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. [Scientific publications: a resource for the physician's intellectual development].

    Science.gov (United States)

    Zárate, Arturo

    2013-01-01

    The physician's professional life involves reading and analysis of scientific journals, regardless of the specialization field. The hospital and academic areas lead to the scientific-literary activity development. The aim of this editorial is to make some reflections about the way a physician reaches intellectual development, through the creation of a culture of writing and reading scientific publications.

  3. Health issues of asylum seekers and refugees.

    Science.gov (United States)

    Kisely, Stephen; Stevens, Margaret; Hart, Bret; Douglas, Charles

    2002-02-01

    This paper is written on behalf of the West Australian Branch of the Australasian Faculty of Public Health Medicine. As public health physicians, we feel it is important that public health professionals should contribute constructively to address the needs of a socially deprived, marginalised group with high rates of physical and psychiatric morbidity. Depending on the definition, there are between 18 and 48 million asylum seekers and refugees in the world. Most seek protection in neighbouring countries, largely in Africa and Asia, rather than coming to North America, Europe and Australasia. Contrary to popular belief, numbers of successful applications to Australia's humanitarian program have actually fallen. This article attempts to correct misperceptions and misapprehensions about the effect of asylum seekers on the public health. Public health professionals should lobby for changes to Govemment policy that at present leave asylum seekers vulnerable to a cycle of poverty, ill-health and limited access to health services.

  4. 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

  5. Scientific writing training for academic physicians of diverse language backgrounds.

    Science.gov (United States)

    Cameron, Carrie; Deming, Stephanie P; Notzon, Beth; Cantor, Scott B; Broglio, Kristine R; Pagel, Walter

    2009-04-01

    Research articles are the coin of the realm for anyone working in academia, and success or failure to publish determines a biomedical researcher's career path. At the same time, the dramatic increase in foreign faculty and trainees in U.S. academia, as well as in international scientific collaboration, adds another dimension to this developmental vacuum: limited English-language skills. Paradoxically, few programs exist to develop and support the skills needed to accomplish the vital task of writing English-language research articles, which does not come naturally to most. To better prepare all trainees for research careers, editors in the Department of Scientific Publications at The University of Texas M. D. Anderson Cancer Center created an in-depth training program that would target the writing skills gap effectively. Instruction focused on structure, rhetorical organization, and the conventions of biomedical publishing. More than 300 trainees have participated in 22 workshops. Results of a survey of 46 participants at 6 months to 2.5 years after workshop completion indicated that participants from all language backgrounds believed the course to have improved their writing (97.8% strongly agreed or agreed), made it easier to begin a manuscript (80.4%), and helped them to get published (56.8%), with nonnative speakers of English reporting somewhat greater perceived benefit than native English speakers. On the basis of these results, the authors conclude that researchers of varied linguistic backgrounds appreciate the need for, and benefit from, instruction in the conventions of scientific writing.

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

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    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…

  7. [The guidelines and other scientific technical instruments for improving, updating and validating the Occupational Physician activities].

    Science.gov (United States)

    Apostoli, P

    2008-01-01

    From 2002 to 2007 the Italian Society of Industrial Medicine and Industrial Hygiene (S.I.M.L.I.I.) produced, in the context of the specific Education and Accreditation Programme for occupational physicians, more than 20 guide lines and consensus document on the most important and controversial themes for our Discipline. These instruments have aimed not only to improve the effectiveness of preventive actions but also to constantly adopt rigorous methodologies based where possible on evidence based medicine procedures. The Italian Occupational physicians agree with guidelines of our Scientific Society, but it appears now to be necessary to critically evaluate our experience, at the light of the new Framework Act for the occupational safety and health "Decreto legislativo 81/08" signed by the President of the Italian Republic on April 9, 2008, which firstly included in a legislative act terms such as technical normative, good practices, guide lines. Another important, mandatory reference, for a Medical Discipline as Occupational Medcine remains, in this debate is, in our Country, the National Program for Guide Lines edited By Italian National Health Institute since 2002 and part of current National System of Guide Lines concerning preparation, dissemination, updating, implementation of guide lines in Medicine. In this paper the main aspects related to different kind of instruments such as guide lines, consensus conference reports, technology assessment, good practices, technical normative, focusing in particular the argument identification, methodology, relationship between different instruments and their production and diffusion, economical and ethical issues and possible conflict of interest.

  8. 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...

  9. 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 ...

  10. 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...

  11. 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

  12. Refugee families during asylum seeking.

    Science.gov (United States)

    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

  13. [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

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

    Science.gov (United States)

    Schock, Katrin; Rosner, Rita; Knaevelsrud, Christine

    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 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 interview. PMID:26333540

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

    Directory of Open Access Journals (Sweden)

    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

  16. 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....

  17. Resilience among asylum seekers living with HIV

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    Orton Lois

    2012-10-01

    Full Text Available Abstract Background A small body of evidence demonstrates the challenges faced by migrant communities living with HIV but has yet to consider in-depth the experience of asylum seekers whose residency status is undetermined. The overall aim of our study was to explore the experiences of those who are both living with HIV and seeking asylum. This paper focuses on the stressors precipitated by the HIV diagnosis and by going through the asylum system; as well as participants’ resilience in responding to these stressors and the consequences for their health and wellbeing. Methods We conducted an ethnographic study. Fieldwork took place in the UK between 2008–2009 and included: 350 hours of observation at voluntary services providing support to black and minority ethnic groups living with HIV; 29 interviews and four focus group discussions with those who were seeking asylum and living with HIV; and 15 interviews with their health and social care providers. Data were analysed using the constant comparative method. Results There were three main stressors that threatened participants’ resilience. First, migration caused them to leave behind many resources (including social support. Second, stigmatising attitudes led their HIV diagnosis to be a taboo subject furthering their isolation. Third, they found themselves trapped in the asylum system, unable to influence the outcome of their case and reliant on HIV treatment to stay alive. Participants were, however, very resourceful in dealing with these experiences. Resilience processes included: staying busy, drawing on personal faith, and the support received through HIV care providers and voluntary organisations. Even so, their isolated existence meant participants had limited access to social resources, and their treatment in the asylum system had a profound impact on perceived health and wellbeing. Conclusions Asylum seekers living with HIV in the UK show immense resilience. However, their isolation

  18. 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.

  19. 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

  20. 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

  1. 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...

  2. 75 FR 409 - Privacy Act of 1974; United States Citizenship and Immigration Services-010 Asylum Information...

    Science.gov (United States)

    2010-01-05

    ... systems: The Refugees, Asylum, and Parole System and the Asylum Pre-Screening System. Refugees, Asylum... States citizens and non-legal permanent residents. Refugees, Asylum, and Parole System and Asylum Pre... Massachusetts Avenue, NW., 3rd Floor, Washington, DC 20529. For privacy issues please contact: Mary...

  3. Haitian Refugees Need Asylum: A Briefing Paper.

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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

  5. ['Being a mother is a science': women, physicians, and the construction of scientific maternity in the 1920's].

    Science.gov (United States)

    Freire, Maria Martha de Luna

    2008-06-01

    The article analyzes the construction of the notion of scientific maternity in Brazil in the 1920s as part of the broad republican reform project meant to build nationhood. With the active participation of women, multiple social agents were involved in configuring the maternalist discourse and in reshaping relations between women and doctors into a partnership negotiated around a mutual interest in valuing maternity. Special attention is paid to the essential role played by women's magazines in this process.

  6. Cultural competence among nurse practitioners working with asylum seekers

    NARCIS (Netherlands)

    J. Suurmond; C. Seeleman; I. Rupp; S. Goosen; K. Stronks

    2010-01-01

    Asylum seekers often have complex medical needs. Little is known about the cultural competences health care providers should have in their contact with asylum seekers in order to meet their needs. Cultural competence is generally defined as a combination of knowledge about certain cultural groups, a

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

  9. 'No "Sane" Person Would Have Any Idea': Patients' Involvement in Late Nineteenth-century British Asylum Psychiatry.

    Science.gov (United States)

    Chaney, Sarah

    2016-01-01

    In his 1895 textbook, Mental Physiology, Bethlem Royal Hospital physician Theo Hyslop acknowledged the assistance of three fellow hospital residents. One was a junior colleague. The other two were both patients: Walter Abraham Haigh and Henry Francis Harding. Haigh was also thanked in former superintendent George Savage's book Insanity and Allied Neuroses (1884). In neither instance were the patients identified as such. This begs the question: what role did Haigh and Harding play in asylum theory and practice? And how did these two men interpret their experiences, both within and outside the asylum? By focusing on Haigh and Harding's unusual status, this paper argues that the notion of nineteenth-century 'asylum patient' needs to be investigated by paying close attention to specific national and institutional circumstances. Exploring Haigh and Harding's active engagement with their physicians provides insight into this lesser-known aspect of psychiatry's history. Their experience suggests that, in some instances, representations of madness at that period were the product of a two-way process of negotiation between alienist and patient. Patients, in other words, were not always mere victims of 'psychiatric power'; they participated in the construction and circulation of medical notions by serving as active intermediaries between medical and lay perceptions of madness.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  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. Usage of psychiatric emergency services by asylum seekers

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... by asylum seekers in Denmark shows some of the acute mental health needs asylum seekers present with. The findings of high levels of suicidal ideation and possible diagnostic difficulties are discussed, as well as possible improvements of the referral and psychiatric evaluation processes....

  14. 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.

  15. 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 ...

  16. 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

  17. 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

  18. 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...

  19. 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...

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

    NARCIS (Netherlands)

    O. Ferguson Sidorenko

    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

  1. 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

  2. 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.

  3. [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

  4. Satisfaction with daily occupations amongst asylum seekers in Denmark

    DEFF Research Database (Denmark)

    Morville, Anne-Le; Erlandsson, Lena-Karin; Danneskiold-Samsøe, Bente;

    2015-01-01

    AIM: The aim of this study was to describe asylum seekers' satisfaction with daily occupations and activity level while in a Danish asylum centre, and whether this changed over time. Another aim was to describe whether exposure to torture, self-rated health measures, and ADL ability were related...... to their satisfaction with daily occupations and activity level. METHODS: A total of 43 asylum seekers at baseline and 17 at follow-up were included. The questionnaires Satisfaction with Daily Occupations, Major Depression Inventory, WHO-5 Wellbeing, Pain Detect, a questionnaire covering torture, and basic social...... information were used as well as Assessment of Motor and Process Skills. RESULTS: The results showed a low level of satisfaction with daily occupations at both baseline and follow-up. There was no statistically significant change in satisfaction or activity level between baseline and the follow...

  5. 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

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

    DEFF Research Database (Denmark)

    Jørgensen, Martin Bak

    2013-01-01

    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......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....... The article draws on a framework derived from political sociology and critical theory....

  7. 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;

    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 changes in ADL...... participated. ADL-ability was measured using Assessment of Motor and Process Skills and questionnaires about exposure to torture, self-reported mental health and pain. ADL motor and process measures, well-being and self-rated health declined from baseline to follow-up. Measures of pain and depression increased......-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 centre at the follow-up and 17 of them...

  8. 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...

  9. 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....

  10. 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...

  11. 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.

  12. [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

  13. 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

  14. Liberty versus Security? EU Asylum Policy and the European Commission

    Directory of Open Access Journals (Sweden)

    Christian Kaunert

    2009-08-01

    Full Text Available The Common European Asylum System (CEAS experienced significant developments during the Tampere programme (1999 – 2004. This article analyses how security is constituted or viewed by the European Union in the area of asylum policy; more importantly how the European Commission, in the face of the emerging discourse on the ‘war on terror’ decided to push for a more inclusive agenda. Thus, the European Commission can (though not always does play a significant role in this process - the role of a supranational policy entrepreneur that enables the normative construction of a policy. The article analyses the high-profile case of the first phase of the CEAS, particularly the four main directives, its legal and political construction, and suggests the significance of the Commission in the political and normative process. Despite the challenges of the ‘war on terror’, the Commission managed to keep the CEAS within the limits of the Geneva Convention.

  15. 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 ...

  16. Forensic dental investigations and age assessment of asylum seekers.

    Science.gov (United States)

    Nuzzolese, Emilio; Di Vella, Giancarlo

    2008-06-01

    Age estimation is useful in forensic investigations to aid in the process of identifying unknown victims as well as living individuals. In many countries age estimation is commonly used to assist immigration authorities in deciding whether refugees or illegal migrants have reached that designated age that separates a juvenile from an adult. This is particularly important for the protection of unaccompanied minors. Italy is a country of great appeal for immigration as people from other Mediterranean countries can easily reach Italian coasts. In Italy, as in other western world countries, unaccompanied asylum seekers deemed to be under 18 face a very different path through the immigration system. They cannot be deported and are sent through a juvenile system where they have access to education programmes and may be granted a residence permit. The Section of Legal Medicine of the University of Bari was approached by Judges and Immigration Police with the question to assess the age of unaccompanied asylum seekers who claim to be below 18 years of age. The contribution of forensic odontologists for age estimation was recognised and since November 2006 age estimation of asylum seekers in Bari (Italy) relies on clinical and dental examination together with skeletal maturation as seen on radiographs of the left hand and wrist, the pelvis for iliac crests and root development and mineralisation of third molars as seen on an orthopantomogram. PMID:18630106

  17. 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...

  18. 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

  19. 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

  20. 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.

  1. 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

  2. Psychosocial problems in asylum seekers' children : the parent, child, and teacher perspective using the strengths and difficulties questionnaire

    NARCIS (Netherlands)

    Wiegersma, P.A.; Stellinga-Boelen, A.A.M.; Reijneveld, S.A.

    2011-01-01

    Children of asylum seekers are at risk for psychosocial problems because of their flight history and exceptional living circumstances. This study aims to assess the association of sociodemographic factors and asylum procedural factors with psychosocial problems of asylum seekers' children, and diffe

  3. [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

  4. 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

  5. Coercion, prohibition and great expectations: The continuing failure of the Common European Asylum System

    NARCIS (Netherlands)

    M. den Heijer; J. Rijpma; T. Spijkerboer

    2016-01-01

    This contribution explains the European asylum policy crisis from three structural weaknesses of the Common European Asylum System: its reliance on coercion within the EU, its unrealistic expectations of what borders can achieve and the premise of prohibition of refugee movement in its external dime

  6. 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 §...

  7. 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...

  8. 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…

  9. Physician unionization.

    Science.gov (United States)

    Lebowitz, P H

    1997-01-01

    Typically, doctors have seemed unsuited for and uncomfortable with the idea of unions but with the current changes in practices and referral patterns, doctors are looking--at least warily--at unions. Two sets of laws apply to possible unionization of physicians; one, federal antitrust laws, the other, both federal and state labor laws as they apply to changes in the medical profession. Antitrust laws are designed to protect competition by prohibiting price fixing. Another typical antitrust issue that applies to healthcare is that of a group boycott or refusal to deal, where competitors try to coerce a third party to set prices where competitors want them set. Congress' earliest legislation to aide the labor movement involved exceptions to the antitrust laws. Some provisions of the laws are limited to workers who are employees, defined as someone who is employed by any person. Doctors are searching for solutions that provide the collective power of the labor laws without offending the antitrust laws. The question is whether doctors can form unions under these two conflicting forces. The first main issue is whether the doctor is or is not an employee. Although radiologic technologists, typically employees of hospitals or provider groups, have been unionized for years, doctors are usually not employees, at least not if they have their own practices. Although not employees, physicians may affiliate with a larger union to use that broader bargaining power, a purpose that is permissible under current law. Membership in a union does have its responsibilities and disadvantages. Some have suggested that the definition of employee be broadened to cover physician duties under managed care payer agreements, for example. Meanwhile, the Federal Trade Commission and the Justice Department are watching that non-employee physicians not use the union label to mask price fixing, boycotts or refusals to deal.

  10. 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...

  11. 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

  12. [Family reunification and family formation of asylum migrants].

    Science.gov (United States)

    Den Dulk, W; Nicolaas, H

    1998-09-01

    "Estimates have been made of the number of family-reunifying and family-forming migrants of asylum migrants [in the Netherlands], using population stock data per 1 January 1997 obtained from the municipal population registers. The estimates are based on such demographic characteristics as country of birth, age, sex, marital status, year of marriage, family situation after the migration and year of most recent settlement in the Netherlands.... The calculations refer to the years 1990-1996 and are carried out for the following countries: Afghanistan, Angola, Ethiopia, Ghana, Iraq, Iran, (former) Yugoslavia, Somalia, Sri Lanka, Vietnam and Zaire." (EXCERPT) PMID:12348734

  13. 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...

