An invitational conference led by the World Organization of Family Doctors (Wonca) involving selected delegates from 34 countries was held in Kingston, Ontario, Canada, March 8 to12, 2003. The conference theme was “Improving Health Globally: The Necessity of Family Medicine Research.” Guiding conference discussions was the value that to improve health care worldwide, strong, evidence-based primary care is indispensable. Eight papers reviewed before the meeting formed the basic material from which the conference developed 9 recommendations. Wonca, as an international body of family medicine, was regarded as particularly suited to pursue these conference recommendations:



Research achievements in family medicine should be displayed to policy makers, health (insurance) authorities, and academic leaders in a systematic way.


In all countries, sentinel practice systems should be developed to provide surveillance reports on illness and diseases that have the greatest impact on the population’s health and wellness in the community.


A clearinghouse should be organized to provide a central repository of knowledge about family medicine research expertise, training, and mentoring.


National research institutes and university departments of family medicine with a research mission should be developed.


Practice-based research networks should be developed around the world.


Family medicine research journals, conferences, and Web sites should be strengthened to disseminate research findings internationally, and their use coordinated. Improved representation of family medicine research journals in databases, such as Index Medicus, should be pursued.


Funding of international collaborative research in family medicine should be facilitated.


International ethical guidelines, with an international ethical review process, should be developed in particular for participatory (action) research, where researchers work in partnership with communities.


When implementing these recommendations, the specific needs and implications for developing countries should be addressed.




The Wonca executive committee has reviewed these recommendations and the supporting rationale for each. They plan to follow the recommendations, but to do so will require the support and cooperation of many individuals, organizations, and national governments around the world.

/pdf/improving-health-care-globally-a-critical-review-of-the-9c65jsbavm.pdf

Improving Health Care Globally: A Critical Review of the Necessity of Family Medicine Research and Recommendations to Build Research Capacity

Technical developments in spiral CT scanning mean that considerably smaller lung cancers can now be identified than with previous methods of detection. Only time will tell whether this enhanced capability will result in a reduction in the number of deaths from lung cancer. The implications and problems of screening for lung cancer are discussed. Screening implies a careful refinement of a range of clinical activities that must be routinely delivered in a carefully coordinated fashion to allow for the possibility of improved outcome. Critical analyses of the nuances of this process are essential if the field is to move forward.

https://thorax.bmj.com/content/thoraxjnl/57/12/1071.full.pdf

Lung cancer • 2: Screening and early diagnosis of lung cancer

The impact of organised screening programmes on the stage-specific incidence of breast cancer in some Italian areas

Health and social care professionals are required to work together to deliver person-centered care. Professionals therefore find themselves making decisions within multidisciplinary teams. For educators, there has been a call to bring students from differing professions together to learn to enable more effective teamwork, interprofessional communication, and collaborative practice. This multidisciplinary working is complicated by the increasingly complex nature of ethical dilemmas that health and social care professionals face. It is therefore widely recognized that the teaching and learning of ethics within health and social care courses is valuable. In this paper, we briefly make the case in support of teaching and learning health and social care ethics through the medium of interprofessional education (IPE). The purpose of this paper is to provide guidance to educators intending to design ethics-orientated IPE for health and social care students. The guidance is based on the ongoing experiences of designing and implementing ethics-orientated IPE across five departments within two universities located in the North of England over a five-year period. Descriptions of the ethics-orientated IPE activities are included in the guide, along with key resources recommended.

/pdf/interprofessional-education-and-practice-guide-designing-39lknbm3uv.pdf

Interprofessional education and practice guide: designing ethics-orientated interprofessional education for health and social care students.

There are several ways to prevent and treat hypertrophic scars. In recent years, lasers have been quite extensively used in treating scars. For example, Pulsed Dye Laser (PDL) and Intense Pulsed Light (IPL) can accelerate mutation of scar, whereas non-ablative and ablative fractional laser can improvescar texture. Dual-wave-length laser treatment is extensively used for blood vessel diseases but is rarely used and less reported for treatment of hypertrophic scars. Our study focuses on the efficacy and safety of dual-wave-length PDL and Nd:YAG in treatment of hypertrophic scars. Twenty-five patients in our study complaining of hypertrophic scars were treated with combined PDL/Nd:YAG laser at 4-6 weeks intervals. Following this, the patients and observers assessed these scars by using Patient Scar Assessment Scale (PSAS) and Observer Scar Assessment Scale (OSAS). The resultsshowed that hypertrophic scar was significantly improved after several laser treatments, and no severe adverse effects were observed. Considering the safety and satisfactory effects of dual-wave-length laser treatment, it can be regarded as a good method for treating hypertrophic scars. This study clearly demonstrates that combined PDL/Nd:YAG laser treatment is an effective, safe and well-tolerated treatment option for hypertrophic scars.

Effective treatment for hypertrophic scar with dual-wave-length PDL and Nd:YAG in Chinese patients.

EDITOR—We should like to raise some concerns about the ATAC (arimidex, tamoxifen alone or in combination) trial, which was reported on in the Lancet after only half the time stipulated in the protocol (2.5 years instead of 5).1 Ravdin has raised important points: “Early reporting rules can powerfully …

https://www.bmj.com/content/bmj/326/7402/1329.2.full.pdf

Clare Dimmer

Papers

ATAC trial: reporting interim results is not helpful.

Screening mammography: setting the record straight. Authors' reply

Screening mammography: setting the record straight.