arztliche Autorität in der Frühen Neuzeit" (medical authority in early modem times) is discussed how these influences altered the professional conditions for physicians. "Haushalt" (household) can be understood as a social community as well as a monetary budget in this context: physicians earned their money with a lot of different ventures beside medical practice, as commerce, farming, banking, or mining etc. Expenses for houses, gardens, interior etc. were based on needs of everyday life but could also be signs of luxury. Thus the physicians demonstrated the high social status they had acquired, and some of them thereby placed themselves at one social level with the nobility. Even scientific books can be estimated as a special case of such a conspicuous consumption for in most cases publishing made high investments without monetary benefit necessary. Thus scientific reputation was to some degree foreseeable: epoch-making books like above all Andreas Vesalius' "De humani Corporis fabrica libri septem" (Basel 1543) had to be financed out of the assets of the family (in Vesalius' case: a high-standing family in the emperor's services). Other sources show clearly that many doctors were not able to afford publishing comparable elaborated and expensive books. PMID:19830955

  4. Seroprevalence of Antibodies against Measles, Rubella and Varicella among Asylum Seekers Arriving in Lower Saxony, Germany, November 2014-October 2015.

    Science.gov (United States)

    Toikkanen, Salla E; Baillot, Armin; Dreesman, Johannes; Mertens, Elke

    2016-01-01

    The number of asylum seekers arriving in Germany has increased rapidly since 2014 and cases of vaccine-preventable diseases at reception centres were reported. Asylum seekers 12 years and older arriving in Lower Saxony were serologically screened for antibodies against measles, rubella and varicella between November 2014 and October 2015. We calculated the seroprevalence from the screening data by disease, country of origin and age group and compared them to literature-based herd immunity thresholds in order to identify immunisation gaps. In total, 23,647 specimens were included in our study. Although the vast majority of asylum seekers tested positive for antibodies against measles, rubella and varicella, the seroprevalences were not sufficient to ensure herd immunity. The seroprevalences varied substantially between countries of origin and increased with age. Immunisation of asylum seekers against measles, rubella and varicella is needed and the detailed information on seroprevalences among subgroups of asylum seekers can be used for targeted immunisations at reception centres. PMID:27376309

  5. Case notes, case histories, and the patient's experience of insanity at Gartnavel Royal Asylum, Glasgow, in the nineteenth century.

    Science.gov (United States)

    Andrews, J

    1998-08-01

    This article is concerned primarily with questions as to how and why case notes were produced and utilized, and how they may (or may not) be used by historians. More specifically, it discusses how the Glasgow Royal Asylum's case notes may be deployed to access patients' experiences of madness and confinement. The deficiencies and biases of the case record are also explored. So too is the relationship of case notes with other asylum based records, including reception order questionnaires, with a separate section on patient writings as part of the case history corpus. This leads into an analysis of how the Asylum's case notes became case histories and for what purposes. These subjects are related to changes and continuities in medical ideologies about insanity, social attitudes to the insane and the nature of medical practice in asylums. Some fundamental shifts in emphasis in the use of the case note and case history occurred in this period. These shifts were associated with an increased emphasis on organic interpretations of mental disease and on clinical approaches to insanity; with the medicalization of asylum records and the wider discourse on insanity, and with declining deference to the public at large in the presentation of cases. The survey concludes by analysing the changing place of patient testimony within the case record. PMID:11620430

  6. The developmental consequences for asylum-seeking children living with the prospect for five years or more of enforced return to their home country

    NARCIS (Netherlands)

    Kalverboer, M.E.; Zijlstra, A.E.; Knorth, E.J.

    2009-01-01

    This study examines the European legal framework and policy on children's rights and on the development and developmental risks of children from asylum-seeking families who have lived in asylum centres for over five years with the prospect of being forced to return to their home country. The legal p

  7. The Quality of the Childrearing Environment of Refugee or Asylum-Seeking Children and the Best Interests of the Child : Reliability and Validity of the BIC-Q

    NARCIS (Netherlands)

    Zijlstra, A. Elianne; Kalverboer, Margrite E.; Post, Wendy J.; Knorth, Erik J.; Ten Brummelaar, Mijntje D. C.

    2012-01-01

    The Best Interest of the Child Questionnaire (BIC-Q) has been designed as an instrument for screening the quality of the rearing situation of asylum-seeking or refugee children. It is intended to aid legal decisions in asylum procedures. The aim of this study was to determine the reliability and the

  8. High Prevalence of Infectious Diseases and Drug-Resistant Microorganisms in Asylum Seekers Admitted to Hospital; No Carbapenemase Producing Enterobacteriaceae until September 2015

    NARCIS (Netherlands)

    Ravensbergen, Sofanne J.; Lokate, Mariette; Cornish, Darren; Kloeze, Eveline; Ott, Alewijn; Friedrich, Alex W.; van Hest, Rob; Akkerman, Onno W.; Lange, de Wiel C.; van der Werf, Tjip S.; Bathoorn, Erik; Stienstra, Ymkje

    2016-01-01

    Introduction The current refugee crisis emphasizes the need for information on infectious diseases and resistant microorganisms in asylum seekers with possible consequences for public health and infection control. Methods We collected data from asylum seekers admitted to our university hospital or w

  9. Burnout among physicians.

    Science.gov (United States)

    Romani, Maya; Ashkar, Khalil

    2014-01-01

    Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work; it includes emotional exhaustion, depersonalization, and low personal accomplishment. Burnout among physicians has garnered significant attention because of the negative impact it renders on patient care and medical personnel. Physicians who had high burnout levels reportedly committed more medical errors. Stress management programs that range from relaxation to cognitive-behavioral and patient-centered therapy have been found to be of utmost significance when it comes to preventing and treating burnout. However, evidence is insufficient to support that stress management programs can help reducing job-related stress beyond the intervention period, and similarly mindfulness-based stress reduction interventions efficiently reduce psychological distress and negative vibes, and encourage empathy while significantly enhancing physicians' quality of life. On the other hand, a few small studies have suggested that Balint sessions can have a promising positive effect in preventing burnout; moreover exercises can reduce anxiety levels and exhaustion symptoms while improving the mental and physical well-being of healthcare workers. Occupational interventions in the work settings can also improve the emotional and work-induced exhaustion. Combining both individual and organizational interventions can have a good impact in reducing burnout scores among physicians; therefore, multidisciplinary actions that include changes in the work environmental factors along with stress management programs that teach people how to cope better with stressful events showed promising solutions to manage burnout. However, until now there have been no rigorous studies to prove this. More interventional research targeting medical students, residents, and practicing physicians are needed in order to improve psychological well-being, professional careers, as well as the

  10. Physician health and wellness.

    Science.gov (United States)

    McClafferty, Hilary; Brown, Oscar W

    2014-10-01

    Physician health and wellness is a critical issue gaining national attention because of the high prevalence of physician burnout. Pediatricians and pediatric trainees experience burnout at levels equivalent to other medical specialties, highlighting a need for more effective efforts to promote health and well-being in the pediatric community. This report will provide an overview of physician burnout, an update on work in the field of preventive physician health and wellness, and a discussion of emerging initiatives that have potential to promote health at all levels of pediatric training. Pediatricians are uniquely positioned to lead this movement nationally, in part because of the emphasis placed on wellness in the Pediatric Milestone Project, a joint collaboration between the Accreditation Council for Graduate Medical Education and the American Board of Pediatrics. Updated core competencies calling for a balanced approach to health, including focus on nutrition, exercise, mindfulness, and effective stress management, signal a paradigm shift and send the message that it is time for pediatricians to cultivate a culture of wellness better aligned with their responsibilities as role models and congruent with advances in pediatric training. Rather than reviewing programs in place to address substance abuse and other serious conditions in distressed physicians, this article focuses on forward progress in the field, with an emphasis on the need for prevention and anticipation of predictable stressors related to burnout in medical training and practice. Examples of positive progress and several programs designed to promote physician health and wellness are reviewed. Areas where more research is needed are highlighted. PMID:25266440

  11. Leasing physician office space.

    Science.gov (United States)

    Murray, Charles

    2009-01-01

    When leasing office space, physicians should determine the effective lease rate (ELR) for each building they are considering before making a selection. The ELR is based on a number of factors, including building quality, building location, basic form of lease agreement, rent escalators and add-on factors in the lease, tenant improvement allowance, method of square footage measurement, quality of building management, and other variables. The ELR enables prospective physician tenants to accurately compare lease rates being quoted by building owners and to make leasing decisions based on objective criteria. PMID:19743715

  12. [Communication and mental health: a discursive analysis of posters of the National Anti-Asylum Campaign Movement in Brazil].

    Science.gov (United States)

    Espirito Santo, Wanda; Araujo, Inesita Soares de; Amarante, Paulo

    2016-01-26

    The article analyzes two posters that with the same slogan - "Asylums nevermore" - promote National Anti-Asylum Day. The analysis was based on principles of the symptomatology of social discourse, articulating analytical concepts and practices arising from the French School and the pragmatic dimension of discourse analysis. The results revealed affirmation strategies of the movement for the qualification and exacerbation of the issues of the enunciation and other enunciators, namely political actors of the anti-asylum movement and their allies. It also reveals the attempt to disqualify competitive discourse, especially that which discloses the serious problems of its institutional models, but also by juxtaposing the positive presence of the issuers and enunciators of the posters. PMID:27276046

  13. Hitler's Jewish Physicians.

    Science.gov (United States)

    Weisz, George M

    2014-07-01

    The mystery behind the behavior of infamous personalities leaves many open questions, particularly when related to the practice of medicine. This paper takes a brief look at two Jewish physicians who played memorable roles in the life of Adolf Hitler. PMID:25120923

  14. Physician Li Bo

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Li Bo,32,an attending physician at Xiyuan Hospital of the China Academy of Chinese Medical Sciences,spent a year and a half between 2008 and 2010 participating in a traditional Chinese medicine (TCM) project at the Muhimbili National Hospital in Dar Es Salaam,Tanzania.Now back in Beijing,he spoke to ChinAfrica

  15. Physicians and Insider Trading.

    Science.gov (United States)

    Kesselheim, Aaron S; Sinha, Michael S; Joffe, Steven

    2015-12-01

    Although insider trading is illegal, recent high-profile cases have involved physicians and scientists who are part of corporate governance or who have access to information about clinical trials of investigational products. Insider trading occurs when a person in possession of information that might affect the share price of a company's stock uses that information to buy or sell securities--or supplies that information to others who buy or sell--when the person is expected to keep such information confidential. The input that physicians and scientists provide to business leaders can serve legitimate social functions, but insider trading threatens to undermine any positive outcomes of these relationships. We review insider-trading rules and consider approaches to securities fraud in the health care field. Given the magnitude of the potential financial rewards, the ease of concealing illegal conduct, and the absence of identifiable victims, the temptation for physicians and scientists to engage in insider trading will always be present. Minimizing the occurrence of insider trading will require robust education, strictly enforced contractual provisions, and selective prohibitions against high-risk conduct, such as participation in expert consulting networks and online physician forums, by those individuals with access to valuable inside information. PMID:26457747

  16. Physician Challenges in 2015.

    Science.gov (United States)

    Cascardo, Debra

    2015-01-01

    While the influx of new patients resulting from the ACA will increase the number of people receiving healthcare, the regulations associated with it will add to physicians' administrative duties, as will government regulations associated with HIPAA and Meaningful Use. Further stress will come from the demands of both payers and patients, requiring doctors to walk a fine line to protect themselves from litigation. Technology also will play an increasing role. The continuing move toward EHRs and the new ICD-10 coding standard will require investments in software, testing, and training staff, and may also require an investment in new computer hardware. Physicians and staff will have to teach patients how to use EHR portals and how to follow the record-keeping requirements of their insurance providers. The regulatory changes and increased costs of time and money associated with them may drive many physicians out of private practice and into hospital system-based team practices, which will face a greater challenge in recruiting and retaining top talent. Other physicians, in contrast, may continue to seek the independence of private practice; some of them may decide to stop accepting insurance because of their need for autonomy in their practices. Regardless of what decisions doctors choose to make within the changing nature of healthcare, it is important to keep abreast of the changes and develop a plan for dealing with them, in 2015 and beyond. PMID:26182706

  17. Longevity of Thai physicians.

    Science.gov (United States)

    Sithisarankul, Pornchai; Piyasing, Veera; Boontheaim, Benjaporn; Ratanamongkolgul, Suthee; Wattanasirichaigoon, Somkiat

    2004-10-01

    The objectives of this study were to explore characteristics of the long-lived Thai physicians. We sent 983 posted questionnaires to 840 male and 143 female physicians. We obtained 327 of them back after 2 rounds of mailing, yielding a response rate of 33.3 percents. The response rate of male physicians was 32.4 percents and that of female physicians was 38.5 percents. Their ages were between 68-93 years (75.1 +/- 4.86 years on average). The majority were married, implying that their spouses were also long-lived. Around half of them still did some clinical work, one-fourth did some charity work, one-fourth did various voluntary works, one-fifth did some business, one-fifth did some academic work, and some did more than one type of work. Most long-lived physicians were not obese, with BMI of 16.53-34.16 (average 23.97 +/- 2.80). Only 8 had BMI higher than 30. BMIs were not different between male and female physicians. However, four-fifths of them had diseases that required treatment, and some of them had more than one disease. The five most frequent diseases were hypertension, diabetes, ischemic heart disease, dyslipidemia, and benign prostate hypertrophy, respectively. Most long-lived physicians did exercise (87.8%), and some did more than one method. The most frequent one was walking (52.3%). Most did not drink alcohol or drank occasionally, only 9.0% drank regularly. Most of them slept 3-9 hours per night (average 6.75 +/- 1.06). Most (78.3%) took some medication regularly; of most were medicine for their diseases. Most did not eat macrobiotic food, vegetarian food, or fast food regularly. Most long-lived physicians practiced some religious activities by praying, paying respect to Buddha, giving food to monks, practicing meditation, and listening to monks' teaching. They also used Buddhist practice and guidelines for their daily living and work, and also recommended these to their younger colleagues. Their recreational activities were playing musical instruments

  18. [Advanced online search techniques and dedicated search engines for physicians].

    Science.gov (United States)

    Nahum, Yoav

    2008-02-01

    In recent years search engines have become an essential tool in the work of physicians. This article will review advanced search techniques from the world of information specialists, as well as some advanced search engine operators that may help physicians improve their online search capabilities, and maximize the yield of their searches. This article also reviews popular dedicated scientific and biomedical literature search engines. PMID:18357673

  19. Thai physicians health survey.

    Science.gov (United States)

    Wattanasirichaigoon, Somkiat; Ruksakom, Hansa; Polboon, Navapun; Sithisarankul, Pornchai; Visanuyothin, Taweesin

    2004-10-01

    Physicians often conduct research on other occupations' health or general populations' health, but their health has hardly been studied systematically. The authors conducted a cross-sectional descriptive survey on 440 physicians systematically selected from their medical license numbers. The response rate was 86.4% (380 out of 440). Two-hundred and twenty-nine were male, and 151 were female. Their average age was 40.8 years (range: 22-74). Most of them were Buddhists (93.9%), specialists (64.2%), married only once and still lived with their spouses (59.5%), and concurrently practiced medicine (95.5%). Their overall satisfaction as physicians was 60.2% high, and 37.2% moderate. Their average sleep time was 6-8 hours per night for 58.9%. Most had eye problems (74.9%) and most were refractive errors such as myopia. Most (63.8%) of them did not have any prevalent diseases. Whereas those who had diseases had (in order) allergy, hypertension, asthma, diabetes, and cancer. Their current illnesses included respiratory tract infection. Most physicians did not smoke (94.2%) nor drink alcohol (70.5%). Most of them were not vegetarians (60.4%), did not eat fast food (99.2%). Interestingly, 41.4% of them were accounted for spending less than twice per week for exercise. As expected, 23.7% of them were exposed to blood, 14.5% to respiratory tract secretion, and 13.7% to pus/secretion from wounds. This study serves as a basis for health promotion approach to medical community and does create awareness of health among Thai physicians. PMID:21218585

  20. Non-clinicians’ judgments about asylum seekers’ mental health: how do legal representatives of asylum seekers decide when to request medico-legal reports?

    Directory of Open Access Journals (Sweden)

    Lucy Wilson-Shaw

    2012-10-01

    Full Text Available Background : Procedures for determining refugee status across Europe are being speeded up, despite the high prevalence of mental health difficulties among asylum seekers. An assurance given is that ‘‘vulnerable applicants’’ will be identified and excluded from accelerated procedures. Although experts have recommended assessments to be undertaken by experienced clinicians, this is unlikely to happen for political and financial reasons. Understanding how non-clinically qualified personnel perform assessments of mental health issues is timely and crucial. Misrecognition of refugees due to the inappropriate use of accelerated procedures involves the risk of returning the very people who have the right to protection from further persecution. Objective : To examine the decision making of immigration lawyers, who are an example of a group of nonclinicians who decide when and whether to refer asylum-seekers for psychiatric assessment. Method : Semi-structured interviews were conducted with 12 legal representatives working with people seeking refugee or human rights protection in the United Kingdom. The resultant material was analysed using Framework Analysis. Results : Themes clustered around the legal case, the client, the representative and the systems, all with sub-themes. A mapping exercise integrated these themes to show how representatives brought together questions of (1 evidential reasons for a report, influenced by their legal, psychological and case law knowledge, and (2 perceived evidence of mental distress, influenced by professional and personal experiences and expectations. Conclusions : The legal representatives interviewed were well-informed and trained in psychological issues as well as clearly dedicated to their clients. This helped them to attempt quasi-diagnoses of common mental health problems. They nonetheless demonstrated stereotypical understanding of post-traumatic stress disorder and other possible diagnoses and the

  1. The Physician-Patient Relationship: A patient-physician's view

    OpenAIRE

    Ennis, Jeffrey H

    1990-01-01

    The physician-patient relationship, like any human relationship, blends two types of interactions described by philosopher Martin Buber. In an “I-It” interaction, the physician objectifies the patient and his or her problem; in an “I-Thou” interaction, the physician perceives the patient as an emotional being. My encounters with medical practitioners as a patient with brachial neuritis and Guillain-Barré syndrome illustrate these forms of the physician-patient relationship.

  2. "What if No One Had Spoken out Against this Policy?" The Rise of Asylum Seeker and Refugeee Advocacy in Australia

    Directory of Open Access Journals (Sweden)

    Diane Gosden

    2006-02-01

    Full Text Available This paper examines the rise of an asylum seeker and refugee advocacy movement in Australia in recent years. It situates this phenomenon within Alberto Melucci's understanding of social movements as variable and diffuse forms of social action involved in challenging the logic of a system. Following this theoretical framework, it explores the empirical features of this particular collective action, as well as the struggle to redefine the nature of the relationship between citizens of a sovereign state and 'the other' in the personage of asylum seekers and refugees.

  3. Turning Asylum Seekers into ‘Dangerous Criminals’: Experiences of the Criminal Justice System of those Seeking Sanctuary

    OpenAIRE

    Monish Bhatia

    2015-01-01

    Since the events of 9/11 in the US in 2001 and, four years later, the 7/7 London bombings in the UK, warnings of terrorist attacks are high on the public agenda in many western countries. Politicians and tabloid press in the UK have continued to make direct and indirect connections between asylum seekers, terrorism and crime. This has increasingly resulted in harsh policy responses to restrict the movement of ‘third-world’ nationals, criminalisation of immigration and asylum policy, and makin...

  4. Adult Asylum Seekers from the Middle East Including Syria in Central Europe: What Are Their Health Care Problems?

    OpenAIRE

    Pfortmueller, Carmen Andrea; Schwetlick, Miriam; Mueller, Thomas; Lehmann, Beat; Exadaktylos, Aristomenis Konstantinos

    2016-01-01

    Background Forced displacement related to persecution and violent conflict has reached a new peak in recent years. The primary aim of this study is to provide an initial overview of the acute and chronic health care problems of asylum seekers from the Middle East, with special emphasis on asylum seekers from Syria. Methods Our retrospective data analysis comprised adult patients presenting to our emergency department between 01.11.2011 and 30.06.2014 with the official resident status of an “a...

  5. School and community-based interventions for refugee and asylum seeking children: a systematic review.

    Directory of Open Access Journals (Sweden)

    Rebecca A Tyrer

    Full Text Available Research for effective psychological interventions for refugee and asylum-seeking children has intensified. The need for interventions in environments more easily accessed by children and families is especially relevant for newly arrived populations. This paper reviews the literature on school and community-based interventions aimed at reducing psychological disorders in refugee and asylum-seeking children.Comprehensive searches were conducted in seven databases and further information was obtained through searching reference lists, grey literature, and contacting experts in the field. Studies were included if they reported on the efficacy of a school or community-based mental health intervention for refugee or asylum-seeking children. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively. The marked heterogeneity of studies excluded conducting a meta-analysis but study effect-sizes were calculated where possible. Twenty one studies met inclusion criteria for the review reporting on interventions for approximately 1800 refugee children. Fourteen studies were carried out in high-income countries in either a school (n = 11 or community (n = 3 setting and seven studies were carried out in refugee camps. Interventions were either primarily focused on the verbal processing of past experiences (n = 9, or on an array of creative art techniques (n = 7 and others used a combination of these interventions (n = 5. While both intervention types reported significant changes in symptomatology, effect sizes ranged from 0.31 to 0.93 and could mainly be calculated for interventions focusing on the verbal processing of past experiences.Only a small number of studies fulfilled inclusion criteria and the majority of these were in the school setting. The findings suggest that interventions delivered within the school setting can be successful in

  6. Pro-asylum Advocacy in the EU: Challenging the State of Exception

    OpenAIRE

    Hintjens, Helen; Kumar, Rajiv; Pouri, Ahmed

    2011-01-01

    textabstractIntroduction. This chapter explores examples of how pro-asylum advocates challenge the harsh measures used to punish those who try to enter or reside in the EU illegally, taking examples from The Netherlands and the UK. We explore organized resistance to the ‘3-Ds’, which are so typical of EU-wide migration policies: destitution, detention and deportation. Together these are the backbone of policies of deterrence. Sections 2 and 3 explore how ‘global apartheid’ and the ‘state of e...

  7. Asylum, Refuge and Public Policy: Current Trends and Future Dilemmas in the UK

    OpenAIRE

    Schuster, L; Solomos, J.

    2001-01-01

    Britain is a signatory of the 1950 European Convention on Human Rightsand Fundamental Freedoms and the 1951 Convention Relating to the Status of Refugees. It is only in the last decade, however, with the passage of the 1993 Asylum and Immigration Appeal Act and the 1998 Human Rights Act, that these two Conventions have became part of British law. This paper begins by exploring the impact of the incorporation of the 1951 Convention and then moves on to look at the hopes that are now pinned on ...

  8. The Intersection of Statelessness and Refugee Protection in US Asylum Policy

    Directory of Open Access Journals (Sweden)

    Maryellen Fullerton

    2014-07-01

    Full Text Available More than ten million people are stateless today. In a world of nation states, they live on the margins without membership in any state, and, as a consequence, have few enforceable legal rights. Stateless individuals face gaps in protection and in many cases experience persecution that falls within the refugee paradigm. However, US asylum policy does not adequately address the myriad legal problems that confront the stateless, who have been largely invisible in the jurisprudence and academic literature. Two federal appellate court opinions shed new light on the intersection of statelessness and refugee law in the United States. In 2010, Haile v. Holder examined the asylum claim of a young man rendered stateless when the Ethiopian government issued a decree denationalizing ethnic Eritreans.  In a 2011 case, Stserba v. Holder, the court reviewed an asylum claim by a woman who became stateless when the Soviet Union collapsed, and the successor state of Estonia enacted citizenship legislation that included a language requirement. This article analyzes the opinions which suggest that state action depriving residents of citizenship on ethnic and other protected grounds warrants a presumption of persecution.  This article also identifies additional circumstances in which stateless individuals may have a well-founded fear of persecution that qualifies them for asylum in the United States.In addition, this article notes that although far too many stateless individuals face persecution, not all of them do. Stateless persons who do not fear persecution, however, are also vulnerable. The absence of state protection condemns them to a precarious existence and their inability to obtain passports or other travel documents often prevents their return to states where they formerly resided. The refusal of most states to admit noncitizens frequently keeps stateless persons in limbo. Stateless individuals stranded in the United States live under a supervisory

  9. Interference with the patient-physician relationship

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2012-11-01

    Full Text Available No abstract available. Article truncated at 150 words. “Life is like a boomerang. Our thoughts, deeds and words return to us sooner or later, with astounding accuracy.”-Brant M. Bright, former project leader with IBM A recent sounding board in the New England Journal of Medicine discussed legislative interference with the patient-physician relationship (1. The authors, the executive staff leadership of the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, and the American College of Surgeons believe that legislators should abide by principles that put patients’ best interests first. Critical to achieving this goal is respect for the importance of scientific evidence, patient autonomy, and the patient-physician relationship. According to the authors, lawmakers are increasingly intruding into the realm of medical practice, often to satisfy political agendas without regard to established, evidence-based guidelines for care. The article goes on to cite examples including: The Florida ….

  10. Family physicians: supply and demand.

    OpenAIRE

    Bowman, M A

    1989-01-01

    The nation's supply of family physicians as estimated by the Graduate Medical Education National Advisory Committee appears fairly accurate. At the same time, the demands for family physicians appear to be strong, partially because case-management systems recognize the cost-effectiveness and appropriate training of family physicians for their needs. The largest factor inhibiting the supply of such physicians appears to be the relatively lower income of family practice compared to other specia...

  11. Physician Assistant Genomic Competencies.

    Science.gov (United States)

    Goldgar, Constance; Michaud, Ed; Park, Nguyen; Jenkins, Jean

    2016-09-01

    Genomic discoveries are increasingly being applied to the clinical care of patients. All physician assistants (PAs) need to acquire competency in genomics to provide the best possible care for patients within the scope of their practice. In this article, we present an updated version of PA genomic competencies and learning outcomes in a framework that is consistent with the current medical education guidelines and the collaborative nature of PAs in interprofessional health care teams. PMID:27490287

  12. Physicians in Literature: Three Portrayals

    OpenAIRE

    Cameron, Ian A.

    1986-01-01

    Literature can provide an objective glimpse of how the public perceives physicians. Physicians have been recipients of the full range of human response in literature, from contempt to veneration. This article examines the impressions of three authors: Mark Twain, Sir Arthur Conan Doyle, and Arthur Hailey. Their descriptions provide insight into the complex relationship physicians have with their colleagues and patients.

  13. Physician nutrition education.

    Science.gov (United States)

    Kiraly, Laszlo N; McClave, Stephen A; Neel, Dustin; Evans, David C; Martindale, Robert G; Hurt, Ryan T

    2014-06-01

    Nutrition education for physicians in the United States is limited in scope, quality, and duration due to a variety of factors. As new data and quality improvement initiatives highlight the importance of nutrition and a generation of nutrition experts retire, there is a need for new physician educators and leaders in clinical nutrition. Traditional nutrition fellowships and increased didactic lecture time in school and postgraduate training are not feasible strategies to develop the next generation of physician nutrition specialists in the current environment. One strategy is the development of short immersion courses for advanced trainees and junior attendings. The most promising courses include a combination of close mentorship and adult learning techniques such as lectures, clinical experiences, literature review, curricular development, research and writing, multidisciplinary interactions, and extensive group discussion. These courses also allow the opportunity for advanced discourse, development of long-term collaborative relationships, and continued longitudinal career development for alumni after the course ends. Despite these curricular developments, ultimately the field of nutrition will not mature until the American Board of Medical Specialties recognizes nutrition medicine with specialty board certification. PMID:24690613

  14. A mixed-method study of expert psychological evidence submitted for a cohort of asylum seekers undergoing refugee status determination in Australia.

    Science.gov (United States)

    Tay, Kuowei; Frommer, Naomi; Hunter, Jill; Silove, Derrick; Pearson, Linda; San Roque, Mehera; Redman, Ronnit; Bryant, Richard A; Manicavasagar, Vijaya; Steel, Zachary

    2013-12-01

    The levels of exposure to conflict-related trauma and the high rates of mental health impairment amongst asylum seekers pose specific challenges for refugee decision makers who lack mental health training. We examined the use of psychological evidence amongst asylum decision makers in New South Wales, Australia, drawing on the archives of a representative cohort of 52 asylum seekers. A mixed-method approach was used to examine key mental health issues presented in psychological reports accompanying each asylum application, including key documents submitted for consideration of asylum at the primary and review levels. The findings indicated that the majority of decision makers at both levels did not refer to psychological evidence in their decision records. Those who did, particularly in the context of negative decisions, challenged the expert findings and rejected the value of such evidence. Asylum seekers exhibiting traumatic stress symptoms such as intrusive thoughts and avoidance, as well as memory impairment, experienced a lower acceptance rate than those who did not across the primary and review levels. The findings raise concern that trauma-affected asylum seekers may be consistently disadvantaged in the refugee decision-making process and underscore the need to improve the understanding and use of mental health evidence in the refugee decision-making setting. The study findings have been used to develop a set of guidelines to assist refugee decision makers, mental health professionals and legal advisers in improving the quality and use of psychological evidence within the refugee decision-making context. PMID:24331888

  15. Resident physicians in Mexico: tradition or humiliation

    Directory of Open Access Journals (Sweden)

    Donovan Casas Patiño

    2013-08-01

    Full Text Available Mexico has a great history and tradition in relation to the training of resident physicians, but what we find behind this process?, Power relations implied and not implied, unnoticed or ignored for convenience by the academic and health institutions, with the aggravation of forgetting its commitment to the training of men and women "professionals" and limited to meet another indicator of "human resources for health." The resident physician in academic and scientific training is immersed in this dehumanized maelstrom and ends up becoming a character for the domain of knowledge as power, forgetting that his act and its rationale lies in the principle of "primum non nocere" to that we would add: nor your person, nor your fellowman, much less whom you have the moral, ethical and civic responsibility to convey some of your knowledge and your experience, that is, part of your essence”.

  16. Managing margins through physician engagement.

    Science.gov (United States)

    Sears, Nicholas J

    2012-07-01

    Hospitals should take the following steps as they seek to engage physicians in an enterprisewide effort to effectively manage margins: Consider physicians' daily professional practice requirements and demands for time in balancing patient care and administrative duties. Share detailed transactional supply data with physicians to give them a behind-the-scenes look at the cost of products used for procedures. Institute physician-led management and monitoring of protocol compliance and shifts in utilization to promote clinical support for change. Select a physician champion to provide the framework for managing initiatives with targeted, efficient communication. PMID:22788036

  17. Physician leadership in changing times.

    Science.gov (United States)

    Cochran, Jack; Kaplan, Gary S; Nesse, Robert E

    2014-03-01

    Today, hospitals and physicians are reorganizing themselves in novel ways to take advantage of payment incentives that reward shared accountability for the total health care experience. These delivery system changes will take place with our without physician leadership. To optimize change on behalf of patients, physicians must play a conscious role in shaping future health care delivery organizations. As physician leaders of three of the nation׳s largest integrated health care delivery systems - Kaiser Permanente, Virginia Mason Medical Center, and the Mayo Clinic Health System - we call on physicians to view leadership and the development of leaders as key aspects of their role as patient advocates. PMID:26250084

  18. Gender and offender status predicting treatment success in refugees and asylum seekers with PTSD

    Directory of Open Access Journals (Sweden)

    Håkon Stenmark

    2014-01-01

    Full Text Available Background: Current knowledge is limited regarding patient characteristics related to treatment outcome of posttraumatic stress disorders (PTSD in refugees and asylum seekers. Objective: Gender, torture status, offender status, level of anger, and level of depression were investigated for possible effects on the treatment outcome. Method: Patient characteristics were explored in 54 refugees and asylum seekers who had completed a treatment program for PTSD. Non-responders (10, those who had the same or higher levels of symptom severity after treatment, were compared with responders, those who had lower symptom severity after treatment (44. Symptom severity was measured by Clinician-Administered PTSD Scale. The non-responders and responders constituted the dichotomous, dependent variable. The independent variables were gender, torture status, offender status, level of anger, and level of depression. T-tests and Exact Unconditional Homogeneity/Independence Tests for 2X2 Tables were used to study the relationship to treatment outcome. Results: Being male and reporting to have been a violent offender were significantly more frequent characteristics among the non-responders compared to the responders. The levels of pretreatment anger, depression and torture status did not affect the treatment outcome. Conclusions: The study adds support to findings that females benefit more from treatment of PTSD than males and that violent offenders are difficult to treat within the standard treatment programs.