  14. 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 ...

  15. [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

  16. Serbian migration policy concerning irregular migration and asylum in the context of the EU integration process

    Directory of Open Access Journals (Sweden)

    Marta Stojić-Mitrović

    2016-02-01

    Full Text Available In this paper I would like to present Serbian migration policy concerning irregular migration and asylum in the context of the attempts of the Serbian state to become a member of the European Union. I would describe the history of the asylum system prior and after the implementation of the independent asylum system in Serbia in 2008. My presentation of the Serbian migration policy would be channelled by the analysis of some particular political issues, such as the externalization of the EU borders’ control, as well as some relevant elements of the European integration process, like visa liberalization. The second, more culturally specific dimension of the issue would be accessed through the demonstration of both legislative and public conceptualizations of the irregular migrants, asylum seekers and refugees in Serbia.

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. [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.

  2. [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

  3. Britishness, asylum-seekers and the northern working class: 1851.

    Science.gov (United States)

    Belchem, John

    2002-01-01

    The arrival of a small group of Polish-Hungarian refugees in Liverpool in 1851 reveals a lot about contemporary political views in the United Kingdom. The refugees were members of General Wysocki's Polish legion, which had fought Russia and Austria during the Hungarian revolution in 1848-49. While British liberals had hailed the nationalist cause from a distance, they were made uneasy by the presence of the refugee republicans with radical ideas. For that reason, British liberals worked with the government to try to send the Hungarian refugees to the United States. On the other hand, tradesmen and artisans in Liverpool - who were drawn to the social democratic ideas of liberty expressed by the revolutionaries of 1848 - organized a successful campaign to grant the refugees asylum.

  4. 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;

    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...... participated. ADL-ability was measured using Assessment of Motor and Process Skills and questionnaires about exposure to torture, self-reported mental health and pain. ADL motor and process measures, well-being and self-rated health declined from baseline to follow-up. Measures of pain and depression increased......-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 them...

  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. [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

  7. 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

  8. 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 ...

  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. ‚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...

  11. 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...

  12. 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.

  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. 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

  15. 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

  16. [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

  17. Wanted: Well-Rounded Physicians.

    Science.gov (United States)

    Sorrel, Amy Lynn

    2015-10-01

    The Association of American Medical Colleges has revamped the MCAT for the first time in nearly three decades. While the new exam retains the science-based testing historically included, it adds new topics and approaches meant to keep up with a rapidly changing health care delivery system. It aims to test and train aspiring physicians based less on memorizing scientific facts and more on competency: putting that scientific knowledge into practice. Questions on the new MCAT pertain to concepts such as self-identity, social stratification, and multiculturalism and ask students to apply them to certain scenarios. PMID:26457841

  18. 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…

  19. 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 ....... A key issue is whether the critique is not itself a part of the self-legitimation of disciplinary power.......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...... the study draws upon Foucauldian concepts like disciplinary power, confession, pastoral power and subjectivation. I will argue that the critique of the patient provides us with an example of the way that disciplinary power works in the case of an informal indictment of the methods and practice at an asylum...

  20. [Jonathan Swift's asylum in Dublin--Ireland's introduction to institutional psychiatry 250 years ago].

    Science.gov (United States)

    Reuber, M

    1995-09-01

    250 years ago, the satirical writer and clergyman Jonathan Swift from Dublin (1667-1745) founded the first Irish lunatic asylum. Rejecting the theories put forward by the English philosopher Thomas Hobbes and the doctor Thomas Willis, he was influenced by the ideas of the Scottish doctor and the "enlightened" thinker John Locke. Swift's St. Patrick's Hospital did not, however, realise a new philosophical concept: architecture and therapeutic approach of the new institution were clearly modelled on the much older Hospital of St. Mary of Bethlehem ( = Bedlam). Despite its conservative conceptual basis, the first institution dedicated to the mentally ill and intellectually subnormal in Ireland became a starting point for the apparantly unstoppable expansion of the, at one time, most comprehensive asylum system in the world. After Swift's Hospital had been enlarged twice at the tax-payers' expense (1778, 1793), the administration decided to relieve the institution by erecting the Richmond Asylum (1810), the first public asylum in Ireland. When this establishment also became overcrowded, in 1817, legislation was passed which led to the establishment of the oldest system of public asylums in Europe.

  1. 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.

  2. 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

  3. The Moral Economy of Lying: Subjectcraft, Narrative Capital, and Uncertainty in the Politics of Asylum.

    Science.gov (United States)

    Beneduce, Roberto

    2015-01-01

    Based on narratives of asylum-seekers from sub-Saharan Africa in northern Italy, in this article I analyze the narrative strategies used by immigrants to meet the eligibility criteria established by asylum law. For many of them, this means "arranging" biographical details within what I call "a moral economy of lying." The first question I discuss is what types of experience and 'subject positions' these narrative strategies reveal or generate. I then examine the arbitrariness and the bureaucratic violence of the asylum evaluation process, and the role of these procedures in the making of nation-language and current technologies of citizenship. Finally, I consider the politics of testification, recognition, and memory these discourses and practices combine to shape. I analyze these issues from an historical point of view of the politics of identity, truth, and falsehood as imposed in a recent past by colonizers onto the colonized.

  4. Do supranational EU institutions make a difference? EU asylum law before and after ‘communitarization’

    Science.gov (United States)

    Ripoll Servent, Ariadna; Trauner, Florian

    2014-01-01

    ABSTRACT This article examines whether the empowerment of the European Union's (EU) supranational institutions has had an impact on the development of EU asylum. By systematically investigating EU asylum law before and after ‘communitarization’, it argues that its ‘policy core’ has maintained a high degree of continuity. An advocacy coalition under the leadership of the interior ministers managed to co-opt pivotal actors in the newly empowered European Commission and European Parliament. By contenting themselves with changes of secondary order, these EU institutions accepted and institutionalized the restrictive and weakly integrated core of EU asylum set by the Council in the first negotiation round. Their role and decisions were driven not only by the negotiation dynamics and political expediency, but also by new inter- and intra-institutional norms fostering consensual practices. PMID:26924934

  5. The physical and psychological effects of torture in Kurds seeking asylum in the United Kingdom.

    Science.gov (United States)

    Bradley, Lloyd; Tawfiq, Nouran

    2006-01-01

    There were over 2000 applications for asylum from Turkish nationals to the UK in 2003. A large proportion of these were person of Kurdish origin, many of whom claimed to have suffered torture. We sought to evaluate the physical and psychological effects of torture in those with physical injuries. A total of 97 Kurdish asylum seekers requiring medical evaluation for evidence of torture were examined and interviewed in the presence of an interpreter. Physical injuries, pain, disability and psychopathology were documented for each. A wide variety of injuries and psychological disorders were documented. Posttraumatic stress disorder, major depression and organic brain damage were present in a substantial proportion of those surveyed. Methods of torture not previously documented were revealed. There are long term healthcare needs of this population, which are complex and require a multidisciplinary approach. Survivors of torture may be disadvantaged in the asylum process because of organic brain damage or major psychological disturbance. PMID:17460346

  6. The Moral Economy of Lying: Subjectcraft, Narrative Capital, and Uncertainty in the Politics of Asylum.

    Science.gov (United States)

    Beneduce, Roberto

    2015-01-01

    Based on narratives of asylum-seekers from sub-Saharan Africa in northern Italy, in this article I analyze the narrative strategies used by immigrants to meet the eligibility criteria established by asylum law. For many of them, this means "arranging" biographical details within what I call "a moral economy of lying." The first question I discuss is what types of experience and 'subject positions' these narrative strategies reveal or generate. I then examine the arbitrariness and the bureaucratic violence of the asylum evaluation process, and the role of these procedures in the making of nation-language and current technologies of citizenship. Finally, I consider the politics of testification, recognition, and memory these discourses and practices combine to shape. I analyze these issues from an historical point of view of the politics of identity, truth, and falsehood as imposed in a recent past by colonizers onto the colonized. PMID:26258605

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

    DEFF Research Database (Denmark)

    Seeberg, Peter

    2015-01-01

    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......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...... the migrants arriving mainly in Italy and Greece, so that all 28 EU member states will take their part of the responsibility. The plan should – according to the EU-Commission – be mandatory and this has resulted in criticism from several member states, not least the UK. The article claims that the idea from...

  8. 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

  9. 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,...

  10. Rethinking the Carceral through an Institutional Lens: On prisons and asylums in the United States

    Directory of Open Access Journals (Sweden)

    Bernard E. Harcourt

    2009-10-01

    Full Text Available IntroductionThe classic texts of social theory tell a consistent story not only about the rise and (in some cases fall of discrete carceral institutions, but also of the remarkable continuity of confinement and social exclusion.  This pattern is reflected in the writings of Erving Goffman on Asylums (1961, Gerald Grob on The State and the Mentally Ill (1966, David Rothman on The Discovery of the Asylum (1971, and Michel Foucault (1961. In Madness and Civilization, Foucault traces the con...

  11. Moving images: psychoanalytically informed visual methods in documenting the lives of women migrants and asylum seekers.

    Science.gov (United States)

    Haaken, Janice K; O'Neill, Maggie

    2014-01-01

    While feminist arts-based projects have gained legitimacy, theory guiding the use of visual images in field research has lagged. Drawing on psychoanalytic-feminist theory and participatory action research methods, the article presents a study carried out with women refugee and asylum seekers that focuses on their experiences in seeking a place of safety in the United Kingdom. The aim was to produce through photography and videography a collective account of asylum as a daily process. In discussing the study, the authors provide a psychoanalytic framework for working through ethical, political, and methodological dilemmas in the use of visual imagery in feminist research.

  12. Physician-Assisted Death

    OpenAIRE

    Senn, John S.

    1994-01-01

    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.

  13. 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 ...

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

    NARCIS (Netherlands)

    F.J.J. ter Heide; T.M. Mooren; W. Kleyn; A. de Jongh; R.J. Kleber

    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 Mov

  15. A foot in the door: access to asylum in South Africa

    NARCIS (Netherlands)

    D. Vigneswaran

    2008-01-01

    Asylum seekers in South Africa experience extreme difficulties lodging their claims at the Department of Home Affairs. This paper utilizes new survey data to measure the extent of the Department’s failures to provide access to the status determination process. The principal finding is that South Afr

  16. 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

  17. 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

  18. 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.

  19. People Seeking Asylum in Australia and their Access to Employment: Just What Do We Know?

    Directory of Open Access Journals (Sweden)

    Caroline Fleay

    2016-07-01

    Full Text Available Public and political claims about the employment of people from a refugee background in Australia do not always reflect the research findings in this area. For example, recent claims by a senior Coalition Government Minister about people seeking asylum who arrived to Australia by boat during the previous Labor Government’s terms in office (2007-13 posit that many have limited employment prospects. However, given there is little research or government reporting on the experiences of asylum seekers who arrived during this time, and none that focuses specifically on their employment, there is no evidence to support this. A review of research on the employment experiences of people from a refugee background, and Australian policies, suggests a more nuanced picture. This includes research that found while initially people from a refugee background are more likely to be unemployed, have temporary jobs and lower incomes than other newly arrived immigrants, second-generation refugees have higher levels of labour market participation than the general population. Research also highlights that refugees may experience a range of barriers to accessing employment, including discrimination, and a review of Australian policies indicates these are likely to have exacerbated some of these barriers for asylum seekers who arrived to Australia by boat. In addition, given previous findings that public attitudes can be influenced by representations made in public and political discourses, the public statements of senior Ministers may be further deepening barriers to accessing employment faced by asylum seekers who arrived by boat.

  20. A diagnostic analysis of the Casebooks of Ticehurst House Asylum, 1845-1890.

    Science.gov (United States)

    Turner, T H

    1992-01-01

    Ticehurst House, a private asylum, flourished during the nineteenth century as the most expensive of such establishments, being owned and run by the Drs Newington over five successive generations. The discovery of the full set of patient casebooks begun in 1845-6 made it possible to review in detail the clinical features of a complete cohort of patients admitted to the asylum between 1845 and 1890. Six-hundred-and-one patients were thus analysed in terms of their age, sex, length of stay, symptoms, treatment and outcome. Modern operational diagnoses were used, and 80% of the cohort were found to conform to Research Diagnostic Criteria, in particular to the categories for schizophrenia and manic-depressive disorder. An additional finding was the high prevalence of movement and postural disorder among the schizophrenic group, as well as a significant trend towards the selection of a treatable, good-outcome group of patients with manic-depressive illness. These results are discussed by comparison with other modern studies of the asylum period, and in the contemporary context of Victorian psychological medicine. It is suggested that the violence, physicality and chronicity of psychotic illness must be seen as central to the debate about the rise of the asylum in nineteenth-century Britain. Furthermore, the similarity in core symptoms found in such patients and those seen in the 1980s indicates that the categories 'schizophrenia' and 'manic-depressive disorder' have a robust validity that is not confined to the social parameters of a particular time period.

  1. Language Analysis in the Context of the Asylum Process: Procedures, Validity, and Consequences

    Science.gov (United States)

    Reath, Anne

    2004-01-01

    In 1993, the language section of the Swedish Migration Board initiated the production of documents they called "language analyses" to aid in the processing of asylum seekers. Today, 11 years later, 2 privately owned companies in Stockholm produce these documents. These companies have produced language analyses not only for the Swedish Migration…

  2. 77 FR 76352 - Adjustment of Status of Refugees and Aliens Granted Asylum

    Science.gov (United States)

    2012-12-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOMELAND SECURITY 8 CFR Part 209 Adjustment of Status of Refugees and Aliens Granted Asylum CFR Correction In Title 8 of the Code of Federal Regulations, revised as of January 1, 2012, on page 175, in Sec....

  3. 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…

  4. 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

  5. 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…

  6. 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…

  7. 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

  8. 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

  9. 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.

  10. 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…

  11. 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...

  12. 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

  13. 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

  14. 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 ...

  15. 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 ...

  16. Physicians, unions, and antitrust.

    Science.gov (United States)

    Hirshfeld, E B

    1999-01-01

    The increasing consolidation of our healthcare delivery systems and the concomitant push for perceived efficiencies, speed, and profits has laid the foundation for a renewed interest in unionization by many physicians. This Article analyzes the barriers to such unionization that are posed by the antitrust laws, and provides an analysis of how to proceed with unionization without violating those laws. The Article also analyzes the current status of physician ability to unionize, and surveys the present status of physician unions.

  17. 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 ...

  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.

  19. [The relevance of occupational physician for physicians].

    Science.gov (United States)

    Hosaka, Takashi

    2012-01-01

    The Japan Medical Association launched a project team to examine health conditions of physicians working at hospitals in 2008. First, cross-sectional study was conducted among total number of 10,000 physicians, who were randomly selected from the Japan Medical Association (JMA). They were asked to fill in a basic questionnaire that was used to collect demographic data and to complete the Japanese version of Quick Inventory of Depressive Symptomatology (QIDS-SR-16). As a result, an adjusted response rate was 40.5%. Fifty-three % of the respondents did not consult with the colleagues about their unhealthy conditions, 46% had less than 4 holidays in a month, and 41% slept for less than 6 hours. More importantly, from a psychiatric point of view, 6% thought of committing suicide several times a week, 9% showed lack of interest, and 6% felt lack of energy. The QIDS-SR-16 also indicated 8.7% were in a moderately depressed state and 1.9% suffered from severe depression. Secondly, the project team provided a consulation service through E-mail and telephone to listen and advice to JMA members who had the needs. However, there were only few consultations that took place. Thirdly, the project team held several workshops in 12 different locations targeting occupational physicians working in hospitals. The workshops included case conferences and lectures on mental health. From 2010 to 2011, there were total of 450 participants. Finally, in addition to these attempts, the author has been working as an occupational physician for a major department of a University hospital. The author thinks from these experiences that the location of an external occupational physician would be most effective for prevention and early detection of mental problems among physicians working in hospitals. PMID:22712204

  20. "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

  1. 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.

  2. 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.

  3. [The humble physician].

    Science.gov (United States)

    Barnhoorn, P C

    2016-01-01

    A good physician is a humble physician. Humility can be defined as the middle ground between meekness and vanity, or the insight that what we know and what we are capable of is incomplete. This insight is needed to develop a realistic self-image and to prevent unprofessional behaviour among doctors. PMID:27650023

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. Asylum-seeking children's experiences of detention in Canada: A qualitative study.