  19. Social factors ameliorate psychiatric disorders in community-based asylum seekers independent of visa status.

    Science.gov (United States)

    Hocking, Debbie C; Kennedy, Gerard A; Sundram, Suresh

    2015-12-15

    The impact of industrialised host nations' deterrent immigration policies on the mental health of forced migrants has not been well characterised. The present study investigated the impact of Australia's refugee determination process (RDP) on psychiatric morbidity in community-based asylum-seekers (AS) and refugees. Psychiatric morbidity was predicted to be greater in AS than refugees, and to persist or increase as a function of time in the RDP. The effect on mental health of demographic and socio-political factors such as health cover and work rights were also investigated. Psychiatric morbidity was measured prospectively on five mental health indices at baseline (T1, n=131) and an average of 15.7 months later (T2, n=56). Psychiatric morbidity in AS significantly decreased between time points such that it was no longer greater than that of refugees at T2. Caseness of PTSD and demoralisation reduced in AS who gained protection; however, those who maintained asylum-seeker status at T2 also had a significant reduction in PTS and depression symptom severity. Reduced PTS and demoralisation symptoms were associated with securing work rights and health cover. Living in the community with work rights and access to health cover significantly improves psychiatric symptoms in forced migrants irrespective of their protection status. PMID:26518226

  20. Sleeping patterns of Afghan unaccompanied asylum-seeking adolescents: a large observational study.

    Science.gov (United States)

    Bronstein, Israel; Montgomery, Paul

    2013-01-01

    Unaccompanied asylum-seeking children (UASC) have experienced multiple traumas and are a high-risk group for posttraumatic stress disorder (PTSD). The effects of trauma are known to be associated with sleep problems; indeed sleeping problems are core features of PTSD. However, there has been no systematic research examining the sleep of this high risk group of children. This study presents the first evidence on the sleeping patterns of Afghan UASC living in the UK. A total of 222 male Afghan children, aged 13-18, were interviewed using validated self-report questionnaires measuring sleeping patterns and PTSD. Overall, UASC patterns for bed time and rise time appear acculturated to the country of asylum. Mean UASC sleep onset latency scores were approximately 20 minutes greater compared with normative scores, which may be a reflection of UASC pre-migration and post-migration experiences. As expected, UASC who screened above the clinical cut-off for PTSD reported significantly greater sleep onset latency, increased nightmares, and less total sleep time compared to the non-PTSD group. The results may be of particular interest to clinicians given that, compared to screening for PTSD, screening for sleep problems may be a less culturally disputed form of initial assessment indicating distress in UASC. Similarly, the field of UASC and refugee child interventions is largely focused on trauma, yet sleep may provide a novel avenue for equally or more effective treatment. PMID:23457517

  1. Seeking asylum in Denmark: Refugee children's mental health and exposure to violence

    DEFF Research Database (Denmark)

    Montgomery, Edith; Foldspang, Anders

    2005-01-01

    Aims: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. Methods: Shortly after arrival in Denmark, the pare...... exposure to violence and their present mental health. There seems to be good reason to systematically integrate evidence on the children of refugee families in the treatment of applications for permission to stay.......Aims: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. Methods: Shortly after arrival in Denmark......, the parents of 311 Middle-Eastern children answered a structured interview on their children’s exposure to organized violence and their mental health. The families were followed-up as concerns receipt of a residence permit. Results: At arrival in Denmark, the children’s patterns of previous exposure...

  2. Monitoring for Equality? Asylum Seekers and Refugees' Retention and Achievement in English for Speakers of Other Languages (ESOL)

    Science.gov (United States)

    Phillimore, Jenny

    2011-01-01

    Interest in the integration of refugees has grown with the increase in numbers of asylum seekers dispersed across the UK. The ability to communicate effectively in English is seen as the key priority in facilitating integration, while a lack of English language is seen as one of the major barriers to refugee employment. Some 267 million British…

  3. Refugees and Asylum Seekers in the UK: The Challenges of Accessing Education and Employment. NIACE Briefing Sheet 91

    Science.gov (United States)

    National Institute of Adult Continuing Education, 2009

    2009-01-01

    This briefing paper endeavours to highlight the challenges facing refugees and asylum seekers in the United Kingdom in accessing education, training and employment. It does not claim to cover all the issues but is intended as a starting point for providers of adult learning and/or advice. It initially sets out the facts about definitions and…

  4. Local Conceptualisations of the Education of Asylum-Seeking and Refugee Students: From Hostile to Holistic Models

    Science.gov (United States)

    Pinson, Halleli; Arnot, Madeleine

    2010-01-01

    Sociological research on the presence and yet invisibility of asylum-seeking and refugee pupils in the educational system in the UK is noticeably absent. This article offers insights into the ways in which the presence and the needs of such pupils are conceptualised by local authorities and schools. It draws on the results of a survey of 58…

  5. Could the BIC-Q be a decision-support tool to predict the development of asylum-seeking children?

    NARCIS (Netherlands)

    Zijlstra, A. Elianne; Kalverboer, Margrite E.; Post, Wendy J.; Ten Brummelaar, Mijntje D. C.; Knorth, Erik J.

    2013-01-01

    The Best Interest of the Child Questionnaire (BIC-Q) is an instrument to measure the quality of the childrearing environment. We used a sample of asylum-seeking children (N = 79) in the Netherlands to determine the relationship between the quality of the childrearing environment and the child's inte

  6. The conceptually-oriented physician.

    Science.gov (United States)

    Fuller, B F; Fuller, F

    1979-07-01

    This article is based on the authors' book "Physician or Magician: The Myths and Realities of Patient Care" (McGraw Hill and Hemisphere, 1978). In this paper, the authors contend that the main problem confronting medical practice and medical education today is that there is no consensus on what physicians should be doing. Should they be technologists or should they be conceptually-oriented? The authors further state that these two types of physicians are trained in different approaches to problem solving. They conclude by saying that both types of physicians are needed if the quality of patient care is to improve while containing cost, but that the conceptually-oriented physician--the primary physician--should be in charge of all treatment patients receive. This is because the primary physicians as well as the Cartesian approach. Therefore, they would be better able to determine the risks and benefits to each patient of various technological regimens. PMID:514116

  7. The Role of the Physician-Scientist in Our Evolving Society

    Directory of Open Access Journals (Sweden)

    Michael R. Rosen

    2011-10-01

    Full Text Available The physician-scientist represents the medical-scientific version of the “triple threat” athlete. Yet, in medicine as in sports, specialization and business are ever more in the forefront. As the field of medicine evolves, it is likely that the role of the physician, the scientist, and the physician-scientist will continue to change. Whether this is for the good or bad will only be known in hindsight.

  8. The Role of the Physician-Scientist in Our Evolving Society

    OpenAIRE

    Michael R. Rosen

    2011-01-01

    The physician-scientist represents the medical-scientific version of the “triple threat” athlete. Yet, in medicine as in sports, specialization and business are ever more in the forefront. As the field of medicine evolves, it is likely that the role of the physician, the scientist, and the physician-scientist will continue to change. Whether this is for the good or bad will only be known in hindsight.

  9. Primary-care physician compensation.

    Science.gov (United States)

    Olson, Arik

    2012-01-01

    This article reviews existing models of physician compensation and presents information about current compensation patterns for primary-care physicians in the United States. Theories of work motivation are reviewed where they have relevance to the desired outcome of satisfied, productive physicians whose skills and expertise are retained in the workforce. Healthcare reforms that purport to bring accountability for healthcare quality and value-rather than simply volume-bring opportunities to redesign primary-care physician compensation and may allow for new compensation methodologies that increase job satisfaction. Physicians are increasingly shunning the responsibility of private practice and choosing to work as employees of a larger organization, often a hospital. Employers of physicians are seeking compensation models that reward both productivity and value. PMID:22786738

  10. Consolidation guidelines for physician practices.

    Science.gov (United States)

    Bigalke, J T; Garbrecht, G H; McBee, D

    1998-03-01

    The trend of acquiring and consolidating physician practices is expected to continue for some time. The growth of physician practice management companies (PPMCs) has created accounting and financial reporting issues for these new physician organizations. The type of management arrangement ultimately affects the decision of whether or not to consolidate practices. In analyzing consolidation opportunities, PPMCs should consider the terms of the management agreement, which determine who controls the practice, and the advantages and disadvantages of consolidation. PMID:10177404

  11. Understanding physicians' response to AIDS.

    OpenAIRE

    Taylor, K M; Shapiro, M.; Skinner, H A; Eakin, J; Kelner, M

    1989-01-01

    Attempts to comprehend physicians' extreme reaction to AIDS (acquired immune deficiency syndrome) have met with great difficulty since the disease brings into question traditional norms and assumptions. As the medical profession struggles to develop guidelines and policies to help it deal with this disease, it can draw on very little systematic research on the effect of AIDS on physicians' attitudes and practices. We suggest a framework developed from the literature on physicians' and society...

  12. Protecting and assisting refugees and asylum-seekers in Malaysia : the role of the UNHCR, informal mechanisms, and the 'Humanitarian exception'

    OpenAIRE

    Lego, Jera Beah H.

    2012-01-01

    This paper problematizes Malaysia's apparently contradictory policies – harsh immigration rules applied to refugees and asylum seekers on the one hand, and the continued presence and functioning of the United Nations High Commissioner for Refugees (UNHCR) on the other hand. It asks how it has been possible to protect and assist refugees and asylum seekers in light of such policies and how such protection and assistance is implemented, justified, and maintained. Giorgio Agamben's concept of th...

  13. Seen But Not Heard?:Parallels and Dissonances in the Treatment of Rape Narratives across the Asylum and Criminal Justice Contexts

    OpenAIRE

    Cowan, Sharon; Baillot, Helen; Munro, Vanessa

    2009-01-01

    A significant proportion of women seeking refugee status in the United Kingdom will claim to have been raped in their country of origin. Even where this is not the sole basis of an asylum claim, it may be relevant to its determination. While criminal justice responses to rape have been the subject of extensive academic criticism and legislative reform, the processes of disclosure and credibility assessment in the asylum context have received little attention. This article explores possible pa...

  14. Building the right physician platform.

    Science.gov (United States)

    Pizzo, James J; Sullivan, Luke; Ryan, Debra L

    2015-07-01

    The challenges health systems often face in aligning physicians with organizational cost and quality goals related to the delivery of value-based care differ between employed and independent physicians. With employed physicians, the focus should be on right-sizing the service delivery network and employed medical group, building a sustainable compensation program, enhancing the revenue cycle, increasing use of midlevel providers, and implementing a common technology platform. With independent physicians, the focus should be on understanding available contracting models, participating in shared-savings arrangements, considering alternative payment distribution models, choosing the right metrics, and exploring shared branding options. PMID:26376510

  15. The physician as moral entrepreneur.

    Science.gov (United States)

    Clarke, J N

    1982-12-01

    This paper argues that the work of the contemporary physician is at least in part the work of a moral entrepreneur. The effects of religious affiliation and religiosity on the decision making of a modern doctor are examined in an analysis of the responses of 231 physicians to a mailed questionnaire. Decision-making issues were considered to be those with social/moral implications. Religious physicians tend to favor clergy involvement in social and procreative issues. Roman Catholic physicians oppose the involvement of the medical profession in birth control issues. PMID:24310078

  16. Unaccompanied & Denied: Regional Legal Framework for Unaccompanied Minors Asylum Seekers (UMAS

    Directory of Open Access Journals (Sweden)

    Rohaida Nordin

    2015-12-01

    Full Text Available Unaccompanied minor asylum seekers are vulnerable and thus, provided special international law protections. However, in reality, they are being mistreated as illegal immigrants and on thereceiving end of ethnic violence, discrimination, restrictions in enjoyment of their rights duly recognised by international human rights law. This article identifies legislative, policy and supportmechanisms which encompass the minimum UMAS guardianship standards at international law and which are evidence-based from best practice models for the provision of guardians for UMASinternationally. It presents situation of UMAS in relation to human rights violations with emphasis on the legal framework and practices in Australia and five ASEAN State Members. This article also highlights the various stands taken by various countries providing better legal framework and practices regarding the terms for protection and enforcement of human rights for UMAS. Finally, this article provides recommendations for Australia and ASEAN Member States to adopt in order to realise the international human rights of UMAS with respect to guardianship.

  17. Representation of Refugees, Asylum-Seekers and Refugee Affairs In Hungarian Dailies

    Directory of Open Access Journals (Sweden)

    Lilla VICSEK

    2008-11-01

    Full Text Available How does the press in Hungary write about refugees, asylum-seekers and refugee affairs? We sought to answer this question. Articles appearing in 2005 and 2006 in two leading national Hungarian dailies were examined with quantitative content analysis. The results show that the articles analyzed often treat refugee affairs as an “official” political matter. The high proportion of legislation and political positions conveys the image that refugee affairs are a state or intergovernmental matter, an “official”, legal, political issue rather than for example a humanitarian question. Most of the articles published in both papers write about problems and conflicts in connection with refugee affairs. The negative media image has different significance for different topics. We argue that the question of refugee affairs is a topic where the image shown by the media is of great relevance: the media can be a more important source of information on this subject than personal contacts.

  18. Human lead exposure in a late 19th century mental asylum population

    International Nuclear Information System (INIS)

    Lead isotope ratios and lead (Pb) levels were analyzed in 33 individuals from a forgotten cemetery at the Colorado Mental Health Institute at Pueblo, Colorado dating to 1879-1899. Isotopic ratios from healing bone fractures, cortical bone, and tooth dentine provide information about sources of Pb exposures over a range of time that illuminates individual's life histories and migration patterns. Historical records and Pb production data from the 19th century were used to create a database for interpreting Pb exposures for these African, Hispanic and European Americans. The analysis of these individuals suggests that Pb exposure noticeably impacted the mental health of 5-10% of the asylum patients in this frontier population, a high number by standards today, and that differences exist in the three ancestral groups' exposure histories

  19. Human lead exposure in a late 19th century mental asylum population.

    Science.gov (United States)

    Bower, Nathan W; McCants, Sarah A; Custodio, Joseph M; Ketterer, Michael E; Getty, Stephen R; Hoffman, J Michael

    2007-01-01

    Lead isotope ratios and lead (Pb) levels were analyzed in 33 individuals from a forgotten cemetery at the Colorado Mental Health Institute at Pueblo, Colorado dating to 1879-1899. Isotopic ratios from healing bone fractures, cortical bone, and tooth dentine provide information about sources of Pb exposures over a range of time that illuminates individual's life histories and migration patterns. Historical records and Pb production data from the 19th century were used to create a database for interpreting Pb exposures for these African, Hispanic and European Americans. The analysis of these individuals suggests that Pb exposure noticeably impacted the mental health of 5-10% of the asylum patients in this frontier population, a high number by standards today, and that differences exist in the three ancestral groups' exposure histories. PMID:17126382

  20. Human lead exposure in a late 19th century mental asylum population

    Energy Technology Data Exchange (ETDEWEB)

    Bower, Nathan W. [Department of Chemistry, Colorado College, Colorado Springs, CO 80903-3294 (United States)]. E-mail: nbower@coloradocollege.edu; McCants, Sarah A. [Department of Chemistry, Colorado College, Colorado Springs, CO 80903-3294 (United States); Custodio, Joseph M. [Department of Chemistry, Colorado College, Colorado Springs, CO 80903-3294 (United States); Ketterer, Michael E. [Departments of Chemistry and Biochemistry, Northern Arizona University, Flagstaff, AZ 86011-5698 (United States); Getty, Stephen R. [Biological Sciences Curriculum Study, Colorado Springs, CO 80918 (United States); Hoffman, J. Michael [Department of Anthropology, Colorado College, Colorado Springs, CO 8090-3294 (United States)

    2007-01-01

    Lead isotope ratios and lead (Pb) levels were analyzed in 33 individuals from a forgotten cemetery at the Colorado Mental Health Institute at Pueblo, Colorado dating to 1879-1899. Isotopic ratios from healing bone fractures, cortical bone, and tooth dentine provide information about sources of Pb exposures over a range of time that illuminates individual's life histories and migration patterns. Historical records and Pb production data from the 19th century were used to create a database for interpreting Pb exposures for these African, Hispanic and European Americans. The analysis of these individuals suggests that Pb exposure noticeably impacted the mental health of 5-10% of the asylum patients in this frontier population, a high number by standards today, and that differences exist in the three ancestral groups' exposure histories.

  1. The City of Others: Photographs from the City of London Asylum Archive

    Directory of Open Access Journals (Sweden)

    Caroline Bressey

    2011-09-01

    Full Text Available This photographic essay presents images from the City of London Asylum archive as a example of how the visual can be used to expand our investigations of social histories of Victorian London, particularly the multi-cultural nature of the city. The essay argues that images are an essential part of the research process, but also discusses some of the disadvantages and ethical tensions encountered through the use of such portraits for historical recovery. Despite these caveats, the paper concludes that we have much to learn from the images that present images of the city that would otherwise be difficult, if not impossible, for twenty-first-century researchers to access.

  2. Scientific visualization and radiology

    International Nuclear Information System (INIS)

    Scientific visualization is the visual presentation of numerical data. The National Center for Supercomputing Applications (NCSA) has developed methods for visualizing computerbased simulations of digital imaging data. The applicability of these various tools for unique and potentially medical beneficial display of MR images is investigated. Raw data are obtained from MR images of the brain, neck, spine, and brachial plexus obtained on a 1.5-T imager with multiple pulse sequences. A supercomputer and other mainframe resources run a variety of graphic and imaging programs using this data. An interdisciplinary team of imaging scientists, computer graphic programmers, an physicians works together to achieve useful information

  3. Physician Requirements-1990. For Cardiology.

    Science.gov (United States)

    Tracy, Octavious; Birchette-Pierce, Cheryl

    Professional requirements for physicians specializing in cardiology were estimated to assist policymakers in developing guidelines for graduate medical education. The determination of physician requirements was based on an adjusted needs rather than a demand or utilization model. For each illness, manpower requirements were modified by the…

  4. Physician Actuated Computerized Treatment (PACT)

    OpenAIRE

    Speck, Pat K.

    1984-01-01

    PACT was developed by clinical Physicians for practicing physicians. With PACT, you can be assured that Doctor/Computer Interface fuses smoothly and simultaneously with an on-line data-base medical record management system. PACT has been found appropriate for in out patient care delivery by all medical specialties including dentistry, physical therapy, social workers and veterinarians.

  5. Physician Education in Sleep Disorders.

    Science.gov (United States)

    Orr, William C.; And Others

    1980-01-01

    The lack of physician knowledge in the diagnosis and management of sleep disorders is discussed. An examination of physicians demonstrated knowledge deficiencies and a survey of medical schools showed that 46 percent offered no training in the area of sleep physiology or disorders. Recommendations for addressing the situation are offered. (JMD)

  6. Physicians' strikes and the competing bases of physicians' moral obligations.

    Science.gov (United States)

    MacDougall, D Robert

    2013-09-01

    Many authors have addressed the morality of physicians' strikes on the assumption that medical practice is morally different from other kinds of occupations. This article analyzes three prominent theoretical accounts that attempt to ground such special moral obligations for physicians--practice-based accounts, utilitarian accounts, and social contract accounts--and assesses their applicability to the problem of the morality of strikes. After critiquing these views, it offers a fourth view grounding special moral obligations in voluntary commitments, and explains why this is a preferable basis for understanding physicians' moral obligations in general and especially as pertaining to strikes. PMID:24199524

  7. Shared consultant physician posts.

    LENUS (Irish Health Repository)

    Cooke, J

    2012-01-31

    Our aim was to assess the acceptability and cost-efficiency of shared consultancy posts. Two consultant physicians worked alternate fortnights for a period of twelve months. Questionnaires were distributed to general practitioners, nurses, consultants and junior doctors affected by the arrangement. Patients or their next of kin were contacted by telephone. 1\\/17 of consultants described the experience as negative. 14\\/19 junior doctors reported a positive experience. 11 felt that training had been improved while 2 felt that it had been adversely affected. 17\\/17 GPs were satisfied with the arrangement. 1\\/86 nurses surveyed reported a negative experience. 1\\/48 patients were unhappy with the arrangement. An extra 2.2 (p<0.001) patients were seen per clinic. Length of stay was shortened by 2.49 days (p<0.001). A saving of 69,212 was made due to decreased locum requirements. We present data suggesting structured shared consultancy posts can be broadly acceptable and cost efficient in Ireland.

  8. Violence Against Women and Asylum Seeking: Global Problems and Local Practices Applied to Guatemalan Women Immigrating for Safety

    OpenAIRE

    Roselyn Costantino; Karen Smith Rotabi; Debra H. Rodman

    2012-01-01

    This paper, based on broader discussions surrounding gender violence and immigration in the U.S., provides critical information on the historical context of extreme violence against women and femicide plaguing Central American societies today. Drawing on experiences of precedent setting cases of Guatemalan women, the authors offer suggestions for culturally specific treatment of and support for women who seek asylum in the U.S. out of justified fear for their and their family members’ lives s...

  9. Acts of Citizenship as a Politics of Resistance? Reflections on realizing concrete rights within the Israeli asylum regime

    OpenAIRE

    Müller, T.R.

    2016-01-01

    This paper investigates how Eritrean refugees in Israel and civil society organisations who engage with refugee issues contest the exclusionary politics of asylum in Israel. It presents various acts of claims-making initiated by Eritrean refugees themselves or in response to hostility by others, as well as acts inaugurated by Israeli civil society organisations on behalf of or with refugee populations. Drawing on the concept of activist acts of citizenship developed by Engin Isin, the paper s...

  10. [Social history of open care of the mentally ill--from the municipal asylum to social psychiatric care].

    Science.gov (United States)

    Haselbeck, H

    1985-09-01

    Outpatient psychiatric care linked to a hospital or institution is as old as psychiatry defining itself as a science. During the time of the Liberal Movement in Germany and the various revolutions that took place in several European countries (including Austria and various German states) in 1848, people were full of ideas and sociorevolutionary projects. It was then that they became conscious of the need to meet mentally ill persons in their own environment in order to help them in an adequate manner. Griesinger described in great detail such work as envisaged by him for his projected "municipal asylum" or "city asylum". However, all efforts in this direction were quashed in 1868 by a majority decision on the part of psychiatrics in favour of large-scale lunatic asyluma located far away from the densely populated areas. At the turn of the century, social awareness again began to grow; the asylums were overcrowded; and costs had risen tremendously. This resulted in building up a non-institutionalised "open service and care" for the insane. On the one hand, it was an outpatient care system in close co-operation with the asylum, i.e. the patients were looked up in their homes (Erlangen Model), whereas in several big cities the community Public Health Office was responsible for such psychiatric care (Gelsenkirchen Model). In the German Republic that existed from 1919 to 1933, "open" psychiatric care was extended, and the psychiatrist who advocated it were gradually drawn into a maelstrom of a sociodarwinistic type of racialism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3903811

  11. Refugee education in countries of first asylum: Breaking open the black box of pre-resettlement experiences

    OpenAIRE

    Dryden-Peterson, Sarah Elizabeth

    2015-01-01

    The number of refugees who have fled across international borders due to conflict and persecution is at the highest level in recorded history. The vast majority of these refugees find exile in low-income countries neighboring their countries of origin. The refugee children who are resettled to North America, Europe, and Australia arrive with previous educational experiences in these countries of first asylum. This article examines these pre-resettlement educational experiences of refugee chil...

  12. 'Hearing the Right Gaps':Enabling and Responding to Disclosures of Sexual Violence within the UK Asylum Process

    OpenAIRE

    Cowan, Sharon; Baillot, Helen; Munro, Vanessa

    2013-01-01

    The barriers that prevent or delay female victims of sexual assault from disclosing to criminal justice authorities, and the obstacles that often disincline professional and lay decision-makers from finding such narratives credible have been well documented. This article explores the extent to which such difficulties may be replicated, and compounded, in the case of female asylum-seekers; it will examine the complex ways in which the structure and processes, as well as the heavily politicized...

  13. ‘Hearing the Right Gaps’:Enabling and Responding to Disclosures of Sexual Violence within the UK Asylum Process

    OpenAIRE

    Cowan, Sharon; Baillot, Helen; Munro, Vanessa

    2012-01-01

    The barriers that prevent or delay female victims of sexual assault from disclosing to criminal justice authorities, and the obstacles that often disincline professional and lay decision-makers from finding such narratives credible, have been well documented. This article explores the extent to which such difficulties may be replicated, and compounded, in the case of female asylum-seekers; it will examine the complex ways in which the structure and processes, as well as the heavily politicise...

  14. Unaccompanied Asylum-Seeking Refugee Children’s Forced Repatriation: Social Workers’ and Police Officers’ Health and Job Characteristics

    OpenAIRE

    Sundqvist, Johanna; Hansson, Jonas; Ghazinour, Mehdi; Ögren, Kenneth; Padyab, Mojgan

    2015-01-01

    During the past ten years the number of unaccompanied asylum-seeking refugee children has dramatically increased in Sweden. Some of them are permitted to stay in the receiving country, but some are forced back to their country of origin. Social workers and police officers are involved in these forced repatriations, and such complex situations may cause stressful working conditions. This study aimed to bridge the gap in knowledge of the relationship between general mental health and working wi...

  15. Measuring the health impact of human rights violations related to Australian asylum policies and practices: A mixed methods study

    OpenAIRE

    Mulholland Kim; Allotey Pascale; Johnston Vanessa; Markovic Milica

    2009-01-01

    Abstract Background Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Methods We designed a mixed methods study to address the study aim. A cross-sect...

  16. Responses to language barriers in consultations with refugees and asylum seekers: a telephone survey of Irish general practitioners.

    LENUS (Irish Health Repository)

    MacFarlane, Anne

    2008-01-01

    BACKGROUND: Refugees and asylum seekers experience language barriers in general practice. Qualitative studies have found that responses to language barriers in general practice are ad hoc with use of both professional interpreters and informal interpreters (patients\\' relatives or friends). However, the scale of the issues involved is unknown. This study quantifies the need for language assistance in general practice consultations and examines the experience of, and satisfaction with, methods of language assistance utilized. METHODS: Data were collected by telephone survey with general practitioners in a regional health authority in Ireland between July-August 2004. Each respondent was asked a series of questions about consulting with refugees and asylum seekers, the need for language assistance and the kind of language assistance used. RESULTS: There was a 70% (n = 56\\/80) response rate to the telephone survey. The majority of respondents (77%) said that they had experienced consultations with refugees and asylum seekers in which language assistance was required. Despite this, general practitioners in the majority of cases managed without an interpreter or used informal methods of interpretation. In fact, when given a choice general practitioners would more often choose informal over professional methods of interpretation despite the fact that confidentiality was a significant concern. CONCLUSION: The need for language assistance in consultations with refugees and asylum seekers in Irish general practice is high. General practitioners rely on informal responses. It is necessary to improve knowledge about the organisational contexts that shape general practitioners responses. We also recommend dialogue between general practitioners, patients and interpreters about the relative merits of informal and professional methods of interpretation so that general practitioners\\' choices are responsive to the needs of patients with limited English.

  17. Turning Asylum Seekers into ‘Dangerous Criminals’: Experiences of the Criminal Justice System of those Seeking Sanctuary

    Directory of Open Access Journals (Sweden)

    Monish Bhatia

    2015-10-01

    Full Text Available Since the events of 9/11 in the US in 2001 and, four years later, the 7/7 London bombings in the UK, warnings of terrorist attacks are high on the public agenda in many western countries. Politicians and tabloid press in the UK have continued to make direct and indirect connections between asylum seekers, terrorism and crime. This has increasingly resulted in harsh policy responses to restrict the movement of ‘third-world’ nationals, criminalisation of immigration and asylum policy, and making the violation of immigration laws punishable through criminal courts. This paper largely highlights the narratives of five asylum seekers who committed ‘crime’ by breaching immigration laws and were consequently treated as ‘dangerous criminals’ by the state authorities. More importantly it shows how these individuals experienced this treatment. The aim of this paper is to give voice to the victims of state abuse, claim space for victim agency, gather victim testimonies, challenge official explanations and in the process confront criminal and racist state practices.

  18. Protection of human rights of asylum seekers and illegal migrants: Practice of European court of human rights

    Directory of Open Access Journals (Sweden)

    Đukanović Anđela

    2013-01-01

    Full Text Available The European Court of Human Rights plays an important role in protecting the rights of asylum seekers and illegal migrants through a set of different human rights. Requests for interim measures under Rule 39 of the Rules of Court have also great importance. In cases involving illegal migrants and asylum-seekers, the Court was often in a difficult position, given the contradictions that could arise from the protection of human rights and the legitimate aim of the Contracting States to control the entry, residence and expulsion of aliens. The recent Courts judgments in the case of M. S. S. against Belgium and in the case of Jama Hirsi and others v. Italy are particularly important because of their remarkable influence on the perception of the common asylum system in the EU. [Projekat Ministarstva nauke Republike Srbije, br. 179029: Srbija u savremenim međunarodnim odnosima: Strateški pravci razvoja i učvršćivanja položaja Srbije u međunarodnim integrativnim procesima - spoljnopolitički, međunarodni ekonomski, pravni i bezbednosni aspekti

  19. Unaccompanied Asylum-Seeking Refugee Children's Forced Repatriation: Social Workers' and Police Officers' Health and Job Characteristics.

    Science.gov (United States)

    Sundqvist, Johanna; Hansson, Jonas; Ghazinour, Mehdi; Ögren, Kenneth; Padyab, Mojgan

    2015-01-01

    During the past ten years the number of unaccompanied asylum-seeking refugee children has dramatically increased in Sweden. Some of them are permitted to stay in the receiving country, but some are forced back to their country of origin. Social workers and police officers are involved in these forced repatriations, and such complex situations may cause stressful working conditions. This study aimed to bridge the gap in knowledge of the relationship between general mental health and working with unaccompanied asylum-seeking refugee children who are due for forced repatriation. In addition, the role of psychosocial job characteristics in such relationships was investigated. A questionnaire including sociodemographic characteristics, the Swedish Demand-Control-Support Questionnaire, and the 12-item General Mental Health Questionnaire were distributed nationally. Univariate and multivariable regression models were used. Poorer mental health was associated with working with unaccompanied asylum-seeking refugee children among social workers but not among police officers. Psychological job demand was a significant predictor for general mental health among social workers, while psychological job demand, decision latitude, and marital status were predictors among police officers. Findings are discussed with special regard to the context of social work and police professions in Sweden. PMID:26153185

  20. Physicians' changing attitudes about striking.

    Science.gov (United States)

    Wassertheil-Smoller, S; Croen, L; Siegel, B

    1979-01-01

    Both interns and residents and practicing physicians express substantial support for physicians' organizing for collective bargaining and striking. These findings, from 1146 respondents to a 1976 survey of the alumni of the Albert Einstein College of Medicine, indicate that profound changes have occurred in physicians' views on these issues. Although the greatest support for striking came from interns and residents, with 67 per cent of them indicating they think physicians should be allowed to strike, the survey found an increasing pattern of militancy commencing with 1964 graduates. Physicians in private practice and those who spent two-thirds or more of their time in direct patient care were the most likely to support strikes by physicians (60 per cent), while the least support came from those fulltime on medical school faculties (39 per cent). No differences in support for striking were found in relation to sex, religion or size of community in which physicians practice. A longitudinal examination of the medical school Class of 1975 at matriculation, at graduation and during internship training reveals that a major growth of support for striking occurred between matriculation and graduation. PMID:759745

  1. Female genital cutting: an evidence-based approach to clinical management for the primary care physician.

    Science.gov (United States)

    Hearst, Adelaide A; Molnar, Alexandra M

    2013-06-01

    The United States has more than 1.5 million immigrants from countries in Africa and the Middle East where female genital cutting (FGC) is known to occur. Often, FGC occurs in infancy and childhood in the countries where it is practiced, but patients of any age can present with complications. Lack of understanding of this common problem can potentially alienate and lower quality of care for this patient population. We provide an introduction to the practice of FGC and practice guidelines for the primary care physician. We reviewed original research, population-based studies, and legal research from PubMed, Scopus, CINAHL plus, PsycINFO, and Legal Trac. The terms searched included female genital cutting, female genital circumcision, and female genital mutilation alone and with the term complications or health consequences; no limit on date published. Legal databases were searched using the above terms, as well as international law and immigration law. Editorials and review articles were excluded. This review discusses the different types of FGC, important cultural considerations for physicians caring for patients with FGC, the common early and late medical complications and their management, and psychosocial issues associated with FGC. Current laws pertaining to FGC are briefly reviewed, as well as implications for patients seeking asylum status in the United States because of FGC. Finally, the article presents evidence-based, culturally sensitive approaches to discussions of FGC with girls and women for whom this is an issue. PMID:23726401

  2. Scientific Misconduct.

    Science.gov (United States)

    Gross, Charles

    2016-01-01

    Scientific misconduct has been defined as fabrication, falsification, and plagiarism. Scientific misconduct has occurred throughout the history of science. The US government began to take systematic interest in such misconduct in the 1980s. Since then, a number of studies have examined how frequently individual scientists have observed scientific misconduct or were involved in it. Although the studies vary considerably in their methodology and in the nature and size of their samples, in most studies at least 10% of the scientists sampled reported having observed scientific misconduct. In addition to studies of the incidence of scientific misconduct, this review considers the recent increase in paper retractions, the role of social media in scientific ethics, several instructional examples of egregious scientific misconduct, and potential methods to reduce research misconduct. PMID:26273897

  3. Physician-assessment and physician-enhancement programs in Canada.

    Science.gov (United States)

    Page, G G; Bates, J; Dyer, S M; Vincent, D R; Bordage, G; Jacques, A; Sindon, A; Kaigas, T; Norman, G R; Kopelow, M; Moran, J

    1996-01-01

    In the mid-1980s, the licensing authorities in Quebec, Ontario and Manitoba have introduced programs to conduct in-depth assessments of the clinical skills and abilities of physicians with suspected deficiencies. These assessments are intended to supplement the provincial licensing authorities' existing peer review or patient-complaint mechanisms by confirming the physicians' overall level of competence and identifying specific clinical strengths and weaknesses. An "educational prescription", based on the results of the assessment, focuses on aspects of clinical practice in which the physicians need or wish to enhance their skills. In some situations, licensure decisions are based on the assessment information. This article describes the programs in Quebec, Ontario and Manitoba. Each program comprises a different process of personal assessment and individualized continuing medical education to help physicians improve their clinical competence, and each is built on sound principles of clinical competence assessment and educational planning. PMID:23511980

  4. [Dangerous liaisons--physicians and pharmaceutical sales representatives].

    Science.gov (United States)

    Granja, Mónica

    2005-01-01

    Interactions between physicians and detailers (even when legitimate ones) raise scientific and ethical questions. In Portugal little thinking and discussion has been done on the subject and the blames for bribery have monopolized the media. This work intended to review what has been said in medical literature about these interactions. How do physicians see themselves when interacting with pharmaceutical companies and their representatives? Do these companies in fact change their prescriptive behaviour, and, if so, how do they change it? How can physicians interact with detailers and still keep their best practice? A Medline research, from 1966 till 2002, was performed using the key-words as follows. A database similar to Medline but concerning medical journals published in Portugal, Index das Revistas Médicas Portuguesas, was also researched from 1992 to 2002. Pharmaceutical companies are profit bound and they allot promoting activities, and detailing in particular, huge amounts of money. Most physicians hold firmly to the belief that they are able to resist and not be influenced by drug companies promotion activities. Nevertheless, all previous works on literature tell us the opposite. Market research also indicates that detailers effectively promote drug sales. Various works also suggest that the information detailers provide to physicians may be largely incorrect, even comparing it to the written information provided by the pharmaceutical companies they work for. The frequency at which portuguese physicians (especially family physicians) contact with pharmaceutical sales representatives is higher than the frequency reported in countries where the available studies come from (namely, Canada and the United States of America). This may put portuguese physicians at a higher risk, making it imperative that work and wide debate are initiated among the class. PMID:16202335

  5. [Peculiarity of the occupational physician].

    Science.gov (United States)

    Pagliaro, G; Simonini, S; del Bufalo, P; Serra, A; Ramistella, E

    2011-01-01

    Aim of this contribution is to consider, although in a concise way, the peculiarity of the Occupational Physician's activity operating in Health care sector, that employs about 5% of Italian workers. Particularly, we bring into focus the global roll that the Occupational Physician must fulfil in a reality where he is the protagonist towards the safeguard of the worker's safe, already submitted to several occupational risks, and about the safety of the third parties, which is more important than in other sectors. Shared elaboration in this article shows that Occupational Physician of the Health care sector has the same problems and expectations everywhere, in our Country. PMID:23393851

  6. Physician-assessment and physician-enhancement programs in Canada.

    OpenAIRE

    Page, G.G; Bates, J.; Dyer, S M; Vincent, D R; Bordage, G; Jacques, A.; Sindon, A.; Kaigas, T; Norman, G R; Kopelow, M

    1995-01-01

    Since the mid-1980s, the licensing authorities in Quebec, Ontario and Manitoba have introduced programs to conduct in-depth assessments of the clinical skills and abilities of physicians with suspected deficiencies. These assessments are intended to supplement the provincial licensing authorities' existing peer review or patient-complaint mechanisms by confirming the physicians' overall level of competence and identifying specific clinical strengths and weaknesses. An "educational prescriptio...

  7. Special article: physician burnout-the experience of three physicians

    Directory of Open Access Journals (Sweden)

    Raschke RA

    2015-04-01

    Full Text Available No abstract available. Article truncated at 150 words. Our fellowship held a discussion on physician burnout which was facilitated by Kris Cooper PhD, a psychologist who has long experience working with struggling physicians. We were joined by three physicians who volunteered to share their personal experiences regarding burnout. Each of these three physicians are exceptional in their devotion to their profession, high self-expectation, and level of professional achievement. Yet the commendable personal characteristics they share may have actually set them up to ultimately suffer burnout. Each of them responded to burnout in a different way. The first physician is an intensivist who left work suddenly 6 months ago, likely never to return. Over a long career, this physician had earned the respect of his colleagues and was beloved by the nurses for seeming to always knowing the right thing to do and dedicating himself fully to the care of the sickest patients and their families. For most of ...

  8. Unique Physician Identification Number (UPIN) Directory

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Unique Physician Identification Number (UPIN) Directory contains selected information on physicians, doctors of Osteopathy, limited licensed practitioners and...

  9. Physician Compare National Downloadable File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Physician Compare National Downloadable File is organized at the individual eligible professional level; each line is unique at the professional/enrollment...

  10. Internet resources for family physicians.

    OpenAIRE

    Anthes, D. L.; Berry, R.E.; Lanning, A

    1997-01-01

    PROBLEM BEING ADDRESSED: The internet has experienced tremendous growth over the past few years and has many resources in the field of family medicine. However, many family physicians remain unaware of how the Internet can be used to enhance their practice and of how to gain access to this powerful tool. OBJECTIVE OF PROGRAM: To characterize components of the Internet, to explore how family physicians can use the Internet to enhance practice, and to increase awareness of how to gain access to...

  11. Physicians' perspectives on massage therapy.

    OpenAIRE

    Verhoef, M J; Page, S.A.

    1998-01-01

    OBJECTIVE: To examine the knowledge, opinions, and referral behaviour of family physicians with respect to massage therapy and to explore factors associated with referral. DESIGN: A random, cross-sectional mailed survey. SETTING: Alberta family practices. PARTICIPANTS: Family physicians (n = 300). MAIN OUTCOME MEASURES: A self-report survey was developed for the study. This survey contained questions about sociodemographic and practice characteristics, perceived knowledge of massage therapy, ...

  12. Consultations by Asylum Seekers: Recent Trends in the Emergency Department of a Swiss University Hospital

    Science.gov (United States)

    Srivastava, David; Exadaktylos, Aristomenis K.

    2016-01-01

    Background Large-scale war-related migration to Switzerland and other European countries is currently challenging European health systems. Little is known about recent patterns and trends in Emergency Department (ED) consultations by Asylum Seekers (AS). Methods A retrospective single-centre analysis was performed of the data from all adult patients with the official status of “Asylum Seeker” or “Refugee” who consulted the ED of Bern University Hospital, Switzerland, between June 2012 and June 2015. Patient characteristics and clinical information, such as triage category, type of referral and discharge, violence-related injury and diagnostic group on discharge, were extracted from the computerised database or determined from the medical reports. Changes in categorical variables between the three studied years were described. Results A total of 1,653 eligible adult patients were identified in the 3-year period. Between the first (06/12–06/13) and third periods (06/14–06/15), the number of presentations per year increased by about 45%. The AS came from 62 different nations, the most common countries being Eritrea (13%), Somalia (13%) and Syria (11%). The mean age was 33.3 years (SD 12.3) and two thirds (65.7%) were male. The proportion of women increased over time. Moreover the relative proportions shifted from patients between 20 and 50 years to patients of under 20 or over 60 years. Nearly two thirds of the patients were walk-in emergencies and this proportion increased over time. The mean triage score was 2.9 (SD 0.7), with more than 90% presenting as “urgent consultation”. About half of the patients were treated for trauma (17.2%), infections (16.8%) or psychiatric problems (14.2%). Trauma was seen in a higher proportion of male than female patients. About 25% of the patients were admitted for in-hospital treatment. Conclusions The recent rise in AS in the population has lead to an increase in AS presenting to EDs. This changes the composition of

  13. Translation through argumentation in medical research and physician-citizenship.

    Science.gov (United States)

    Mitchell, Gordon R; McTigue, Kathleen M

    2012-06-01

    While many "benchtop-to-bedside" research pathways have been developed in "Type I" translational medicine, vehicles to facilitate "Type II" and "Type III" translation that convert scientific data into clinical and community interventions designed to improve the health of human populations remain elusive. Further, while a high percentage of physicians endorse the principle of citizen leadership, many have difficulty practicing it. This discrepancy has been attributed, in part, to lack of training and preparation for public advocacy, time limitation, and institutional resistance. As translational medicine and physician-citizenship implicate social, political, economic and cultural factors, both enterprises require "integrative" research strategies that blend insights from multiple fields of study, as well as rhetorical acumen in adapting messages to reach multiple audiences. This article considers how argumentation theory's epistemological flexibility, audience attentiveness, and heuristic qualities, combined with concepts from classical rhetoric, such as rhetorical invention, the synecdoche, and ethos, yield tools to facilitate translational medicine and enable physician-citizenship. PMID:22392535

  14. Traumatized by practice: PTSD in physicians.

    Science.gov (United States)

    Lazarus, Arthur

    2014-01-01

    Posttraumatic stress disorder (PTSD) is underrecognized in physicians, even though it may be more prevalent in physicians than in the general population in the United States. Five types of physicians appear to be particularly prone to developing PTSD: (1) emergency physicians; (2) physicians practicing in underserved and remote areas; (3) physicians in training (i.e., medical residents); (4) physicians involved in malpractice litigation; and (5) physicians who are "second victims" in the sense that they are indirectly exposed to trauma. In addition to experiencing trauma, the cumulative stress of practice may cause PTSD. The road to recovery for physicians with PTSD entails proper diagnosis and treatment, which includes maintaining a high index of suspicion for the occurrence of PTSD in predisposed physicians, and individual or group therapy. Physicians in leadership positions should advocate for effective support programs for their colleagues with PTSD. PMID:25807606

  15. Fleeing the Drug War Next Door: Drug-related Violence as a Basis for Refugee Protection for Mexican Asylum-Seekers

    Directory of Open Access Journals (Sweden)

    Holly Buchanan

    2011-02-01

    Full Text Available The death toll in Mexico due to drug-related violence has continued to rise since President Felipe Calderón initiated the Mexican Government's crackdown on drug trafficking organizations in 2006. Pervasive corruption among state and local government officials and alleged human rights violations by the Mexican military have added to the gravity of the endemic drug-related violence in Mexico. In response to the continuous violence in Mexico perpetrated by drug trafficking organiza- tions, a substantial number of Mexican citizens have fled to the United States seeking asylum. Due to the strict requirements for refugee status under international law and asylum protection under U.S. law, individuals seeking protection based on drug-related violence face several legal obstacles. This Article addresses the extent to which drug-related violence may con- stitute a basis for refugee status protection under international refugee law and U.S. asylum law. It seeks to provide insight into the potential viability of claims for refugee status brought by Mexican asylum-seekers fleeing drug-related violence. This Article concludes with a discussion on complementary protection under the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment for Mexican asylum-seekers.

  16. Fleeing the Drug War Next Door: Drug-related Violence as a Basis for Refugee Protection for Mexican Asylum-Seekers

    Directory of Open Access Journals (Sweden)

    Holly Buchanan

    2011-02-01

    Full Text Available The death toll in Mexico due to drug-related violence has continued to rise since President Felipe Calderón initiated the Mexican Government's crackdown on drug trafficking organizations in 2006. Pervasive corruption among state and local government officials and alleged human rights violations by the Mexican military have added to the gravity of the endemic drug-related violence in Mexico. In response to the continuous violence in Mexico perpetrated by drug trafficking organiza- tions, a substantial number of Mexican citizens have fled to the United States seeking asylum. Due to the strict requirements for refugee status under international law and asylum protection under U.S. law, individuals seeking protection based on drug-related violence face several legal obstacles. This Article addresses the extent to which drug-related violence may con- stitute a basis for refugee status protection under international refugee law and U.S. asylum law. It seeks to provide insight into the potential viability of claims for refugee status brought by Mexican asylum-seekers fleeing drug-related violence. This Article concludes with a discussion on complementary protection under the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment for Mexican asylum-seekers.  

  17. Access to Personal Data and the Right to Good Governance during Asylum Procedures after the CJEU’s YS and M. and S. judgment (C-141/12 and C-372/12)

    NARCIS (Netherlands)

    E. Brouwer; F. Zuiderveen Borgesius

    2015-01-01

    In the YS. and M. and S. judgment, the Court of Justice of the European Union ruled on three procedures in which Dutch judges asked for clarification on the right of asylum seekers to have access to the documents regarding the decision on asylum applications. The judgment is relevant for interpretin

  18. Physician treatment decisions in a multiple treatment model. The effect of physician supply.

    Science.gov (United States)

    McCombs, J S

    1984-08-01

    This paper develops a neoclassical utility maximization model of physician behavior in which the physician determines the price of physician office and hospital visits, the utilization rates for physician office and hospital visits and hospital days, and the resources and physician time inputs in the production of visits. The model assumes that the physician acts as a perfect agent for the patient. The analysis traces substitutions between physician office visits, physician hospital visits, and hospital days in response to changes in physician supply. The analysis also traces physician supply induced changes in the input mix used to produce visits. The substitution effects of physician supply are then used to reinterpret previous statistical estimates of the physician supply elasticities of per capita utilization of physician office visits and hospital days, length of visit, waiting time, and physician workloads. PMID:10268370

  19. The politics of death in Mexico: dislocating human rights and asylum law through hybrid agents.

    Directory of Open Access Journals (Sweden)

    Ariadna Estévez

    2013-12-01

    Full Text Available In 2006 Mexico’s then-president Felipe Calderón declared war on drug trafficking. The human toll was devastating with the loss of over 95,000 lives and the forced disappearance of more than 27,000 people. In addition, two percent of the Mexican population was displaced with families forced to flee their homes in the face of criminal violence. This article offers an explanation of how death, forced disappearances, persecution and exile are in essence the specific effects of governmentalization of the Mexican state. This govern­mentalization includes the shared use, by criminals and authorities, of techniques for dominating the population and controlling the conduct of citizens through the practices of death, that is, by employing the politics of death (necropolitics. The article goes on to discuss how the objectives, rationality and governmentalization of the State serve to dislocate human rights discourse in such a way that its truth politics excludes people suffering serious human rights violations, such as Mexican asylum seekers. This is accompanied by a new mode of subjectivity produced by Mexico's politics of death – the Endriago subject – which operates as a hybrid perpetrator of human rights violations.

  20. The role of social support in the acculturation and mental health of unaccompanied minor asylum seekers.

    Science.gov (United States)

    Oppedal, Brit; Idsoe, Thormod

    2015-04-01

    There is a lack of knowledge about psychosocial resources that may sustain post-resettlement psychological adjustment among unaccompanied minor asylum-seekers. The aim of this study is to investigate the impact of social support from family abroad and friends on acculturation, discrimination, and mental health among these vulnerable children and youth. Questionnaire data were collected from a population-based multi-ethnic sample involving 895 unaccompanied minors resettled in municipalities in all regions of the country. They met in groups in their local communities. The informants were on average 18.6 years, and had an average length of stay in Norway of 3.5 years. The findings showed that the participants suffered from high levels of ongoing war related intrusive symptoms and depression. Still, at the same time they engaged in adaptation processes that are normative to youth with immigrant backgrounds, in terms of constructing supportive networks and developing culture competence. In accordance with the main effect hypothesis, social support had direct effects on depression and indirect effects by increasing culture competence that may aid the young refugees in dealing with discrimination. However, there were no effects of social support on symptoms of PTSD. The findings give direction to areas of interventions, beyond dealing with the sequel of the traumas the unaccompanied minors have been exposed to, not only for clinicians, but also social workers and school personnel. PMID:25614276

  1. Vicarious resilience and vicarious traumatisation: Experiences of working with refugees and asylum seekers in South Australia.

    Science.gov (United States)

    Puvimanasinghe, Teresa; Denson, Linley A; Augoustinos, Martha; Somasundaram, Daya

    2015-12-01

    The negative psychological impacts of working with traumatised people are well documented and include vicarious traumatisation (VT): the cumulative effect of identifying with clients' trauma stories that negatively impacts on service providers' memory, emotions, thoughts, and worldviews. More recently, the concept of vicarious resilience (VR) has been also identified: the strength, growth, and empowerment experienced by trauma workers as a consequence of their work. VR includes service providers' awareness and appreciation of their clients' capacity to grow, maintaining hope for change, as well as learning from and reassessing personal problems in the light of clients' stories of perseverance, strength, and growth. This study aimed at exploring the experiences of mental health, physical healthcare, and settlement workers caring for refugees and asylum seekers in South Australia. Using a qualitative method (data-based thematic analysis) to collect and analyse 26 semi-structured face-to-face interviews, we identified four prominent and recurring themes emanating from the data: VT, VR, work satisfaction, and cultural flexibility. These findings-among the first to describe both VT and VR in Australians working with refugee people-have important implications for policy, service quality, service providers' wellbeing, and refugee clients' lives. PMID:25795221

  2. Toward a European Immigration Policy and a Common Sets of Rules on Asylum

    Directory of Open Access Journals (Sweden)

    Rinaldo Bontempi

    2001-05-01

    Full Text Available This article deals with two Reports on immigration and asylum presented by the Commission in late November of 2000, which represented an important step in the evolution of the functions of the Government of the European Union in relation to issues previously dealt with within the context of the rules of national sovereignty.The Commission here proposes a “comprehensive” policy dealing with all (economic, social, political and humanitarian aspects related to the phenomenon of migration and, as a result, brings to the fore the need for effective coordination between the work of governments on the one hand, and that of social agents, associations, local andregional authorities on the other. According to the Commission, the principal elements of this new comprehensive approach are the following five policies: new channels for legal immigration; combatting illegal immigration; long-term immigration policies;cooperation with countries of origin; admission for humanitarian reasons. Of course, all this is but the beginning of a political process that is complex, difficult and sure to bring out the contradictions between the universalist callings of our democracies and the pressure from some sectors for simple control. Still, the course that has been set is the right one and merits a commitment to follow.

  3. Physicians beware: revisiting the physician practice acquisition frenzy.

    Science.gov (United States)

    Eichmiller, Judith Riley

    2014-01-01

    This commentary compares the current physician practice acquisition frenzy to that of the mid-1990s and reflects on lessons learned. The bottom line: Physicians must understand that there were no "white knights" in the 1990s, and there really aren't any today. This article delineates five main factors that both physicians and hospital executives should thoroughly explore and agree on before an alignment or acquisition. Agreement on these issues is the glue that holds the deal together after the merger. These factors eliminate both buyer and seller remorse and delve into the true cultural alignment that must take place as the healthcare industry addresses the challenges of the future. PMID:25108989

  4. Family physicians and patients: is effective nutrition interaction possible?

    Science.gov (United States)

    Truswell, A S

    2000-01-01

    This article summarizes presentations from an international workshop held in Heelsum, Netherlands, 14-16 December 1998 that was sponsored by the Dutch Dairy Foundation on Nutrition and Health, the Department of Nutrition at Wageningen Agricultural University, the Dutch College of General Practitioners, and the International Union of Nutritional Sciences. Twenty-one speakers and 12 other participants were invited from 9 countries: the Netherlands, the United States, the United Kingdom, Australia, Canada, Denmark, New Zealand, Spain, and Sweden. The workshop was chaired by GJAJ Hautvast and the scientific secretary was GJ Hiddink. Family physicians are highly trusted. Many consultations include a nutritional aspect, but physicians do not discuss nutrition with their patients as often as they could. Major barriers include short visit times, the paucity of nutrition teaching in medical schools, and poor compliance of patients with physicians' dietary prescriptions. Problems, practicalities, operational research, and some solutions were discussed at this meeting of leading family doctors with interested nutritionists. Family physicians have to distill the essentials for their patients from many different specialties ranging from ophthalmology to podiatry. They look for clarity of recommendations from nutrition researchers. Among developments discussed at the meeting that can increase nutritional work in family medicine are 1) new opportunities to teach nutrition in vocational training programs, 2) some manuals and a new journal specially written by nutritional scientists for family physicians, 3) nutritional advice being incorporated into computer software for family physicians, 4) more dietitians working with family physicians, and 5) nutrition training for practice nurses in some countries. PMID:10617940

  5. Development of a Scale for Measuring Physician Perception: Physician Related Health Care Perception Scale

    Directory of Open Access Journals (Sweden)

    Meryem Heybet1

    2016-04-01

    Full Text Available Aim: Recently increased incidence of workplace violence in health care highlights the need for investigating the causes of such changes in clinical practice settings. The focus on the changes in attitudes of patients let us wonder whether the physician perception of the patients has changed and what the current perception is. The objective was to build up a scale to measure patients’ perceptions of health care. Methods: For developing a new scale we decided eight factors to be included in the scale; respect, trust, patient-doctor relation, medical practice skills, being knowledgeable about the medicine as a job, the perceptions and reflections of doctors in media, thoughts about violence against physicians and comply to rules of hospital. 77 attitude sentences were created. The draft scale with these attitude sentences were reviewed by two psychiatrists and a family physician who have experience with scale development. According to received feedbacks, the attitude sentences were further revised. Randomly selected 93 patients, who are above 18 years of age and who are willing to participate, were included in the study. We measured sentences by 5 fold Likert scale. We analyzed data by factor and reliability methods in SPSS 13.00 for Windows and evaluated for validity. Principal Component Analysis and Varimax rotation were used. Results: We obtained a scale with 6 factors and 34 attitude sentences. Cronbachalpha value was 0.891 (corrected 0.894. Factors were; respect, trust, patientdoctor relation, being knowledgeable about the medicine as a job, thoughts about violence against physicians and comply to rules of hospital. According to Principal Component Analysis, total variance explained rate 58.8%. Conclusions: There is no scale in the literature to measure patients’ perception of health care, so this scientific scale makes a high contribution to the current literature.

  6. Psychiatric rehabilitation education for physicians.

    Science.gov (United States)

    Rudnick, Abraham; Eastwood, Diane

    2013-06-01

    As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011). PMID:23750768

  7. 42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

    Science.gov (United States)

    2010-10-01

    ... teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.172 Physician fee schedule payment for services of teaching physicians....

  8. [The pharmacist-physician collaboration for IPW: from physician's perspective].

    Science.gov (United States)

    Son, Daisuke; Kawamura, Kazumi; Nakashima, Mitsuko; Utsumi, Miho

    2015-01-01

    Interprofessional work (IPW) is increasingly important in various settings including primary care, in which the role of pharmacists is particularly important. Many studies have shown that in cases of hypertension, diabetes, dyslipidemia, and metabolic syndrome, physician-pharmacist collaboration can improve medication adherence and help to identify drug-related problems. Some surveys and qualitative studies revealed barriers and key factors for effective physician-pharmacist collaboration, including trustworthiness and role clarification. In Japan, some cases of good collaborative work between pharmacists and physicians in hospitals and primary care settings have been reported. Still, community pharmacists in particular have difficulties collaborating with primary care doctors because they have insufficient medical information about patients, they feel hesitant about contacting physicians, and they usually communicate by phone or fax rather than face to face. Essential competencies for good interprofessional collaboration have been proposed by the Canadian Interprofessional Health Collaborative (CIHC): interprofessional communication; patient/client/family/community-centered care; role clarification; team functioning; collaborative leadership; and interprofessional conflict resolution. Our interprofessional education (IPE) team regularly offers educational programs to help health professionals learn interprofessional collaboration skills. We expect many pharmacists to learn those skills and actively to facilitate interprofessional collaboration. PMID:25743907

  9. A physician's exposure to defamation.

    Science.gov (United States)

    Mandell, W J

    1992-01-01

    The article defines defamation, discusses how to avoid a defamation action, and suggests defenses against a defamation action. Several examples are given that demonstrate common situations where liability exists and how a physician should respond. The article explains that at times we have a duty to speak and differentiates between our legal, moral, and ethical duty. Defamation should not be a concern for those involved in the peer review process, as long as they are truthful or act in a good faith belief that what they are saying is true. The article should enhance peer review by encouraging physicians to participate without fear of a retaliatory law suit. PMID:1603860

  10. Why MNsure matters to physicians.

    Science.gov (United States)

    Silversmith, Janet

    2015-01-01

    MNsure, the state's health insurance exchange, has helped expand insurance coverage in Minnesota since it began operating in October 2013. To be price-competitive, many insurers developed products with more limited provider networks than those generally available before MNsure's launch. In some states, this network design strategy has led to concerns about limited access to services and prompted action on the part of physicians and lawmakers. Minnesota physicians need to be aware of changes in network design in order to support access to care for their patients. PMID:25665268

  11. Unemployment and health: physicians' role.

    Science.gov (United States)

    Guirguis, S S

    1999-01-01

    Unemployment has been documented to have detrimental impacts on a person's mental, physical and social well being. When unemployment or being out of work is due to injury or sickness, the effects are compounded by mental and social factors. In an effort to prevent prolonged unemployment due to injury or sickness, changes were made to existing disability income supplement plans to redirect their focus from basic income support to active employment measures. This is intended to reduce individual's dependency on financial assistance and encourage individuals to take personal responsibility for getting back to work. The various disability insurance plans require primary care physicians to provide opinion and participate in the recovery and safety return to work of injured or sick persons. The physician approach to medical care of the injured/sick person with employment problems should focus on return to work as a goal of treatment. The patient should be seen as part of a social or environmental system and not as an isolated individual. The physician has a significant role to play in the diagnosis, determining functional abilities and participation in the return to work plan. The physician positive participation, not only provides an intrinsic cost saving value in insurance costs, but more important, helps patients maintain gainful employment. Work often helps in regaining health. Many factors are involved in a return to work outcome and physicians need to know how to identify and track the factors that facilitate or impede return to work. The challenge for the physician is to utilize the available resources to facilitate the recovery and communicate with other parties involved in the return to work process. This paper discusses the disability insurance plans in Canada and the community expectations from physicians dealing with patients who are out of work because of injury or sickness. It is acknowledged that primary care physicians' skills are not adequate in this

  12. Limited Resettlement and Ongoing Uncertainty: responses to and experiences of people seeking asylum in Australia and Indonesia

    Directory of Open Access Journals (Sweden)

    Caroline Fleay

    2016-07-01

    Full Text Available In the wake of the Coalition Government’s narrow victory in the first Australian election since the adoption of policies known as Operation Sovereign Borders, this special edition of Cosmopolitan Civil Societies focuses its attention on the treatment of refugees and asylum seekers1 . It explores some of the experiences of people both in Australia and Indonesia who are seeking a life of safety, as well as the responses of civil society groups and governments, following the commencement of policies that have vastly reduced the opportunities for refugee resettlement in Australia.

  13. Physician burnout: A neurologic crisis.

    Science.gov (United States)

    Sigsbee, Bruce; Bernat, James L

    2014-12-01

    The prevalence of burnout is higher in physicians than in other professions and is especially high in neurologists. Physician burnout encompasses 3 domains: (1) emotional exhaustion: the loss of interest and enthusiasm for practice; (2) depersonalization: a poor attitude with cynicism and treating patients as objects; and (3) career dissatisfaction: a diminished sense of personal accomplishment and low self-value. Burnout results in reduced work hours, relocation, depression, and suicide. Burned-out physicians harm patients because they lack empathy and make errors. Studies of motivational factors in the workplace suggest several preventive interventions: (1) Provide counseling for physicians either individually or in groups with a goal of improving adaptive skills to the stress and rapid changes in the health care environment. (2) Identify and eliminate meaningless required hassle factors such as electronic health record "clicks" or insurance mandates. (3) Redesign practice to remove pressure to see patients in limited time slots and shift to team-based care. (4) Create a culture that promotes career advancement, mentoring, and recognition of accomplishments. PMID:25378679

  14. Hitler’s Jewish Physicians

    Science.gov (United States)

    Weisz, George M.

    2014-01-01

    The mystery behind the behavior of infamous personalities leaves many open questions, particularly when related to the practice of medicine. This paper takes a brief look at two Jewish physicians who played memorable roles in the life of Adolf Hitler. PMID:25120923

  15. Hitler’s Jewish Physicians

    Directory of Open Access Journals (Sweden)

    George M. Weisz

    2014-07-01

    Full Text Available The mystery behind the behavior of infamous personalities leaves many open questions, particularly when related to the practice of medicine. This paper takes a brief look at two Jewish physicians who played memorable roles in the life of Adolf Hitler.

  16. Ethical principles for physician rating sites.

    Science.gov (United States)

    Strech, Daniel

    2011-01-01

    During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites' effects on physicians' performance, patient outcomes, or the public's trust in health care, most contributions refer to normative arguments, hypothetical effects, or indirect evidence. This paper aims, first, to structure the ethical debate about the basic concept of physician rating sites: allowing patients to rate, comment, and discuss physicians' performance, online and visible to everyone. Thus, it provides a more thorough and transparent starting point for further discussion and decision making on physician rating sites: what should physicians and health policy decision makers take into account when discussing the basic concept of physician rating sites and its possible implications on the physician-patient relationship? Second, it discusses where and how the preexisting evidence from the partly related field of public reporting of physician performance can serve as an indicator for specific needs of evaluative research in the field of physician rating sites. This paper defines the ethical principles of patient welfare, patient autonomy, physician welfare, and social justice in the context of physician rating sites. It also outlines basic conditions for a fair decision-making process concerning the implementation and regulation of physician rating sites, namely, transparency, justification, participation, minimization of conflicts of interest, and openness for revision. Besides other issues described in this paper, one trade-off presents a special challenge and will play an important role when deciding about more- or less-restrictive physician rating sites regulations: the potential psychological and financial harms for

  17. Taking care of patients--does it matter whether the physician is a woman?

    OpenAIRE

    Arnold, R M; Martin, S. C.; Parker, R M

    1988-01-01

    Researchers have recently begun to compare male and female physicians' attitudes toward patients, medical knowledge, and practice styles. Although women start medical school with more "humanistic views," the conservative effect of medical socialization on both male and female students attenuates these differences. While some studies suggested that men are more scientifically knowledgeable, recent studies showed no significant differences in physicians' medical knowledge. Male and female physi...