    Science.gov (United States)

    Kronick, Rachel; Rousseau, Cécile; Cleveland, Janet

    2015-05-01

    Children and parents seeking asylum are regularly detained in Canada, however little is known about the experiences of detained families. International literature suggests that the detention of children is associated with significant morbidity. Our study aims to understand the experiences of detained children and families who have sought asylum in Canada by using a qualitative methodology that includes semistructured interviews and ethnographic participant observation. Detention appears to be a frightening experience of deprivation that leaves children feeling criminalized and helpless. Family separation further shatters children's sense of well-being. Children's emotional and behavioral responses to separation and to detention suggest that the experience is acutely stressful and, in some cases, traumatic--even when detention is brief. Distress and impairment may persist months after release. Given the burden of psychological suffering and the harmful consequences of separating families, children should not be detained for immigration reasons and parents should not be detained without children.

  9. [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

  10. [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.

  11. 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...

  12. 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...

  13. 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.

  14. 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.

  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. 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.

  17. 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...

  18. 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.

  19. 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

  20. 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.

  1. 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

  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 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...

  4. 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...

  5. 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.

  6. 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...

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

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    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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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.

  15. Instrumentation problems for physicians.

    Science.gov (United States)

    Turner, G O

    1980-01-01

    The physician has, for whatever reasons, diminished his or her level of involvement on the team dedicated to developing, refining, and evaluating medical technology. As a result, the challenge confronting the physician and the technology development team today is to orchestrate a team structure that will ensure the greatest input and commitment from physicians and other professionals during current and future technology development. The charges of cost escalation and dehumanization in our system of health care delivery will also be discussed, as will the lack of, or confusion about, access to data concerning cost of a given instrument, and fuzzy semantics and perspectives on technology and instrumentation. The author suggests answers to, or means to ameliorate, the problems.

  16. Marital stability among physicians.

    Science.gov (United States)

    Rose, K D; Rosow, I

    1972-03-01

    Analysis of 57,514 initial complaints for divorce, separate maintenance, and annulment filed in California during the first six months of 1968 reveals that physicians are considerably less prone to marital failure than men of comparable age in the general population. Furthermore, when compared to professionals in general, doctors also appear less prone to marital collapse. For physicians, marriages break down in the greatest numbers and at the greatest rate between the ages of 35 and 44. Women doctors are at least 40% more prone to marital instability than men, and black physicians are nearly 70% more prone to divorce than their white colleagues. Of the individual specialists, orthopedists and psychiatrists possibly have the highest rates of marital demise.

  17. [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

  18. 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

  19. 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.

  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. 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

  2. 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...

  3. Physician Satisfaction and Physician Well-Being: Should Anyone Care?

    Directory of Open Access Journals (Sweden)

    Lawrence P. Casalino

    2015-05-01

    Full Text Available We present a model of hypothesized relationships between physician satisfaction, physician well-being and the quality of care, in addition to a review of relevant literature. The model suggests that physicians who are stressed, burned out, depressed, and/or have poor self-care are more likely to be dissatisfied, and vice-versa. Both poor physician well-being and physician dissatisfaction are hypothesized to lead to diminished physician concentration, effort, empathy, and professionalism. This results in misdiagnoses and other medical errors, a higher rate of inappropriate referrals and prescriptions, lower patient satisfaction and adherence to physician recommendations, and worse physician performance in areas not observed by others. Research to date largely supports the model, but high quality studies are few. Research should include studies that are prospective, larger, and have a stronger analytic design, ideally including difference in differences analyses comparing quality of care for patients of physicians who become dissatisfied to those who remain satisfied, and vice versa.Keywords: physician satisfaction, physician dissatisfaction, quality of care, physician well-being, physician burnout 

  4. 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

  5. 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

  6. 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.

  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. 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

  9. Naturopathic physicians: holistic primary care and integrative medicine specialists.

    Science.gov (United States)

    Litchy, Andrew P

    2011-12-01

    The use of Complimentary and Alternative Medicine (CAM) is increasing in the United States; there is a need for physician level practitioners who possess extensive training in both CAM and conventional medicine. Naturopathic physicians possess training that allows integration of modern scientific knowledge and the age-old wisdom of natural healing techniques. Naturopathic philosophy provides a framework to implement CAM in concert with conventional therapies. The naturopathic physician's expertise in both conventional medicine and CAM allows a practice style that provides excellent care through employing conventional and CAM modalities while utilizing modern research and evidence-based medicine. PMID:22432775

  10. 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.

  11. The future for physician assistants.

    Science.gov (United States)

    Cawley, J F; Ott, J E; DeAtley, C A

    1983-06-01

    Physician assistants were intended to be assistants to primary care physicians. Physicians in private practice have only moderately responded to the availability of these professionals. Cutbacks in the numbers of foreign medical graduates entering American schools for graduate medical education, concern for overcrowding in some specialties, and the economic and clinical capabilities of physician assistants have lead to new uses for these persons. Physician assistants are employed in surgery and surgical subspecialties; in practice settings in institutions such as medical, pediatric, and surgical house staff; and in geriatric facilities, occupational medicine clinics, emergency rooms, and prison health systems. The projected surplus of physicians by 1990 may affect the use of physician assistants by private physicians in primary care.

  12. 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 ….

  13. 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.

  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. 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

  16. 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......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...... in a refugee camp, and seven out of 10 had witnessed violence. Half of the children had a tortured parent. Considerably more children of families who did not get a residence permit had lost a parent (30.6% versus 13.7%; P , 0.001). In both groups about two-thirds suffered from anxiety and about 30% from sleep...... 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....

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Israel Bronstein

    Full Text Available 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.

  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. 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...

  1. Changing physician prescribing behaviour.

    Science.gov (United States)

    Gray, J

    2006-01-01

    Didactic approaches to educating physicians and/or other health professionals do not produce changes in learner behaviour. Similarly, printed materials and practice guidelines have not been shown to change prescribing behaviour. Evidence-based educational approaches that do have an impact on provider behaviour include: teaching aimed at identified learning needs; interactive educational activities; sequenced and multifaceted interventions; enabling tools such as patient education programs, flow charts, and reminders; educational outreach or academic detailing; and audit and feedback to prescribers. Dr. Jean Gray reflects over the past 25 years on how there has been a transformation in the types of activities employed to improve prescribing practices in Nova Scotia. The evolution of Continuing Medical Education (CME) has resulted in the creation of the Drug Evaluation Alliance of Nova Scotia (DEANS) program, which is one exemplar of an evidence-based educational approach to improving physician prescribing in that province. Key words: Evidence-based, education, prescribing.

  2. 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

  3. 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.

  4. Physicians in literature: three portrayals.

    Science.gov (United States)

    Cameron, I A

    1986-02-01

    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.

  5. 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

  6. 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…

  7. Vitamin D levels in children of asylum seekers in The Netherlands in relation to season and dietary intake

    NARCIS (Netherlands)

    Stellinga-Boelen, Annette A. M.; Wiegersma, P. Auke; Storm, Huub; Bijleveld, Charles M. A.; Verkade, Henkjan J.

    2007-01-01

    Low dietary intake and limited sun exposure during Dutch winters, in particular when combined with highly pigmented skin, could compromise the vitamin D status of asylum seekers' children in The Netherlands. We determined the vitamin D status of children living in The Netherlands, but originating fr

  8. "Confinement of the higher orders": the social role of private lunatic asylums in Ireland, C. 1820-60.

    Science.gov (United States)

    Mauger, Alice

    2012-04-01

    The period 1820-60 marked an era of transition and diversity in Ireland that rapidly transformed the face of Irish society. Inextricably linked with these processes was the expansion of Ireland's private asylum system. This system diverged from its British counterpart both in the socioeconomic cohort it served and in the role it played within the mental health-care system as a whole. The implementation of the 1842 Private Asylums (Ireland) Act, the first legislative measure geared exclusively toward the system, highlighted the growing importance of private care in Ireland as well as providing for the licensing and regulation of these institutions for the first time. To date, historians of Irish medicine have focused almost exclusively on the pauper insane. This article aims to shift this emphasis toward other categories of the Irish insane through exploration of the Irish private asylum system, its growth throughout the period, and the social profile of private patients. I shall also interrogate the trade in lunacy model through exploration of financial considerations, discharge and recovery rates, and conditions of care and argue that while Irish private institutions were a lucrative business venture, the quality of care upheld was apparently high. Finally, I shall argue that Irish private asylums catered primarily for the upper classes and briefly explore alternative provisional measures for other non-pauper sectors of society.

  9. 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

  10. Objections to asylum seeker centers: Individual and contextual determinants of resistance to small and large centers in the Netherlands

    NARCIS (Netherlands)

    Lubbers, M.; Coenders, M.T.A.; Scheepers, P.L.H.

    2006-01-01

    Over the last 15 years, numerous asylum seeker centres (ASCs) have been founded in the Netherlands, often preceded and followed by neighbourhood unrest. In this contribution we show to what extent people object to the foundation of ASCs of different sizes. We set out to answer the question of which

  11. Objections to Asylum Seeker Centres : Individual and Contextual Determinants of Resistance to Small and Large Centres in the Netherlands

    NARCIS (Netherlands)

    Lubbers, Marcel; Coenders, Marcel; Scheepers, Peer

    2006-01-01

    Over the last 15 years, numerous asylum seeker centres (ASCs) have been founded in the Netherlands, often preceded and followed by neighbourhood unrest. In this contribution we show to what extent people object to the foundation of ASCs of different sizes. We set out to answer the question of which

  12. Reconstructing Harry: a genealogical study of a colonial family 'inside' and 'outside' the Grahamstown Asylum, 1888-1918.

    Science.gov (United States)

    Wilbraham, Lindy

    2014-04-01

    Recent scholarship has explored the dynamics between families and colonial lunatic asylums in the late nineteenth century, where families actively participated in the processes of custodial care, committal, treatment and release of their relatives. This paper works in this historical field, but with some methodological and theoretical differences. The Foucauldian study is anchored to a single case and family as an illness narrative that moves cross-referentially between bureaucratic state archival material, psychiatric case records, and intergenerational family-storytelling and family photographs. Following headaches and seizures, Harry Walter Wilbraham was medically boarded from his position as Postmaster in the Cape of Good Hope Colony of South Africa with a 'permanent disease of the brain', and was committed to the Grahamstown Asylum in 1910, where he died the following year, aged 40 years. In contrast to writings about colonial asylums that usually describe several patient cases and thematic patterns in archival material over time and place, this study's genealogical lens examines one white settler male patient's experiences within mental health care in South Africa between 1908 and 1911. The construction of Harry's 'case' interweaves archival sources and reminiscences inside and outside the asylum, and places it within psychiatric discourse of the time, and family dynamics in the years that followed. Thus, this case study maps the constitution of 'patient' and 'family' in colonial life, c.1888-1918, and considers the calamity, uncertainty, stigma and silences of mental illness.

  13. 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…

  14. The Principle of Non-Discrimination : An Empty Promise for the Preventive Health Care of Asylum Seekers and Undocumented Migrants?

    NARCIS (Netherlands)

    Flegar, Veronika

    2015-01-01

    The principle of non-discrimination in Article 2 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) holds that its rights are equally applicable to ‘everyone’. Nevertheless, evidence from the national context suggests that access to health care for asylum seekers and undo

  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. [PERSONALIZED MEDICINE: NEW CHALLENGES FOR THE PHYSICIAN].

    Science.gov (United States)

    Scheen, A J

    2015-01-01

    The clinician has to cope with new advances in medicine. Traditional medicine, which is based upon pathophysiological reasoning and clinical experience, has been reinforced by evidence-based medicine, which relies on levels of evidence provided by controlled clinical trials carried out on cohorts of patients. Since a few years, personalized medicine has been put at the forefront. A therapy tailored to every patient, if possible characterized by biomarkers, among which, since the achievement of the whole human genome sequencing, an increasing number of genetic markers. Personalized medicine should be used as a complement of traditional and evidence-based medicine. Physicians should progressively integrate this new strategy in their therapeutic approach. Hence, clinicians have to face new challenges as far as scientific knowledge, practical applications and physician-patient relationship are concerned.

  17. 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

  18. 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

  19. 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

  20. Patients' and physicians' attitudes regarding the physician's professional appearance.

    Science.gov (United States)

    Gjerdingen, D K; Simpson, D E; Titus, S L

    1987-07-01

    Although physician appearance has been a topic of interest to medical historians for more than two centuries, little objective investigation has been made into patients' and physicians' attitudes toward the physician's appearance. This study analyzed responses from 404 patients, residents, and staff physicians regarding their attitudes toward various aspects of the male and female physician's professional appearance. Positive responses from all participants were associated with traditional items of dress such as the dress, shirt and tie, dress shoes, and nylons, and for physician-identifying items such as a white coat and a name tag. Negative responses were associated with casual items such as blue jeans, scrub suits, athletic shoes, clogs, and sport socks. Negative ratings were also associated with overly feminine items such as prominent ruffles and female dangling earrings and such temporarily fashionable items as long hair on men, male earrings, and patterned hose on women. Overall, patients were less discriminating in their attitude toward physician appearance than physicians. Patients rated traditional items less positively and casual items less negatively. This study confirms the importance of the physician's appearance in physician-patient communication.

  1. 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...

  2. 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...

  3. Being a family physician: Experience of general physicians working in rural and urban healthcare centers in Iran

    Directory of Open Access Journals (Sweden)

    Setareh Abdoli

    2014-01-01

    Full Text Available Background: The family physician program in the form of a referral system is one the best administrative strategies, especially in rural and low populated regions (under 20,000 people of Iran in 2006. Objectives: This study was conducted with the aim of general physician′s experience as practicing in family physician program. Materials and Methods: This study was a qualitative study using conventional content analysis. The data were gathered by in-depth interview with 12 family physicians working in rural and low populated urban health and treatment center in a province located in west of Iran in 2011. Findings: The findings highlighted that five main themes and 12 subthemes reflected the general physician′s experience as family physicians. They were: The physician′s lost identity (physician: Belittled and physician: Shattered in the system, the physician left in the system (physician: Extorted and lacking supportive environment, passive and thoughtless practice (learning, a faded element, and scientific practice on the verge of demise, the unstable foundation of the program (insufficient groundwork, lack of comprehensiveness, and the change in the program′s nature during practice, and sparks of success (satisfaction with need-based practice, proper distribution of general physicians within the country, and effective management of chronic diseases. Interpretation and Conclusions: The findings indicated serious challenges in family physician program. Ignoring these problems may lead to medical and financial resources wasting. So a permanent progressing program needs solving defects of the valuable program in Iran to improve healthcare in rural and low-populated regions.

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. 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.

  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. The physician leader as logotherapist.

    Science.gov (United States)

    Washburn, E R

    1998-01-01

    Today's physicians feel helpless and angry about changing conditions in the medical landscape. This is due, in large part, to our postmodernist world view and the influence of corporations on medical practice. The life and work of existentialist psychiatrist Viktor Frankl is proposed as a role model for physicians to take back control of their profession. Physician leaders are in the best position to bring the teachings and insight of Frankl's logotherapy to rank-and-file physicians in all practice settings, as well as into the board rooms of large medical corporations. This article considers the spiritual and moral troubles of American medicine, Frankl's answer to that affliction, and the implications of logotherapy for physician organizations and leadership. Physician executives are challenged to take up this task.

  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. American College of Chest Physicians

    Science.gov (United States)

    ... American College of Chest Physicians and Sunovion announce strategic initiative focused on the importance of drug delivery in the management of COPD Sunovion Pharmaceuticals, Inc. (Sunovion) and the ...

  13. I had some problems back home with a big group of people and it was not safe for me there anymore so I had to run away : How LGBT asylum seekers move

    OpenAIRE

    Östlund, Rosanna

    2016-01-01

    Due to the increased number of the amount of asylum-seekers that have migrated to Sweden lately, the topic has received increased attention. This has contributed to housing shortage and policy reforms for new migrants to arise in order to ensure that everybody gets housing. Asylum seekers often experience more difficult patterns to housing, and for LGBT asylum seekers especially since they are such a marginalised group in our society already. Housing is an important part in the initial settle...

  14. 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…

  15. Abortion and compelled physician speech.

    Science.gov (United States)

    Orentlicher, David

    2015-01-01

    Informed consent mandates for abortion providers may infringe the First Amendment's freedom of speech. On the other hand, they may reinforce the physician's duty to obtain informed consent. Courts can promote both doctrines by ensuring that compelled physician speech pertains to medical facts about abortion rather than abortion ideology and that compelled speech is truthful and not misleading.

  16. 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.