  18. Gender and the professional career of primary care physicians in Andalusia (Spain

    Directory of Open Access Journals (Sweden)

    Luna Juan de Dios

    2011-02-01

    Full Text Available Abstract Background Although the proportion of women in medicine is growing, female physicians continue to be disadvantaged in professional activities. The purpose of the study was to determine and compare the professional activities of female and male primary care physicians in Andalusia and to assess the effect of the health center on the performance of these activities. Methods Descriptive, cross-sectional, and multicenter study. Setting: Spain. Participants: Population: urban health centers and their physicians. Sample: 88 health centers and 500 physicians. Independent variable: gender. Measurements: Control variables: age, postgraduate family medicine specialty (FMS, patient quota, patients/day, hours/day housework from Monday to Friday, idem weekend, people at home with special care, and family situation. Dependent variables: 24 professional activities in management, teaching, research, and the scientific community. Self-administered questionnaire. Descriptive, bivariate, and multilevel logistic regression analyses. Results Response: 73.6%. Female physicians: 50.8%. Age: female physicians, 49.1 ± 4.3 yrs; male physicians, 51.3 ± 4.9 yrs (p versus male physicians. There were no differences in healthcare variables. Thirteen of the studied activities were less frequently performed by female physicians, indicating their lesser visibility in the production and diffusion of scientific knowledge. Performance of the majority of professional activities was independent of the health center in which the physician worked. Conclusions There are gender inequities in the development of professional activities in urban health centers in Andalusia, even after controlling for family responsibilities, work load, and the effect of the health center, which was important in only a few of the activities under study.

  19. Scientific millenarianism

    International Nuclear Information System (INIS)

    Today, for the first time, scientific concerns are seriously being addressed that span future times--hundreds, even thousands, or more years in the future. One is witnessing what the author calls scientific millenarianism. Are such concerns for the distant future exercises in futility, or are they real issues that, to the everlasting gratitude of future generations, this generation has identified, warned about and even suggested how to cope with in the distant future? Can the four potential catastrophes--bolide impact, CO2 warming, radioactive wastes and thermonuclear war--be avoided by technical fixes, institutional responses, religion, or by doing nothing? These are the questions addressed in this paper

  20. A physician's due: measuring physician billing performance, benchmarking results.

    Science.gov (United States)

    Woodcock, Elizabeth W; Browne, Robert C; Jenkins, Jennifer L

    2008-07-01

    A 2008 study focused on four key performance indicators (KPIs) and staffing levels to benchmark the FYO7 performance of physician group billing operations. A comparison of the change in the KPIs from FYO3 to FYO7 for a number of these billing operations disclosed across-the-board improvements. Billing operations did not show significant changes in staffing levels during this time, pointing to the existence of obstacles that prevent staff reductions in this area. PMID:18683420

  1. The institutional response to mental disorder in Ireland: censuses of Irish asylums, psychiatric hospitals and units 1844-2014.

    Science.gov (United States)

    Walsh, D; Daly, A; Moran, R

    2016-08-01

    Before the eighteenth century, there was limited response to the problem of psychiatric illness in Ireland as in many other countries. The asylums of the 1820s and 1830s were no sooner opened than they were overcrowded. A second wave of asylum building commenced in the second half of the nineteenth century continuing up to the early twentieth century. In 1966, the Report of the Commission on Mental Illness noted that the rate of psychiatric beds in Ireland per 1,000 was one of the highest in the world. The report called for a change in the policy of caring for the mentally ill in psychiatric hospitals to more community-based settings and in psychiatric units located in general hospital settings, along with a call for more research into mental illness. The result of the latter was the establishment of the first census of psychiatric patients resident in psychiatric hospitals. Thus began fifty years of census reporting and the subsequent establishment of the National Psychiatric Inpatient Reporting System (NPIRS). PMID:26667467

  2. Factors associated with latent tuberculosis among asylum seekers in Switzerland: a cross-sectional study in Vaud County

    Directory of Open Access Journals (Sweden)

    Sarivalasis Apostolos

    2012-11-01

    Full Text Available Abstract Background Screening and treatment of latent tuberculosis infection (LTBI in asylum seekers (AS may prevent future cases of tuberculosis. As the screening with Interferon Gamma Release Assay (IGRA is costly, the objective of this study was to assess which factors were associated with LTBI and to define a score allowing the selection of AS with the highest risk of LTBI. Methods In across-sectional study, AS seekers recently arrived in Vaud County, after screening for tuberculosis at the border were offered screening for LTBI with T-SPOT.TB and questionnaire on potentially risk factors. The factors associated with LTBI were analyzed by univariate and multivariate regression. Results Among 393 adult AS, 98 (24.93% had a positive IGRA response, five of them with active tuberculosis previously undetected. Six factors associated with LTBI were identified in multivariate analysis: origin, travel conditions, marital status, cough, age and prior TB exposure. Their combination leads to a robust LTBI predictive score. Conclusions The prevalence of LTBI and active tuberculosis in AS is high. A predictive score integrating six factors could identify the asylum seekers with the highest risk for LTBI.

  3. Physician participation in clinical research and trials: issues and approaches

    Directory of Open Access Journals (Sweden)

    Sami F Shaban

    2011-03-01

    research culture’. This article examines the barriers to and benefits of physician participation in clinical research as well as interventions needed to increase their participation, including the specific role of undergraduate medical education. The main challenge is the unwillingness of many physicians and patients to participate in clinical trials. Barriers to participation include lack of time, lack of resources, trial-specific issues, communication difficulties, conflicts between the role of clinician and scientist, inadequate research experience and training for physicians, lack of rewards and recognition for physicians, and sometimes a scientifically uninteresting research question, among others. Strategies to encourage physician participation in clinical research include financial and nonfinancial incentives, adequate training, research questions that are in line with physician interests and have clear potential to improve patient care, and regular feedback. Finally, encouraging research culture and fostering the development of inquiry and research-based learning among medical students is now a high priority in order to develop more and better clinician-researchers.Keywords: physician, clinical research, clinical trial, medical education

  4. [Physician versus 'off-label" ordinance].

    Science.gov (United States)

    Kordus, Katarzyna; Spiewak, Radosław

    2015-01-01

    Polish physicians are obliged by legislation to prescribe drugs authorized for the sale in the Republic of Poland, based on registration documentation, including the Summaries of Product Characteristics (SPC). So called 'off label' treatment occurs in case of the conflict between prescription and information contained in the SPC, which may be considered as a 'medical experiment'. In case of adverse drug reactions, such classification excludes the responsibility of the marketing authorization holders, and damages are not covered by obligatory third party insurance, which can pose financial and legal consequences to the doctor. Deviations from SPC-compliant prescription may include a different way of drug administration, drug administration compliant with the indications yet in patients for whom there is no specified drug dosage, or in case of an indication not contained in the SPC. Medicinal products with equivalent active component, form and dose can have different registration indications in the SPC, and the actively promoted dispensation of less expensive substitutes by the pharmacists may, against doctor's will, result in the use that is non-compliant with registration of the substitute drug. Pharmacotherapy of 'orphan diseases', for which there are no registered medicinal products, also becomes an essential issue as it forces doctors into 'off-label' prescriptions. Moreover, the reimbursement of drugs in most cases is limited to medicinal products that are prescribed according to the registration indications. The pleas by medical professionals to make ordination and reimbursement of drugs depend on active pharmaceutical ingredient and evidence of efficacy, as well as to introduce Evidence Based Medicine (EBM) standards for the treatment of diseases, did not receive proper attention from the governing bodies. Therefore, a fundamental question remains unanswered as to what should be the principal gauge for physicians' therapeutic decision: the ethics, conscience

  5. Sexual Maltreatment of Unaccompanied Asylum-Seeking Minors from the Horn of Africa: A Mixed Method Study Focusing on Vulnerability and Prevention

    Science.gov (United States)

    Lay, Margaret; Papadopoulos, Irena

    2009-01-01

    Objectives: The study described in this paper sought to identify the social, cultural, and political factors that effect African unaccompanied asylum-seeking minors' (UASM) vulnerability to sexual maltreatment in England. It aimed to illuminate how child protection measures could be strengthened for this highly marginalized group. Methods: A mixed…

  6. A Lie More Disastrous than the Truth: Asylum and the identification of trafficked women in the UK

    Directory of Open Access Journals (Sweden)

    Abigail Stepnitz

    2012-09-01

    Full Text Available This article explores the impact that nationality can have on a person’s experience of being identified as a victim of trafficking in the UK. Responses to individuals and disparities in rates of recognition depending on nationality are cause for great concern. The rhetoric and the response to women who have experienced trafficking varies considerably depending upon the citizenship, residency and documentation status of the individual, particularly highlighting the differential treatment of trafficking cases of British women, European Union nationals, and third-country (non UK, non EU nationals, the majority of whom are also asylum seekers. This differential treatment is played out in multiple ways, many of which result in women’s inability to realise procedural and substantive rights. The article examines the use of official “identification” mechanisms that place women into the administrative category of “victim”, and the central role of the asylum system in all areas of UK anti-trafficking responses. This above all, to refuse to be a victim. Unless I can do that I can do nothing. I have to recant, give up the old belief that I am powerless... A lie which was always more disastrous than the truth would have been. The word games, the winning and losing games are finished; at the moment there are no others but they will have to be invented, withdrawing is no longer possible. — Margaret Atwood, Surfacing1 The response to human trafficking into and within the United Kingdom is a complicated and yet incomplete combination of strategies, interventions and rhetoric, focused predominantly on immigration control and crime reduction, with support to individuals and prevention of exploitation as convenient outputs but not drivers of policy or practice. The introduction of human rights-based approaches has only emerged over the last decade, with discussions about the rights and entitlements of the trafficked beginning in earnest only in the

  7. Patient–physician communication regarding electronic cigarettes

    Directory of Open Access Journals (Sweden)

    Michael B. Steinberg

    2015-01-01

    Discussion: Physician communication about e-cigarettes may shape patients' perceptions about the products. More research is needed to explore the type of information that physicians share with their patients regarding e-cigarettes and harm reduction.

  8. The Crucible of Physician Performance Reports

    OpenAIRE

    Sorokin, Rachel

    2011-01-01

    Individualized physician performance reports are an emerging phenomena. The narrative piece examines one physician’s experience with individualized physician performance reports. Reforming the data collection process could enhance the value of the reports to stakeholders.

  9. Physician equity alliances: attractive alternatives to PHOs.

    Science.gov (United States)

    Goldstein, D

    1997-04-01

    Physician equity alliances are becoming attractive alternatives to PHOs as integrative models for partnering with physicians, securing managed care contracts and increasing revenue. Unlike many PHOs, these alliances provide mechanisms for asset integration and long-term relationships along with utilization management, sophisticated information systems, access to capital and opportunities for physicians to integrate clinically. There are six major types of physician equity alliances: majority physician-owned, clinic without walls, health system joint venture, publicly held physician practice management company, specialty network, and venture capital. The type of alliance that a physician group practice ultimately develops depends on vision, values, method of capitalization, initial organizer of the alliance, level of involvement of physicians in business issues, corporate structure desired, and characteristics of the managed care market in which the alliance will operate. PMID:10166285

  10. AMA Physician Select: Online Doctor Finder

    Science.gov (United States)

    ... Membership | JAMA Network | AMA Store DoctorFinder This online physician Locator helps you find a perfect match for ... with basic professional information on virtually every licensed physician in the United States. This includes more than ...

  11. Medicares Physician Quality Reporting System (PQRS)...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicares Physician Quality Reporting System (PQRS) allows providers to report measures of process quality and health outcomes. The authors of Medicares Physician...

  12. Scientific Inquiry

    Science.gov (United States)

    National Science Teachers Association (NJ1), 2004

    2004-01-01

    Scientific inquiry reflects how scientists come to understand the natural world, and it is at the heart of how students learn. From a very early age, children interact with their environment, ask questions, and seek ways to answer those questions. Understanding science content is significantly enhanced when ideas are anchored to inquiry…

  13. Physicians under the influence: social psychology and industry marketing strategies.

    Science.gov (United States)

    Sah, Sunita; Fugh-Berman, Adriane

    2013-01-01

    Pharmaceutical and medical device companies apply social psychology to influence physicians' prescribing behavior and decision making. Physicians fail to recognize their vulnerability to commercial influences due to self-serving bias, rationalization, and cognitive dissonance. Professionalism offers little protection; even the most conscious and genuine commitment to ethical behavior cannot eliminate unintentional, subconscious bias. Six principles of influence - reciprocation, commitment, social proof, liking, authority, and scarcity - are key to the industry's routine marketing strategies, which rely on the illusion that the industry is a generous avuncular partner to physicians. In order to resist industry influence, physicians must accept that they are vulnerable to subconscious bias and have both the motivation and means to resist industry influence. A culture in which accepting industry gifts engenders shame rather than gratitude will reduce conflicts of interest. If greater academic prestige accrues to distant rather than close relationships with industry, then a new social norm may emerge that promotes patient care and scientific integrity. In addition to educating faculty and students about the social psychology underlying sophisticated but potentially manipulative marketing and about how to resist it, academic medical institutions should develop strong organizational policies to counteract the medical profession's improper dependence on industry. PMID:24088157

  14. Health services utilization and physician income trends

    OpenAIRE

    Sandier, Simone

    1989-01-01

    Statistics from several Organization for Economic Cooperation and Development countries on consumption and cost of health care services, physician workload, and physician earnings are presented. Data are analyzed according to type of physician payment used: fee for service, per case, capitation, or salary. Incentives theoretically embodied in each payment method are often offset by other factors—scale of charges, patient out-of-pocket payment, and patient access or physician activity restrict...

  15. Physicians, Social Media, and Conflict of Interest

    OpenAIRE

    DeCamp, Matthew

    2012-01-01

    Physicians and patients increasingly use social media technologies, such as Facebook, Twitter, and weblogs (blogs), both professionally and personally. Amidst recent reports of physician misbehavior online, as well as concerns about social media’s potential negative effect on trust in the medical profession, several national-level physician organizations have created professional guidelines on social media use by physicians. Missing from these guidelines is adequate attention to conflict of i...

  16. Liver transplantation for nontransplant physicians

    Directory of Open Access Journals (Sweden)

    Amany AbdelMaqsod Sholkamy

    2014-01-01

    Full Text Available Many of the nontransplant physicians who manage hepatic patients (internists and hepatologists keep asking about liver transplantation. The purpose of this article is to highlight important topics a nontransplant colleague may require in his practice. There are many topics in this respect; however, three most important topics need to be highlighted; those are; the time of referral to transplantation, the indications and contraindications and the metabolic issues regarding a transplanted patient. Still, there are no clear guidelines for the management of many of the metabolic issues regarding liver transplanted patients. And this why, collaborative efforts of transplant and nontransplant physicians are needed to conduct multicenter, long term randomized controlled trials and proper follow up programs.

  17. Physicians? Opinions of Phytotherapy Products

    OpenAIRE

    Murat Kartal; Alev Yücel; Zerrin Gamsızkan; Alev Kurt

    2011-01-01

    Aim: This study has been conducted to determine of family physicians’ level of knowledge and perspectives with herbal products therapy (phytotherapy) - and herbal products.Material and Methods; Present study, which is a type of descriptive study, is designed with the participation of the family physician specialists and assistants working public or private health organizations in several cities in between June 2007 and April 2008 by via electronic mail. In this research, a specifica...

  18. 22 CFR 62.27 - Alien physicians.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Alien physicians. 62.27 Section 62.27 Foreign... Provisions § 62.27 Alien physicians. (a) Purpose. Pursuant to the Mutual Educational and Cultural Exchange... Foreign Medical Graduates must sponsor alien physicians who wish to pursue programs of graduate...

  19. 42 CFR 405.2412 - Physicians' services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Physicians' services. 405.2412 Section 405.2412 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE... Health Center Services § 405.2412 Physicians' services. (a) Physicians' services are...

  20. Physician's Death Anxiety and Patient Outcomes.

    Science.gov (United States)

    Schulz, Richard; Aderman, David

    1978-01-01

    It was shown that terminal patients of physicians with high death anxiety survive longer during their final hospital stay than terminal patients of physicians with low death anxiety. Physicians high in death anxiety seem to be less willing to accept patients' terminality and use heroic measures to keep them alive. (Author)

  1. Physician Incentives in Health Maintenance Organizations

    Science.gov (United States)

    Gaynor, Martin; Rebitzer, James B.; Taylor, Lowell J.

    2004-01-01

    Managed care organizations rely on incentives that encourage physicians to limit medical expenditures, but little is known about how physicians respond to these incentives. We address this issue by analyzing the physician incentive contracts in use at a health maintenance organization. By combining knowledge of the incentive contracts with…

  2. EMDR versus stabilisation in traumatised asylum seekers and refugees: results of a pilot study

    Directory of Open Access Journals (Sweden)

    Rolf J. Kleber

    2011-08-01

    Full Text Available Traumatised asylum seekers and refugees are clinically considered a complex population. Discussion exists on whether with this population treatment guidelines for post-traumatic stress disorder (PTSD should be followed and Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT or Eye Movement Desensitisation and Reprocessing (EMDR should be applied, or whether a phased model starting with stabilisation is preferable. Some clinicians fear that trauma-focused interventions may lead to unmanageable distress or may be ineffective. While cognitive-behavioural interventions have been found to be effective with traumatised refugees, no studies concerning the efficacy of EMDR with this population have been conducted as yet.In preparation for a randomised trial comparing EMDR and stabilisation with traumatised refugees, a pilot study with 20 participants was conducted. The objective was to examine feasibility of participation in a randomised trial for this complex population and to examine acceptability and preliminary efficacy of EMDR.Participants were randomly allocated to 11 sessions of either EMDR or stabilisation. Symptoms of PTSD (SCID-I, HTQ, depression and anxiety (HSCL-25, and quality of life (WHOQOL-BREF were assessed at pre- and post-treatment and 3-month follow-up.Participation of traumatised refugees in the study was found feasible, although issues associated with complex traumatisation led to a high pre-treatment attrition and challenges in assessments. Acceptability of EMDR was found equal to that of stabilisation with a high drop-out for both conditions. No participants dropped out of the EMDR condition because of unmanageable distress. While improvement for EMDR participants was small, EMDR was found to be no less efficacious than stabilisation. Different symptom courses between the two conditions, with EMDR showing some improvement and stabilisation showing some deterioration between pre-treatment and post-treatment, justify the conduct

  3. Clinical guidelines: Involvement of peers increases physician adherence

    Institute of Scientific and Technical Information of China (English)

    Pascal Vignally; Jean Charles Grimaud; Roland Sambuc; St(e)phanie Gentile

    2008-01-01

    The literature illustrates the important issue of physician adherence to guidelines in their daily practice. In a quantitative study, we asked a random sample of 100 hospital gastroenterologists to evaluate their knowledge of guidelines and awareness of promoters. The degree to which guidelines were considered reliable was not related to the scientific evidence but was significantly associated with the promoter. The French Society of Gastroenterology was considered to be a more reliable promoter than national health agencies and pharmaceutical industries. Gastroenterologists become aware of guidelines mainly through their specialty society (62%). Specialty societies appear to be a more important source of information on guidelines for physicians. National health agencies should involve the specialty societies in the guideline development process to achieve changes in clinical practice.

  4. The relationship between physician humility, physician-patient communication, and patient health.

    OpenAIRE

    Ruberton, PM; Huynh, HP; Miller, TA; Kruse, E.; Chancellor, J; Lyubomirsky, S

    2016-01-01

    Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical vi...

  5. Empowering Physicians with Financial Literacy.

    Science.gov (United States)

    Bar-Or, Yuval

    2015-01-01

    Most doctors complete their medical training without sufficient knowledge of business and finance. This leads to inefficient financial decisions, avoidable losses, and unnecessary anxiety. A big part of the problem is that the existing options for gaining financial knowledge are flawed. The ideal solution is to provide a simple framework of financial literacy to all students: one that can be adapted to their specific circumstances. That framework must be delivered by an objective expert to young physicians before they complete medical training. PMID:26399037

  6. Scientific Fraud

    OpenAIRE

    Balk-Møller, Carl August; Mogensen, Sofia Lin; RAATRÆ LUNDSTEIN, SARAH; Haubroe Larsen, André; Lohse, Mayasarah; Reininger Ardilsø, Lisa; Henrysdóttir, Gu∂run; Sondergaard, Nikolai

    2014-01-01

    This study examines the developments of SSRIs and the presence of them in the market. Dr. Peter Gøtszche’s book “Deadly Medicines and Organized Crime”, claims that scientific fraud is a big part of the pharmaceutical industry and the whole healthcare system in general. Through analyzing Peter Gøtszche’s book and several of his sources, the study aims to create a roadmap in the project, that resembles the process of the antidepressant drugs have to go through, to go from an idea to a patient. ...

  7. The Association Between Postnatal Depression, Acculturation and Mother-Infant Bond Among Eritrean Asylum Seekers in Israel.

    Science.gov (United States)

    Nakash, Ora; Nagar, Maayan; Lurie, Ido

    2016-10-01

    We examined the association between postnatal depression (PND), acculturation and mother-infant bond among 38 Eritrean asylum seekers in Israel, who were within 6 months of delivery. Participants completed a survey in their native language. A high rate of women (81.6 %) met the clinical threshold for PND on the Edinburgh Postnatal Depression Scale. Higher severity of PND (partial r = -.64, p < .001), higher identification with Israeli culture (partial r = -.45, p = .02), and lower quality of romantic relationship were associated with impaired mother-infant bond (partial r = .58, p = .002). Findings highlight the need to establish services to screen and treat PND among this vulnerable population in the receiving countries. PMID:26864379

  8. [Sequential traumatization, trauma-related disorders and psychotherapeutic approaches in war-traumatized adult refugees and asylum seekers in Germany].

    Science.gov (United States)

    Böttche, Maria; Heeke, Carina; Knaevelsrud, Christine

    2016-05-01

    The impact of war and violence on the mental and physical health of the civilian population is immense. Traumatization is often experienced sequentially, which leads to a higher risk for developing trauma-related disorders (PTSD, depression, chronic pain).Refugees traumatized by war experience specific stressors related to their status of residence (e. g., application hearing, length of the asylum procedure). Together with limited access to health care, these constitute additional risk factors for developing somatic and psychological illnesses.Adequate treatment for this highly vulnerable group requires a multimodal approach facilitated by translators. According to the S3 guidelines (S3-Richtlinien), trauma-adapted psychotherapeutic treatment has to be complemented by the activities of social workers, by medical treatment, and by legal advice. PMID:27072498

  9. Violence Against Women and Asylum Seeking: Global Problems and Local Practices Applied to Guatemalan Women Immigrating for Safety

    Directory of Open Access Journals (Sweden)

    Roselyn Costantino

    2012-05-01

    Full Text Available This paper, based on broader discussions surrounding gender violence and immigration in the U.S., provides critical information on the historical context of extreme violence against women and femicide plaguing Central American societies today. Drawing on experiences of precedent setting cases of Guatemalan women, the authors offer suggestions for culturally specific treatment of and support for women who seek asylum in the U.S. out of justified fear for their and their family members’ lives should they return to their country of origin. The arguments presented are predicated on the belief that women worldwide share experiences of myriad forms of male domination and gender inequality which, however, play out differently on their bodies and lives in ways that must be accounted for in our attempt to offer them appropriate care and assist them in creating the tools they need to change their circumstances.

  10. Scientific Growth

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    As one of the world's largest grain consumers,food security has always been a major concern for the Chinese nation.China must confront the challenge of feeding a fifth of the world's population with less than 9 percent of the planet's arable land.In 2011,China's grain output recorded growth for the eighth successive year,and total production reached an all-time high of 571million tons.In terms of food security,China's goal is to maintain a self-sufficiency rate of above 95 percent.However,an annual net population growth of 7.39 million and the effective decline of the area of farmland in the country,as a result of urbanization,make achieving such selfsufficiency a serious challenge.Given the heavy burden placed on Chinese agriculture,constantly raising productivity by relying on scientific and technological progress has become a priority for China's agricultural sector.The Ministry of Agriculture,for example,has worked to raise China's annual grain yield per-unit area by 1 percent,on average,over the past decade.Last year,the contributory rate of scientific and technological development to China's agriculture reached 52 percent,surpassing the contribution made by land,labor and other production factors for the first time in history.

  11. The Phoenix Physician: defining a pathway toward leadership in patient-centered care.

    Science.gov (United States)

    Good, Robert G; Bulger, John B; Hasty, Robert T; Hubbard, Kevin P; Schwartz, Elliott R; Sutton, John R; Troutman, Monte E; Nelinson, Donald S

    2012-08-01

    Health care delivery has evolved in reaction to scientific and technological discoveries, emergent patient needs, and market forces. A current focus on patient-centered care has pointed to the need for the reallocation of resources to improve access to and delivery of efficient, cost-effective, quality care. In response to this need, primary care physicians will find themselves in a new role as team leader. The American College of Osteopathic Internists has developed the Phoenix Physician, a training program that will prepare primary care residents and practicing physicians for the changes in health care delivery and provide them with skills such as understanding the contributions of all team members (including an empowered and educated patient), evaluating and treating patients, and applying performance metrics and information technology to measure and improve patient care and satisfaction. Through the program, physicians will also develop personal leadership and communication skills. PMID:22904250

  12. Developing physician leaders in academic medical centers. Part 1: Their changing role.

    Science.gov (United States)

    Bachrach, D J

    1996-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management, intramurally conducted courses in leadership skill development; management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. This article article was prepared by the author from research into and presentation of a thesis entitled. "The Importance of Leadership Training And Development For Physicians In Academic Medical Centers In An Increasingly Complex Healthcare Environment, " prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in the College (ACHE). Part 2 will appear in the next issue of the Journal. PMID:10162876

  13. Views of United States Physicians and Members of the American Medical Association House of Delegates on Physician-assisted Suicide.

    Science.gov (United States)

    Whitney, Simon N.; Brown, Byron W.; Brody, Howard; Alcser, Kirsten H.; Bachman, Jerald G.; Greely, Henry T.

    2001-01-01

    Ascertained the views of physicians and physician leaders toward legalization of physician-assisted suicide. Results indicated members of AMA House of Delegates strongly oppose physician-assisted suicide, but rank-and-file physicians show no consensus either for or against its legalization. Although the debate is adversarial, most physicians are…

  14. Physician communication in the operating room.

    Science.gov (United States)

    Kirschbaum, Kristin A; Rask, John P; Fortner, Sally A; Kulesher, Robert; Nelson, Michael T; Yen, Tony; Brennan, Matthew

    2015-01-01

    In this study, communication research was conducted with multidisciplinary groups of operating-room physicians. Theoretical frameworks from intercultural communication and rhetoric were used to (a) measure latent cultural communication variables and (b) conduct communication training with the physicians. A six-step protocol guided the research with teams of physicians from different surgical specialties: anesthesiologists, general surgeons, and obstetrician-gynecologists (n = 85). Latent cultural communication variables were measured by surveys administered to physicians before and after completion of the protocol. The centerpiece of the 2-hour research protocol was an instructional session that informed the surgical physicians about rhetorical choices that support participatory communication. Post-training results demonstrated scores increased on communication variables that contribute to collaborative communication and teamwork among the physicians. This study expands health communication research through application of combined intercultural and rhetorical frameworks, and establishes new ways communication theory can contribute to medical education. PMID:24885399

  15. The Clinical Research Forum and Association of American Physicians disagree with criticism of the NIH Roadmap

    OpenAIRE

    Crowley, William; Courtney, John; Pardes, Herbert; Moskowitz, Jay; Orringer, Eugene; Rubenstein, Arthur; Wood, Alastair; Rettig, Richard; Ausiello, Dennis; Brenner, David; Collins, Francis; Elias, Jack; Greene, Warner; Horowitz, Ralph; Jameson, Larry

    2006-01-01

    As representatives of 50 leading academic medical centers focusing on clinical research and many of academic medicine’s scientific leaders, the Clinical Research Forum and Association of American Physicians disagree with the JCI’s recent editorials on the NIH Roadmap, Elias Zerhouni’s leadership, and the future directions of biomedical research.

  16. Physician Agency and Adoption of Generic Pharmaceuticals

    OpenAIRE

    Toshiaki Iizuka

    2012-01-01

    I examine physician agency in health care services in the context of the choice between brand-name and generic pharmaceuticals. I examine micro-panel data from Japan, where physicians can legally make profits by prescribing and dispensing drugs. The results indicate that physicians often fail to internalize patient costs, explaining why cheaper generics are infrequently adopted. Doctors respond to markup differentials between the two versions, indicating another agency problem. However, gener...

  17. The Emotional Intelligence of Resident Physicians

    OpenAIRE

    McKinley, Sophia Kim

    2014-01-01

    Since academic literature indicates that emotional intelligence (EI) is tied to work performance, there is increasing interest in understanding physician EI. We studied the EI of resident physicians in surgery, pediatric, and pathology residency programs at three academic centers to describe the EI profiles of residents in different specialties and determine whether gender differences in resident physician EI profiles mirror those in the general population. 325 residents were electronically...

  18. Psychopathology in adolescent children of physicians.

    OpenAIRE

    Stein, B A; Leventhal, S. E.

    1984-01-01

    The clinical records of 27 adolescent children of physicians who were treated in a psychiatric unit for adolescents were studied. Most of the children had been referred by their physician fathers for evaluation of conduct or mood disorders. These referrals were often the focus of family distress. There appeared to be no typical syndrome presented by physicians' children. Those treating such patients should be especially sensitive to the possibility that parental denial will increase the patie...

  19. Notifiable Disease Surveillance and Practicing Physicians

    OpenAIRE

    Krause, Gérard; Ropers, Gwendolin; Stark, Klaus

    2005-01-01

    Primary care physicians in Germany are essential participants in infectious disease surveillance through mandatory reporting. Feedback on such surveillance should reflect the needs and attitudes of these physicians. These issues were investigated in a questionnaire survey among 8,550 randomly sampled physicians in Germany in 2001. Of the 1,320 respondents, 59.3% claimed not to have received any feedback on infectious disease surveillance, and 3.7% perceived feedback as not important. Logistic...

  20. Physician-patient communication in managed care.

    OpenAIRE

    Gordon, G H; Baker, L; Levinson, W

    1995-01-01

    The quality of physician-patient communication affects important health care outcomes. Managed care presents a number of challenges to physician-patient communication, including shorter visits, decreased continuity, and lower levels of trust. Good communication skills can help physicians create and maintain healthy relationships with patients in the face of these challenges. We describe 5 communication dilemmas that are common in managed care and review possible solutions suggested by recent ...