  17. Abortion and compelled physician speech.

    Science.gov (United States)

    Orentlicher, David

    2015-01-01

    Informed consent mandates for abortion providers may infringe the First Amendment's freedom of speech. On the other hand, they may reinforce the physician's duty to obtain informed consent. Courts can promote both doctrines by ensuring that compelled physician speech pertains to medical facts about abortion rather than abortion ideology and that compelled speech is truthful and not misleading. PMID:25846035

  18. Out of sound, out of mind: noise control in early nineteenth-century lunatic asylums in England and Ireland

    OpenAIRE

    Fennelly, K.L.

    2014-01-01

    This article examines the rhetoric and design principles invested in public lunatic asylum architecture in the early nineteenth century. Using case studies from England and Ireland, this article will focus on the creation of a sensory environment conducive to the reform of these institutions, and how this was applied – intentionally or otherwise – in the built environment. Objections to door locks and the noise made by footsteps testify to the weight placed on the importance of the patient’s ...

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

    Directory of Open Access Journals (Sweden)

    Mosinkie Phillip I

    2008-12-01

    Full Text Available Abstract 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.

  20. 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...

  1. 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.

  2. 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...

  3. [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

  4. 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...

  5. [The changing role of physicians].

    Science.gov (United States)

    Siegrist, J

    2012-09-01

    Despite a very successful process of professionalisation during the past 150 years, today's physicians face several challenges urging them to adapt their traditional professional role and the patient-physician relationship inherent in this role. Among these challenges, a growing economic influence on physicians' practices, new demands from particular groups of patients (consumerism, role of the Internet etc.), and increasing inter-professional competition deserve special attention. New evidence of an association between a stressful work environment and physician's increased health risks provides additional support in favour of this notion. This contribution suggests potential directions of change of the physician's role by pointing to (a) a growing 'feminisation' of medicine, (b) an even stronger emphasis on patient needs and (c) extended teamwork and inter-professional cooperation.

  6. 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

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. Indo-Muslim Physicians

    OpenAIRE

    Speziale, Fabrizio

    2009-01-01

    Encyclopaedia Iranica, E. Yarshater, éd., (http://www.iranica.com); Medicine (ṭebb, pezeški) constitutes the scientific field on which the largest corpus of works has been composed in Muslim India. Most of these works were written in Persian, and to a lesser extent in Arabic, and later in Urdu from the Colonial period. Main scholars and authors were often attached to the courts of Indian sultans and many composed medical works for Muslim nobles. Several medical scholars occupied also importan...

  12. 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

  13. 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

  14. [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

  15. [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.

  16. [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

  17. 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...

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

    Directory of Open Access Journals (Sweden)

    Salla E. Toikkanen

    2016-06-01

    Full Text Available 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.

  19. 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.

  20. 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.  

  1. 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...

  2. Today's Physicians Seek Career Direction.

    Science.gov (United States)

    Morgan-Haker, Veronica R.

    1998-01-01

    Changes in the role of the physician in today's society have made their career choices risky. Career specialists have an opportunity to assist those who do not normally seek career advice outside their own profession. (JOW)

  3. Working with Generation X physicians.

    Science.gov (United States)

    Shields, Mark C; Shields, Margaux T

    2003-01-01

    Learn ways to integrate Generation X physicians into your hospital or practice. Discover how their career goals differ from the earlier generation's and find out how health care organizations can help meet those goals.

  4. Scientific news

    NARCIS (Netherlands)

    NN,

    1994-01-01

    The Rijksherbarium/Hortus Botanicus acquired funds through NWO (Netherlands Organisation for Scientific Research) to participate in a 7-year interdisciplinary cooperative programme of Indonesian and Dutch scientific institutions aiming at research in Irian Jaya, Cenderawasih province (the Bird’s Hea

  5. 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.

  6. 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.

  7. Erving Goffman's asylums and institutional culture in the mid-twentieth-century United States.

    Science.gov (United States)

    Gambino, Matthew

    2013-01-01

    Sociologist Erving Goffman based his seminal work Asylums (1961) on a year of field research at St. Elizabeths Hospital in Washington, DC. Goffman described the mental hospital as a "total institution," in which regimentation dominated every aspect of daily life and patients were denied even the most basic means of self-expression; rather than promote recovery, such conditions produced the sorts of disordered behavior for which men and women were ostensibly admitted. A closer look at the changes transforming St. Elizabeths around the time of Goffman's research reveals a far richer portrait of institutional culture. Group therapy, psychodrama, art and dance therapy, patient newspapers, and patient self-government-each of which debuted at the hospital in the 1940s and 1950s-provided novel opportunities for men and women to make themselves heard and to take their fate into their own hands. While these initiatives did not reach all of the patients at St. Elizabeths, surviving documentation suggests that those who participated found their involvement rewarding and empowering. Goffman explicitly set out to describe "the social world of the hospital inmate." His failure to appreciate fully the capacities of his subjects, however, appears to have led him to underestimate the importance of these developments.

  8. 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

  9. 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

  10. 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.

  11. 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

  12. Physician motivation, satisfaction and survival.

    Science.gov (United States)

    Zimberg, S E; Clement, D G

    1997-01-01

    Physicians are working harder today and enjoying it less. What has happened to create such dissatisfaction among those in one of the most autonomous professions? What can be done to address the anger, fear and unhappiness? This article is an analysis of the factors influencing human motivation. Maslow's hierarchy of needs--physiological, safety/security, social/affiliation, esteem and self-actualization--is used to suggest ways physicians can satisfy their needs in turbulent financial and professional times.

  13. [The clinic and the general physician].

    Science.gov (United States)

    Jinich, Horacio

    2004-01-01

    The clinician's activity consists of in the simple words of Dr. Gonzalo Castañeda "knowledge, good deeds and bread winning ". The respective value that clinicians grant to each of these, is variable, but even those whose priority is the latter of the three are obliged to accomplish the other two. Knowledge requires continuous medical education. Effective education requires the ability to separate the "wheat from the chaff". It is important to know how to study. Knowing the patient requires careful collection of symptoms, signs, and paraclinical data, as well as awareness of the sensitivity, specificity, and positive and negative predictive value of the data, but acknowledgment of the important discrepancies that occur among different observers as well as in the same observer at different times should not be disregarded. Clinical medicine is a scientific art that challenges the reasoning and decision-making abilities of the practitioner, who must apply various diagnostic strategies, the hypothetic-deductive strategy usually being the most important of all. Knowing the disease that the patient bears is not enough: it is equally important to know the patient who bears the disease. In clinical medicine there are no diseases, only diseased people. The biological approach to the patient must be substituted by a biopsycho-social one. The clinician's main objective--to heal, has become enormously fiacilitated by the dramatic progress of modern scientific medicine, which has provided the physician with powerful but dangerous tools. The old Hippocratic aphorism, primum non nocere, should never beforgotten. Equally essential for the clinician is application of evidence-based knowledge applied to diagnostic and therapeutic measures; there should be no room for past attitudes that were supported by empires and the advice of "authorities". A solid and warm patient-physician relationship is a tremendously important aspect of the healer's behavior.

  14. 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

  15. 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.

  16. [A Polish physician's impressions from the Viennese Clinic of Winternitz].

    Science.gov (United States)

    Kierzek, A

    1999-01-01

    The achievements of Vincenz Priestnitz, Sebastian Kneipp and Wilhelm Winternitz for the development of hydrotherapy are presented at the beginning. The professional and scientific activities of Winternitz are strongly pointed out. Eugeniusz Piasecki (1872-1947), the Polish physician and theorist of physical education impressions from Vieneese Clinic of Winternitz are depicted widely. The role of Winternitz in formation of modern hydrotherapy in Polish territories is presented finally. PMID:10695389

  17. 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.

  18. Memory frictions and reconciliation: Neo-victorian gothic and gender violence in Katy Darby’s The Whores’ Asylum (2012)

    OpenAIRE

    Romero Ruiz, María Isabel

    2015-01-01

    Katy Derby’s first novel, The Whores’ Asylum (2012), is an attempt to deal with the issue of prostitution and rescue work in Oxford in the 1880s. Jericho is an area where, away from the prestigious university colleges, drunkards, thieves and prostitutes loiter around in depraved houses of accommodation and taverns. The protagonists, Stephen Chapman –a brilliant medical student --, Edward Fraser –a Theology student –, and Diana – the woman who runs a refuge for fallen women – are the three ang...

  19. [Habitus, capital and fields: the search for an acting head of the Hamburg Asylum Friedrichsberg in 1897].

    Science.gov (United States)

    Sammet, Kai

    2005-01-01

    In 1897 Hamburg was in search of an Oberarzt for the asylum Friedrichsberg who should function as the acting head of the head Wilhelm Reye (1833-1912). This search was part of the intended reformation of the outmoded psychiatric care in Hamburg. During this application procedure the Hamburg Physikus John Wahncau examined all possible candidates and applicants. The article explores the election process by using some sociological categories developed by Pierre Bourdieu (habitus, capital, field). The author argues that not only meritocratic attributes led to the choice of one candidate, but also his functional "fitting" into the field in Hamburg.

  20. [Medical care for asylum seekers and refugees at the University Medical Center Hamburg-Eppendorf--A case series].

    Science.gov (United States)

    Sothmann, Peter; Schmedt auf der Günne, Nina; Addo, Marylyn; Lohse, Ansgar; Schmiedel, Stefan

    2016-01-01

    As the number of refugees rises, medical care for refugees, asylum seekers and people with unclear residence status becomes a priority task for our health system. While access to health care is restricted for these groups of people in many German states, Hamburg provides unrestricted access to healthcare for refugees by handing out health insurance cards on arrival. Daily practice shows, however, that adequate medical care is still not always easy to achieve. In this case series we demonstrate that barriers to health care still exist on many levels. We discuss these barriers and further propose strategies to improve and to secure access to adequate health care.

  1. Physician business deals: surveying the new landscape.

    Science.gov (United States)

    Harris, John M; Kaplan, Karin Chernoff

    2009-05-01

    Strong hospitals and health systems should be on the lookout for opportunities today to acquire physician businesses at depressed fair market values. In some instances, an outright purchase of physicians' interest in a physician-hospital joint venture may be preferable; in others, the hospital may benefit more from simply increasing its interest in the venture. A critical part of the strategy should be taking steps to ensure the physicians remain engaged, including addressing physicians' income goals and need for control.

  2. 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

  3. [Physicians in Mexico, 1970-1990].

    Science.gov (United States)

    Frenk, J; Durán-Arenas, L; Vázquez-Segovia, A; García, C; Vázquez, D

    1995-01-01

    A study was carried out in 1970 on the distribution of medical personnel in Mexico. At that time an unequal distribution of physicians was detected, but not emphasized given the general shortage of physicians in the country. At the present time, the situation has changed. In this article the analysis of the 1990 census data using traditional indicators of availability of physicians in the country, as well as indirect criteria of physician requirements is presented. In the year of reference there were 157,407 physicians in the country, with a national average of 673 persons per physician. The distribution of physicians by state showed a great deal of variation in the number of persons per physician. For example, the state of Chiapas has 1,642 inhabitants per physician, whereas the Federal District has 292. The relation between trained and employed physicians shows another important phenomenon: there is a high percentage of physicians that do not practice clinical medicine (19.4%). Nevertheless, the number of physicians almost tripled the growth experienced by the general population, and important differences among and within states do persist. Furthermore, a new paradoxical effect has emerged, the presence of underemployment and unemployment of physicians, even in communities with greater needs for medical care. This indicates that the strategy of training more physicians has not solved the problems of accessibility and coverage, but in fact has fostered new problems and perhaps greater inequalities. PMID:7754425

  4. 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

  5. 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.

  6. The Mindful Physician and Pooh

    Science.gov (United States)

    Winter, Robin O.

    2013-01-01

    Resident physicians are particularly susceptible to burnout due to the stresses of residency training. They also experience the added pressures of multitasking because of the increased use of computers and mobile devices while delivering patient care. Our Family Medicine residency program addresses these problems by teaching residents about the…

  7. 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

  8. Incest and the family physician.

    Science.gov (United States)

    Boekelheide, P D

    1978-01-01

    This paper is a review of incest from epidemiologic, familial, and individual points of view. The incest taboo has characterized almost every culture and society throughout the ages. Respect for the incest barrier is a cultural demand made by society and is not a physiological or biological imperative. Overt incest occurs in a dysfunctional family through tension-reducing "acting out." The family physician is in a unique position to observe and understand the family dynamics which both help maintain defenses against the incestuous wishes as well as, in some families, contribute to the practice of incest. For 2,000 years physicians have taken the Hippocratic oath, with its explicit love relationship clause, as a reminder of their ethical responsibilities towards their patients. Examples of para-incestuous relationships between vulnerable individuals and authoritative helping figures are cited. A psychodynamic rationale is offered as to why sexual relationships between patients and their family physicians are not therapeutically beneficial. Clues for assessment and ten preventive measures are presented to enable physicians to monitor themselves and the families in their practice.

  9. TQM: a paradigm for physicians.

    Science.gov (United States)

    Snyder, D A

    1993-01-01

    Change, even when for the better, is always accompanied by apprehension and even outright fear. It is therefore not surprising to hear health care workers, especially physicians, expressing their concerns about this "new" management philosophy through a spectrum of reactions that vary from skeptical or grudging acceptance to outright dismissal of all of the new "alphabet soup" associated with TQM.

  10. 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

  11. 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.

  12. Physician-centered management guidelines.

    Science.gov (United States)

    Pulde, M F

    1999-01-01

    The "Fortune 500 Most Admired" companies fully understand the irreverent premise "the customer comes second" and that there is a direct correlation between a satisfied work force and productivity, service quality, and, ultimately, organizational success. If health care organizations hope to recruit and retain the quality workforce upon which their core competency depends, they must develop a vision strategic plan, organizational structure, and managerial style that acknowledges the vital and central role of physicians in the delivery of care. This article outlines a conceptual framework for effective physician management, a "critical pathway," that will enable health care organizations to add their name to the list of "most admired." The nine principles described in this article are based on a more respectful and solicitous treatment of physicians and their more central directing role in organizational change. They would permit the transformation of health care into a system that both preserves the virtues of the physician-patient relationship and meets the demand for quality and cost-effectiveness. PMID:10387270

  13. Involving physicians in TQM. To gain physician support for quality management, hospital administrators must treat physicians as customers.

    Science.gov (United States)

    McCarthy, G J

    1993-12-01

    The process of integrating physicians into a hospital's total quality management (TQM) program is not simple. Physicians will not view TQM as an acceptable strategy in the absence of a positive working relationship with hospital managers. Physicians must see hospital managers as colleagues who can help improve their medical practices both in efficiency and patient care. The first step in involving physicians in TQM is creating an environment that enhances physician relationships. The CEO should be actively involved with the medical staff, and senior hospital managers should work at cultivating physician relationships. Physician needs and the centrality of the physician-management relationship should enter into every management discussion. Also, managers must solicit physician feedback regularly. Managers can introduce physicians to TQM by accompanying them to off-site TQM programs for a few days. Managers should also coordinate a continuing education program at the hospital, inviting a physician to address medical staff about TQM. Physicians are more likely to respond positively to one of their peers than they would to a consultant or business manager. Managers should then invite hospital-based physicians to participate on TQM interdisciplinary teams to resolve a problem chosen by the senior medical staff. The problem should be one that promises to be a quick fix, thereby ensuring demonstrable success of TQM and allaying any doubts. After an initial demonstration of TQM's success, the cycle is repeated. A year or two later, managers should invite off-site clinicians to join interdisciplinary teams on issues important to them.

  14. 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...

  15. Physicians? Opinions of Phytotherapy Products

    Directory of Open Access Journals (Sweden)

    Murat Kartal

    2011-05-01

    Full Text Available 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 specifically developed questionnaire including 11 questions was applied for the physicians. Results: 150 physicians participated in to the research from 30 provinces. The half of the study participants (75 people was male. The mean age was 34.4. The 63.1% of the participating physicians stated that they applied or interested in phytotherapy. The 36.9% of physicians determined that they were against to phytotherapy or not interested. The major reasons of the opposition or indifference are lack of evidence-based and not having enough study in this subject (50.0%, the insufficient legal regulations (16.7%, only being able to be a the placebo effect (8.3%, and the thinking of being able to have harmful side effects (4.2%. There was not statistically significant difference between gender and interest in phytotherapy (p: 0.567. The 28.2% of the participating physicians stated that they ask to their patients whether using herbal products or not before their treatment or prescription. Conclusion  Phytotherapy, which is frequently mentioned and used in currently, is a fact to be considered whether it is interested or not. Many studies show that it is useful while the physicians taking medical history to inquire about if the patient use of this any product, to detect possible interactions and harms. In addition, the studies emphasize that the production and consumption of herbal products is still not designed with legal regulation, there is no standardization of quality and evidence

  16. 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…

  17. 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

  18. Financial implications of serving as team physician.

    Science.gov (United States)

    Lemak, Larry

    2007-04-01

    Time is the greatest negative financial burden that you accept as a sports medicine physician, because the only way to produce revenue as a physician is with your time. This cost measured in time of doing business as a team physician can be high. Unless being a team physician is very rewarding to you through personal satisfaction or the other intangible indirect benefits associated with the role, being a team physician may not be a good financial decision for you as a person and a physician, or for your practice and your family.