  1. Difficulties facing physician mothers in Japan.

    Science.gov (United States)

    Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

    2011-01-01

    Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce. PMID:22027270

  2. Physician buy-in for EMRs.

    Science.gov (United States)

    Yackanicz, Lori; Kerr, Richard; Levick, Donald

    2010-01-01

    Implementing an EMR in an ambulatory practice requires intense workflow analysis, introduction of new technologies and significant cultural change for the physicians and physician champion. This paper will relate the experience at Lehigh Valley Health Network in the implementation of an ambulatory EMR and with the physician champions that were selected to assist the effort. The choice of a physician champion involves political considerations, variation in leadership and communication styles, and a cornucopia of personalities. Physician leadership has been shown to be a critical success factor for any successful technology implementation. An effective physician champion can help develop and promote a clear vision of an improved future, enlist the support of the physicians and staff, drive the process changes needs and manage the cultural change required. The experience with various types of physician champions will be discussed, including, the "reluctant leader", the "techie leader", the "whiny leader", and the "mature leader". Experiences with each type have resulted in a valuable, "lessons learned" summary. LVHN is a tertiary academic community medical center consisting of 950 beds and over 450 employed physicians. LVHN has been named to the Health and Hospital Network's 100 Top Wired and 25 Most Wireless Hospitals. PMID:20397333

  3. Physician Dual Practice: A Descriptive Mapping Review of Literature

    Science.gov (United States)

    MOGHRI, Javad; ARAB, Mohammad; RASHIDIAN, Arash; AKBARI SARI, Ali

    2016-01-01

    Background: Physician dual practice is a common phenomenon in almost all countries throughout the world, which could potential impacts on access, equity and quality of services. This paper aims to review studies in physician dual practice and categorize them in order to their main objectives and purposes. Methods: Comprehensive literature searches were undertaken in order to obtain main papers and documents in the field of physician dual practice. Systematic searches in Medline and Embase from 1960 to 2013, and general searches in some popular search engines were carried out in this way. After that, descriptive mapping review methods were utilized to categorize eligible studies in this area. Results: The searches obtained 404 titles, of which 81 full texts were assessed. Finally, 24 studies were eligible for inclusion in our review. These studies were categorized into four groups - “motivation and forces behind dual practice”, “consequences of dual practice”, “dual practice Policies and their impacts”, and “other studies” - based on their main objectives. Our findings showed a dearth of scientifically reliable literature in some areas of dual practice, like the prevalence of the phenomenon, the real consequences of it, and the impacts of the implemented policy measures. Conclusion: Rigorous empirical and evaluative studies should be designed to detect the real consequences of DP and assess the effects of interventions and regulations, which governments have implemented in this field.

  4. [Comments on the Confucian physician].

    Science.gov (United States)

    Li, Jian-xiang

    2009-09-01

    Confucianism gradually permeated and influenced the development of TCM from the Song dynasty, and the term "Confucian physician" is still in use today. With the impact of Confucianism, whether in the compilation of the medical classics or the explanation and conclusion of the medical theories as well as in medical education and ethics, all developed dramatically. But the Confucianism had also a negative effect on the development of medicine. For example, SU Dong-po cured the epidemics with "Sheng san zi", but he exaggerated its action and recorded it. The later intellectuals learnt from him without differentiation and many people suffered. Another example is, with the influence of ideas of "serve the parents" and "help the public", adult children treated their parents by cutting their own thigh. Even some wealthy and intelligent people blindly applied the prescription without differentiation. PMID:19930954

  5. Physicians on board: an examination of physician financial interests in ASCs using longitudinal data.

    Science.gov (United States)

    Yee, Christine A

    2011-09-01

    This paper investigates physician financial interests in ambulatory surgery centers (ASCs) using novel, longitudinal data that identify board members (directors) of ASCs in Florida. Improving on prior research, the estimated models in this paper disentangle physician director selection effects from the causal impact of these financial interests. The data suggest that even prior to their financial interest, physician directors had larger procedure volumes than non-directors. Physician directors also referred more lower-risk patients. On average, ASC board membership led to a 27% increase in a physician's procedure volume and a 16% increase in a physician's colonoscopy volume. Simulations suggest that 5% of the colonoscopies performed in Florida between 1997 and 2004 may have been due to physician ASC board membership. The evidence also suggests that physician directors steered patients from hospitals to their affiliate ASCs. In addition, they referred and/or treated more lower-risk patients as a result of board membership. PMID:21855155

  6. Sexual health is dead in my body: participatory assessment of sexual health determinants in refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands

    OpenAIRE

    Keygnaert, Ines; Vettenburg, Nicole; Roelens, Kristien; Temmerman, Marleen

    2014-01-01

    Background: Although migrants constitute an important proportion of the European population, little is known about migrant sexual health. Existing research mainly focuses on migrants' sexual health risks and accessibility issues while recommendations on adequate sexual health promotion are rarely provided. Hence, this paper explores how refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands define sexual health, search for sexual health information and perceive sexu...

  7. Basic demographic and professional characteristics of US women physicians.

    OpenAIRE

    E. Frank; Rothenberg, R; Brown, W V; Maibach, H

    1997-01-01

    Women physicians are a rapidly growing percentage of the physician population in the United States; yet, their fundamental characteristics and largely unknown. The Women Physicians' Health Study is the first large, national study of US women physicians, comprising a random sample (n = 4,501 respondents) of women physicians aged 30 to 70. Data from the Women Physicians' Health Study showed that African-American and Latina or Hispanic physicians were underrepresented, and Asian-American and for...

  8. Physician-Assisted Dying: Acceptance by Physicians Only for Patients Close to Death

    OpenAIRE

    Zenz, Julia; Tryba, Michael; Zenz, Michael

    2014-01-01

    This study reports on German physicians’ views on legalization of euthanasia and physician-assisted suicide, comparing this with a similar survey of UK doctors. A questionnaire was handed out to attendants of a palliative care and a pain symposium. Complete answers were obtained from 137 physicians. Similar to the UK study, about 30% of the physicians surveyed support euthanasia in case of terminal illness and more support physician-assisted suicide. In contrast, in both countries, a great ma...

  9. Paraprofessional counselling within asylum seekers' groups in the Netherlands: transferring an approach for a non-western context to a European setting.

    Science.gov (United States)

    Kieft, Barbara; Jordans, Mark J D; de Jong, Joop T V M; Kamperman, Astrid M

    2008-03-01

    This article presents the application of a psychosocial care approach, which has been developed for and in a non-western context, within an asylum seekers' setting in the Netherlands. The project aimed to increase access to basic psychosocial care to a target population that experiences difficulties in entering mental healthcare services, by a group of trained peer asylum seekers and refugees. The development of an informal paraprofessional support system makes better use of existing resources, provides secondary benefits for the participants and helps to overcome the treatment gap between perceived needs and the formal mental healthcare system. The article describes the key components of such an approach, the Dutch context, the project implementation and finishes with a discussion on outcomes, strengths and weaknesses, risks and recommendations. In summary, we found this community approach to be applicable and relevant within an asylum seekers' centre, as it incorporates an additional easy-access level of psychosocial care and social agency, which seemed to empower participants and help prevent psychosocial problems from becoming more severe. PMID:18344254

  10. High Prevalence of Infectious Diseases and Drug-Resistant Microorganisms in Asylum Seekers Admitted to Hospital; No Carbapenemase Producing Enterobacteriaceae until September 2015

    Science.gov (United States)

    Ravensbergen, Sofanne J.; Lokate, Mariëtte; Cornish, Darren; Kloeze, Eveline; Ott, Alewijn; Friedrich, Alex W.; van Hest, Rob; Akkerman, Onno W.; de Lange, Wiel C.; van der Werf, Tjip S.; Bathoorn, Erik

    2016-01-01

    Introduction The current refugee crisis emphasizes the need for information on infectious diseases and resistant microorganisms in asylum seekers with possible consequences for public health and infection control. Methods We collected data from asylum seekers admitted to our university hospital or who presented at the Emergency Department (n = 273). We collected general and demographic characteristics including country of origin, the reason of presentation, and the screening results of multi-drug resistant organisms. Results 67% of the patients were male with a median age of the study group of 24 years (IQR 15–33); 48% of the patients had an infectious disease—predominantly malaria with P. vivax or tuberculosis. Patients also reported with diseases which are less common—e.g. leishmaniasis, or even conditions rarely diagnosed in Europe—e.g. louse borne relapsing fever. A carriage rate of 31% for multi-drug resistant microorganisms (MDRO) was observed, with ESBL-expressing E.coli (n = 20) being the most common MDRO. No carriage of Carbapenemase Producing Enterobacteriaceae was found. Conclusion The current refugee crisis in Europe challenges hospitals to quickly identify and respond to communicable diseases and the carriage of MDRO. A rapid response is necessary to optimize the treatment of infectious diseases amongst asylum seekers to maximize infection control. PMID:27144599

  11. High Prevalence of Infectious Diseases and Drug-Resistant Microorganisms in Asylum Seekers Admitted to Hospital; No Carbapenemase Producing Enterobacteriaceae until September 2015.

    Directory of Open Access Journals (Sweden)

    Sofanne J Ravensbergen

    Full Text Available The current refugee crisis emphasizes the need for information on infectious diseases and resistant microorganisms in asylum seekers with possible consequences for public health and infection control.We collected data from asylum seekers admitted to our university hospital or who presented at the Emergency Department (n = 273. We collected general and demographic characteristics including country of origin, the reason of presentation, and the screening results of multi-drug resistant organisms.67% of the patients were male with a median age of the study group of 24 years (IQR 15-33; 48% of the patients had an infectious disease-predominantly malaria with P. vivax or tuberculosis. Patients also reported with diseases which are less common-e.g. leishmaniasis, or even conditions rarely diagnosed in Europe-e.g. louse borne relapsing fever. A carriage rate of 31% for multi-drug resistant microorganisms (MDRO was observed, with ESBL-expressing E.coli (n = 20 being the most common MDRO. No carriage of Carbapenemase Producing Enterobacteriaceae was found.The current refugee crisis in Europe challenges hospitals to quickly identify and respond to communicable diseases and the carriage of MDRO. A rapid response is necessary to optimize the treatment of infectious diseases amongst asylum seekers to maximize infection control.

  12. Discussion of “Attitude of Physicians Towards Automatic Alerting in Computerized Physician Order Entry Systems”

    DEFF Research Database (Denmark)

    Bates, D. W.; Baysari, M. T.; Dugas, M.;

    2013-01-01

    With these comments on the paper “Attitude of Physicians Towards Automatic Alerting in Computerized Physician Order Entry Systems”, written by Martin Jung and coauthors, with Dr. Elske Ammenwerth as senior author, the journal wants to stimulate a broad discussion on computerized physician order e...

  13. Estimation of physician supply by specialty and the distribution impact of increasing female physicians in Japan

    Directory of Open Access Journals (Sweden)

    Yasunaga Hideo

    2009-10-01

    Full Text Available Abstract Background Japan has experienced two large changes which affect the supply and distribution of physicians. They are increases in medical school enrollment capacity and in the proportion of female physicians. The purpose of this study is to estimate the future supply of physicians by specialty and to predict the associated impact of increased female physicians, as well as to discuss the possible policy implications. Methods Based on data from the 2004 and 2006 National Survey of Physicians, Dentists and Pharmacists, we estimated the future supply of physicians by specialty, using multistate life tables. Based on possible scenarios of the future increase in female physicians, we also estimated the supply of physicians by specialty. Results Even if Japan's current medical school enrollment capacity is maintained in subsequent years, the number of physicians per 1000 population is expected to increase from 2.2 in 2006 to 3.2 in 2036, which is a 46% increase from the current level. The numbers of obstetrician/gynecologists (OB/GYNs and surgeons are expected to temporarily decline from their current level, whereas the number of OB/GYNs per 1000 births will still increase because of the declining number of births. The number of surgeons per 1000 population, even with the decreasing population, will decline temporarily over the next few years. If the percentage of female physicians continues to increase, the overall number of physicians will not be significantly affected, but in specialties with current very low female physician participation rates, such as surgery, the total number of physicians is expected to decline significantly. Conclusion At the current medical school enrollment capacity, the number of physicians per population is expected to continue to increase because of the skewed age distribution of physicians and the declining population in Japan. However, with changes in young physicians' choices of medical specialties and as the

  14. How physician networks are selling themselves.

    Science.gov (United States)

    Volz, D

    1999-01-01

    A growing number of physicians are creating discount networks due to the anger they feel about their loss of professional autonomy and financial compensation to managed care. They are seeking a niche among patients who lack adequate health insurance coverage or are dissatisfied with their plans. To win patients, the physician networks are marketing services that are deeply discounted. PMID:10351396

  15. 42 CFR 410.20 - Physicians' services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Physicians' services. 410.20 Section 410.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.20 Physicians'...

  16. The Physician as a Marriage Counselor

    Science.gov (United States)

    Trainer, Joseph B.

    1973-01-01

    The author describes the emergence of a new style of family physician whose education is incorporating more behavioral science and whose practice moves increasingly into the field of marital and sexual problems. Closer cooperation between physicians and clinical psychologists and marriage counselors is advocated. (Editor)

  17. Construction of a Physician Skills Inventory

    Science.gov (United States)

    Richard, George V.; Zarconi, Joseph; Savickas, Mark L.

    2012-01-01

    The current study applied Holland's RIASEC typology to develop a "Physician Skills Inventory". We identified the transferable skills and abilities that are critical to effective performance in medicine and had 140 physicians in 25 different specialties rate the importance of those skills. Principal component analysis of their responses produced…

  18. A Study of the Educationally Influential Physician.

    Science.gov (United States)

    Kaufman, David M.; Ryan, Kurt; Hodder, Ian

    1999-01-01

    A survey of 172 family doctors found that they approached educationally influential (EI) physicians they knew through their hospitals; only 20% used e-mail and 40% the Internet for medical information; EI physicians helped extend their knowledge and validate innovations found in the literature; and health care reform was negatively affecting…

  19. Promoting Scientific Spirit to Cultivate Scientific Culture

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Scientific culture is an advanced culture that is based on scientific knowledge and supported by the scientific method, with scientific thinking as its core and scientific spirit as its soul. During the process of modernization, it has profound impacts on human society in terms of values, ethics, mode of thinking, lifestyle and code of conduct, offering human civilization an important ideological source, physical foundation, technological tool and effective carrier.

  20. Can complexity science inform physician leadership development?

    Science.gov (United States)

    Grady, Colleen Marie

    2016-07-01

    Purpose The purpose of this paper is to describe research that examined physician leadership development using complexity science principles. Design/methodology/approach Intensive interviewing of 21 participants and document review provided data regarding physician leadership development in health-care organizations using five principles of complexity science (connectivity, interdependence, feedback, exploration-of-the-space-of-possibilities and co-evolution), which were grouped in three areas of inquiry (relationships between agents, patterns of behaviour and enabling functions). Findings Physician leaders are viewed as critical in the transformation of healthcare and in improving patient outcomes, and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system, such as health care. Physician leadership development remains a low priority for most health-care organizations, although physicians admit to being limited in their capacity to lead. This research was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can provide data regarding leadership development for physicians. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician's relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership and medical education that provides minimal opportunity for leadership skill development. Practical Implications This research provides practical

  1. Pharmaceutical marketing research and the prescribing physician.

    Science.gov (United States)

    Greene, Jeremy A

    2007-05-15

    Surveillance of physicians' prescribing patterns and the accumulation and sale of these data for pharmaceutical marketing are currently the subjects of legislation in several states and action by state and national medical associations. Contrary to common perception, the growth of the health care information organization industry has not been limited to the past decade but has been building slowly over the past 50 years, beginning in the 1940s when growth in the prescription drug market fueled industry interest in understanding and influencing prescribing patterns. The development of this surveillance system was not simply imposed on the medical profession by the pharmaceutical industry but was developed through the interactions of pharmaceutical salesmen, pharmaceutical marketers, academic researchers, individual physicians, and physician organizations. Examination of the role of physicians and physician organizations in the development of prescriber profiling is directly relevant to the contemporary policy debate surrounding this issue. PMID:17502635

  2. 42 CFR 483.360 - Consultation with treatment team physician.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Consultation with treatment team physician. 483.360... treatment team physician. If a physician or other licensed practitioner permitted by the state and the... the resident's treatment team physician, unless the ordering physician is in fact the...

  3. Family physicians: importance and relevance.

    Science.gov (United States)

    Yeravdekar, Rajiv; Yeravdekar, Vidya Rajiv; Tutakne, M A

    2012-07-01

    Due to rapid advancement in medical technology and knowledge patients today prefer treatment from specialists, if they can afford it. Medical treatment has become a purchasable commodity, to be procured as and when required, based on cost and availability.This is unfortunate but true. Specialisation tends to divide the patients into'parts' and increases the cost of treatment. Moreover no single physician is in charge of the patient as a whole to maintain long term continuity and coordinate the treatments given by different specialists. Since long term dependence on 'family doctor' has reduced, trust deficit in the profession has started creeping in. It is essential to rejuvenate the concept of family doctors equipped with skills suitable for modern technology and practice, to restore the faith of patients in medical professionals. Family doctor can provide a 'single window clearance' for all healthcare needs of an individual. Exploitation of gullible patient can be prevented when the family doctor becomes the friend and guide for all treatments being given to the individual. Society should be educated on the benefits of getting the treatment through the family doctor. The family doctor then becomes the Authorised Medical Attendant (AMA), responsible for all treatments beings provided to the patients. The Medical Council of India (MCI) may consider incorporating this in code of medical ethics. PMID:23520678

  4. Physicians' perceptions and uses of commercial drug information sources: an examination of pharmaceutical marketing to physicians.

    Science.gov (United States)

    Spiller, L D; Wymer, W W

    2001-01-01

    Data were collected from physicians attending a medical conference. This exploratory study was primarily interested in two areas. First, the investigators were interested in better understanding physicians' responses to different promotional tactics typically used by the pharmaceutical industry. Pharmaceutical representatives were most useful, followed by drug samples and infomercials in medical journals. Direct mail, promotional faxes, and promotional products were used less by physicians. Second, the investigators were interested in learning what information sources influenced physicians' drug choices. Physicians were primarily influenced by their prior experience with a drug, then by drug compendiums, and journal articles. Physicians were also influenced by information provided by the industry and other factors, like the drug's price and their patients' financial situations. Managerial implications for marketing to physicians and ideas for future research are discussed. PMID:11727295

  5. Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Mulholland Kim

    2009-02-01

    Full Text Available Abstract Background Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Methods We designed a mixed methods study to address the study aim. A cross-sectional survey was conducted with 71 Iraqi Temporary Protection Visa (TPV refugees and 60 Iraqi Permanent Humanitarian Visa (PHV refugees, residing in Melbourne, Australia. Prior to a recent policy amendment, TPV refugees were only given temporary residency status and had restricted access to a range of government funded benefits and services that permanent refugees are automatically entitled to. The quantitative results were triangulated with semi-structured interviews with TPV refugees and service providers. The main outcome measures were self-reported physical and psychological health. Standardised self-report instruments, validated in an Arabic population, were used to measure health and wellbeing outcomes. Results Forty-six percent of TPV refugees compared with 25% of PHV refugees reported symptoms consistent with a diagnosis of clinical depression (p = 0.003. After controlling for the effects of age, gender and marital status, TPV status made a statistically significant contribution to psychological distress (B = 0.5, 95% CI 0.3 to 0.71, p ≤ 0.001 amongst Iraqi refugees. Qualitative data revealed that TPV refugees generally felt socially isolated and lacking in control over their life circumstances, because of their experiences in detention and on a temporary visa. This sense of powerlessness and, for some, an implicit awareness they were being denied basic human rights, culminated in a strong sense of injustice. Conclusion Government asylum policies

  6. 42 CFR 414.50 - Physician or other supplier billing for diagnostic tests performed or interpreted by a physician...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Physician or other supplier billing for diagnostic tests performed or interpreted by a physician who does not share a practice with the billing physician... HEALTH SERVICES Physicians and Other Practitioners § 414.50 Physician or other supplier billing...

  7. Psychosocial challenges facing physicians of today.

    Science.gov (United States)

    Arnetz, B B

    2001-01-01

    Fundamental changes in the organization, financing, and delivery of health care have added new stressors or opportunities to the medical profession. These new potential stressors are in addition to previously recognized external and internal ones. The work environment of physicians poses both psychosocial, ergonomic, and physico-chemical threats. The psychosocial work environment has, if anything, worsened. Demands at work increase at the same time as influence over one's work and intellectual stimulation from work decrease. In addition, violence and the threat of violence is another major occupational health problem physicians increasingly face. Financial constraint, managed care and consumerism in health care are other factors that fundamentally change the role of physicians. The rapid deployment of new information technologies will also change the role of the physician towards being more of an advisor and information provider. Many of the minor health problems will increasingly be managed by patients themselves and by non-physician professionals and practitioners of complementary medicine. Finally, the economic and social status of physicians are challenged which is reflected in a slower salary increase compared to many other professional groups. The picture painted above may be seen as uniformly gloomy. In reality, that is not the case. There is growing interest in and awareness of the importance of the psychosocial work environment for the delivery of high quality care. Physicians under stress are more likely to treat patients poorly, both medically and psychologically. They are also more prone to make errors of judgment. Studies where physicians' work environment in entire hospitals has been assessed, results fed-back, and physicians and management have worked with focused improvement processes, have demonstrated measurable improvements in the ratings of the psychosocial work environment. However, it becomes clear from such studies that quality of the

  8. Hospitals' marketing challenge: influencing physician behavior.

    Science.gov (United States)

    MacStravic, R C

    1985-05-01

    Physicians' referring and admitting behavior as well as their clinical management practices are major determinants of hospitals' profitability under prospective payment. Four techniques are available to hospitals that seek to increase market share: Recruitment and retention strategies. In planning the mix of specialties represented on staff, hospitals should consider the effects of a physician's practice on the hospital's case mix. Peer pressure. Peer review programs in hospitals as well as through medical or specialty societies may help persuade physicians to alter their use of services. Education and information programs. Hospitals can assist physicians in patient management by conducting economic grand rounds, developing committees to study and communicate cost data to physicians, and providing information on alternatives to hospitalization. Incentives. Putting physicians at risk by linking planned expenditures to hospital financial performance can influence practice patterns. Other techniques include offering limited partnerships to medical staff members and merging the hospital and medical staff into one corporation. Hospitals may also need to influence physicians away from ventures that compete directly with the institution, such as ambulatory surgery centers. PMID:10271500

  9. Developing physicians as catalysts for change.

    Science.gov (United States)

    George, Aaron E; Frush, Karen; Michener, J Lloyd

    2013-11-01

    Failures in care coordination are a reflection of larger systemic shortcomings in communication and in physician engagement in shared team leadership. Traditional medical care and medical education neither focus on nor inspire responses to the challenges of coordinating care across episodes and sites. The authors suggest that the absence of attention to gaps in the continuum of care has led physicians to attempt to function as the glue that holds the health care system together. Further, medical students and residents have little opportunity to provide feedback on care processes and rarely receive the training and support they need to assess and suggest possible improvements.The authors argue that this absence of opportunity has driven cynicism, apathy, and burnout among physicians. They support a shift in culture and medical education such that students and residents are trained and inspired to act as catalysts who initiate and expedite positive changes. To become catalyst physicians, trainees require tools to partner with patients, staff, and faculty; training in implementing change; and the perception of this work as inherent to the role of the physician.The authors recommend that medical schools consider interprofessional training to be a necessary component of medical education and that future physicians be encouraged to grow in areas outside the "purely clinical" realm. They conclude that both physician catalysts and teamwork are essential for improving care coordination, reducing apathy and burnout, and supporting optimal patient outcomes. PMID:24072124

  10. The Importance of Resources and Security in the Socio-Economic Integration of Refugees. A Study on the Impact of Length of Stay in Asylum Accommodation and Residence Status on Socio-Economic Integration for the Four Largest Refugee Groups in the Netherlands

    NARCIS (Netherlands)

    L. Bakker (Linda); J.M. Dagevos (Jaco); G.B.M. Engbersen (Godfried)

    2013-01-01

    textabstractIn many European countries, including the Netherlands, refugees stay in asylum accommodation pending a decision on their asylum request. While it seems evident that the lack of resources and insecurity about the future experienced during this stay will impact refugees' subsequent ability

  11. Family physicians' perspectives regarding palliative radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To assess family physicians' views on common indications for palliative radiotherapy and to determine whether this influences patient referral. Methods and materials: A 30-item questionnaire evaluating radiotherapy knowledge and training developed at the Ottawa Regional Cancer Centre (ORCC) was mailed to a random sample of 400 family physicians in eastern Ontario, Canada. The completed surveys were collected and analyzed, and form the basis of this study. Results: A total of 172 completed surveys were received for a net response rate of 50% among practicing family physicians. Almost all of the physicians (97%) had recently seen cancer patients in their offices, with 85% regularly caring for patient with advanced cancer. Fifty-four percent had referred patients in the past for radiotherapy and 53% had contacted a radiation oncologist for advice. Physicians who were more knowledgeable about the common indications for palliative radiotherapy were significantly more likely to refer patients for radiotherapy (P<0.01). Inability to contact a radiation oncologist was correlated with not having referred patients for radiotherapy (P<0.01). Only 10% of the physicians had received radiotherapy education during their formal medical training. Conclusions: Many of the family physicians surveyed were unaware of the effectiveness of radiotherapy in a variety of common palliative situations, and radiotherapy referral was correlated with knowledge about the indications for palliative radiotherapy. This was not surprising given the limited education they received in this area and the limited contact they have had with radiation oncologists. Strategies need to be developed to improve continuing medical education opportunities for family physicians and to facilitate more interaction between these physicians and radiation oncologists

  12. Philosophy on astronaut protection: A physician`s perspective

    Energy Technology Data Exchange (ETDEWEB)

    Holloway, H.

    1997-04-30

    The National Aeronautics and Space Administration has a responsibility to assure that proper ethical standards are applied in establishing and applying limits for the control of radiation doses to the astronauts. Such a responsibility obviously includes assuring that the astronauts are properly informed of the hazards associated with individuals missions and that they agree to accept the associated risks. The responsibility, however, does not end there. It includes a need to discuss how to initiate a discourse for developing the related ethical standards and how to determine who should be involved in their establishment. To assure that such proper communications on matters that encompass the realms of policy, science, politics, and ethics. There is also a need to mesh public perceptions with those of the scientific and technical community. This will be a monumental undertaking.

  13. [Which place for physicians in blood supply?].

    Science.gov (United States)

    Danic, B; Pelletier, B

    2013-05-01

    Historically, blood transfusion has been divised, enhanced and organized by physicians. The special status of blood led to ensure that collection of blood and its components were placed under the supervision of a physician. Throughout its history, blood transfusion organization in France has established an exclusive exercise of the collection of blood and its components entrusted to doctors, thus creating the concept of "medicine of donation". This view is changing, and programmed exercise of this activity by nurses led to question about this profession perimeter, its necessary evolution, and finally about the place of physicians in blood supply. PMID:23537956

  14. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

    Science.gov (United States)

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the

  15. First and foremost, physicians: the clinical versus leadership identities of physician leaders.

    Science.gov (United States)

    Quinn, Joann Farrell; Perelli, Sheri

    2016-06-20

    Purpose - Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach - Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings - These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications - Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications - These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications - This work points to a broader and more fundamental need - a modified mindset about the nature and value of physician leadership. Originality/value - This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer

  16. A group-based approach to stabilisation and symptom management in a phased treatment model for refugees and asylum seekers

    Directory of Open Access Journals (Sweden)

    Mary E. A. Robertson

    2013-12-01

    Full Text Available Background: Traumatised asylum seekers and refugees may present with significant and complex mental health problems as a result of prolonged, extreme, and multiple traumatic events. This is further complicated by ongoing complex social circumstances. Concepts: In our work at the Traumatic Stress Clinic (TSC, the understanding afforded by the concept of complex posttraumatic stress disorder (PTSD together with the related notion of a phased treatment model, provides a useful framework for organising our work with this population. Clinical Applications: An explication of complex PTSD as it applies to our client group is presented, followed by a description of our phased treatment model and an outline of the core principles, which guide our clinical approach. Our symptom management and stabilisation groups have been developed and refined over time and draw on techniques from a variety of cognitive behavioural therapies. These are described in some detail with illustrative clinical case vignettes. Conclusion: This paper concludes with some reflections on the challenges inherent to working with this complex client group.

  17. Political representation for social justice in nursing: lessons learned from participant research with destitute asylum seekers in the UK.

    Science.gov (United States)

    Cuthill, Fiona

    2016-09-01

    The concept of social justice is making a revival in nursing scholarship, in part in response to widening health inequalities and inequities in high-income countries. In particular, critical nurse scholars have sought to develop participatory research methods using peer researchers to represent the 'voice' of people who are living in marginalized spaces in society. The aim of this paper is to report on the experiences of nurse and peer researchers as part of a project to explore the experiences of people who find themselves destitute following the asylum process in the UK. In seeking to explore social injustice, three challenges are identified: lack of a robust political theory, institutional/professional constraints and an absence of skills to engage with the politics of social (in)justice. Each challenge is presented, opposing voices outlined and some possible solutions are suggested. The work of political theorist Nancy Fraser is used as a conceptual framework, in particular her focus on mis/framing and political representation for social justice. In addition, it is suggested that social justice needs to be further embedded in nursing policy and curriculum. Finally, nurses are encouraged to develop practical political skills to engage with both politics and the media in a neoliberal globalizing world. PMID:27562573

  18. Find a Physical Medicine & Rehabilitation Physician

    Science.gov (United States)

    ... searchable database that allows you to locate a practicing PM&R physician in your area. Please read ... AAPM&R Who We Are and Our Focus Leadership & Governance Volunteerism Membership Councils & Groups Member Directory Corporate ...

  19. Marketing to physicians in a digital world.

    Science.gov (United States)

    Manz, Christopher; Ross, Joseph S; Grande, David

    2014-11-13

    Pharmaceutical marketing can lead to overdiagnosis, overtreatment, and overuse of medications. Digital advertising creates new pathways for reaching physicians, allowing delivery of marketing messages at the point of care, when clinical decisions are being made. PMID:25390738

  20. Physician Fee Schedule Carrier Specific Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) has condensed all 56 Physician Fee Schedule (PFS) carrier specific pricing files into one zip file. It is...

  1. Physician outcome measurement: review and proposed model.

    Science.gov (United States)

    Siha, S

    1998-01-01

    As health care moves from a free-for-service environment to a capitated arena, outcome measurements must change. ABC Children's Medical Center is challenged with developing comprehensive outcome measures for an employed physician group. An extensive literature review validates that physician outcomes must move beyond revenue production and measure all aspects of care delivery. The proposed measurement model for this physician group is a trilogy model. It includes measures of cost, quality, and service. While these measures can be examined separately, it is imperative to understand their integration in determining an organization's competitive advantage. The recommended measurements for the physician group must be consistent with the overall organizational goals. The long-term impact will be better utilization of resources. This will result in the most cost effective, quality care for the health care consumer. PMID:10339092

  2. The Exam-Room Physician Workstation

    OpenAIRE

    Russler, Daniel C.

    1989-01-01

    By combining and configuring commercially available hardware and software, we have developed a networked system of exam-room physician workstations that provides a platform for physician charting, medical reference, and patient education. The physical platform consists of IBM compatible computers and ethernet hardware. The software platform is a hypertext document management system called Idex distributed on a Novell network. Key features of the workstation include a graphical user interface,...

  3. Modeling solutions to Tanzania's physician workforce challenge

    Directory of Open Access Journals (Sweden)

    Alex J. Goodell

    2016-06-01

    Full Text Available Background: There is a great need for physicians in Tanzania. In 2012, there were approximately 0.31 physicians per 10,000 individuals nationwide, with a lower ratio in the rural areas, where the majority of the population resides. In response, universities across Tanzania have greatly increased the enrollment of medical students. Yet evidence suggests high attrition of medical graduates to other professions and emigration from rural areas where they are most needed. Objective: To estimate the future number of physicians practicing in Tanzania and the potential impact of interventions to improve retention, we built a model that tracks medical students from enrollment through clinical practice, from 1990 to 2025. Design: We designed a Markov process with 92 potential states capturing the movement of 25,000 medical students and physicians from medical training through employment. Work possibilities included clinical practice (divided into rural or urban, public or private, non-clinical work, and emigration. We populated and calibrated the model using a national 2005/2006 physician mapping survey, as well as graduation records, graduate tracking surveys, and other available data. Results: The model projects massive losses to clinical practice between 2016 and 2025, especially in rural areas. Approximately 56% of all medical school students enrolled between 2011 and 2020 will not be practicing medicine in Tanzania in 2025. Even with these losses, the model forecasts an increase in the physician-to-population ratio to 1.4 per 10,000 by 2025. Increasing the absorption of recent graduates into the public sector and/or developing a rural training track would ameliorate physician attrition in the most underserved areas. Conclusions: Tanzania is making significant investments in the training of physicians. Without linking these doctors to employment and ensuring their retention, the majority of this investment in medical education will be jeopardized.