  19. Assessing the Relationship between Community Education, Political Efficacy and Electoral Participation: A Case Study of the Asylum Seeking Community in Cork

    Science.gov (United States)

    Harris, Clodagh; Murphy, Philip

    2012-01-01

    This paper assesses the relationship between community education and internal political efficacy. In particular it examines the association between voter/civic programmes run in advance of the 2009 local elections in Ireland and internal political efficacy amongst the asylum seeking community in Cork. A survey is used to test this relationship.…

  20. 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…

  1. 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.

  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. Cuidadores del adulto mayor residente en asilos Caretakers of elderly persons living in asylums

    Directory of Open Access Journals (Sweden)

    Zoila Edith Hernández Zamora

    2006-06-01

    Full Text Available Se reitera el incremento que en los últimos años ha tenido la población de adultos mayores, hecho que repercute en el número también cada vez más alto de personas residentes en asilos para ancianos, lugares que por lo regular dependen del estado y cuyas características tanto materiales como su infraestructura en cuanto a personal especializado para atender a las personas que ahí viven, deja mucho que desear. Este último aspecto es el punto cardinal de este trabajo, ya que los cuidadores, trátese de enfermeras, psicólogo, médicos, trabajadoras sociales, entre otros, realizan un papel crucial en el funcionamiento de tales instituciones. El cuidador, al igual que los residentes, es un ser humano, con una carga inherente a la labor que realiza y que, además, transita por todas las emociones o conflictos que implica desempeñar su puesto, al igual que los que cuida, necesita ser cuidado y atendido para el logro del bienestar de ambos.This article underlines the increase in the population of elderly persons that has occurred in recent years and has resulted in ever-increasing numbers of residents living in asylums for the aged, or old people’s homes. Such institutions are generally dependent on the state, and their material characteristics as well as their infrastructure in regard to the specialized personnel for attending to the people residing there leave much to be desired. This last aspect is the central point of this work since the caretakers, be they nurses, psychologists, doctors, social workers or others, perform a crucial role in the functioning of such institutions. The caretaker, like the residents, is a human being with a duty that is inherent in his/her work and who, in addition, is subject to all the emotions or conflicts that the job implies. Just like the persons under his care, he requires care and attention in order to maintain the well-being of all those concerned.

  4. 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

  5. [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

  6. 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.

  7. Organizational aspects of physician joint ventures.

    Science.gov (United States)

    Rublee, D A; Rosenfield, R H

    1987-03-01

    This article describes organizational forms of physician joint ventures. Four models are described that typify physician involvement in health care joint ventures: limited partnership syndication, venture capital company, provider network, and alternative delivery system. Important practical issues are discussed.

  8. 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...

  9. Hospital characteristics and patient populations served by physician owned and non physician owned orthopedic specialty hospitals

    Directory of Open Access Journals (Sweden)

    Vaughan-Sarrazin Mary S

    2007-09-01

    Full Text Available Abstract Background The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantly from non physician owned specialty hospitals and thus merit the additional scrutiny that has been proposed. Our objective was to assess whether physician owned specialty orthopedic hospitals and non physician owned specialty orthopedic hospitals differ with respect to hospital characteristics and patient populations served. Methods We conducted a descriptive study using Medicare data of beneficiaries who underwent total hip replacement (THR (N = 10,478 and total knee replacement (TKR (N = 15,312 in 29 physician owned and 8 non physician owned specialty orthopedic hospitals during 1999–2003. We compared hospital characteristics of physician owned and non physician owned specialty hospitals including procedural volumes of major joint replacements (THR and TKR, hospital teaching status, and for profit status. We then compared demographics and prevalence of common comorbid conditions for patients treated in physician owned and non physician owned specialty hospitals. Finally, we examined whether the socio-demographic characteristics of the neighborhoods where physician owned and non physician owned specialty hospitals differed, as measured by zip code level data. Results Physician owned specialty hospitals performed fewer major joint replacements on Medicare beneficiaries in 2003 than non physician owed specialty hospitals (64 vs. 678, P Conclusion Physician owned specialty orthopedic hospitals differ significantly from non physician owned specialty orthopedic hospitals and may warrant the additional scrutiny policy makers have proposed.

  10. 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.

  11. 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

  12. 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...

  13. 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...

  14. Organizational commitment of military physicians.

    Science.gov (United States)

    Demir, Cesim; Sahin, Bayram; Teke, Kadir; Ucar, Muharrem; Kursun, Olcay

    2009-09-01

    An individual's loyalty or bond to his or her employing organization, referred to as organizational commitment, influences various organizational outcomes such as employee motivation, job satisfaction, performance, accomplishment of organizational goals, employee turnover, and absenteeism. Therefore, as in other sectors, employee commitment is crucial also in the healthcare market. This study investigates the effects of organizational factors and personal characteristics on organizational commitment of military physicians using structural equation modeling (SEM) on a self-report, cross-sectional survey that consisted of 635 physicians working in the 2 biggest military hospitals in Turkey. The results of this study indicate that professional commitment and organizational incentives contribute positively to organizational commitment, whereas conflict with organizational goals makes a significantly negative contribution to it. These results might help develop strategies to increase employee commitment, especially in healthcare organizations, because job-related factors have been found to possess greater impact on organizational commitment than personal characteristics.

  15. Organizational commitment of military physicians.

    Science.gov (United States)

    Demir, Cesim; Sahin, Bayram; Teke, Kadir; Ucar, Muharrem; Kursun, Olcay

    2009-09-01

    An individual's loyalty or bond to his or her employing organization, referred to as organizational commitment, influences various organizational outcomes such as employee motivation, job satisfaction, performance, accomplishment of organizational goals, employee turnover, and absenteeism. Therefore, as in other sectors, employee commitment is crucial also in the healthcare market. This study investigates the effects of organizational factors and personal characteristics on organizational commitment of military physicians using structural equation modeling (SEM) on a self-report, cross-sectional survey that consisted of 635 physicians working in the 2 biggest military hospitals in Turkey. The results of this study indicate that professional commitment and organizational incentives contribute positively to organizational commitment, whereas conflict with organizational goals makes a significantly negative contribution to it. These results might help develop strategies to increase employee commitment, especially in healthcare organizations, because job-related factors have been found to possess greater impact on organizational commitment than personal characteristics. PMID:19780367

  16. Welcome to electronic physician journal

    Directory of Open Access Journals (Sweden)

    Mehrdad Jalalian

    2009-10-01

    Full Text Available I am delighted to welcome you to the first issue of "Electronic Physician" Journal, the first electronic journal in Iran with license from Iranian ministry of culture. With your help we aim to make this journal a reputable publication for medical and health science. The electronic physician is an electronic journal which publishes the research works as well as reviews, case reports, documentaries and other acceptable formats of articles.I would like to express my great gratitude to all the authors for their excellent contribution to the journal and the reviewers for their efforts in starting up this journal. It is expected that with the efforts of the great editors of the journal we receive new research articles from all parts of the world.The next volume of the journal will be published in 2010 and each manuscript is expected to be published online as soon as it passes the peer review process.

  17. 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.

  18. 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...

  19. 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…

  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. 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...

  2. 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.

  3. Measuring physician attitudes of service quality.

    Science.gov (United States)

    Walbridge, S W; Delene, L M

    1993-01-01

    The quality of physician services is not yet included in the current Medicare Resource-Based Relative Value Scale (RBRVS) formula. Future RBRVS reimbursement calculations may incorporate a quality index. The authors' research sought to explore the applicability of SERVQUAL determinants when measuring physician perceptions of service quality. Process quality determinants, such as "Reliability," "Assurance," and "Empathy," were rated higher in relative importance by physicians than outcome quality determinants, such as "Core Medical Services," and six of the seven service quality determinants were rated higher by older physicians. Further analyses indicated that physicians' perceptions of health care service quality varied because of factors such as number of years in practice and gender.

  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. 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.

  6. Physician unionization efforts gain momentum, support.

    Science.gov (United States)

    Keating, G C

    1999-11-01

    Physicians increasingly are assuming the status of employees in healthcare organizations. Physicians also are seeing restrictions imposed on their practices by healthcare organizations seeking to control costs of care delivery. These trends have led a growing number of physicians to attempt to organize into unions. Obstacles to physician unionization efforts have included Federal antitrust laws that prohibit physicians from organizing, as well as physician reluctance to engage in organized activities they see as antithetical to their professional duties (e.g., strikes). In addition, physicians' attempts to unionize frequently have failed due to provisions of the National Labor Relations Act, which authorize collective bargaining only among individuals designated as "employees." Physicians seeking to form unions often are thwarted by the argument that they are not employees, but rather students, independent contractors, or supervisors, and therefore not entitled to protection under the act. Nonetheless, a number of recent developments, such as the American Medical Association's decision to endorse unionization by physicians and the National Labor Relations Board's decision that attending physicians should be regarded as employees, not supervisors, are creating a climate more conducive to physician unionization in the United States.

  7. Review article: burnout in emergency medicine physicians.

    Science.gov (United States)

    Arora, Manit; Asha, Stephen; Chinnappa, Jason; Diwan, Ashish D

    2013-12-01

    Training and the practice of emergency medicine are stressful endeavours, placing emergency medicine physicians at risk of burnout. Burnout syndrome is associated with negative outcomes for patients, institutions and the physician. The aim of this review is to summarise the available literature on burnout among emergency medicine physicians and provide recommendations for future work in this field. A search of MEDLINE (1946-present) (search terms: 'Burnout, Professional' AND 'Emergency Medicine' AND 'Physicians'; 'Stress, Psychological' AND 'Emergency Medicine' AND 'Physicians') and EMBASE (1988-present) (search terms: 'Burnout' AND 'Emergency Medicine' AND 'Physicians'; 'Mental Stress' AND 'Emergency Medicine' AND 'Physicians') was performed. The authors focused on articles that assessed burnout among emergency medicine physicians. Most studies used the Maslach Burnout Inventory to quantify burnout, allowing for cross-study (and cross-country) comparisons. Emergency medicine has burnout levels in excess of 60% compared with physicians in general (38%). Despite this, most emergency medicine physicians (>60%) are satisfied with their jobs. Both work-related (hours of work, years of practice, professional development activities, non-clinical duties etc.) and non-work-related factors (age, sex, lifestyle factors etc.) are associated with burnout. Despite the heavy burnout rates among emergency medicine physicians, little work has been performed in this field. Factors responsible for burnout among various emergency medicine populations should be determined, and appropriate interventions designed to reduce burnout.

  8. 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

  9. Social Support from Sponsorships as a Moderator of Acculturative Stress: Predictors of Effects on Refugees and Asylum Seekers.

    Science.gov (United States)

    Renner, Walter; Laireiter, Anton-Rupert; Maier, Marco J

    2012-01-01

    N = 63 refugees and asylum seekers, 27 women and 36 men with a mean age of 33.08 years (SD = 10.3) from Chechnya and Afghanistan were granted sponsorships for six months and were randomized to an intervention and a waiting-list control group. Only participants with a history of traumatization benefited from the intervention. For the traumatized sub-sample, sponsorships led to a significant and stable decrease in anxiety, depression, and psychological problems as compared to the control group, with effect sizes comparable to those of psychotherapy. The effects being rather palliative than instrumental, however, sponsorships did not instigate improvements in acculturation, societal contact, or coping capability. Women benefited more from the intervention than men, and Afghans more than Chechen.

  10. 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.

  11. Physicians' attitudes about their professional appearance.

    Science.gov (United States)

    Gjerdingen, D K; Simpson, D E

    1989-01-01

    Thirty-five residents and 77 staff physicians from three residency programs in Minnesota and Wisconsin completed questionnaires about their attitudes toward various components of the physician's appearance. Most participants showed positive responses to traditional physician attire such as white coat, name tag, shirt and tie, dress pants, skirt or dress, nylons, and dress shoes. Negative responses were associated with casual items such as sandals, clogs, athletic shoes, scrub suits, and blue jeans. Cronbach's alpha analysis identified four cohesive appearance scales: traditional male appearance, casual male appearance, traditional female appearance, and casual female appearance. Older physician participants favored a more traditional appearance than did younger physicians, and of the physicians who were 35 years and younger, staff physicians tended to show more conservative views toward professional appearance than did residents.

  12. [Are American physicians more satisfied?--results from an International Study of Physicians in University Hospitals].

    Science.gov (United States)

    Janus, K; Amelung, V E; Baker, L C; Gaitanides, M; Rundall, T G; Schwartz, F W

    2009-04-01

    Understanding the factors that affect physicians' job satisfaction is important not only to physicians themselves, but also to patients, health system managers, and policy makers. Physicians represent the crucial resource in health-care delivery. In order to enhance efficiency and quality in health care, it is indispensable to analyse and consider the motivators of physicians. Physician job satisfaction has significant effects on productivity, the quality of care, and the supply of physicians. The purpose of our study was to assess the associations between work-related monetary and non-monetary factors and physicians' work satisfaction as perceived by similar groups of physicians practicing at academic medical centres in Germany and the U.S.A., two countries that, in spite of differing health-care systems, simultaneously experience problems in maintaining their physician workforce. We used descriptive statistics, factor and correlation analyses to evaluate physicians' responses to a self-administered questionnaire. Our study revealed that overall German physicians were less satisfied than U.S. physicians. With respect to particular work-related predictors of job satisfaction we found that similar factors contributed to job satisfaction in both countries. To improve physicians' satisfaction with working conditions, our results call for the implementation of policies that reduce the time burden on physicians to allow more time for interaction with patients and colleagues, increase monetary incentives, and enhance physicians' participation in the development of care management processes and in managerial decisions that affect patient care. PMID:19288428

  13. Gender, family status and physician labour supply.

    Science.gov (United States)

    Wang, Chao; Sweetman, Arthur

    2013-10-01

    With the increasing participation of women in the physician workforce, it is important to understand the sources of differences between male and female physicians' market labour supply for developing effective human resource policies in the health care sector. Gendered associations between family status and physician labour supply are explored in the Canadian labour market, where physicians are paid according to a common fee schedule and have substantial discretion in setting their hours of work. Canadian 1991, 1996, 2001 and 2006 twenty percent census files with 22,407 physician observations are used for the analysis. Although both male and female physicians have statistically indistinguishable hours of market work when never married and without children, married male physicians have higher market hours, and their hours are unchanged or increased with parenthood. In contrast, female physicians have lower market hours when married, and much lower hours when a parent. Little change over time in these patterns is observed for males, but for females two offsetting trends are observed: the magnitude of the marriage-hours effect declined, whereas that for motherhood increased. Preferences and/or social norms induce substantially different labour market outcomes. In terms of work at home, the presence of children is associated with higher hours for male physicians, but for females the hours increase is at least twice as large. A male physician's spouse is much less likely to be employed, and if employed, has lower market hours in the presence of children. In contrast, a female physician's spouse is more likely to be employed if there are three or more children. Both male and female physicians have lower hours of work when married to another physician. Overall, there is no gender difference in physician market labour supply after controlling for family status and demographics. PMID:23931941

  14. Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience.

    Science.gov (United States)

    Swensen, Stephen; Kabcenell, Andrea; Shanafelt, Tait

    2016-01-01

    The process of creating healthy organization-physician relationships is critical to organizational success. Partnerships in process improvement can nurture these relationships and mitigate burnout by meeting physicians' psychological needs. To flourish, physicians need some degree of choice (control over their lives), camaraderie (social connectedness), and an opportunity for excellence (being part of something meaningful). Organizations can provide these opportunities by establishing constructive organization-physician relationships and developing physician leaders. We present a case study from the Mayo Clinic that supports the foundational principles of a physician-engagement model. We developed the Listen-Act-Develop model as an integrated strategy to reduce burnout and engage physicians in the mission of the organization. The intent of the model is to maximize physician wellness by fostering engagement and mitigating the drivers of burnout. This model provides a path to increase physician satisfaction and meaning in work and to improve organizational effectiveness.