  4. Physician Burnout: Coaching a Way Out

    OpenAIRE

    Gazelle, Gail; Liebschutz, Jane M.; Riess, Helen

    2014-01-01

    ABSTRACT Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. In addition, physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture that emphasizes perfectionism, denial of personal vulnerability, and delayed gratification. Professional coaching, long utilized in the business world, provides a results-o...

  5. Physician Burnout: Coaching a Way Out

    OpenAIRE

    Gazelle, Gail; Liebschutz, Jane M.; Riess, Helen

    2014-01-01

    Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. In addition, physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture that emphasizes perfectionism, denial of personal vulnerability, and delayed gratification. Professional coaching, long utilized in the business world, provides a results-oriented a...

  6. Physician Fee Policy and Medicaid Program Costs

    OpenAIRE

    Jonathan Gruber; Kathleen Adams; Newhouse, Joseph P.

    1997-01-01

    We investigate the hypothesis that increasing access for the indigent to physician offices shifts care from hospital outpatient settings and lowers Medicaid costs (the so-called offset effect'). To evaluate this hypothesis we exploit a large increase in physician fees in the Tennessee Medicaid program, using Georgia as a control. We find that beneficiaries shifted care from clinics to offices, but that there was little or no shifting from hospital outpatient departments or emergency rooms. Th...

  7. Engaging Physicians in Risk Factor Reduction

    OpenAIRE

    Springrose, James V.; Friedman, Felix; Gumnit, Stephen A.; Schmidt, Eric J.

    2010-01-01

    OptumHealth tested the feasibility of physician-directed population management in 3 primary care practices and with 546 continuously insured patients who exhibited claims markers for coronary artery disease, diabetes, and/or hypertension. During the intervention portion of the study, we asked physicians to improve the following health measurements: blood pressure, body mass index, cholesterol, hemoglobin A1c, and smoking status. We offered a modest pay-for-outcomes incentive for each risk fac...

  8. Depression-Burnout Overlap in Physicians

    OpenAIRE

    Walter Wurm; Katrin Vogel; Anna Holl; Christoph Ebner; Dietmar Bayer; Sabrina Mörkl; Istvan-Szilard Szilagyi; Erich Hotter; Hans-Peter Kapfhammer; Peter Hofmann

    2016-01-01

    Background Whether burnout is a distinct phenomenon rather than a type of depression and whether it is a syndrome, limited to three “core” components (emotional exhaustion, depersonalization and low personal accomplishment) are subjects of current debate. We investigated the depression-burnout overlap, and the pertinence of these three components in a large, representative sample of physicians. Methods In a cross-sectional study, all Austrian physicians were invited to answer a questionnaire ...

  9. Evaluation of physician's attitude and knowledge

    OpenAIRE

    Sekineh Shafia; Jobin Hemati; Leila Meskini; Aliraza Khalilian

    2008-01-01

    (Received 19 Jun, 2008; Accepted 20 Oct, 2008) Abstract This study aimed to determine the knowledge and attitudes to wards homeopathy among general practitioner and specialist physicians in Sari.Our results indicate Sari physicians had not sufficient knowledge obout homeopathy; but they liked collaboration with homeopaths for treatment of their patients and have courses for homeopathy education. J Mazand Univ Med Sci 2008; 18(66): 102-103(Persian

  10. Breastfeeding Education: A Physician and Patient Assessment

    OpenAIRE

    Stolzer, J. M.; Syed Afzal Hossain

    2014-01-01

    In the study presented here, Likert scaled surveys derived from the Surgeon General’s Blueprint for Action on Breastfeeding (2000) were mailed to 400 practicing physicians in a Midwestern state to assess medical school breastfeeding education. In addition, 500 surveys were mailed to women in the same Midwestern state who had given birth within the last year to determine what type of breastfeeding information they were receiving from their attending physicians. The purpose of this study is to ...

  11. Low Job Satisfaction Among Physicians in Egypt

    Directory of Open Access Journals (Sweden)

    Amira Gamal Abdel-Rahman

    2008-04-01

    Full Text Available AIM/BACKGROUND: Physician’s job satisfaction is a cornerstone for improving the quality of health care, and its continuity. To identify the extent of job satisfaction and explain its main components among physicians, together with finding out the main indicators for job satisfaction. METHODS: We randomly selected physicians from the Egyptian Ministry of Health and Population Hospitals. All participants were asked to fill a self administrated questionnaire which included data pertaining socio-demographic characteristics and job satisfaction regarding salaries/incentives, monitoring, administration system, management, career satisfaction, relationship with colleagues, social support, opportunities for promotion, and job responsibilities. Satisfied was defined as satisfaction of>60%. RESULTS: Two hundred and thirty eight physicians participated in this study; with mean age of 37.1+ 9.4 years, and 70.2% were males. Only 42.9% of the physicians’ reported job satisfaction. Relationship with colleagues was the most important component of satisfaction with mean of 81.3+19.6 while, salaries/incentives were the least one with mean of 16.2+ 14. The overall current satisfying domains were not significantly associated with marital status or educational level, however it was significantly associated with specialty. Neither age nor gender was significantly associated with the degree of job satisfaction. CONCLUSION: Our results call for paying more attention to improve physicians’ job satisfaction in Egypt, to meet needed higher standards in health care. [TAF Prev Med Bull. 2008; 7(2: 91-96

  12. Physician-patient communication: breaking bad news.

    Science.gov (United States)

    Fields, Scott A; Johnson, W Michael

    2012-01-01

    Physicians often struggle with how to manage the task of breaking bad news with patients. Moreover, the arduous nature of the task can contribute to physician detachment from the patient or an avoidance of breaking the news in a timely manner. A plan of action can only improve physician confidence in breaking bad news, and also make the task more manageable. Over a decade ago, Rabow and McPhee offered a strategy; the ABCDE plan, which provided a patient centered framework from which to deliver troubling news to patients and families. At the heart of this plan was the creation of a safe environment, the demonstration of timely communication skills, and the display of empathy on the physician's part. Careful consideration of the doctor's own reactions to death and dying also played an important role. A close review of the five tenets of this plan indicates the relevance of Rabow and McPhee's strategy today. The patient base in our nation and state continues to be older, on average, and physicians are faced with numerous patients who have terminal illness. A constructive plan with specific ideas for breaking bad news can help physicians effectively navigate this difficult task. PMID:22655433

  13. Family physician perspectives on primary immunodeficiency diseases

    Directory of Open Access Journals (Sweden)

    Jordan eOrange

    2016-03-01

    Full Text Available Primary immunodeficiency diseases (PID include over 250 diverse disorders. The current study assessed management of PID by family practice physicians. The American Academy of Allergy, Asthma, and Immunology Primary Immunodeficiency Committee and the Immune Deficiency Foundation conducted an incentivized mail survey of family practice physician members of the American Medical Association and the American Osteopathic Association in direct patient care. Responses were compared with subspecialist immunologist responses from a similar survey. Surveys were returned by 528 (of 4500 surveys mailed family practice physicians, of whom 44% reported following ≥1 patient with a PID. Selective immunoglobulin A (IgA, deficiency (21%, and chronic granulomatous disease (11% were most common and were followed by significantly more subspecialist immunologists (P<.0001. Use of intravenously administered Ig, and live viral vaccinations across PID was significantly different (P<.0001. Few family practice physicians were aware of professional guidelines for diagnosis and management of PID (4% vs. 79% of subspecialist immunologists, P<.0001. Family practice physicians will likely encounter patients with a PID diagnoses during their career. Differences in how family practice physicians and subspecialist immunologists manage patients with PID underscore areas where improved educational and training initiatives may benefit patient care.

  14. [The physician in the Greek city].

    Science.gov (United States)

    Koelbing, H M

    1989-01-01

    In the cities of ancient Greece, as well as later in Rome, the doctor's responsibility was already a controversial subject. The practice of healing was not subject to any official regulation: no protection of good physicians, no punishment of malpractice. While physicians often lead an itinerant life, cities endeavoured to secure the presence of a good one by appointing him town or public physician on the basis of a one-year contract. This did not mean, however, a "health service" free of charge for patients. The variety of healing persons including midwives and medicals slaves is reviewed. Some short texts which were added in later times to the "Works of Hippocrates" ("Physician", "Precepts", "Decorum") provide us with some information on a physician's daily life (see also H.M. Koelbing, The Hippocratic physician at his patient's bedside, in Practitioner 224, 1980, 551-554). From Hippocrates ("Prognostic") to the hellenistic period ("Decorum"), we note an important change as to the revelation of a bad prognosis: Hippocrates advocates the blunt information of the patient when there is no hope for him; but his follower in a later century takes into consideration the patient's psychology. He hides the cruel truth from him while informing openly his relatives and near friends. This is the first time in history we come across the principle of the doctor's double truth, strongly, advocated e.g. by Thomas Percival in his "Medical Ethics" (1803), but much disputed today. PMID:2673940

  15. Family physician perceptions of working with LGBTQ patients: physician training needs

    OpenAIRE

    Beagan, Brenda; Fredericks, Erin; Bryson, Mary

    2015-01-01

    Background Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. Method In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care....

  16. Attitudes of patients and physicians regarding physician dress and demeanor in the emergency department.

    Science.gov (United States)

    Colt, H G; Solot, J A

    1989-02-01

    To compare the opinions of patients and physicians regarding physician dress and demeanor in the emergency department, we conducted a cross-sectional survey of 190 ED patients and 129 medical specialists, family practitioners, surgeons, and emergency physicians in a community hospital. Seventy-three percent of physicians and 43% of patients thought that physical appearance influenced patient opinion of medical care. Forty-nine percent of patients believed emergency physicians should wear white coats, but only 18% disliked scrub suits. Patients were more tolerant of casual dress than were physicians. Both groups disliked excessive jewelry, prominent ruffles or ribbons, long fingernails, blue jeans, and sandals. Opinions and practices of emergency physicians were similar to those of other medical specialists. Most physicians (96%) addressed patients by surname or title, but 43% of patients preferred being called by their first names. The age, gender, income, and education of patients did not influence how they wished to be addressed. Larger studies are needed to assess the influence of age, sex, race, and depth of feeling regarding first-name address and physician attire in the ED. PMID:2783838

  17. Religion, spirituality, health and medicine: Why should Indian physicians care?

    Directory of Open Access Journals (Sweden)

    Chattopadhyay S

    2007-01-01

    Full Text Available Religion, spirituality, health and medicine have common roots in the conceptual framework of relationship amongst human beings, nature and God. Of late, there has been a surge in interest in understanding the interplay of religion, spirituality, health and medicine, both in popular and scientific literature. A number of published empirical studies suggest that religious involvement is associated with better outcomes in physical and mental health. Despite some methodological limitations, these studies do point towards a positive association between religious involvement and better health. When faced with disease, disability and death, many patients would like physicians to address their emotional and spiritual needs, as well. The renewed interest in the interaction of religion and spirituality with health and medicine has significant implications in the Indian context. Although religion is translated as dharma in major Indian languages, dharma and religion are etymologically different and dharma is closer to spirituality than religion as an organized institution. Religion and spirituality play important roles in the lives of millions of Indians and therefore, Indian physicians need to respectfully acknowledge religious issues and address the spiritual needs of their patients. Incorporating religion and spirituality into health and medicine may also go a long way in making the practice of medicine more holistic, ethical and compassionate. It may also offer new opportunities to learn more about Ayurveda and other traditional systems of medicine and have more enriched understanding and collaborative interaction between different systems of medicine. Indian physicians may also find religion and spirituality significant and fulfilling in their own lives.

  18. "They think we're OK and we know we're not". A qualitative study of asylum seekers' access, knowledge and views to health care in the UK

    Directory of Open Access Journals (Sweden)

    Mullen Kenneth

    2007-05-01

    Full Text Available Abstract Background The provision of healthcare for asylum seekers is a global issue. Providing appropriate and culturally sensitive services requires us to understand the barriers facing asylum seekers and the facilitators that help them access health care. Here, we report on two linked studies exploring these issues, along with the health care needs and beliefs of asylum seekers living in the UK. Methods Two qualitative methods were employed: focus groups facilitated by members of the asylum seeking community and interviews, either one-to-one or in a group, conducted through an interpreter. Analysis was facilitated using the Framework method. Results Most asylum seekers were registered with a GP, facilitated for some by an Asylum Support nurse. Many experienced difficulty getting timely appointments with their doctor, especially for self-limiting symptoms that they felt could become more serious, especially in children. Most were positive about the health care they received, although some commented on the lack of continuity. However, there was surprise and disappointment at the length of waiting times both for hospital appointments and when attending accident and emergency departments. Most had attended a dentist, but usually only when there was a clinical need. The provision of interpreters in primary care was generally good, although there was a tension between interpreters translating verbatim and acting as patient advocates. Access to interpreters in other settings, e.g. in-patient hospital stays, was problematic. Barriers included the cost of over-the-counter medication, e.g. children's paracetamol; knowledge of out-of-hours medical care; and access to specialists in secondary care. Most respondents came from countries with no system of primary medical care, which impacted on their expectations of the UK system. Conclusion Most asylum seekers were positive about their experiences of health care. However, we have identified issues

  19. [Use of information sources by recently graduated physicians of Lima].

    Science.gov (United States)

    Mejia, Christian R; Caceres, Onice J; Vera, Claudia A; Nizama-Vía, Ayar; Curioso, Walter H; Mayta-Tristán, Percy

    2014-01-01

    In order to determine the use of information sources by recently graduated physicians of Lima, Peru in 2011, a survey was conducted among graduated physicians at seven universities. They were asked about the use of search engines in the health area during their year of medical internship [last year of medical school]. Regular use was defined as the source being used once a week or daily. For 490 respondents, regularly used information sources were SciELO, accessed by 173 (36.4%); PubMed 165 (34.4%); HINARI 117 (25.5%); UpToDate 98 (22.3%); Cochrane Library 94 (20.6%); LILACS 91 (19.8%); a hospital institutional library 70 (15.0%); LIPECS 39 (8.7%); and Peru BVS 42 (9.3%). Only a minority regularly accessed information sources related to health. It is necessary to improve capacity in the efficient use of various resources of scientific information in a continuous way and that reaches students and health professionals. PMID:25597724

  20. The Impact of Direct Provision Accommodation for Asylum Seekers on Organisation and Delivery of Local Primary Care and Social Care Services: A Case Study

    LENUS (Irish Health Repository)

    Pieper, Hans-Olaf

    2011-05-15

    Abstract Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

  1. John Freind: physician, chemist, Jacobite, and friend of Voltaire's.

    Science.gov (United States)

    Rowlinson, J S

    2007-05-22

    John Freind (1675/76-1728) achieved distinction in several walks of life, first as a classical scholar, then as a physician and as a chemist who advocated Newtonian philosophy. His clinical practice was generally conservative and he was against the newly introduced practice of inoculating the smallpox. His principles were Tory and High Church; his loyalty to the house of Stuart involved him in the Jacobite plot of 1722, and a spell in the Tower of London. His money was part of the foundation of Dr Lee's benefaction to Christ Church, which still survives in name in scientific posts in Oxford. He was among the circle of friends that Voltaire formed during his two-year stay in England and, 50 years later, Voltaire took him and his son as the principal characters in a conte philosophique defending a deistic attitude against both atheism and revealed religion. PMID:17645124

  2. [Pieter Bleeker (1819-1878) physician and passionate naturalist].

    Science.gov (United States)

    van Heiningen, Teunis Willem

    2010-01-01

    Pieter Bleeker (1819-1878), born in a modest family, made his career as a naturalist and military physician in the Dutch East Indies (1842-1860). He maintained a lively correspondence with Auguste Duméril (Paris). Many scientific museums were eagerly looking forward to receiving parts of his splendid collections of tropical fishes. His "Atlas Ichthyologique des Indes Orientales Néerlandaises" was published between 1862 and 1877. His efforts, in the field of ichthyology and tropical medicine, rendered him two doctorates honoris causa (Leyden University--1846; Utrecht University--1849). In 1855 he was elected member of the Royal Netherlands Academy of Arts and Sciences. In 1856 he was elected correspondent of the Museum National d'Histoire Naturelle (Paris). In January 1864 he received the knighthood of the "Légion d'honneur" of the French empire. PMID:21560380

  3. Clinical Criteria for Physician Aid in Dying.

    Science.gov (United States)

    Orentlicher, David; Pope, Thaddeus Mason; Rich, Ben A

    2016-03-01

    More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized to provide a prescription for AID. Accordingly, we have updated the clinical criteria of Quill, et al., based on the many years of experience with AID. With more jurisdictions authorizing AID, it is critical that physicians can turn to reliable clinical criteria. As with any medical practice, AID must be provided in a safe and effective manner. Physicians need to know (1) how to respond to a patient's inquiry about AID, (2) how to assess patient decision making capacity, and (3) how to address a range of other issues that may arise. To ensure that physicians have the guidance they need, Compassion & Choices convened the Physician Aid-in-Dying Clinical Criteria Committee, in July 2012, to create clinical criteria for physicians who are willing to provide AID to patients who request it. The committee includes experts in medicine, law, bioethics, hospice, nursing, social work, and pharmacy. Using an iterative consensus process, the Committee drafted the criteria over a one-year period. PMID:26539979

  4. Opinions of Family Physicians about Family Counseling

    Directory of Open Access Journals (Sweden)

    Kenan Taştan1

    2016-04-01

    Full Text Available Objective: As of mission, Family physician is responsible for all the health problems of the family members. In this sense, it is necessary to counsel individuals and families in need. In this study, it is aimed to evaluate the knowledge and thoughts of family physicians about family counseling in Turkey. Methods: The Research was conducted among the family physicians working in Turkey in 2013. In order to get demographic characteristics, opinions and suggestions of the family physicians about family counseling, a questionnaire was developed by the researchers. The survey was administered to the participants via the internet. Data from 421 participants were evaluated. Results: The mean age of participants was 41.7 ± 7.2 years. 67.1% of them were male and 32.9% female. Of the participants, while 11.3% stated that they received training in family counseling, 88.7% stated not received. When the frequency of family counseling need was questioned, 3.4% of the participants pointed out that they have never needed, 44% is rarely needed, 39.9% frequently needed, 12.7% very frequently needed. Of the family physicians, while 21.7% was thinking that they are competent about solving family problems, 78.3% was not competent. Meanwhile, 76.3% of family physicians wanted to have training on the family counseling, while 23.7% stated that they do not want. Conclusion: It was found that there is a shortage of training of the family physicians on the subject of family counseling. In order to compensate this shortage, it would be beneficial to include the subject of family counseling in the curriculum of medical faculty and arrange in-service training to the family doctors working in the primary care.

  5. [Physician practice patterns and attitudes to euthanasia in Germany. A representative survey of physicians].

    Science.gov (United States)

    Kirschner, R; Elkeles, T

    1998-04-01

    Growing life expectancy and increasing pharmaceutical and technical methods in medicine are leading to more and more discussions among the general population and among physicians as to whether methods to shorten the sufferings of mortally ill persons should be legalised further. In Australia 60% of physicians wish to be able to perform active euthanasia if this would be legal. In the Netherlands physicians do not commit an offence if they perform euthanasia on the basis of ethically consented rules. In the FRG the National Board of Physicians (Bundesärztekammer) still rejects any liberalisation concerning active euthanasia. However, little is known of the attitudes and behaviour of physicians concerning the questions of active and passive euthanasia. Sponsored by Gruner and Jahr publishers for a magazine "Stern" publication we conducted a representative study among physicians working in hospitals and their colleagues in free practices concerning this topic. Beginning with qualitative interviews with 50 physicians we tested the questionnaire developed and looked for the data production method best fitting for this difficult matter resulting in telephone interviews or a self-administered questionnaire. In the main study a representative sample of n = 282 physicians in free practices and n = 191 physicians in hospitals were interviewed. The response rates were 94% and 51% respectively. Analysis of non-responses did not indicate any bias. Half of the physicians think that a broader discussion on euthanasia is necessary, 34% disagree and 17% consider even a discussion already dangerous. 6% of the physicians in hospitals and 11% in free practices have already experienced methods of active euthanasia. Half of the physicians have seen patients who strongly wished euthanasia, a situation which happens once in every two years. The majority of physicians feel a deep understanding but only a minority of 4% comply with the wish. The vast majority of physicians advocate

  6. IN WHICH DIRECTION DO THE EFFORTS PROCEED? THE EUROPEAN UNION’S ATTEMPTS TO DEVELOP A COMMON IMMIGRATION AND ASYLUM POLICY

    OpenAIRE

    Şirin Öner, N. Aslı

    2015-01-01

    In the period which began in the mid-1980s and continued until today, there has been an increase in the number of refugees, asylum-seekers and irregular migrants. The Central and Eastern Europeans, who had the opportunity to participate in the migration movements with the removal of the political barriers and the persons displaced as a result of bloody conflicts in the Balkans played an important role in the increase in the number of people migrating to the Western Europe. The increase in the...

  7. Patient Trust in Physicians: Empirical Evidence from Shanghai, China

    Directory of Open Access Journals (Sweden)

    Da-Hai Zhao

    2016-01-01

    Conclusions: Patient trust in physicians in Shanghai, China is higher than previously reported. Furthermore, the most crucial reason for patient distrust in physicians is the information asymmetry between patients and physicians, which is a natural property of the physician–patient relationship, rather than the so-called for-profit characteristic of physicians or patients' excessive expectations.

  8. Opinions of Primary Care Family Physicians About Family Medicine Speciality Training Program

    Directory of Open Access Journals (Sweden)

    Hamit Sirri Keten

    2014-04-01

    Material and Method: A total of 170 family physicians working in Kahramanmaras were included in the study. After obtaining informed consent a questionnaire comprising questions regarding socio-demographic properties, conveying contracted family physicians as family medicine specialists and organization of the training program was applied to participants. Results: Among physicians participating in the study 130 (76.5% were male and 40 (23.5% were female, with a mean age of 40.7±7.1 (min = 26 years, max = 64 years. The mean duration of professional experience of physicians was 15.3±7.0 (min = 2 years, max = 40 years years. Of all, 91 (53.5% participants had already read the decree on family medicine specialist training program for contracted family physicians. A hundred and fifteen (67.6% family physicians supported that Family Medicine Specialty program should be taken part-time without interrupting routine medical tasks. Only 51 (30.0% participants stated the requirement of an entrance examination (TUS for family medicine specialty training. Conclusion: Family medicine specialty training program towards family physicians should be considered in the light of scientific criteria. In family medicine, an area exhibited a holistic approach to the patient; specialty training should be through residency training instead of an education program. For this purpose, family medicine departments in medical faculties should play an active role in this process. Additionally further rotations in needed branches should be implemented with a revision of area should be performed. In medicine practical training is of high importance and distant or part-time education is not appropriate, and specialist training shall be planned in accordance with the medical specialty training regulations. [Cukurova Med J 2014; 39(2.000: 298-304

  9. A instituição asilar como fator potencializador da disfagia The asylum as worsening factor for dysphagia

    Directory of Open Access Journals (Sweden)

    Ana Maria Furkim

    2010-12-01

    Full Text Available OBJETIVO: verificar se as condições referentes à estrutura geral dos asilos, recursos humanos e rotinas diárias de alimentação em instituições asilares, podem potencializar alterações da dinâmica da deglutição em idosos. MÉTODOS: foi aplicado questionário aos dirigentes de cinco instituições asilares do município do Rio de Janeiro, no qual constavam perguntas em relação aos recursos materiais, humanos e rotina alimentar. RESULTADOS: o asilo do sistema privado foi o único a aproximar-se das condições ideais da estrutura geral para o atendimento do idoso. Em relação aos recursos humanos existentes, nenhum dos asilos possuía todos os profissionais exigidos pela portaria nº810/89. Em relação às rotinas diárias de alimentação, em uma das instituições pesquisadas, cuja maioria dos residentes não faziam uso de próteses dentárias, não havia restrição na consistência alimentar oferecida. Outro fator significativo diz respeito à negligência referente à higiene bucal, favorecendo a colonização de bactérias na cavidade oral, podendo agravar infecções pulmonares no caso de microaspirações. O fato dos idosos deitarem para dormir logo após o término das refeições, como ocorrido em três das instituições pesquisadas, tem grande importância na medida em que favorece a ocorrência de episódios de refluxo gastroesofágico. CONCLUSÃO: foram observados que em todas as instituições pesquisadas há fatores que podem potencializar um distúrbio de deglutição, como problemas em relação à estrutura geral e ou aos recursos humanos e ou relativos à rotina alimentar estabelecida.PURPOSE: to check if the conditions related to general structure, human resources and daily routine of feeding in asylums can increase the chances for an alteration in the deglutition process of the elderlies. METHODS: a questionnaire was elaborated to be applied to the directors of five institutions in the city of Rio de Janeiro

  10. Motivational determinants among physicians in Lahore, Pakistan

    Directory of Open Access Journals (Sweden)

    Souares Aurélia

    2010-07-01

    Full Text Available Abstract Introduction Human resource crises in developing countries have been identified as a critical aspect of poor quality and low accessibility in health care. Worker motivation is an important facet of this issue. Specifically, motivation among physicians, who are an important bridge between health systems and patients, should be considered. This study aimed to identify the determinants of job motivation among physicians, a neglected perspective, especially in developing countries. Methods A stratified random sample of 360 physicians was selected from public primary, public secondary and public and private tertiary health facilities in the Lahore district, Pakistan. Pretested, semi-structured, self-administered questionnaires were used. For the descriptive part of this study, physicians were asked to report their 5 most important work motivators and demotivators within the context of their current jobs and in general. Responses were coded according to emergent themes and frequencies calculated. Of the 30 factors identified, 10 were classified as intrinsic, 16 as organizational and 4 as socio-cultural. Results Intrinsic and socio-cultural factors like serving people, respect and career growth were important motivators. Conversely, demotivators across setups were mostly organizational, especially in current jobs. Among these, less pay was reported the most frequently. Fewer opportunities for higher qualifications was a demotivator among primary and secondary physicians. Less personal safety and poor working conditions were important in the public sector, particularly among female physicians. Among private tertiary physicians financial incentives other than pay and good working conditions were motivators in current jobs. Socio-cultural and intrinsic factors like less personal and social time and the inability to financially support oneself and family were more important among male physicians. Conclusion Motivational determinants differed

  11. When the foundations of life have been upset... An integrated clinical and experimental study with refugees an asylum seekers

    Directory of Open Access Journals (Sweden)

    Schiltz, Lony

    2013-06-01

    Full Text Available Aim Recent research results in clinical psychology, health psychology and neurobiology underline the relationship between dissociative states, complex posttraumatic syndromes and borderline functioning [11]. Our study is meant to investigate the traumatic hypothesis of borderline functioning and to develop appropriate psychotherapeutic measures based on artistic mediations.Material and Methods.To estimate the effect of traumatic events, from the beginning of life up to recent stressors, linked to natural catastrophes, war, political persecution and migration, we undertook an integrated clinical and experimental study with a sample of 73 refugees and asylum seekers. In a second stage, those who suffered from PTSD or complex post-traumatic states were offered to attend arts psychotherapeutic sessions.To investigate the personality functioning at the structural level, we used a mixed quantitative and qualitative methodology, combining a semi-structured biographical interview, a projective test, i.e. the Sentences Completion Test, for which we developed a new manner of interpretation, and psychometric scales, i.e. the HADS and the Index of Wellbeing . Furthermore, we analysed the artistic production (pictures, stories written under musical induction with the help of rating scales constructed in the phenomenological and structural tradition.Results. With the help of non parametric multidimensional statistics, we extracted two profiles of personality functioning, linked either to repeated breaks, negligence and maltreatment from the beginningof life, or either to a recent external catastrophe, interrupting a continuous life course. Through the evaluation of the arts therapeutic sessions, we could note the first signs of resumption of the blocked process of subjectivation.Discussion.The results of the study support the traumatogenic hypothesis of borderline functioning, as well as current clinical considerations concerning the defensive role of

  12. Sleep and recovery in physicians on night call: a longitudinal field study.

    OpenAIRE

    Malmberg Birgitta; Kecklund Göran; Karlson Björn; Persson Roger; Flisberg Per; Ørbaek Palle

    2010-01-01

    Abstract Background It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and reco...

  13. DIABETIC RETINOPATHY: HOW AWARE ARE THE PHYSICIANS?

    Directory of Open Access Journals (Sweden)

    Narendra P

    2014-05-01

    Full Text Available PURPOSE: The purpose of the study was to assess the awareness of physicians in rural Kolar district towards diabetes and diabetic retinopathy. MATERIALS AND METHODS: A cross sectional survey was conducted in rural Kolar district during May 2013. The study participants were 38 physicians and 2 general practitioners who had special training in diabetes. The data were collected by means of filling up of pre-tested specially designed questionnaires focused on awareness towards Diabetes Mellitus and Diabetic retinopathy. The assessment was done by total score as satisfactory (Diabetic retinopathy awareness index >12, moderately satisfactory (DRAI 9-11 or unsatisfactory if index 12 was attained by only 55% (22/40 practitioners. Nearly 62.5% of physicians refer the diabetics to ophthalmologists only when they develop significant vision problems. CONCLUSION: This survey highlighted some of the lacunae in the knowledge about referral system of the general physicians and identified the need for improvement in awareness regarding the management of the patients with diabetes and diabetic retinopathy. To improve patient compliance, physician needs to educate their diabetic patients about the importance of setting an annual eye examination routinely before the development of vision loss.

  14. The physician's response to climate change.

    Science.gov (United States)

    Sarfaty, Mona; Abouzaid, Safiya

    2009-05-01

    Climate change will have an effect on the health and well-being of the populations cared for by practicing physicians. The anticipated medical effects include heat- and cold-related deaths, cardiovascular illnesses, injuries and mental harms from extreme weather events, respiratory illnesses caused by poor air quality, infectious diseases that emanate from contaminated food, water, or spread of disease vectors, the injuries caused by natural disasters, and the mental harm associated with social disruption. Within several years, such medical problems are likely to reach the doorsteps of many physicians. In the face of this reality, physicians should assume their traditional roles as medical professionals, health educators, and community leaders. Clinicians provide individual health services to patients, some of whom will be especially vulnerable to the emerging health consequences of global warming. Physicians also work in academic medical institutions and hospitals that educate and provide continuing medical education to students, residents, and practitioners. The institutions also produce a measurable carbon footprint. Societies of physicians at national, state, and local levels can choose to use their well-developed avenues of communication to raise awareness of the key issues that are raised by climate change as well as other environmental concerns that have profound implications for human health and well-being. PMID:19418286

  15. Do emergency physicians trust their patients?

    Science.gov (United States)

    Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Ammirati, Christine; Bertrand, Catherine; Charlin, Bernard; Dory, Valérie

    2016-06-01

    The primary focus of research on the physician-patient relationship has been on patients' trust in their physicians. In this study, we explored physicians' trust in their patients. We held semi-structured interviews with expert emergency physicians concerning a patient they had just been managing. The physicians had been equipped with a head-mounted micro camera to film the encounter from an "own point of view perspective". The footage was used to stimulate recall during the interviews. Several participants made judgments on the reliability of their patients' accounts from the very beginning of the encounter. If accounts were not deemed reliable, participants implemented a variety of specific strategies in pursuing their history taking, i.e. checking for consistency by asking the same question at several points in the interview, cross-referencing information, questioning third-parties, examining the patient record, and systematically collecting data held to be objective. Our study raises the question of the influence of labeling patients as "reliable" or "unreliable" on their subsequent treatment in the emergency department. Further work is necessary to examine the accuracy of these judgments, the underlying cognitive processes (i.e. analytic versus intuitive) and their influence on decision-making. PMID:26907536

  16. Physician-Hospital Alignment in Orthopedic Surgery.

    Science.gov (United States)

    Bushnell, Brandon D

    2015-09-01

    The concept of "alignment" between physicians and hospitals is a popular buzzword in the age of health care reform. Despite their often tumultuous histories, physicians and hospitals find themselves under increasing pressures to work together toward common goals. However, effective alignment is more than just simple cooperation between parties. The process of achieving alignment does not have simple, universal steps. Alignment will differ based on individual situational factors and the type of specialty involved. Ultimately, however, there are principles that underlie the concept of alignment and should be a part of any physician-hospital alignment efforts. In orthopedic surgery, alignment involves the clinical, administrative, financial, and even personal aspects of a surgeon's practice. It must be based on the principles of financial interest, clinical authority, administrative participation, transparency, focus on the patient, and mutual necessity. Alignment can take on various forms as well, with popular models consisting of shared governance and comanagement, gainsharing, bundled payments, accountable care organizations, and other methods. As regulatory and financial pressures continue to motivate physicians and hospitals to develop alignment relationships, new and innovative methods of alignment will also appear. Existing models will mature and evolve, with individual variability based on local factors. However, certain trends seem to be appearing as time progresses and alignment relationships deepen, including regional and national collaboration, population management, and changes in the legal system. This article explores the history, principles, and specific methods of physician-hospital alignment and its critical importance for the future of health care delivery. PMID:26375539

  17. The occupational hazards of emergency physicians.

    Science.gov (United States)

    Dorevitch, S; Forst, L

    2000-05-01

    Emergency physicians are exposed to a variety of occupational hazards. Among these are infectious diseases, such the human immunodeficiency virus, hepatitis B and C viruses, and tuberculosis. Hepatitis G virus is transmissible but may not be a cause of illness. The likelihood of being exposed to these agents appears to be higher in the ED than other medical settings but estimates of the prevalence of these diseases in the ED vary, depending on the patient population served. Estimates of risk for contracting these infections are reviewed. Measures to prevent these exposures can reduce risk, but compliance is low, particularly for those involving changes in the behavior of emergency physicians (such as not recapping needles). Latex allergy is a hazard of health care workers. Its prevalence is reported to be quite high, but these findings are difficult to interpret in the absence of a universally accepted definition of the condition. Its prevalence in emergency physicians is not known. Other noninfectious hazards include workplace violence and exposure to nitrous oxide. The health effects of rotating shift work may put emergency physicians at increased risk of coronary artery disease and impaired reproductive health. Emotional stress is another hazard of emergency physicians, and may lead to burnout. PMID:10830687

  18. Physician boundary violations in a physician's health program: a 19-year review.

    Science.gov (United States)

    Brooks, Elizabeth; Gendel, Michael H; Early, Sarah R; Gundersen, Doris C; Shore, Jay H

    2012-01-01

    Managing and treating physicians with professional boundary violations is of paramount importance with vast implications for public safety. Physician Health Programs (PHPs) evaluate and monitor many, if not most, physicians receiving care for these abuses. We conducted a chart review of 120 physicians monitored for boundary violations. We made intergroup and intragroup comparisons (i.e., examining nonpatient, patient nonsexual, and patient sexual offenses). The violator group as a whole differed from the general PHP population, in that more were men between 40 and 49 years of age. More of the violators were mandated for evaluation and reported an abusive history. The rate of psychiatrists exceeded that typically seen by the PHP. Other differences were found according to the type of violation committed. Post hoc analysis revealed that physician-patients with a history of prior boundary violations were more likely to commit violations of a sexual nature. No further incidents were reported for 88 percent of the cohort. PMID:22396343

  19. Anger Management and Factors that Influence Anger in Physicians

    OpenAIRE

    Emel Koçer; Abdulkadir Koçer; Fatih Canan

    2011-01-01

    Objective: There are limited data regarding anger and its management with respect to physicians and many other professionals. Our objective was to evaluate anger expression and control in physicians. Material and Methods: The physicians of the Düzce School of Medicine were the participants in the study. Physicians were assigned to either an internal medicine or a surgery study group. Each group contained physicians from several specialties. The Spielberger State-Trait Anger Expression Invento...

  20. Anger Management and Factors that Influence Anger in Physicians

    OpenAIRE

    Koçer, Emel; Koçer, Abdulkadir; Canan, Fatih

    2011-01-01

    Objective: There are limited data regarding anger and its management with respect to physicians and many other professionals. Our objective was to evaluate anger expression and control in physicians. Material and Methods: The physicians of the Düzce School of Medicine were the participants in the study. Physicians were assigned to either an internal medicine or a surgery study group. Each group contained physicians from several specialties. The Spielberger State-Trait Anger Expressi...

  1. Determinants of increasing trends of self-medication: physicians, perspectives

    OpenAIRE

    Khan, Hafeezullah; Maheen, Safirah; Bashir, Sajid; Abbas, Ghulam; Sher, Muhammad; Ashraf, Zaman; Mahmood, Asif; Sarfraz, Mohammad K.

    2012-01-01

    The objective of study was to take and evaluate opinions of the physicians about various aspects of self-medication. A self-fabricated questionnaire of 38 questions was distributed among 292 physicians. Prominent involvement of females in self-medication was suggested by 176 (60 %) physicians. The self-medication trend is more common in financially lower class as reported by 146 (50 %) physicians and in uneducated community as suggested by 165 (57 %) physicians. Family habits and easy to reme...

  2. Effectiveness of a Unique Support Group for Physicians in a Physician Health Program.

    Science.gov (United States)

    Sanchez, Luis T; Candilis, Philip J; Arnstein, Fredrick; Eaton, Judith; Barnes Blood, Diana; Chinman, Gary A; Bresnahan, Linda R

    2016-01-01

    State Physician Health Programs (PHPs) assess, support, and monitor physicians with mental, behavioral, medical, and substance abuse problems. Since their formation in the 1970s, PHPs have offered support groups following the 12-step model for recovery from substance use disorders (SUDs). However, few programs have developed support groups for physicians without SUDs. This study at the Massachusetts PHP (Physician Health Services Inc.) represents the first effort to survey physician attitudes concerning a unique support group that goes beyond classic addiction models. The group was initiated because of the observation that physicians with problems other than SUDs did not fit easily into the 12-step framework. It was hypothesized that such a group would be effective in helping participants control workplace stress, improve professional and personal relationships, and manage medical and psychiatric difficulties. With a response rate of 43% (85 respondents), the survey identified a strong overall impact of the Physician Health Services Inc. support group, identifying positive effects in all areas of personal and professional life: family and friends, wellness, professional relationships, and career. Respondents identified the role of the facilitator as particularly important, underscoring the facilitator's capacity to welcome participants, manage interactions, set limits, and maintain a supportive emotional tone. The implications for physician health extend from supporting a broader application of this model to using a skilled facilitator to manage groups intended to reduce the stress and burnout of present-day medical practice. The results encourage PHPs, hospitals, medical practices, and physician groups to consider implementing facilitated support groups as an additional tool for maintaining physician health. PMID:26813489

  3. Still on physicians' attitude to medical marijuana

    Directory of Open Access Journals (Sweden)

    Olukayode Abayomi

    2014-12-01

    Full Text Available Desai and Patel highlighted in a recent review that and ldquo;there are several issues related to medical marijuana, which concern public health such as its medical use, harmful effects, laws and physicians role. and rdquo; Certainly, physician's perspectives and position on the relative harm and benefits of marijuana contribute to the growing controversy over its legalization in western countries. Interestingly, the seeming resistance of physicians in western countries to marijuana prescription appears to mirror the position of psychiatrists in developing countries. For instance, in a recent survey of psychiatrists in Nigeria, up to 55% of psychiatrists were against the medical use of marijuana. [Int J Basic Clin Pharmacol 2014; 3(6.000: 1098-1098

  4. Physician unionization: a threat to integration?

    Science.gov (United States)

    1999-08-01

    Physicians, primarily those salaried by hospitals and health systems, are increasingly turning to labor unions to help them in their frustration over what they see as eroding clinical autonomy as well as diminishing compensation. Significantly, non-salaried physicians are also looking to the concept of collective bargaining as a tool in their negotiations with health insurers. The pro-labor doctors may get some of what they're looking for in the coming months and years, with a combination of economic and political forces driving the nascent trend forward regionally and nationwide. But victory won't come without a struggle and some major legal and regulatory hassles. And what will physician unionization mean for integrated health systems and other large healthcare organizations? Plenty, say industry observers and those in the trenches. PMID:10557405

  5. Low Job Satisfaction Among Physicians in Egypt

    Directory of Open Access Journals (Sweden)

    Amira Gamal Abdel-Rahman

    2008-04-01

    Full Text Available AIM/BACKGROUND: Physician’s job satisfaction is a cornerstone for improving the quality of health care, and its continuity. To identify the extent of job satisfaction and explain its main components among physicians, together with finding out the main indicators for job satisfaction. METHODS: We randomly selected physicians from the Egyptian Ministry of Health and Population Hospitals. All participants were asked to fill a self administrated questionnaire which included data pertaining socio-demographic characteristics and job satisfaction regarding salaries/incentives, monitoring, administration system, management, career satisfaction, relationship with colleagues, social support, opportunities for promotion, and job responsibilities. Satisfied was defined as satisfaction of>60%. RESULTS: Two hundred and thirty eight physicians participated in this study; with mean age of 37.1+ 9.4 years, and 70.2% were males. Only 42.9% of the physicians’ reported job satisfaction. Relationship with colleagues was the most important component of satisfaction with mean of 81.3+19.6 while, salaries/incentives were the least one with mean of 16.2+ 14. The overall current satisfying domains were not significantly associated with marital status or educational level, however it was significantly associated with specialty. Neither age nor gender was significantly associated with the degree of job satisfaction. CONCLUSION: Our results call for paying more attention to improve physicians’ job satisfaction in Egypt, to meet needed higher standards in health care. [TAF Prev Med Bull 2008; 7(2.000: 91-96

  6. The Artistic Activities of Family Physicians

    Directory of Open Access Journals (Sweden)

    Adem Özkara1,2

    2015-03-01

    Full Text Available Objective: Medicine and art have been intertwined throughout history. Physicians who are interested in art are known more successful and satisfied than others. The aim of this study is to detect the interest of family doctors about art; to find out branch of art interested in and to determine the importance of the art in medical practice. Methods: This cross-sectional study was accessing with conducted family physicians via e-mail in January-February 2012. A questionnaire, which determines the interest of Family Physicians of art, was administered to physicians. 272 (18%. Participants replied to our descriptive questionnaire study. Results: There were 133 (48.9% male and 139 (51.1% female. 156 (57.4% participants were interested in arts. The most common three interests of participants are: 26.5% (n=72 photography, 14.7% (n=40 literacy, 14.0% (n=38 painting. Artistic activities, which the participants wanted to do, 26.4% (n=72, play a musical instrument, 16.2% (n=44, painting, 7% (n=19, and theater. There’s a statistically significant relation between thinking “medicine is an art” and being interested in arts. Conclusion: Our study confirms the most interested art forms are photography and writing and the most wanted art form to do are playing musical instruments and painting. In our study, communication with patients was emphasized as an art in family medicine at descriptions of majority of the physicians. Therefore, family physicians are needed to support the arts orientation.

  7. Screening for hepatocellular carcinoma by Egyptian physicians

    Institute of Scientific and Technical Information of China (English)

    Sahar; M; Hassany; Ehab; F; Abdou; Moustafa; Mohamed; El; Taher; Afaf; Adel; Abdeltwab; Hubert; E; Blum

    2015-01-01

    AIM: To assess the practice of Egyptian physicians in screening patients for hepatocellular carcinoma(HCC). METHODS: The study included 154 physicians from all over Egypt caring for patients at risk for HCC. The study was based on a questionnaire with 20 items. Each questionnaire consisted of two parts:(1) personal information regarding the physician(name, age, specialty and type of health care setting); and(2) professional experience in the care of patients at risk for HCC development(screening, knowledge about the cause and natural course of liver diseases and HCC risk). RESULTS: Sixty-eight percent of doctors with an MD degree, 48% of doctors with a master degree or a diploma and 40% of doctors with a Bachelor of Medicine, Bachelor of Surgery certificate considered the hepatitis C virus(HCV) genotype as risk factor for HCC development(P < 0.05). Ninety percent of physicians specialized in tropical medicine, internal medicine or gastroenterology and 67% of physicians in other specialties advise patients to undergo screening for HCV and hepatitis B virus infection as well as liver cirrhosis(P < 0.05). Eighty-six percent of doctors in University Hospitals and 69% of Ministry of Health(MOH) doctors consider HCV infection as the leading cause of HCC in Egypt(P < 0.05). Seventy-two percent of doctors with an MD degree, 55% of doctors with a master degree or a diploma, 56% of doctors with an MBBCH certificate, 74% of doctors in University Hospitals and 46% of MOH hospital doctors consider abdominal ultrasonography as the most important investigation in HCC screening(P < 0.05). Sixty-five percent of physicians in tropical medicine, internal medicine or gastroenterology and 37% of physicians in other specialties recommend as HCC screening interval of 3 mo(P < 0.05). Seventy-one percent of doctors with an MD degree, 50% of doctors with a master degree or diploma and 60% of doctors with an MBBCH certificate follow the same recommendation.CONCLUSION: In Egypt, physicians

  8. Healthcare economics for the emergency physician.

    Science.gov (United States)

    Propp, Douglas A; Krubert, Christopher; Sasson, Andres

    2003-01-01

    Although the principles of healthcare economics are not usually part of the fundamental education of emergency physicians, an understanding of these elements will enhance our ability to contribute to improved health-care value. This article introduces the practical aspects of microeconomics, insurance, the supply-and-demand relationship, competition, and costs as they affect the practice of medicine on a daily basis. Being cognizant of how these elements create a dynamic interplay in the health-care industry will allow physicians to better understand the expanded role they need to assume in the ongoing cost and quality debate. PMID:12563583

  9. Physicians practicing other occupations, especially literature.

    Science.gov (United States)

    Green, J P

    1993-03-01

    Literature has been the favored nonmedical pursuit of physicians probably because the practice of medicine is suffused with narratives, the patient's history being one. Arthur Conan Doyle regarded medicine as a "grim romance," Somerset Maugham as an opportunity to see "life in the raw," and William Carlos Williams treated "the patient as a work of art." These sentiments may be linked to humanistic medicine. At some medical schools, literature is taught in the context of and integrated with medicine in an attempt to enhance ethics and empathy which were explicitly expressed by some physician-writers. PMID:8469245

  10. Regional and individual differences in physician practices for joint-ventured versus non-joint-ventured physicians.

    OpenAIRE

    Ahern, M; Scott, E.

    1994-01-01

    OBJECTIVE. This article compares characteristics of physicians who have invested in health care business (joint ventures) to characteristics of physicians who have not, based on a survey of Florida physicians. DATA SOURCES/STUDY SETTING. In early 1990, a survey was mailed to a stratified random sample of 1,000 Florida physicians. Half were randomly selected from lists of joint-ventured physicians who had been identified as owners in a previous study by the Florida Health Care Cost Containment...

  11. If You Want to Go Fast Go Alone, If You Want to Go Far Go Together: On Context-Sensitive Group Treatment of Asylum Seekers and Refugees Traumatized by War and Terror

    NARCIS (Netherlands)

    Drozdek, B.

    2014-01-01

    This thesis presents a model for understanding psychological consequences of exposure to war, torture and political violence in asylum seekers and refugees. This contextual, developmental, and culture-sensitive model is based on theoretical and empirical findings and implies framing and interpreting

  12. [Ethics and occupational physicians: ethics and mission required for occupational physicians].

    Science.gov (United States)

    Fujino, Akihiro

    2013-10-01

    The ethics of occupational physicians are considered from the following three viewpoints: (1) their legal standing and ethics in job execution; (2) ethics in research in occupational medicine; and (3) ethics in the 21st century and fundamental issues. We discuss: in (1), the contract types of occupational physicians and their independency and neutrality, the protection of health information and privacy, and the use of authority and the security measures; in (2), ethical standards of medical research in Japanese and international organizations, the significance and role of ethics committees, and issues characteristic of occupational health research; and in (3), occupational physicians and politic ethics, the practical abilities and ethics necessary for occupational physicians, and the practice and philosophy of occupational medicine as an art. These considerations suggest that occupational physicians, who have a special status based on the governmental policy of the occupational physician system, should develop an ethical consciousness at the core of their duties and perform their mission with responsibility to employees and employers, all of whom are Japanese citizens. Finally, we propose that the ultimate mission of occupational physicians is "to practice occupational medicine as a branch of the humanities." PMID:24107330

  13. Instrumental and affective aspects of physician behavior.

    NARCIS (Netherlands)

    Bensing, J.M.; Dronkers, J.

    1992-01-01

    In a semi-replication study, 103 videotaped real-life general practice consultations of patients with hypertension were observed with Roter's interaction Analysis System (RIAS). RIAS consists of a detailed category system meant to measure each verbal utterance of physician and patient (distinguished

  14. Leadership Attributes of Physician Assistant Program Directors

    Science.gov (United States)

    Eifel, Raymond Leo

    2014-01-01

    Physician assistant (PA) program directors perform an essential role in the initiation, continuation, and development of PA education programs in the rapidly changing environments of both health care and higher education. However, only limited research exists on this academic leader. This study examined the leadership roles of PA program directors…

  15. Physician-patient communication: a lost art?

    Science.gov (United States)

    Frymoyer, John W; Frymoyer, Nan P

    2002-01-01

    In the face of rapid advances in technology, there has been a progressive deterioration of effective physician-patient communication. The American Academy of Orthopaedic Surgeons has identified that patients rate the orthopaedic profession as high in technical and low in communication skills. Poor communication, especially patient-interviewing skills, has been identified in medical students as well as in practicing physicians. Effective communication is associated with improved patient and physician satisfaction, better patient compliance, improved health outcomes, better-informed medical decisions, and reduced malpractice suits, and it likely contributes to reduced costs of care. Recognition of the importance of communication has influenced medical schools to revise curricula and to teach communication skills in residency training and continuing medical education programs. National certifying examinations also are being designed to incorporate these skills. Although written material is useful in increasing awareness of the importance of good physician-patient communication, behavioral change is more likely to occur in a workshop environment. The American Academy of Orthopaedic Surgeons is taking leadership in designing and implementing such an approach for its membership. PMID:11929204

  16. Physician-assisted death and the anesthesiologist.

    Science.gov (United States)

    Mottiar, Miriam; Grant, Cameron; McVey, Mark J

    2016-03-01

    Although physician-assisted death (PAD) is established in certain countries, the legality and ethics of this issue have been debated for decades in Canada. The Supreme Court of Canada has now settled the issue of legality nationally, and as a result of the decision in Carter v. Canada, PAD (which includes both physician-assisted suicide and euthanasia) will become legal on February 6, 2016. It is difficult to predict the potential demand for PAD in Canada. This paper highlights other countries' experiences with PAD in order to shed light on this question and to forecast issues that Canadian physicians will face once the change to the law comes into effect. At present, there is no legislative scheme in place to regulate the conduct of PAD. Physicians and their provincial colleges may find themselves acting as the de facto regulators of PAD if a regulatory vacuum persists. With their specialized knowledge of pharmacology and interdisciplinary leadership, anesthesiologists may be called upon to develop protocols for the administration of PAD as well as to administer euthanasia. Canadian anesthesiologists currently have a unique opportunity to consider the complex ethical issues they will face when PAD becomes legal and to contribute to the creation of a regulatory structure that will govern PAD in Canada. PMID:26739697

  17. Physician Fee Schedule National Payment Amount File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The significant size of the Physician Fee Schedule Payment Amount File-National requires that database programs (e.g., Access, dBase, FoxPro, etc.) be used to read...

  18. Industrial hygiene protection for the podiatric physician

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, B.S.

    1987-07-01

    The podiatrist should remain alert to the potential for exposure to hazardous agents such as those discussed in this article. Exposures in the office or hospital may be evaluated by the methods of industrial hygiene. If control is needed, simple measures can frequently effect substantial reduction in exposure and afford protection to the physician, staff, and patient.

  19. Physician Self-Audit: A Scoping Review

    Science.gov (United States)

    Gagliardi, Anna R.; Brouwers, Melissa C.; Finelli, Antonio; Campbell, Craig E.; Marlow, Bernard A.; Silver, Ivan L.

    2011-01-01

    Introduction: Self-audit involves self-collection of personal performance data, reflection on gaps between performance and standards, and development and implementation of learning or quality improvement plans by individual care providers. It appears to stimulate learning and quality improvement, but few physicians engage in self-audit. The…

  20. Navigating Government Service as a Physician

    Science.gov (United States)

    Koh, Howard K.

    2016-01-01

    Working in government can be a remarkable life experience for anyone but particularly for those who have trained in the worlds of medicine and public health. This article describes some lessons learned from a physician initially based in academic medicine and public health who has since spent more than a decade serving in leadership positions at…

  1. Parasitic Skin Infections for Primary Care Physicians.

    Science.gov (United States)

    Dadabhoy, Irfan; Butts, Jessica F

    2015-12-01

    The 2 epidermal parasitic skin infections most commonly encountered by primary care physicians in developed countries are scabies and pediculosis. Pediculosis can be further subdivided into pediculosis capitis, corporis, and pubis. This article presents a summary of information and a review of the literature on clinical findings, diagnosis, and treatment of these commonly encountered parasitic skin infestations. PMID:26612378

  2. The Impaired Physician: Some Coping Mechanisms

    OpenAIRE

    Nicholson, J. F.

    1980-01-01

    Doctoring is a stressful way of life. Both normal and neurotic needs can increase the complexity of the family physician's life. Certain vulnerable doctors seek easement in tranquilizers, sedatives or alcohol, and can become addicted. Impairment may be episodic or steady, leading to deterioration in personality and ability

  3. The National Day for the Libyan Physician

    Directory of Open Access Journals (Sweden)

    Elmahdi A. Elkhammas

    2007-03-01

    Full Text Available The health sector is a vital component of the growth and maintenance of every economy. When you examine any country’s annual budget, you immediately recognize that a large proportion goes to the healthcare sector. You may also see it is a part of expenditure and not of productivity. In other words, healthcare is a liability item when it comes to the budget. Libya is no exception.The goal of the health planners is to allocate the healthcare budget in ways that will ultimately result in a healthier society. In Libya, unfortunately, it is not clear how much of the budget goes to the health profession and health care delivery, and how much of it is spent on administrative issues. When you focus on the health sector you discover that it is really a significant mover of the productivity line. It is very simple. Healthy citizens are more likely to go to school and be educated. They are also more likely to have steady employment and be productive members of the society. That is not the subject of these comments. No one can deny that the Libyan physicians are on the frontline when it comes to criticism of the health services in Libya. I agree that they should be on the frontline. After all, medical schools in Libya started many years before the creation of other colleges for allied health professionals. They have a major share of responsibility in keeping our citizens healthy. It is also their responsibility to treat those who become sick. This requires a health system with a solid, transparent, ethical, and well organized structure. This is not the subject of my comments either. The purpose of my comments today is to draw attention to the Libyan physicians and recognize them once a year. I feel that they are busy with their work and the basic ingredients of life in a developing country. I also believe that they are relatively forgotten by society. What I would like to propose is the creation of a national observation for the Libyan physician. I think

  4. Depression-Burnout Overlap in Physicians

    Science.gov (United States)

    Wurm, Walter; Vogel, Katrin; Holl, Anna; Ebner, Christoph; Bayer, Dietmar; Mörkl, Sabrina; Szilagyi, Istvan-Szilard; Hotter, Erich; Kapfhammer, Hans-Peter; Hofmann, Peter

    2016-01-01

    Background Whether burnout is a distinct phenomenon rather than a type of depression and whether it is a syndrome, limited to three “core” components (emotional exhaustion, depersonalization and low personal accomplishment) are subjects of current debate. We investigated the depression-burnout overlap, and the pertinence of these three components in a large, representative sample of physicians. Methods In a cross-sectional study, all Austrian physicians were invited to answer a questionnaire that included the Major Depression Inventory (MDI), the Hamburg Burnout Inventory (HBI), as well as demographic and job-related parameters. Of the 40093 physicians who received an invitation, a total of 6351 (15.8%) participated. The data of 5897 participants were suitable for analysis. Results Of the participants, 10.3% were affected by major depression. Our study results suggest that potentially 50.7% of the participants were affected by symptoms of burnout. Compared to physicians unaffected by burnout, the odds ratio of suffering from major depression was 2.99 (95% CI 2.21–4.06) for physicians with mild, 10.14 (95% CI 7.58–13.59) for physicians with moderate, 46.84 (95% CI 35.25–62.24) for physicians with severe burnout and 92.78 (95% CI 62.96–136.74) for the 3% of participants with the highest HBI_sum (sum score of all ten HBI components). The HBI components Emotional Exhaustion, Personal Accomplishment and Detachment (representing depersonalization) tend to correlate more highly with the main symptoms of major depression (sadness, lack of interest and lack of energy) than with each other. A combination of the HBI components Emotional Exhaustion, Helplessness, Inner Void and Tedium (adj.R2 = 0.92) explained more HBI_sum variance than the three “core” components (adj.R2 = 0.85) of burnout combined. Cronbach’s alpha for Emotional Exhaustion, Helplessness, Inner Void and Tedium combined was 0.90 compared to α = 0.54 for the combination of the three

  5. Depression-Burnout Overlap in Physicians.

    Directory of Open Access Journals (Sweden)

    Walter Wurm

    Full Text Available Whether burnout is a distinct phenomenon rather than a type of depression and whether it is a syndrome, limited to three "core" components (emotional exhaustion, depersonalization and low personal accomplishment are subjects of current debate. We investigated the depression-burnout overlap, and the pertinence of these three components in a large, representative sample of physicians.In a cross-sectional study, all Austrian physicians were invited to answer a questionnaire that included the Major Depression Inventory (MDI, the Hamburg Burnout Inventory (HBI, as well as demographic and job-related parameters. Of the 40093 physicians who received an invitation, a total of 6351 (15.8% participated. The data of 5897 participants were suitable for analysis.Of the participants, 10.3% were affected by major depression. Our study results suggest that potentially 50.7% of the participants were affected by symptoms of burnout. Compared to physicians unaffected by burnout, the odds ratio of suffering from major depression was 2.99 (95% CI 2.21-4.06 for physicians with mild, 10.14 (95% CI 7.58-13.59 for physicians with moderate, 46.84 (95% CI 35.25-62.24 for physicians with severe burnout and 92.78 (95% CI 62.96-136.74 for the 3% of participants with the highest HBI_sum (sum score of all ten HBI components. The HBI components Emotional Exhaustion, Personal Accomplishment and Detachment (representing depersonalization tend to correlate more highly with the main symptoms of major depression (sadness, lack of interest and lack of energy than with each other. A combination of the HBI components Emotional Exhaustion, Helplessness, Inner Void and Tedium (adj.R2 = 0.92 explained more HBI_sum variance than the three "core" components (adj.R2 = 0.85 of burnout combined. Cronbach's alpha for Emotional Exhaustion, Helplessness, Inner Void and Tedium combined was 0.90 compared to α = 0.54 for the combination of the three "core" components.This study demonstrates the

  6. Getting Healthy Scientifically

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Recently,Zhao Zhixin,a Beijing-based instructor on scientific bodybuilding and public sport,was interviewed by China Youth Daily,sharing his views on how to get healthy scientifically.Edited excerpts follow:

  7. Sleep and recovery in physicians on night call: a longitudinal field study

    Directory of Open Access Journals (Sweden)

    Malmberg Birgitta

    2010-08-01

    Full Text Available Abstract Background It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call. Methods Sleep, monitored by actigraphy and Karolinska Sleep Diary/Sleepiness Scale on one night after daytime work, one night call, the following first and second nights post-call, and a Saturday night, was compared between 15 anaesthesiologists and 17 paediatricians and ear, nose, and throat surgeons. Results Recovery patterns over the days after night call did not differ between groups, but between days. Mean night sleep for all physicians was 3 hours when on call, 7 h both nights post-call and Saturday, and 6 h after daytime work (p Conclusions Despite considerable sleep loss during work on night call, and unexpectedly short sleep after ordinary day work, the physicians' self-reports indicate full recovery after two nights' sleep. We conclude that these 16-hour night duties were compatible with a short-term recovery in both physician groups, but the limited sleep duration in general still implies a long-term health concern. These results may contribute to the establishment of safe working hours for night-call duty in physicians and other health-care workers.

  8. What is scientific misconduct?

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    2006-01-01

    Selected examples from history are discussed to illustrate the many difficulties in judging scientific behavior. Scientific misconduct is not an a priori given concept but must first be defined. The definitions of scientific misconduct used in the USA and in Denmark are discussed as examples....

  9. 3 CFR - Scientific Integrity

    Science.gov (United States)

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Scientific Integrity Presidential Documents Other Presidential Documents Memorandum of March 9, 2009 Scientific Integrity Memorandum for the Heads of Executive Departments and Agencies Science and the scientific process must inform and guide decisions of...

  10. WWW: The Scientific Method

    Science.gov (United States)

    Blystone, Robert V.; Blodgett, Kevin

    2006-01-01

    The scientific method is the principal methodology by which biological knowledge is gained and disseminated. As fundamental as the scientific method may be, its historical development is poorly understood, its definition is variable, and its deployment is uneven. Scientific progress may occur without the strictures imposed by the formal…

  11. CanMEDS Physician Health Guide: A Practical Handbook for Physician Health and Well-being

    Directory of Open Access Journals (Sweden)

    Kenneth VanDewark

    2010-06-01

    Full Text Available The textbook, CanMEDS Physician Health Guide: A Practical Handbook for Physician Health and Well-being, recently published by The Royal College of Physicians and Surgeons of Canada sheds light on the depth and scope of the CanMEDS competencies and how they relate to the personal health and the well-being of the medical doctor. This text is the latest addition to a growing library of College publications which serve as professional development resources pertaining to the CanMEDS roles. This particular text has developed a conceptual framework of physician health and evaluates and proposes concise strategies to address personal health issues that any medical student, resident or attending may encounter throughout his career.

  12. Factors affecting physician loyalty and exit: a longitudinal analysis of physician-hospital relationships.

    Science.gov (United States)

    Burns, L R; Wholey, D R

    1992-04-01

    This article examines forces that influence physicians to change the percentage of their admissions to a hospital (loyalty) and to cease admitting patients to a hospital altogether (exit). Because physicians are both members of a hospital and consumers of its services, their admitting patterns can be described using models of employee commitment and consumer buying behavior. We test several hypotheses drawn from these literatures using data on physician admissions at hospitals over a two-year period. Results indicate that admitting patterns are explained primarily by convenience and inertia processes characteristic of consumer behavior. On the other hand, factors believed to influence organizational commitment (e.g., decision-making involvement, conflict, economic investments) have little effect on loyalty and exit. The findings question the utility of hospital strategies to improve the climate of physician-hospital relations, and suggest several qualifications for research on the commitment of professionals. PMID:1563950

  13. Global physician budgets as common-property resources: some implications for physicians and medical associations.

    OpenAIRE

    Hurley, J; Card, R

    1996-01-01

    Since 1990 payment for physician services in the fee-for-service sector has shifted from an open-ended system to fixed global budgets. This shift has created a new economic context for practising medicine in Canada. A global cap creates a conflict between physicians' individual economic self-interest and their collective interest in constraining total billings within the capped budget. These types of incentive problems occur in managing what are known in economics as "common-property resource...

  14. What do family physicians consider an error? A comparison of definitions and physician perception

    OpenAIRE

    Pallerla Harini; Elder Nancy C; Regan Saundra

    2006-01-01

    Abstract Background Physicians are being asked to report errors from primary care, but little is known about how they apply the term "error." This study qualitatively assesses the relationship between the variety of error definitions found in the medical literature and physicians' assessments of whether an error occurred in a series of clinical scenarios. Methods A systematic literature review and pilot survey results were analyzed qualitatively to search for insights into what may affect the...