  15. 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…

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

    Science.gov (United States)

    Zenz, Julia; Tryba, Michael; Zenz, Michael

    2014-12-01

    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 majority of physicians oppose medical involvement in hastening death in non-terminal illnesses. The public and parliamentary discussion should face this opposition to assisted suicide by pain and palliative specialists. PMID:25501920

  17. [Dis/arranged medical histories à la Friedrichsberg. Explorations of foreign patients by multilingual fellow patients in a German asylum about 1900].

    Science.gov (United States)

    Wulf, Stefan; Schmiedebach, Heinz-Peter

    2010-01-01

    This paper deals with two examples of a particular patient's activity at the Friedrichsberg Asylum in Hamburg in the beginning of the 20th century. Two multilingual patients assumed the function of interpreters in each case for a foreign fellow patient. They were involved to a great extent in the documentation of the medical histories. Conversations and interrogations carried out by them and recorded by their own hand are passed down in the medical files of their foreign-language fellow patients. After some preliminary remarks about the Friedrichsberg Asylum and its patients, the various activities of patients in the psychiatric institution and the importance of the patients' manner of speaking for the psychiatric diagnosis, the two cases are described in detail. The patient-interpreters were perceived as border-crossers, as "Figures of the Third".

  18. 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

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. Service motives and profit incentives among physicians.

    Science.gov (United States)

    Godager, Geir; Iversen, Tor; Ma, Ching-To Albert

    2009-03-01

    We model physicians as health care professionals who care about their services and monetary rewards. These preferences are heterogeneous. Different physicians trade off the monetary and service motives differently, and therefore respond differently to incentive schemes. Our model is set up for the Norwegian health care system. First, each private practice physician has a patient list, which may have more or less patients than he desires. The physician is paid a fee-for-service reimbursement and a capitation per listed patient. Second, a municipality may obligate the physician to perform 7.5 h/week of community services. Our data are on an unbalanced panel of 435 physicians, with 412 physicians for the year 2002, and 400 for 2004. A physician's amount of gross wealth and gross debt in previous periods are used as proxy for preferences for community service. First, for the current period, accumulated wealth and debt are predetermined. Second, wealth and debt capture lifestyle preferences because they correlate with the planned future income and spending. The main results show that both gross debt and gross wealth have negative effects on physicians' supply of community health services. Gross debt and wealth have no effect on fee-for-service income per listed person in the physician's practice, and positive effects on the total income from fee-for-service. The higher income from fee-for-service is due to a longer patient list. Patient shortage has no significant effect on physicians' supply of community services, a positive effect on the fee-for-service income per listed person, and a negative effect on the total income from fee for service. These results support physician preference heterogeneity.

  4. 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...

  5. Psychotherapy, a concept for the nonpsychiatric physician.

    Science.gov (United States)

    KAHN, J P

    1962-05-01

    Patients tend to repeat with their physician, as with other significant people in their lives, their earlier previous patterns of behavior. The physician as well as the patient is involved in the physician-patient relationship. He will tend to respond to his patients in accordance with his earlier life experiences and his characteristic repetitive behavioral pattern. For both physician and patient, the relationship between them extends beyond the immediate reality situation. Psychotherapy is the utilization of psychological measures in the treatment of sick persons and the deliberate utilization by the physician of the physician-patient relationship for the benefit of the patient. The kind of psychotherapy that is practical and utilizable by the nonpsychiatric physician is that which uses education, reassurance, support and the management of the patient's problems either directly or indirectly or through the intermediary of other people or agencies. The symbolic aspect of the physician-patient relationship is based essentially on the fact that a sick person, because of his anxiety and because of the threat to his physical and psychic integrity, is more dependent and more anxious than he would be if he were well, and therefore he has a correspondingly greater need for the authoritative and protective figure he finds in the physician. Psychotherapy is not directed exclusively to the treatment of flagrantly or obviously neurotic or psychotic patients. It should be and is directed to all sick persons. Limitations in psychotherapy are set by various determinants, among which are the nature of the precipitating factor in the illness, the nature of the sick person, the skill, knowledge and abilities of the physician, and the nature of the physician-patient relationship. In psychotherapy, as in all medicine, the physician should not do anything which may disturb the patient if the disturbance is of no value or if it cannot be followed through with special skills.

  6. 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

  7. 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

  8. 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.

  9. [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

  10. 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.

  11. 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...

  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. 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

  14. Urban-Rural Flows of Physicians

    Science.gov (United States)

    Ricketts, Thomas C.; Randolph, Randy

    2007-01-01

    Context: Physician supply is anticipated to fall short of national requirements over the next 20 years. Rural areas are likely to lose relatively more physicians. Policy makers must know how to anticipate what changes in distribution are likely to happen to better target policies. Purpose: To determine whether there was a significant flow of…

  15. Tailoring hospital marketing efforts to physicians' needs.

    Science.gov (United States)

    Mackay, J M; Lamb, C W

    1988-12-01

    Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.

  16. 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…

  17. 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

  18. 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…

  19. 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

  20. 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

  1. Stakeholder strategies for the physician executive.

    Science.gov (United States)

    Whitehead, C J; Stanton, S Y; Buesseler, J A; Blair, J D

    1989-01-01

    If physician executives are to be effective in confronting the environmental turbulence and uncertainty facing their organizations, they must effectively manage their stakeholders. This article extends the stakeholder approach described in the May-June 1989 issue of Physician Executive as a tool for the physician executive in the development of practical strategies to cope with turbulence and uncertainty. We suggest four generic strategies physician executives can use: involve supportive stakeholders, monitor marginal stakeholders, defend against nonsupportive stakeholders, and collaborate with mixed-blessing stakeholders. As an overarching strategy, a physician executive should try to change the organization's relationships with a stakeholder from a less favorable category to a more favorable one. The stakeholder can then be managed using the generic strategy most appropriate for the category.

  2. Measuring physician attitudes of service quality.

    Science.gov (United States)

    Walbridge, S W; Delene, L M

    1993-01-01

    The quality of physician services is not yet included in the current Medicare Resource-Based Relative Value Scale (RBRVS) formula. Future RBRVS reimbursement calculations may incorporate a quality index. The authors' research sought to explore the applicability of SERVQUAL determinants when measuring physician perceptions of service quality. Process quality determinants, such as "Reliability," "Assurance," and "Empathy," were rated higher in relative importance by physicians than outcome quality determinants, such as "Core Medical Services," and six of the seven service quality determinants were rated higher by older physicians. Further analyses indicated that physicians' perceptions of health care service quality varied because of factors such as number of years in practice and gender. PMID:10126032

  3. 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...

  4. [The occupational physician in France].

    Science.gov (United States)

    Matsuda, Shinya

    2013-10-01

    The French Labor law defines the role and its allocation criteria of the occupational physician (OP) the same as in Japan. In France, occupational medicine is one of the medical specialties. The OP resident must follow the 4 years clinical training before certification. After having finished their residency, they are entitled to work for the occupational health service office of a company or company association (in the case of small and medium sized companies). The most important characteristics of the French system is that they cover all workers regardless of company size. The main role of the OP is prevention of work related diseases and accidents. They are not allowed to do clinical services except for emergency cases. Their main activities are health examinations, health education, patrol and advice for better working condition. Formerly, it was rather difficult to attract the medical students for OP resident course because of its prevention oriented characteristics. A growing concern about the importance of health management at the work site, however, has changed the situation. Now, the number of candidates for OP resident course is increasing. Their task has expanded to cover mental health and other life style related diseases. The 2011 modification of law redefines the role of the OP as a director of an occupational health service office who has a total responsibility of multidisciplinary services. The French and Japanese occupational health systems have many of similarities. A comparative study by researchers of UOEH is expected to yield useful information. PMID:24107336

  5. Walter sutton: physician, scientist, inventor.

    Science.gov (United States)

    Ramirez, Gregory J; Hulston, Nancy J; Kovac, Anthony L

    2015-01-01

    Walter S. Sutton (1877-1916) was a physician, scientist, and inventor. Most of the work on Sutton has focused on his recognition that chromosomes carry genetic material and are the basis for Mendelian inheritance. Perhaps less well known is his work on rectal administration of ether. After Sutton's work on genetics, he completed his medical degree in 1907 and began a 2-year surgical fellowship at Roosevelt Hospital, New York City, NY, where he was introduced to the technique of rectal administration of ether. Sutton modified the work of others and documented 100 cases that were reported in his 1910 landmark paper "Anaesthesia by Colonic Absorption of Ether". Sutton had several deaths in his study, but he did not blame the rectal method. He felt that his use of rectal anesthesia was safe when administered appropriately and believed that it offered a distinct advantage over traditional pulmonary ether administration. His indications for its use included (1) head and neck surgery; (2) operations when ether absorption must be minimized due to heart, lung, or kidney problems; and (3) preoperative pulmonary complications. His contraindications included (1) cases involving alimentary tract or weakened colon; (2) laparotomies, except when the peritoneal cavity was not opened; (3) incompetent sphincter or anal fistula; (4) orthopnea; and (5) emergency cases. Sutton wrote the chapter on "Rectal Anesthesia" in one of the first comprehensive textbooks in anesthesia, James Tayloe Gwathmey's Anesthesia. Walter Sutton died of a ruptured appendix in 1916 at age 39.

  6. 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.

  7. 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

  8. 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.

  9. 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

  10. Regulatory focus affects physician risk tolerance.

    Science.gov (United States)

    Veazie, Peter J; McIntosh, Scott; Chapman, Benjamin P; Dolan, James G

    2014-01-01

    Risk tolerance is a source of variation in physician decision-making. This variation, if independent of clinical concerns, can result in mistaken utilization of health services. To address such problems, it will be helpful to identify nonclinical factors of risk tolerance, particularly those amendable to intervention-regulatory focus theory suggests such a factor. This study tested whether regulatory focus affects risk tolerance among primary care physicians. Twenty-seven primary care physicians were assigned to promotion-focused or prevention-focused manipulations and compared on the Risk Taking Attitudes in Medical Decision Making scale using a randomization test. Results provide evidence that physicians assigned to the promotion-focus manipulation adopted an attitude of greater risk tolerance than the physicians assigned to the prevention-focused manipulation (p = 0.01). The Cohen's d statistic was conventionally large at 0.92. Results imply that situational regulatory focus in primary care physicians affects risk tolerance and may thereby be a nonclinical source of practice variation. Results also provide marginal evidence that chronic regulatory focus is associated with risk tolerance (p = 0.05), but the mechanism remains unclear. Research and intervention targeting physician risk tolerance may benefit by considering situational regulatory focus as an explanatory factor.

  11. 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.

  12. Development of the physician satisfaction survey instrument.

    Science.gov (United States)

    Soo Hoo, W E; Ramer, L

    1998-01-01

    Continuous quality improvement (CQI) activities depend on valid and reliable instruments to generate data. An evaluation of internal and external customer satisfaction is one of the pillars of the CQI process. This article describes the development of a valid and reliable instrument for measuring physicians' satisfaction with the orthopedic nursing units at a major medical trauma center. The physician satisfaction survey instrument was found to be internally consistent (alpha = .95). Confirmatory factor analysis revealed that 68% of the variance in physician satisfaction scores (eigenvalue = 8.14) was explained by using a single-factor model. PMID:10181899

  13. Education and the physician's office laboratory.

    Science.gov (United States)

    Fischer, P M; Addison, L A; Koneman, E W; Crowley, J

    1986-03-21

    The field of physicians' office laboratory testing has witnessed an increase in test volume and advances in technology, but little attention to educational issues. If this field is to continue to grow and to perform high-quality testing, primary care physicians will need to be trained in the role of laboratory director. Office staff will require "in the office" continuing education. Formal technician and technologist training will need to focus some attention on office test procedures. The development of these new educational programs will require the cooperative efforts of primary care physician educators, pathologists, allied health faculty, and the diagnostic equipment industry.

  14. [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

  15. Development of the physician satisfaction survey instrument.

    Science.gov (United States)

    Soo Hoo, W E; Ramer, L

    1998-01-01

    Continuous quality improvement (CQI) activities depend on valid and reliable instruments to generate data. An evaluation of internal and external customer satisfaction is one of the pillars of the CQI process. This article describes the development of a valid and reliable instrument for measuring physicians' satisfaction with the orthopedic nursing units at a major medical trauma center. The physician satisfaction survey instrument was found to be internally consistent (alpha = .95). Confirmatory factor analysis revealed that 68% of the variance in physician satisfaction scores (eigenvalue = 8.14) was explained by using a single-factor model.

  16. 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

  17. [Ethical principles in human scientific research].

    Science.gov (United States)

    Cruz-Coke, R

    1994-07-01

    Hippocrates was the first physician to use the scientific method to find rational and not religious or mythic causes, for the etiology of diseases. Hippocrates and Aristoteles did not dare to dissect the human body. Afterwards however, many scientists such as Herophilus, Erasitastrus, Vesalus and Fallopio, performed experiments in human beings using vivisection. According to that age's ideas, there was no cruelty in performing vivisection in criminals, since useful knowledge for the progress of medicine and relief of diseases was obtained. Only during the nineteenth century and with Claude Bernard (1865), the ethical principles of systematic scientific research in humans were defined. These principles were violated by nazi physicians during Hitler's dictatorship in Germany (1933-1945). As a response to these horrors, the Ethical Codes of Nuremberg (1947) and Geneva (1948), that reestablished all the strength of Hippocratic principles, were dictated. The Nuremberg rules enact that a research subject must give a voluntary consent, that the experiment must by necessary and exempt of death risk, that the research must be qualified and that the experiment must be discontinued if there is a risk for the subject. The Geneva statement is a modernized hippocratic oath that protects patient's life above all. These classical rules, in force at the present time, are the essential guides that must be applied by physicians and researchers.

  18. 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

  19. 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

  20. Family Physician Perspectives on Primary Immunodeficiency Diseases.

    Science.gov (United States)

    Orange, Jordan S; Seeborg, Filiz O; Boyle, Marcia; Scalchunes, Christopher; Hernandez-Trujillo, Vivian

    2016-01-01

    Primary immunodeficiency diseases (PIDs) 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 PID. Selective immunoglobulin A deficiency (21%) and chronic granulomatous disease (11%) were most common and were followed by significantly more subspecialist immunologists (P management of PID (4 vs. 79% of subspecialist immunologists, P 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. PMID:27066486

  1. 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

  2. 10 CFR 712.32 - Designated Physician.

    Science.gov (United States)

    2010-01-01

    ... Designated Physician must be qualified to provide professional expertise in the area of occupational medicine... the privilege to practice by any institution; (4) Being named a defendant in any criminal...

  3. 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.

  4. [Toward the lived experience of the physician].

    Science.gov (United States)

    Bourquin, Céline; Saraga, Michael; Marion-Veyron, Régis; Stiefel, Friedrich

    2016-02-10

    For manyyears, a major focus of interest has been the patient, in the context of a constantly changing society and increasingly complex medical practices. We propose to shift this focus on the physician, who is entangled in a similar, but less evident way. In these three articles, we explore, in succession, the lived experience of the contemporary physician, the ethos which brings together the medical community, and the education of the future physician, using research projects currently under way within the Service of Liaison Psychiatry at Lausanne University Hospital. In this first article, we particularly raise the question of what is the lived experience of the physician and sketch the outline of research. PMID:27039439

  5. The mis-measure of physician performance.

    Science.gov (United States)

    Glickman, Seth W; Schulman, Kevin A

    2013-10-01

    The Affordable Care Act directs the Secretary of Health and Human Services to compare individual physicians using patient experience measures. This policy initiative will utilize the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey program. It will impact over 700,000 eligible physicians and will be tied to reimbursement and the Centers for Medicare and Medicaid Services' Physician Compare reporting feature starting in 2015. We believe that the relevance of this framework to today's clinical environment is a critical issue to address before implementing this regulatory mandate. In this article we discuss our concerns about tying individual physician performance to CG-CAHPS scores, including: 1) intrinsic versus extrinsic approaches to assessing the patient experience, 2) measurement issues, and 3) unintended consequences. We also suggest an alternative pathway and opt-out mechanism to facilitate more rapid translation of service excellence into clinical practice. PMID:24304157

  6. 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...

  7. 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,...

  8. 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...

  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. 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...

  11. 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 ...

  12. 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.

  13. 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...

  14. 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...

  15. Meeting the health and social needs of pregnant asylum seekers: midwifery students' perspectives. Part 2: Dominant discourses and approaches to care.