  15. Popularity of internet physician rating sites and their apparent influence on patients’ choices of physicians

    OpenAIRE

    Burkle, Christopher M.; Keegan, Mark T.

    2015-01-01

    Background There has been a substantial increase in the number of on-line health care grading sites that offer patient feedback on physicians, staff and hospitals. Despite a growing interest among some consumers of medical services, most studies of Internet physician rating sites (IPRS) have restricted their analysis to sampling data from individual sites alone. Our objective was to explore the frequency with which patients visit and leave comments on IPRS, evaluate the nature of comments wri...

  16. Marketing pharmaceutical products to physicians. Sales reps influence physicians' impressions of the industry.

    Science.gov (United States)

    Creyer, E H; Hrsistodoulakis, I

    1998-01-01

    A survey conducted at a large, Midwest teaching hospital provides a better understanding of how marketing activities influence physicians' impressions of the pharmaceutical industry; in particular, the extent to which physicians believe that the pharmaceutical industry understands their needs and the extent to which it is concerned about improving the overall quality of health in the United States. Also, the authors explore the motivation of the pharmaceutical industry: Is it primarily concerned with patients or with its own self-interest? PMID:10180333

  17. Physicians, formula companies, and advertising. A historical perspective.

    Science.gov (United States)

    Greer, F R; Apple, R D

    1991-03-01

    The recent advent of new advertising campaigns for infant formulas aimed at the general public via television commercials, newspapers, free formula coupons, and lay periodicals has disrupted a comfortable symbiotic relationship between infant food manufacturers and the medical profession that has endured for more than 50 years. In the late 19th century, physicians were concerned about the advertising claims of these products and generally felt that indications and directions for their use should be the province of the physician. Between 1929 and 1932, the American Medical Association, through its Committee on Foods and "Seal of Acceptance," essentially required the entire formula industry to advertise only to the medical profession. Since 1932, the US formula industry has developed into a $1.6 billion market. In 1988, Nestlé (absent from the US infant formula industry since the 1940s) acquired the Carnation Company and launched an advertising campaign to the general public for its formula products. Bristol Myers/Mead Johnson, in cooperation with Gerber Products Company, quickly followed suit. These actions threaten to once again remove the realm of infant feeding from the exclusive supervision of the medical profession. The new multimedia public advertising campaigns may increase the cost of infant formula to the general public and have a negative impact on the incidence of breast-feeding. In addition, formula advertising campaigns will likely increase the danger of advertising hyperbole and affect the level of financial support by formula companies for scientific meetings, medical research, education, and social events at medical meetings. PMID:1781817

  18. [International and Israeli physicians' health--information and action plan].

    Science.gov (United States)

    Reis, Shmuel; Sayag, Shlomit; Karkabi, Khalid; Alroi, Gideon

    2008-03-01

    Physician health is a matter of interest for patients' physicians and their teams, managers and policy-makers. It has an impact on public health, physician impairment, patient safety, resource allocation and malpractice litigation. International medical literature, unlike Israel publications, is extensively preoccupied with the domain. Based on 2 MD thesis dissertations, Ministry of Health data and a literature search, the present review addresses many issues. It deals with: physicians' physical and mental health internationally and in Israel, prevention and health promotion, burn-out, the professional lifespan and career, health services utilization, legal and administrative aspects, boundaries, physicians' characteristics and vulnerability, interpersonal relations, care provided by physicians, physicians as patients and finally the impaired physician. International recommendations as well as a proposal for a local action plan are presented. PMID:18488866

  19. Medicare FFS Physician Feedback Program Value-Based Payment

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Physician Feedback - Value-Based Modifier Program provides comparative performance information to physicians as one part of Medicares efforts to improve the...

  20. Systematic review on physician's knowledge about radiation doses and radiation risks of computed tomography

    International Nuclear Information System (INIS)

    Background: The frequent use of computed tomography is a major cause of the increasing medical radiation exposure of the general population. Consequently, dose reduction and radiation protection is a topic of scientific and public concern. Aim: We evaluated the available literature on physicians' knowledge regarding radiation dosages and risks due to computed tomography. Methods: A systematic review in accordance with the Cochrane and PRISMA statements was performed using eight databases. 3091 references were found. Only primary studies assessing physicians' knowledge about computed tomography were included. Results: 14 relevant articles were identified, all focussing on dose estimations for CT. Overall, the surveys showed moderate to low knowledge among physicians concerning radiation doses and the involved health risks. However, the surveys varied considerably in conduct and quality. For some countries, more than one survey was available. There was no general trend in knowledge in any country except a slight improvement of knowledge on health risks and radiation doses in two consecutive local German surveys. Conclusions: Knowledge gaps concerning radiation doses and associated health risks among physicians are evident from published research. However, knowledge on radiation doses cannot be interpreted as reliable indicator for good medical practice.

  1. Nutrition Education Practices and Opinions of Alberta Family Physicians

    OpenAIRE

    Kelly, S. Ann; Joffres, Michel R

    1990-01-01

    A questionnaire was mailed to a random sample of 532 members of the Alberta Chapter of the College of Family Physicians in order to assess the role of physicians in providing nutrition education to their patients. Of the 255 respondents (53% response rate), over 97% agreed that “educating patients about nutrition is an important role for physicians.” Physicians most often gave nutrition information on obesity, constipation, heart disease and hypertension, alcohol, coffee, infant feeding, oste...

  2. Improving empathy of physicians through guided reflective writing

    OpenAIRE

    Anita D. Misra-Hebert; J. Harry Isaacson; Martin Kohn; Alan L. Hull; Mohammadreza Hojat; Papp, Klara K.; Leonard Calabrese

    2012-01-01

    Objectives: This study was designed to explore how guided reflective writing could evoke empathy and reflection in a group of practicing physicians. Methods: Total participants recruited included 40 staff physicians at Cleveland Clinic, a tertiary care academic medical center. Twenty physicians (intervention group) were assigned to participate in a 6-session faculty development program introducing narrative medicine and engaging in guided reflective writing. Ten physicians (comparison group 1...

  3. Transplantation and the primary care physician.

    Science.gov (United States)

    McGill, Rita L; Ko, Tina Y

    2011-11-01

    Increasing appreciation of the survival benefits of kidney transplantation, compared with chronic dialysis, has resulted in more patients with kidney disease being referred and receiving organs. The evolving disparity between a rapidly increasing pool of candidates and a smaller pool of available donors has created new issues for the physicians who care for kidney patients and their potential living donors. This article outlines current efforts to address the growing number of patients who await transplantation, including relaxation of traditional donation criteria, maximization of living donation, and donation schemas that permit incompatible donor-recipient pairs to participate through paired donation and transplantation chains. New ethical issues faced by donors and recipients are discussed. Surgical advances that reduce the morbidity of donors are also described, as is the role of the primary physician in medical issues of both donors and recipients. PMID:22098662

  4. How to divest acquired physician practices.

    Science.gov (United States)

    O'Hare, P K

    1999-02-01

    When an integrated delivery system (IDS) determines it must divest itself of a previously acquired physician practice, it must manage the transaction with care. The IDS most likely will want to maintain a positive ongoing relationship with the physician practice, while avoiding concessions to the practice that could be construed as violations of state and Federal laws. Before proceeding, the IDS should evaluate the reasons for divesting the practice, assess legal issues involved in terminating contracts with the practice, decide how to deal with the practice's assets and office facilities, consider whether covenants not to compete should be enforced, ensure continued access to essential medical records, consider whether to incorporate a "non-disparagement" clause in the termination agreement, and determine what mutual general releases may be necessary. PMID:10345614

  5. Transitioning from physician to nurse practitioner

    Directory of Open Access Journals (Sweden)

    Flowers M

    2014-01-01

    Full Text Available Monica Flowers, Maria OlenickCollege of Nursing and Health Sciences, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL, USAAbstract: Foreign-educated physicians (FEPs, also known as "international medical graduates", represent a rich source of potential primary-care providers. Despite their high level of medical knowledge and skills as well as ethnic and cultural diversity suited to meet the demands of patients, FEPs face many barriers in their attempt to continue to practice medicine in the USA. The program of study at Florida International University's Nicole Wertheim College of Nursing and Health Sciences provides FEPs the opportunity to have an impact on health care and continue to practice medicine in the USA by becoming nurse practitioners.Keywords: foreign-educated physician, FEP, international medical graduate, IMG, nurse practitioner, NP

  6. The Importance of Resources and Security in the Socio-Economic Integration of Refugees. A Study on the Impact of Length of Stay in Asylum Accommodation and Residence Status on Socio-Economic Integration for the Four Largest Refugee Groups in the Netherlands

    OpenAIRE

    Bakker, Linda; Dagevos, Jaco; Engbersen, Godfried

    2013-01-01

    textabstractIn many European countries, including the Netherlands, refugees stay in asylum accommodation pending a decision on their asylum request. While it seems evident that the lack of resources and insecurity about the future experienced during this stay will impact refugees' subsequent ability to integrate with the host society, so far this has hardly been studied in an extensive way. Also, the type of residence status granted can be a source of insecurity that impacts their integration...

  7. What Does Professionalism Mean to the Physician?

    OpenAIRE

    Kanter, Michael H; Nguyen, Miki; Klau, Marc H; Spiegel, Nancy H; Ambrosini, Virginia L

    2013-01-01

    Professionalism, which is a core competency for physicians, can be described as a spectrum of behaviors and may have a significant impact on the problems in today’s changing health care climate. In this article, we discuss the meaning of professionalism and its role in the Southern California Permanente Medical Group (SCPMG) and consider how it may be applied to integrated care delivery systems such as Kaiser Permanente. To understand professionalism, one must consider Stern’s definition, whi...

  8. Changing Physician Practice of Physical Activity Counseling

    OpenAIRE

    Eckstrom, Elizabeth; Hickam, David H.; Lessler, Daniel S; Buchner, David M.

    1999-01-01

    We conducted a prospective controlled trial to determine whether an educational intervention could improve resident physician self-efficacy and counseling behaviors for physical activity and increase their patients’ reported activity levels. Forty-eight internal medicine residents who practiced at a Department of Veterans Affairs hospital received either two workshops on physical activity counseling or no intervention. All residents completed questionnaires before and 3 months after the works...

  9. Transitioning from physician to nurse practitioner

    OpenAIRE

    Flowers M; Olenick M

    2014-01-01

    Monica Flowers, Maria OlenickCollege of Nursing and Health Sciences, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL, USAAbstract: Foreign-educated physicians (FEPs), also known as "international medical graduates", represent a rich source of potential primary-care providers. Despite their high level of medical knowledge and skills as well as ethnic and cultural diversity suited to meet the demands of patients, FEPs face many barri...

  10. Justification: How to get referring physicians involved

    International Nuclear Information System (INIS)

    Barriers to involvement of clinicians in the process of justification include an already overloaded knowledge base, lack of time, inconsistent guidance and disproportionate patient expectations. Strategies to improve referring physicians' input include education, use of imaging referral guidelines, clinical audit and regulation. This article discusses and reviews evidence for approaches to encourage greater participation in justification by clinicians. Approaches are best summarised by 'Awareness, appropriateness and audit'. (authors)

  11. Homophobia: How Physicians Treat Homosexual Patients

    OpenAIRE

    Kuntz, Christiane

    1982-01-01

    Doctors tend to be uncomfortable with homosexual patients, who make up a large part of an average practice. Homosexuality lies along the continuum of sexual expression and should not be considered a perversion. To a greater or lesser extent, it is present in all people, and is acted upon in a variety of ways. Physicians should be aware of the homosexual patient's lifestyle in order to give the best medical care. The epidemiology of disease differs in the homosexual and heterosexual population.

  12. Physician self-awareness: the neglected insight.

    OpenAIRE

    Longhurst, M.

    1988-01-01

    Self-awareness is vital to a physician's development. Understanding the impact of our internal subjective world on our attitudes and values and on the fantasies we have of reality is important to us as doctors. Some of the means of acquiring this self-knowledge include accurately perceiving the reflection of one's self in patients, understanding one's learning style, studying and enjoying the humanities, expressing one's self creatively, maintaining a sense of humour and examining one's react...

  13. Anger Management and Factors that Influence Anger in Physicians

    Directory of Open Access Journals (Sweden)

    Emel Koçer

    2011-03-01

    Full Text Available Objective: There are limited data regarding anger and its management with respect to physicians and many other professionals. Our objective was to evaluate anger expression and control in physicians. Material and Methods: The physicians of the Düzce School of Medicine were the participants in the study. Physicians were assigned to either an internal medicine or a surgery study group. Each group contained physicians from several specialties. The Spielberger State-Trait Anger Expression Inventory, and the Beck Anxiety and Depression Inventories were administered to all participants. The physicians (n=158 were evaluated and compared with controls (n=105 in terms of anger control and sociodemographic variables. Results: Anger-control scores were higher in physicians (p<0.01 and in those who willingly chose the medical profession (p<0.05. Age, number of years as a physician, and the specialty were negatively correlated with anger management in physicians working in the surgical disciplines (p<0.01. Only Beck anxiety and depression scores were positively correlated with anger-trait scores and anger-in scores for physicians working in the internal medicine disciplines (p<0.01.Conclusion: Physicians were relatively successful in coping with anger. A willingness to choose the medical profession was a factor influencing anger control. Age was the major factor affecting anger management in physicians.

  14. Compliance with Mandated Child Abuse Reporting: Comparing Physicians and Teachers.

    Science.gov (United States)

    Kenny, Maureen C.

    2001-01-01

    Fifty-six recently trained physicians and teachers were compared on rates and knowledge of child abuse reporting and responses to vignettes of sexual abuse. Results demonstrated differences between the groups with physicians making significantly more reports and assisting in child abuse reporting more often than teachers. Physicians reported…

  15. The hospital's lifeline: recruiting well-qualified physicians.

    Science.gov (United States)

    Dismuke, B J

    1989-01-01

    A hospital's success in today's competitive and unstable environment depends directly on its ability to recruit well-qualified physicians. Just consider that a physician controls from 70 to 80 percent of healthcare dollars through admissions and referrals. Even the most creative advertising campaign to attract patients cannot increase admissions if there are no physicians to deliver care. PMID:10304008

  16. Suicide Compared to Other Causes of Mortality in Physicians

    Science.gov (United States)

    Torre, Dario M.; Wang, Nae-Yuh; Meoni, Lucy A.; Young, J. Hunter; Klag, Michael J.; Ford, Daniel E.

    2005-01-01

    Physicians frequently are early adopters of healthy behaviors based on their knowledge and economic resources. The mortality patterns of physicians in the United States, particularly suicide, have not been rigorously described for over a decade. Previous studies have shown lower all-cause mortality among physicians yet reported conflicting results…

  17. 42 CFR 417.479 - Requirements for physician incentive plans.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements for physician incentive plans. 417.479... incentive plans. (a) The contract must specify that an HMO or CMP may operate a physician incentive plan... are met. (b) Applicability. The requirements in this section apply to physician incentive...

  18. In their own words: describing Canadian physician leadership.

    Science.gov (United States)

    Snell, Anita J; Dickson, Graham; Wirtzfeld, Debrah; Van Aerde, John

    2016-07-01

    Purpose This is the first study to compile statistical data to describe the functions and responsibilities of physicians in formal and informal leadership roles in the Canadian health system. This mixed-methods research study offers baseline data relative to this purpose, and also describes physician leaders' views on fundamental aspects of their leadership responsibility. Design/methodology/approach A survey with both quantitative and qualitative fields yielded 689 valid responses from physician leaders. Data from the survey were utilized in the development of a semi-structured interview guide; 15 physician leaders were interviewed. Findings A profile of Canadian physician leadership has been compiled, including demographics; an outline of roles, responsibilities, time commitments and related compensation; and personal factors that support, engage and deter physicians when considering taking on leadership roles. The role of health-care organizations in encouraging and supporting physician leadership is explicated. Practical implications The baseline data on Canadian physician leaders create the opportunity to determine potential steps for improving the state of physician leadership in Canada; and health-care organizations are provided with a wealth of information on how to encourage and support physician leaders. Using the data as a benchmark, comparisons can also be made with physician leadership as practiced in other nations. Originality/value There are no other research studies available that provide the depth and breadth of detail on Canadian physician leadership, and the embedded recommendations to health-care organizations are informed by this in-depth knowledge. PMID:27397749

  19. Impacts of Changes in the Physician Manpower Sex Ratio

    Science.gov (United States)

    Stern, Maxine Springer

    1976-01-01

    The findings of a study comparing the types of medical careers of female and male physicians in North Carolina in 1973 are reported. The main question addressed is whether female physicians have different medical careers, in terms of primary specialities and the settings of practice, from male physicians. (LBH)

  20. Are Physicians and Patients in Agreement? Exploring Dyadic Concordance

    Science.gov (United States)

    Coran, Justin J.; Koropeckyj-Cox, Tanya; Arnold, Christa L.

    2013-01-01

    Dyadic concordance in physician-patient interactions can be defined as the extent of agreement between physicians and patients in their perceptions of the clinical encounter. The current research specifically examined two types of concordance: informational concordance--the extent of agreement in physician and patient responses regarding patient…

  1. Physician-Based Tobacco Smoking Cessation Counseling in Belgrade, Serbia

    Science.gov (United States)

    Merrill, Ray; Harmon, Tanner; Gagon, Heather

    2009-01-01

    This study examined physician attitudes and practices pertaining to patient counseling about smoking in Belgrade, Serbia. Data were collected using a cross-sectional survey of 86 physicians at multiple health care facilities. Approximately 74% of physicians agreed that they should routinely ask patients about their smoking habits and 79% agreed…

  2. 42 CFR 415.60 - Allocation of physician compensation costs.

    Science.gov (United States)

    2010-10-01

    ... Physician Services § 415.60 Allocation of physician compensation costs. (a) Definition. For purposes of this... or the carrier. (2) Report the information on which the physician compensation allocation is based to the intermediary or the carrier on an annual basis and promptly notify the intermediary or carrier...

  3. Exploring UK attitudes towards unlicensed medicines use: a questionnaire-based study of members of the general public and physicians

    Directory of Open Access Journals (Sweden)

    Chisholm A

    2012-01-01

    Full Text Available Alison ChisholmOmega Scientific, Yately, UKAims: To undertake a questionnaire-based study to evaluate attitudes towards the use of unlicensed medicines among prescribing doctors and members of the general public (ie, patients. The study also aimed to explore the factors that influence physicians' prescribing decisions and priorities, and to understand the knowledge of the medicines licensing system among members of the public.Methods: Novartis Pharmaceuticals UK Ltd funded the online interview of 500 members of the general public and 249 prescribing physicians. Best practice standards were followed for questionnaire-based studies; no specific treatments or conditions were mentioned or discussed.Results: Few of the participating physicians, only 14%, were very familiar with the UK General Medical Council (GMC guidelines on the use of unlicensed medicines and just 17% felt very comfortable prescribing an unlicensed medication when a licensed alternative was available. Key physician concerns included the lack of safety data (76%, legal implications (76%, and safety monitoring associated with unlicensed medicine use (71%. Patients and physicians agreed that safety and efficacy are the most important prescribing considerations, although 48% of participating physicians were worried that budget pressures may increase pressure to prescribe unlicensed medications on the basis of cost. A high proportion of patients (81% also indicated some degree of concern, were they to be prescribed an unlicensed medication when a licensed alternative was available specifically because it costs less.Conclusions: This UK-based questionnaire study suggests pervasive concerns among prescribers over the safety, monitoring, and legal implications of unlicensed prescribing. High levels of concern were expressed among patients and physicians if cost were to become an influential factor when making decisions between licensed and unlicensed medications.Keywords: patient

  4. Physician-Assisted Death in Canada.

    Science.gov (United States)

    Browne, Alister; Russell, J S

    2016-07-01

    The Criminal Code of Canada prohibits persons from aiding or abetting suicide and consenting to have death inflicted on them. Together, these provisions have prohibited physicians from assisting patients to die. On February 6, 2015, the Supreme Court of Canada declared void these provisions insofar as they "prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition." This declaration of invalidity was scheduled to take effect one year (later extended by six months) after the ruling, to give the government time to put legislation in place. We trace the history of this decision, discuss how it has forever changed the debate on physician-assisted dying, and identify the issues that must be resolved to write the legislation. Of special importance here are the topics of access, safeguards, and conscientious objection. PMID:27348822

  5. Physician information seeking: improving relevance through research.

    Science.gov (United States)

    Gruppen, L D

    1990-04-01

    Health sciences libraries have considerable potential as resources for both formal continuing professional education, as well as the informal continuing education that results from the professional's efforts to solve problems in daily practice. While there is a growing interest in making the resources of health sciences libraries more accessible to practitioners on a routine, day-to-day basis, there also needs to be more awareness of how, when, where, and why professionals look for information in the context of practical problems. This paper reviews recent research that identifies the context in which physicians seek information and advice from external sources, the information sources that physicians access, and the factors that influence which particular sources are sought. The results indicate that physicians vary in their information needs, preferences, motivations, and strategies for seeking information. This diversity suggests that health sciences libraries, in their efforts to be more accessible, should consider "market research" to determine the needs, preferences, and use patterns of the library's targeted users. Libraries may also benefit from exploring alternative methods of improving access to their resources. PMID:2183904

  6. [On the evolution of scientific thought].

    Science.gov (United States)

    de Micheli, Alfredo; Iturralde Torres, Pedro

    2015-01-01

    The Nominalists of the XIV century, precursors of modern science, thought that science's object was not the general, vague and indeterminate but the particular, which is real and can be known directly. About the middle of the XVII Century the bases of the modern science became established thanks to a revolution fomented essentially by Galileo, Bacon and Descartes. During the XVIII Century, parallel to the development of the great current of English Empiricism, a movement of scientific renewal also arose in continental Europe following the discipline of the Dutch Physicians and of Boerhaave. In the XIX Century, Claude Bernard dominated the scientific medicine but his rigorous determinism impeded him from taking into account the immense and unforeseeable field of the random. Nowadays, we approach natural science and medicine, from particular groups of facts; that is, from the responses of Nature to specific questions, but not from the general laws. Furthermore, in recent epistemology, the concept that experimental data are not pure facts, but rather, facts interpreted within a hermeneutical context has been established. Finally a general tendency to retrieve philosophical questions concerning the understanding of essence and existence can frequently be seen in scientific inquiry. In the light of the evolution of medical thought, it is possible to establish the position of scientific medicine within the movement of ideas dominating in our time. PMID:26296626

  7. Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives

    Science.gov (United States)

    Wright, David Kenneth; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

    2015-01-01

    Background Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. Methods We conducted a discourse analysis of print media on physicians’ perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician’s perspective. Results We identified 3 predominant discourses about physicians’ public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Interpretation Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies. PMID:26389090

  8. Robotics and medicine: A scientific rainbow in hospital.

    Science.gov (United States)

    Jeelani, S; Dany, A; Anand, B; Vandana, S; Maheswaran, T; Rajkumar, E

    2015-08-01

    The journey of robotics is a real wonder and astonishingly can be considered as a scientific rainbow showering surprising priceless power in the era of future technologies. The astonishing seven technologies discussed in this paper are da Vinci Robotic surgical system and sperm sorters for infertility, Veebot for blood investigation, Hanako the robotic dental patient for simulating the dental patient and helping a trainee dentist, RP-7 robot who is around-the-clock physician connecting the physician and patient, Robot for Interactive Body Assistance (RIBA) who is a RIBA serving as a nurse, Bushbot serving as a brilliant surgeon, and Virtibot helping in virtual autopsy. Thus, robotics in medicine is a budding field contributing a great lot to human life from before birth to afterlife in seven forms thus gracefully portraying a scientific rainbow in hospital environment. PMID:26538882

  9. Development of a handoff continuity score to improve pediatric ICU physician schedule design for enhanced physician and patient continuity

    OpenAIRE

    Smalley, Hannah K; Keskinocak, Pinar; Vats, Atul

    2011-01-01

    Introduction Few studies investigate the benefits of familiarity or continuity during physician-to-physician handoff of inpatients. Factors such as how recently physicians (MDs) have worked and successive days caring for patients increase continuity, and thus could lead to enhanced handoff efficiency. Evaluating the efficacy of MD scheduling to enhance continuity is currently subjective. Methods An MD group consisting of 9 attending physicians and 7 fellows redesigned its pediatric intensive ...

  10. “The way the Irish asylum system turns people into un-human is my problem”: An Interview with Ifedinma Dimbo

    Directory of Open Access Journals (Sweden)

    Sara Martín-Ruiz

    2015-03-01

    Ifedinma Dimbo currently lives in Dublin, where she works and researches for her PhD in Medical Sociology. The Nigerian-born, Irish-based writer was kind enough to answer my questions via e-mail between the months of August and October 2014, with some final elaboration in January 2015. Ifedinma Dimbo’s writing, as well as her answers in this interview, are an invaluable testimony to a reality that is currently taking place in Ireland and has often been silenced. Now that Irish society is beginning to be aware of the unfair treatment that refugees and asylum seekers receive at the hands of the Irish system, it is high time to let people who, like Ifedinma Dimbo, have made Ireland their home, have their voices heard in the field of Irish Studies. In this interview, Ifedinma Dimbo very sharply shares her views on writing, immigration, religion and Irish society.

  11. Geographical distribution of torture: An epidemiological study of torture reported by asylum applicants examined at the Department of Forensic Medicine, University of Copenhagen

    DEFF Research Database (Denmark)

    Busch, Johannes Rødbro; Hansen, Steen Holger; Hougen, Hans Petter

    2015-01-01

    Using reports from 154 examinations of alleged torture victims among asylum applicants to Denmark conducted by the Department of Forensic Medicine, Univer- sity of Copenhagen, between 2001 and 2013, we have categorized the victims into four geographical regions, as well as according to the conflict...... that caused them to flee. The torture incidents described by the victims were divided into 12 different categories defined by the Istanbul Protocol. These data were cross referenced in order to identify any differences in the prevalence of the 12 forms of torture. The study showed that crush injuries...... were only reported by refugees from Asia, including Afghanistan and Pakistan, and that incidents of electrical torture were reported twice as frequently by torture victims from Middle Eastern and North African countries, though it was lower  among Iraqis, Iranians and ethnic Kurds. Sexual torture was...

  12. Geographical distribution of torture: An epidemiological study of torture reported by asylum applicants examined at the Department of Forensic Medicine, University of Copenhagen.

    Science.gov (United States)

    Busch, J; Hansen, S H; Hougen, H P

    2015-01-01

    Using reports from 154 examinations of alleged torture victims among asylum applicants to Denmark conducted by the Department of Forensic Medicine, University of Copenhagen, between 2001 and 2013, we have categorized the victims into four geographical regions, as well as according to the conflict that caused them to flee. The torture incidents described by the victims were divided into 12 different categories defined by the Istanbul Protocol. These data were cross referenced in order to identify any differences in the prevalence of the 12 forms of torture. The study showed that crush injuries were only reported by refugees from Asia, including Afghanistan and Pakistan, and that incidents of electrical torture were reported twice as frequently by torture victims from Middle Eastern and North African countries, though it was lower among Iraqis, Iranians and ethnic Kurds. Sexual torture was reported by 78% of females and 25% of males. PMID:26932127

  13. Evaluating a scientific collaboratory

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.; Whitton, Mary C.; Maglaughlin, Kelly L.

    2003-01-01

    process of scientific work completed by 20 pairs of participants (upper level undergraduate science students) working face-to-face and remotely. We collected scientific outcomes (graded lab reports) to investigate the quality of scientific work, post-questionnaire data to measure the adoptability of the......The evaluation of scientific collaboratories has lagged behind their development. Do the capabilities afforded by collaboratories outweigh their disadvantages? To evaluate a scientific collaboratory system, we conducted a repeated-measures controlled experiment that compared the outcomes and...... of collaborating remotely. While the data analysis produced null results, considered as a whole, the analysis leads us to conclude there is positive potential for the development and adoption of scientific collaboratory systems....

  14. Robotics and medicine: A scientific rainbow in hospital

    OpenAIRE

    Jeelani, S.; Dany, A.; B Anand; S.Vandana; Maheswaran, T.; Rajkumar, E.

    2015-01-01

    The journey of robotics is a real wonder and astonishingly can be considered as a scientific rainbow showering surprising priceless power in the era of future technologies. The astonishing seven technologies discussed in this paper are da Vinci Robotic surgical system and sperm sorters for infertility, Veebot for blood investigation, Hanako the robotic dental patient for simulating the dental patient and helping a trainee dentist, RP-7 robot who is around-the-clock physician connecting the ph...

  15. Medical perspective on nuclear power; Council on Scientific Affairs

    International Nuclear Information System (INIS)

    This article summarizes a recent report of the Council on Scientific Affairs of the American Medical Association. Major issues summarized in this presentation include the role of and demand for electricity, and an overview of normal operations of nuclear power plants and the nuclear fuel cycle. Unplanned radiation releases from nuclear reactors and risks related to nuclear power are also addressed. Nine recommendations emphasize the safety of reactors, and the role of physicians in the nuclear power issue

  16. Case study of physician leaders in quality and patient safety, and the development of a physician leadership network.

    Science.gov (United States)

    Hayes, Chris; Yousefi, Vandad; Wallington, Tamara; Ginzburg, Amir

    2010-01-01

    There is increasing recognition of the need for physician leadership in quality and patient safety, and emerging evidence that physician leadership contributes to improved care. Hospitals are beginning to establish physician leader positions; however, there is little guidance on how to define these roles and the strategies physician leaders can use toward improving care. This case study examines the roles of four physician leaders, describes their contribution to the design and implementation of hospital quality and patient safety agendas and discusses the creation of a physician network to support these activities. The positions were established between July 2006 and April 2009. All are corporate roles with varying reporting and accountability structures. The physician leads are involved in strategic planning, identifying and leading quality and safety initiatives, physician engagement and culture change. All have significantly contributed to the implementation of hospital improvement activities and are seen as influential among their peers as resources and mentors for local project success. Despite their accomplishments, these physician leads have been challenged by ambiguous role descriptions and difficulty identifying effective improvement strategies. As such, an expanding physician network was created with the goal of sharing approaches and tools and creating new strategies. Physician leaders are an important factor in the improvement of safety and quality within hospitals. This case study provides a template for the creation of such positions and highlights the importance of networking as an effective strategy for improving local care and advancing professional development of physician leaders in quality and patient safety. PMID:20959733

  17. Potential Impact of Increased Numbers of Physicians upon Physician Behavior, Access to, and Cost of, Medical Care. Final Report.

    Science.gov (United States)

    Musgrave, Gerald L.

    The potential impact of the increasing supply of physicians on physician behavior, the cost of medical services, and access to services is addressed in detail in this final research report. Econometric modeling and analyses of economic activity within the health sector were undertaken. An eight equation model of the hospital and physician sectors…

  18. Potential Impact of Increased Numbers of Physicians upon Physician Behavior, Access to, and Cost of, Medical Care. Executive Summary.

    Science.gov (United States)

    Musgrave, Gerald L.

    A study that forecast the consequences of the projected growth in the number of practicing U.S. physicians during the 1980s and beyond is summarized. Attention was directed to the potential impact of the increasing supply of physicians on physician behavior, the cost of medical services, and access to services. Econometric modeling and analysis of…

  19. 20 CFR 10.316 - After selecting a treating physician, may an employee choose to be treated by another physician...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false After selecting a treating physician, may an employee choose to be treated by another physician instead? 10.316 Section 10.316 Employees' Benefits... Benefits Medical Treatment and Related Issues § 10.316 After selecting a treating physician, may...

  20. 20 CFR 30.405 - After selecting a treating physician, may an employee choose to be treated by another physician...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false After selecting a treating physician, may an employee choose to be treated by another physician instead? 30.405 Section 30.405 Employees' Benefits... § 30.405 After selecting a treating physician, may an employee choose to be treated by...