    Science.gov (United States)

    Haith-Cooper, Melanie; Bradshaw, Gwendolen

    2013-08-01

    Pregnant women seeking asylum in the United Kingdom appear particularly vulnerable, having complex health and social care needs and could benefit from a woman centred approach to midwifery care. This article is the second of three parts and reports on the findings from one objective of a wider doctorate study. It focuses on exploring midwifery students' perceptions of how to approach the care of pregnant women seeking asylum. Although the design of the study is explored in article one, in this context, the data was subject to critical discourse analysis to meet this objective. Key words and phrases were highlighted which appeared to reveal power and ideology implicit in the language used when discussing midwifery care of the pregnant woman seeking asylum. Dominant discourses were identified which appeared to influence the way in which care was approached and the possible sources of these discourses critically analysed. The findings suggest an underpinning ideology around following policies and guidelines to meet the physical needs of the woman at the expense of her other holistic needs. Despite learning to adopt a woman centred approach in theory, once in practice some students appear to be socialised into (re)producing these dominant medical and managerial discourses with "midwifery discourse" being marginalised. In addition, some students appeared to have difficulty understanding how to adopt a woman centred approach and the importance of considering the woman's context and its impact on care. These findings have implications for midwifery educators and this article identifies that the recent Nursing and Midwifery Council requirement for students to undertake a caseloading activity could provide the opportunity for them to adopt a consistent woman centred approach in practice, rejecting dominant medical and managerial discourses. However, these discourses appear to influence midwives caring for women more widely and will be difficult to challenge.

  16. 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.

  17. Time clock requirements for hospital physicians.

    Science.gov (United States)

    Shapira, Chen; Vilnai-Yavetz, Iris; Rafaeli, Anat; Zemel, Moran

    2016-06-01

    An agreement negotiated following a doctors' strike in 2011 introduced a requirement that physicians in Israel's public hospitals clock in and out when starting and leaving work. The press reported strong negative reactions to this policy and predicted doctors deserting hospitals en masse. This study examines physicians' reactions toward the clock-in/clock-out policy 6 months after its implementation, and assesses the relationship between these reactions and aspects of their employment context. 676 physicians in 42 hospitals responded to a survey assessing doctor's reactions toward the clock, hospital policy makers, and aspects of their work. Reactions to the clock were generally negative. Sense of calling correlated positively with negative reactions to the clock, and the latter correlated positively with quit intentions. However, overall, respondents reported a high sense of calling and low quit intentions. We suggest that sense of calling buffers and protects physicians from quit intentions. Differences in reactions to the clock were associated with different employment characteristics, but sense of calling did not vary by hospital size or type or by physicians' specialty. The findings offer insights into how physicians' working environment affects their reactions to regulatory interventions, and highlight medical professionalism as buffering reactions to unpopular regulatory policies. PMID:27142179

  18. [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

  19. 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.

  20. The professional responsibility model of physician leadership.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B; Brent, Robert L

    2013-02-01

    The challenges physician leaders confront today call to mind Odysseus' challenge to steer his fragile ship successfully between Scylla and Charybdis. The modern Scylla takes the form of ever-increasing pressures to provide more resources for professional liability, compliance, patient satisfaction, central administration, and a host of other demands. The modern Charybdis takes the form of ever-increasing pressures to procure resources when fewer are available and competition is continuously increasing the need for resources, including managed care, hospital administration, payers, employers, patients who are uninsured or underinsured, research funding, and philanthropy. This publication provides physician leaders with guidance for identifying and managing common leadership challenges on the basis of the professional responsibility model of physician leadership. This model is based on Plato's concept of leadership as a life of service and the professional medical ethics of Drs John Gregory and Thomas Percival. Four professional virtues should guide physician leaders: self-effacement, self-sacrifice, compassion, and integrity. These professional virtues direct physician leaders to treat colleagues as ends in themselves, to provide justice-based resource management, to use power constrained by medical professionalism, and to prevent and respond effectively to organizational dysfunction. The professional responsibility model guides physician leaders by proving an explicit "tool kit" to complement managerial skills.

  1. 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....

  2. 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

  3. 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.

  4. 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

  5. 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

  6. [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

  7. 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

  8. Agreement between physicians and non-physician clinicians in starting antiretroviral therapy in rural Uganda

    Directory of Open Access Journals (Sweden)

    Vasan Ashwin

    2009-08-01

    Full Text Available Abstract Background The scarcity of physicians in sub-Saharan Africa – particularly in rural clinics staffed only by non-physician health workers – is constraining access to HIV treatment, as only they are legally allowed to start antiretroviral therapy in the HIV-positive patient. Here we present a pilot study from Uganda assessing agreement between non-physician clinicians (nurses and clinical officers and physicians in their decisions as to whether to start therapy. Methods We conducted the study at 12 government antiretroviral therapy sites in three regions of Uganda, all of which had staff trained in delivery of antiretroviral therapy using the WHO Integrated Management of Adult and Adolescent Illness guidelines for chronic HIV care. We collected seven key variables to measure patient assessment and the decision as to whether to start antiretroviral therapy, the primary variable of interest being the Final Antiretroviral Therapy Recommendation. Patients saw either a clinical officer or nurse first, and then were screened identically by a blinded physician during the same clinic visit. We measured inter-rater agreement between the decisions of the non-physician health workers and physicians in the antiretroviral therapy assessment variables using simple and weighted Kappa analysis. Results Two hundred fifty-four patients were seen by a nurse and physician, while 267 were seen by a clinical officer and physician. The majority (> 50% in each arm of the study were in World Health Organization Clinical Stages I and II and therefore not currently eligible for antiretroviral therapy according to national antiretroviral therapy guidelines. Nurses and clinical officers both showed moderate to almost perfect agreement with physicians in their Final Antiretroviral Therapy Recommendation (unweighted κ = 0.59 and κ = 0.91, respectively. Agreement was also substantial for nurses versus physicians for assigning World Health Organization Clinical

  9. [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

  10. 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.

  11. 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

  12. 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.

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

    OpenAIRE

    Blum AB; Shea S; Czeisler CA; Landrigan CP; Leape L

    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...

  14. [Martin Luther and his physicians. A contribution to Luther year 1983].

    Science.gov (United States)

    Völker, A

    1983-10-15

    The Luther memorial year 1983 gives rise to describe the reformer's life from the point of view of his diseases as well as of the measures of the physicians treating him. The description of the work of these persons at the same time mediates insights into the level of the therapeutic measures of the 16th century as well as especially into the medico-scientific activities of the University of Wittenberg, where Martin Luther worked for about 35 years.

  15. 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

  16. Patient attitudes toward emergency physician attire.

    Science.gov (United States)

    Li, Siu Fai; Haber, Marc

    2005-07-01

    Previous studies have suggested that Emergency Department (ED) patient satisfaction is unaffected by physician attire. We conducted a before-and-after trial to test this hypothesis. A convenience sample of ED patients was surveyed during a 2-week period. In the first week, emergency physicians wore white coats and formal attire. In the second week, the same physicians wore scrubs. Patients were asked to indicate on a 100-mm visual analog scale (VAS) their ratings of physician appearance, satisfaction, and professionalism. The primary outcome was the difference in VAS scores between the two dress styles. There were 111 patients surveyed. There were no significant differences between patients' evaluation of appearance (Delta=-.68 mm VAS, 95% confidence interval [CI] -5.5 to 4.1), satisfaction (Delta=.83 mm VAS, 95% CI -3.0 to 4.6), or professionalism (Delta=-.46 mm VAS, 95% CI -3.6 to 2.6) between the two dress styles. Emergency physician attire does not affect patient satisfaction.

  17. The physician in the technological age.

    Science.gov (United States)

    Jaspers, K

    1989-09-01

    Translator's summary and notes: Karl Jaspers (1883-1969) argues that modern advances in the natural sciences and in technology have exerted transforming influence on the art of clinical medicine and on its ancient Hippocratic ideal, even though Plato's classical argument about slave physicians and free physicians retains essential relevance for the physician of today. Medicine should be rooted not only in science and technology, but in the humanity of the physician as well. Jaspers thus shows how, within the mind of every medical person, the researcher contests with the physician and the technician with the humanist. Jaspers therefore opposes all modern tendencies that regard men as abstractions. As a creative existentialist influenced by Kierkegaard, Nietzsche, and Husserl, he reasons that clinical medicine should always treat patients as irreducable individuals, and his thinking on psychotherapy argues for a realm of interiority, freedom, intelligibility, and existential communication that transcends the reach of the causal thinking of natural science. This essay, written in 1959, reflects Jaspers' lifelong preoccupation with the philosophical meaning of medicine (he received his MD degree in 1909) and the totality of the human person. It should significantly enhance our own comprehension of medical power, dangers, reasoning, and accomplishments.

  18. 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

  19. 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.

  20. Can price controls induce optimal physician behavior?

    Science.gov (United States)

    Wedig, G; Mitchell, J B; Cromwell, J

    1989-01-01

    Recently, budget-conscious policymakers have shifted their attention to the physician services market and have begun to consider a wide variety of price regulatory schemes for moderating expenditures in this market. In a recent article in this journal, Feldman and Sloan warned that price controls on physician services may cause undesirable declines in service quality, independent of their budgetary ramifications. Our aim in this article is to reconsider the effects of price controls in the broader context of insurance coverage and moral hazard. Our ultimate goal is to assess the benefits of price controls independent of specific assumptions about the controversial issues of demand inducement and income targeting. Using a simple extension of the Feldman/Sloan model, we find that price controls can be and almost certainly are welfare-improving as long as consumers are sufficiently well insured, regardless of where one stands on the inducement issue. The salutary effects of price controls, on the other hand, can be compromised by income-targeting behavior on the part of physicians. We also introduce evidence from Medicare's recent fee freeze to evaluate the possibility of income-targeting behavior empirically. While formal studies of income targeting suggest that its magnitude is small in cross-section, we warn that its effects may be larger over time; this is what our descriptive evidence suggests. We conclude that more dramatic short-term progress on physician fee inflation will require stronger measures, such as putting physicians at risk for consumer expenditures.

  1. 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

  2. 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

  3. 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...

  4. 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...

  5. 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...

  6. Using internal communication as a marketing strategy: gaining physician commitment.

    Science.gov (United States)

    Heine, R P

    1990-01-01

    In the ambulatory care industry, increased competition and promotional costs are pressuring managers to design more creative and effective marketing strategies. One largely overlooked strategy is careful monitoring of the daily communication between physicians and ambulatory care staff providing physician services. Satisfying physician communication needs is the key to increasing physician commitment and referrals. This article outlines the steps necessary to first monitor, then improve the quality of all communication provided to physicians by ambulatory care personnel. PMID:10110694

  7. 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.

  8. Strategies for selling and consolidating physician practices.

    Science.gov (United States)

    Mancino, D M

    1997-01-01

    The changing dynamics of healthcare service delivery is forcing many physicians to consider selling their practices to hospitals or health plans or consolidating them with other practices. Besides being subject to the corporate and tax requirements that apply to the sale of any business, the sale of physician practices is also subject to Federal fraud and abuse and self-referral laws. Several sale strategies are available to physicians who desire to sell or consolidate their practices, including asset sales, stock sales, forward mergers, drop down consolidations, spinoffs, and statutory mergers. Each strategy has advantages and disadvantages, but whichever strategy is chosen, both sellers and buyers must ensure that tax issues are addressed and that the transaction complies with the requirements of Federal anti-kickback and self-referral laws.

  9. 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

  10. 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

  11. Physician dual practice: A review of literature

    DEFF Research Database (Denmark)

    Socha, Karolina; Bech, Mickael

    2010-01-01

    of dual practice effects for the public health care. Methods A systematic literature review identified 23 positions on the subject consisting of journal articles, academic working papers, book chapter, and publications of the WHO. Results The subject is short on evidence. Theoretical analyses indicate......Objectives A combination of public and private practice by physicians, referred to as physician dual practice, has been receiving attention in connection with arguments about its negative impact for the public health care. This paper aims to review and critically discuss findings on the subject...... both positive and negative effects of dual practice. Some of the effects depend, however, on assumptions that are undermined in the broader literature. The analyses assume that the dual practitioners’ objective is to maximise income. Yet, while physicians seem to engage in a private practice on top...

  12. Physician manpower expansionism: a policy review.

    Science.gov (United States)

    Bloom, B S; Peterson, O L

    1979-02-01

    A lack of national health goals has allowed physician manpower policy to be dominated by an expansionist philosophy. Scarce resources have been channeled into the production of specialist physicians trained to provide complex and expensive care for uncommon diseases, using other scare and expensive resources and adding to the steep rise in medical care costs. Society seems to want access to primary care--a lack it views with dismay--and simultaneously fears increasing costs of care. Lack of access plus high cost might lead to rash implementation of other inappropriate policies. Success of policy decisions is pure serendipity if made without reliable and relevant information or based on inappropriate data, such as opinions alone. If information is unavailable, then physician manpower decisions should be delayed or, if made, implemented cautiously.

  13. 'They first killed his heart (then) he took his own life'. Part 1: a review of the context and literature on mental health issues for refugees and asylum seekers.

    Science.gov (United States)

    Procter, Nicholas G

    2005-12-01

    This is the first in a two-part series of papers examining mental health issues for refugees and asylum seekers. Beginning with the suicide of an asylum seeker in Scotland, the paper emphasizes mental health issues for adult and child asylum seekers, stress and memory, suicide, self-harm, risk and protective factors, compulsory health treatments and the prevention of mental illness. It sets the scene for the second paper by drawing implications for nursing practice in the community. Although most literature on refugee and asylum seeker mental health exists outside of nursing scholarship, a majority of the issues reviewed in this paper are mutual challenges for all in the health and helping professions. Nurses interested in refugee and migration issues face two intertwined challenges: that of how to assist migrants with their diverse mental health needs and how, at the same time, to contribute to a society that can promote mental health for all by taking on both the difficulties and opportunities posed by cultural diversity.

  14. 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

  15. Assessing physician job satisfaction and mental workload.

    Science.gov (United States)

    Boultinghouse, Oscar W; Hammack, Glenn G; Vo, Alexander H; Dittmar, Mary Lynne

    2007-12-01

    Physician job satisfaction and mental workload were evaluated in a pilot study of five physicians engaged in a telemedicine practice at The University of Texas Medical Branch at Galveston Electronic Health Network. Several previous studies have examined physician satisfaction with specific telemedicine applications; however, few have attempted to identify the underlying factors that contribute to physician satisfaction or lack thereof. One factor that has been found to affect well-being and functionality in the workplace-particularly with regard to human interaction with complex systems and tasks as seen in telemedicine-is mental workload. Workload is generally defined as the "cost" to a person for performing a complex task or tasks; however, prior to this study, it was unexplored as a variable that influences physician satisfaction. Two measures of job satisfaction were used: The Job Descriptive Index and the Job In General scales. Mental workload was evaluated by means of the National Aeronautics and Space Administration Task Load Index. The measures were administered by means of Web-based surveys and were given twice over a 6-month period. Nonparametric statistical analyses revealed that physician job satisfaction was generally high relative to that of the general population and other professionals. Mental workload scores associated with the practice of telemedicine in this environment are also high, and appeared stable over time. In addition, they are commensurate with scores found in individuals practicing tasks with elevated information-processing demands, such as quality control engineers and air traffic controllers. No relationship was found between the measures of job satisfaction and mental workload. PMID:18047420

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. 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:

  1. Redefining the "Scientific Method".

    Science.gov (United States)

    Spiece, Kelly R.; Colosi, Joseph

    2000-01-01

    Surveys 15 introductory biology textbooks for their presentation of the scientific method. Teaching the scientific method involves more than simplified steps and subjectivity--human politics, cultural influences, and chance are all a part of science. Presents an activity for students to experience the scientific method. (Contains 34 references.)…

  2. 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…

  3. 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....

  4. [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

  5. Patient and house officer attitudes on physician attire and etiquette.

    Science.gov (United States)

    Dunn, J J; Lee, T H; Percelay, J M; Fitz, J G; Goldman, L

    1987-01-01

    To study patient preferences on physician attire and etiquette, we interviewed 200 patients on the general medical services of teaching hospitals in Boston and San Francisco. Of these 200 patients, 65% believed physicians should wear a white coat, 27% believed physicians should not wear tennis shoes, 52% believed physicians should not wear blue jeans, 37% believed male physicians should wear neckties, and 34% believed female physicians should wear dresses or skirts. Forty percent of patients wanted physicians to address them by first name, but only 10% of patients wanted to address their physicians by first name. A concurrent mailed survey of 74 medical house staff members at the two hospitals revealed wide variability in physicians' attire and in how patients were addressed at each institution. Thus, many house officers had habits that were less formal than a substantial portion of their patients preferred.

  6. 42 CFR 410.20 - Physicians' services.

    Science.gov (United States)

    2010-10-01

    .... (a) Included services. Medicare Part B pays for physicians' services, including diagnosis, therapy...) of the Act. (2) A doctor of dental surgery or dental medicine. (3) A doctor of podiatric medicine. (4... list, provided by CMS, of plastic and dental surgeries that may be covered by Medicare and that have...

  7. 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

  8. 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…

  9. Integrating hospital and physician revenue cycle operations.

    Science.gov (United States)

    Lockett, Kevin M

    2014-03-01

    Standardized revenue cycle processes should be a key component of the coordinated care delivery strategy organizations will require to complete the transition to population health management. Integrating hospital and physician revenue cycle operations can help organizations better navigate new payment models, reduce costs, and improve value. The most comprehensive approach involves integrating patient access and registration, coding operations, and receivables management across different settings.

  10. The physician's perception of health care.

    Science.gov (United States)

    Lawrence, R S

    1994-01-01

    A general malaise appears to have settled on the American medical scene; most Americans continue to trust their own physicians but do not trust the medical profession or the health system as a whole, while many physicians feel harassed by the regulatory, bureaucratic, or litigious intrusions upon the patient-doctor relationship. The strains on mutual trust among physicians, their patients, and the public are being played out against a background of contradictions. The advances of biomedicine are offset by the neglect of social and behavioural aspects of medical care. Preoccupation with specialized, hospital-based treatment is accompanied by isolation of public health and preventive interests from medical education and practice. Society remains uncertain whether health care is a right or a privilege while accepting public responsibility for financing the health care of certain groups such as the indigent sick (Medicaid), the elderly (Medicare), Native Americans, or members of the armed forces and veterans. Rising expectations about better outcomes through advances in technology are accompanied by rising anxieties about cost, appropriateness of care, access, and quality. Physicians must alter their perception of health care by adopting a population-based approach to need, a commitment to restoring equity in staffing patterns and compensation between primary care and specialty care, and adoption of a social contract that provides for full access by all Americans to basic cost-effective preventive and clinical services before spending on less cost-effective services.

  11. Physician joint ventures: new opportunities and risks.

    Science.gov (United States)

    Miller, Jeremy N

    2004-01-01

    Joint ventures involving physicians and institutions or lay investors had fallen out of favor in recent years because of concerns about transgressing government regulations. These regulations have now been clarified leading to a resurgent interest in these arrangements. This article outlines the business principles, control issues, legal setting, and the various modalities for joint venturing.

  12. 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...

  13. 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

  14. 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

  15. 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

  16. 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…

  17. [Physicians--victims or promoters of corruption?].

    Science.gov (United States)

    Kind, M

    2002-01-01

    According to the media the recent physician bribery scandal in Germany draws ever further sets. The public prosecutor determines against hospital physicians and coworkers of a pharmaceutical firm. The suspicion: Physicians were recompensed for using up medicines particularly with pleasure trips. Which is qualified in Germany regularly as bribery and advantage grant as well as aid for tax evasion, is punishable in Austria as unfaithfulness, gift acceptance as well as bribery. The following contribution lights up--from Austrian view--the criminal page of the narrow burr between permitted sponsoring and undue corruption in the medicine. Bribery is globally punishable in Austria. Allowances to physicians can be for the payee in particular gift acceptance (section 153a StGB) or gift acceptance by leading employees of a public enterprise (section 305 StGB), for the giver in particular bribery (section 307 StGB). Occasional allowances, which are not located in connection to a concrete business, but only promoted the sympathetic consideration of the recipient, are not usually punishable. The punishing frameworks for offensces reach up to three years imprisonment. In addition still the absorption of enriching comes (section 20 StGB). PMID:12094402

  18. 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…

  19. Training Physicians for Public Health Careers

    Science.gov (United States)

    Hernandez, Lyla M., Ed.; Munthali, A. Wezi, Ed.

    2007-01-01

    Public health efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective public health interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of public health physicians who are prepared to face today's public health challenges.…

  20. [Physicians--victims or promoters of corruption?].

    Science.gov (United States)

    Kind, M

    2002-01-01

    According to the media the recent physician bribery scandal in Germany draws ever further sets. The public prosecutor determines against hospital physicians and coworkers of a pharmaceutical firm. The suspicion: Physicians were recompensed for using up medicines particularly with pleasure trips. Which is qualified in Germany regularly as bribery and advantage grant as well as aid for tax evasion, is punishable in Austria as unfaithfulness, gift acceptance as well as bribery. The following contribution lights up--from Austrian view--the criminal page of the narrow burr between permitted sponsoring and undue corruption in the medicine. Bribery is globally punishable in Austria. Allowances to physicians can be for the payee in particular gift acceptance (section 153a StGB) or gift acceptance by leading employees of a public enterprise (section 305 StGB), for the giver in particular bribery (section 307 StGB). Occasional allowances, which are not located in connection to a concrete business, but only promoted the sympathetic consideration of the recipient, are not usually punishable. The punishing frameworks for offensces reach up to three years imprisonment. In addition still the absorption of enriching comes (section 20 StGB).

  1. 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.

  2. 22 CFR 62.27 - Alien physicians.

    Science.gov (United States)

    2010-04-01

    ... facilitates exchanges for foreign medical graduates seeking to pursue graduate medical education or training... Foreign Medical Graduates shall: (1) Have adequate prior education and training to participate... graduate medical education. The agreement or contract must be signed by both the alien physician and...

  3. 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

  4. Using financial ratios to assess physician practices.

    Science.gov (United States)

    Doelling, P M

    1996-01-01

    Purchasing physician practices has become commonplace in the health care environment today. The most commonly used method to evaluate a physician's practice is the medical practice assessment. Although assessments include examining revenues, expenses, staffing ratios, collection ratios and other pertinent statistics, one of the often overlooked financial areas is the balance sheet. Evaluating a business, such as a medical practice, requires a thorough examination of the total financial picture including assets, liabilities, owner's equity or net worth, and the relationship of all the variables to each other. Ratios put the numbers into perspective by creating relationships between the balance sheet variables of assets, liabilities and owner's equity, and key income statement components of revenues, expenses and net income. As a result, ratios provide a unique perspective to the assessment process and enable a more complete analysis. This article examines the types and uses of ratios to assist physicians, managers, and hospital executives to better evaluate the financial viability of a physician's solo or group practice.

  5. Physicians' appraisal of mobile health monitoring

    NARCIS (Netherlands)

    Okazaki, Shintaro; Castaneda, J. Alberto; Sanz, Silvia; Henseler, Jörg

    2013-01-01

    This study addresses what factors influence and moderate Japanese physicians' mobile health monitoring (MHM) adoption for diabetic patients. In light of the multilevel sequential check theory, the study tests whether novelty seeking, self-efficacy, and compatibility moderate the effects of overall q

  6. 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

  7. 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

  8. ["What do physicians really read?" Medical journals and pharma-marketing between 1900 and the late 1970s].

    Science.gov (United States)

    Thoms, Ulrike

    2014-01-01

    Scientific Journals are widely used sources in the history science. First and foremost they are analyzed under the aspect of professionalization and the development of scientific topics. However, the impact of the increasing number of advertisements on the journals has been almost systematically excluded from historical analysis. The paper analyses the relations between pharma marketing and medical journals. However, the emphasis here is not so much on the development of print advertisements. Instead the paper uses sources, which were produced in the process of marketing to access the history of the medical scientific journal, its change and its reception by physicians.

  9. Are Physicians Good Candidates For Recommending Diet?

    Directory of Open Access Journals (Sweden)

    S Hosseini

    2008-05-01

    Full Text Available Background: Primary prevention status and goals in 2010 are promoting healthy weight and eating habits and dietary ma­nipula­tion considered in all reports to be the cornerstone of prevention and management of chronic diseases. Since in de­velop­ing countries physicians are in the front line of responding patients' questions regarding their diet, we decided to evalu­ate their necessary nutritional knowledge for accomplishing this mission and to identify consideration for improving the paucity of nutrition education and the nutrition literacy in medical training program, we did the same education in medi­cal students.Methods: Applied nutritional knowledge of 150 general, specialist and sub specialist physicians and 202 medical students was evaluated by structured self administrative questionnaire. Eighteen questions which could be self completed in less than 5 minutes were filled by each subject. Results: The percentage of physicians who gave dietary recommendations to their patients was 73% but the mean correct re­sponds to questions were 3.73±2.15 and 5.87±2.14 out of 14 questions in physicians and medical students respectively. Conclusions: Our data show deficient applied nutritional knowledge of physicians is one of   the main problems of hospital mal­nu­trition. As the same results were shown in medical students, this can not be due to forgetting what was learned but can be related to the quality of nutrition training.  

  10. 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.

  11. 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...

  12. 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...

  13. Physician recommendations and patient autonomy: finding a balance between physician power and patient choice.

    Science.gov (United States)

    Quill, T E; Brody, H

    1996-11-01

    Medical care in the United States has rapidly moved away from a paternalistic approach to patients and toward an emphasis on patient autonomy. At one extreme end of this spectrum is the "independent choice" model of decision making, in which physicians objectively present patients with options and odds but withhold their own experience and recommendations to avoid overly influencing patients. This model confuses the concepts of independence and autonomy and assumes that the physician's exercise of power and influence inevitably diminishes the patient's ability to choose freely. It sacrifices competence for control, and it discourages active persuasion when differences of opinion exist between physician and patient. This paper proposes an "enhanced autonomy" model, which encourages patients and physicians to actively exchange ideas, explicitly negotiate differences, and share power and influence to serve the patient's best interests. Recommendations are offered that promote an intense collaboration between patient and physician so that patients can autonomously make choices that are informed by both the medical facts and the physician's experience.

  14. 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

  15. Physician Dissatisfaction in the United States: An Examination

    Directory of Open Access Journals (Sweden)

    Francis J. Crosson

    2015-05-01

    Full Text Available This paper addresses several root causes of dissatisfaction with medical practice among American physicians, and suggests that some, but not all, are potentially remediable. Fixed assumptions about the nature of medical practice in the United States, developed over several decades, appear to be eroding. At the same time, increasing demands on physician time, especially involving low value documentation and administrative tasks are interfering with the physician-patient interaction. In addition, physician practice structure and payment methodologies are beginning to change in the United States leading to a sense of practice instability among physicians. Recent research conducted by the American Medical Association and the RAND Corporation has provided new qualitative and quantitative information about the impact of these trends on physician practices. An evaluation of these research findings indicates that some improvements in physician satisfaction are possible.    Keywords: physician professionalism, practice satisfaction, electronic health records, health care reform in the U.S.

  16. Confirmation and Disconfirmation in Nurse/Physician Communication.

    Science.gov (United States)

    Garvin, Bonnie J.; Kennedy, Carol W.

    1986-01-01

    In an attempt to better understand the quality of interprofessional relationships, research used a confirmation/disconfirmation framework to analyze communication in nurse-physician dyads. Results indicated that nurses and physicians were primarily confirming in their interaction. (SRT)

  17. 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...

  18. Using nonqualified benefits to recruit and retain physicians.

    Science.gov (United States)

    Nolan, M

    2000-10-01

    Financial managers of healthcare organizations often are charged with developing incentives that encourage physicians to join or stay with the organization. Standard incentives such as higher salaries and qualified retirement plans may not attract physicians, because much of a physician's salary increase may be lost to taxes, and regulations limit amounts that physicians can contribute to and receive from qualified retirement plans. Incentives that may be valued more highly by physicians include Section 162 bonus plans, which can allow the healthcare organization to compensate for the fact that bonuses are taxable to physicians; split-dollar welfare benefit plans, which allow the healthcare organization and the physician to split the premium payments, cash values, and death proceeds of a life insurance policy; and discounted stock option plans, which can increase the physician's compensation significantly if the shares appreciate in value by the time they are exercised.

  19. The neglected repercussions of a physician advertising ban.

    Science.gov (United States)

    Zwier, Sandra

    2014-03-01

    Although the adverse implications of physician advertising are the subject of a fierce and sustained debate, there is almost no scholarly discussion on the ethical repercussions of physician advertising bans. The present paper draws attention to these repercussions as they exist today in most of the world, with particular focus on three serious implications for the public: (a) uncertainty about the physician's interests, namely, that patients must trust the physician to put patient wellbeing ahead of possible gains when taking medical decisions; (b) uncertainty about alternative treatments, namely, that patients must trust in the physician's treatment decisions; and (c) uncertainty about the exclusive patient-physician relationship, namely, that patients must develop and maintain a good relationship with one physician. Physician advertising bans continue to tell the public in most of the modern world that these are irrelevant or inappropriate issues, meaning that they are effectively left to the public to resolve.

  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. 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.

  2. 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...

  3. “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.

  4. 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

  5. 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...

  6. 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

  7. Physician executives straddle the digital divide.

    Science.gov (United States)

    Coile, R C

    2001-01-01

    e-Health is here to stay and experts predict that the Internet will become the hub of health care. Rapid advancements in biotechnology and medical research, increasingly curious patients who surf the Internet for medical information, and pressures from managed care companies to contain costs and speed treatments are the central components driving e-health. Despite physician reluctance to embrace the e-revolution, many hospitals and medical groups are employing the Internet and information technology to improve their customer interface, as well as to reduce business costs. This article offers seven e-strategies for health care performance improvement: (1) Supply chain management; (2) e-transactions; (3) care management; (4) improving quality; (5) boosting revenues; (6) outsourcing; and (7) provider networks (Intranets). By helping to incorporate these key e-solutions, physician executives can position their organizations for success in the new millennium.

  8. Qualitative Research on Emergency Medicine Physicians

    DEFF Research Database (Denmark)

    Paltved, Charlotte; Musaeus, Peter

    2012-01-01

    studies on EM physicians were designed using the following strategies of inquiry: Ethnography, mixed methods, action research, grounded theory, phenomenology, content analysis, discourse analysis, and critical incident analysis. The reviewed studies were categorized into four main themes: Education......Aim: This study aims to systematically review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena. EM is a highly complex medical and social environment that can be investigated...... with qualitative research. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and cross references...

  9. Integrative physicians and an herbal cancer "cure".

    Science.gov (United States)

    Ben-Arye, Eran; Rosenberg, Shoshana Keren; Samuels, Noah

    2016-08-01

    Oncologists are frequently asked about herbal remedies claiming to "cure" cancer, or at least delay its progression. While complementary and integrative medicine (CIM) should be aimed primarily at improving quality-of-life (QOL) related concerns, "wonder cures" are part of an alternative health belief model providing hope for a "miracle" where conventional treatment has failed. We describe a physician with extensive small-cell lung cancer (SCLC) undergoing chemotherapy, with significant toxicities and impaired daily function. He had come for an integrative physician (IP) consultation, provided by a medical doctor dually trained in CIM and supportive cancer care, taking place in a conventional supportive cancer care service. We describe the IP consultation in general and regarding an herbal remedy which was being promoted as a "cure" for cancer. The subsequent patient-tailored CIM treatment process, in which patients receive evidence-based guidance on treatments which address QOL-related concerns, are presented. PMID:27652207

  10. 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

  11. Strategic career planning for physician-scientists

    OpenAIRE

    Shimaoka, Motomu

    2015-01-01

    Building a successful professional career in the physician-scientist realm is rewarding but challenging, especially in the dynamic and competitive environment of today’s modern society. This educational review aims to provide readers with five important career development lessons drawn from the business and social science literatures. Lessons 1–3 describe career strategy, with a focus on promoting one’s strengths while minimizing fixing one’s weaknesses (Lesson 1); effective time management i...

  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. 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.

  14. Physician assistants in Australasian emergency departments.

    Science.gov (United States)

    Close, Benjamin; Zolcinski, Robert

    2016-08-01

    A physician assistant (PA) is a university qualified health professional who's primary role is to provide medical care under the direction and supervision of medical staff. This is a new profession in Australasia. The PA is well suited to working in both rural, regional and urban settings that deliver emergency medical care. A perspective is presented on their role and scope of practice within the Australasian emergency care system supported by some early findings from their use in a tertiary ED.

  15. 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

  16. 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.

  17. Aligning Career Expectations with the Practice of Medicine: Physician Satisfaction

    Science.gov (United States)

    Gibson, Denise D.; Borges, Nicole J.

    2009-01-01

    This study examined physicians' level of satisfaction with their job and the match between expectations and actual practice of specialty. Quantitative results suggested that physicians (N = 211) had a moderately high level of overall job satisfaction with no significant differences found between men and women physicians. Among those in primary…

  18. 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.

  19. 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...

  20. 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…