Showing papers in "Canadian Family Physician in 1972"

Problem solving and decision making in primary medical practice.

Abstract: in this by political complications. In France a seventh year has been created in the same way as in Holland; they are advocating an obligatory vocational training for general practice, as in Italy where the situation is still difficult to judge with the impending nationalization of health care. In view of this uncertain situation concerning vocational training for general practice in the EEC, the Working Committee on General Practice of the Standing Committee of Doctors of the EEC asked the Union Europeenne de Medecins Omnipracticiens (UEMO) to propose a vocational training programme of not less than two years, a minimum duration already agreed on in 1966-67. This programme, drafted by the Dutch delegation, was based on the various definitions in use in different countries on the function of the GP in the first line of health care and on a description of his many varied tasks and qualities. It was thoroughly discussed at joint sessions of the Working Committee on General Practice of the Comite Permanent and the UEMO in 1969 and 1970 and was finally adopted by the General Assembly of the Comite Permanent; it was then sent to the EEC commission in Brussels. Meanwhile, between 1969 and 1971 the draft directives for the free movement of doctors in the EEC were considered in the various EEC institutions and in 1971 arrived at the Council of Ministers. Many modifications have been proposed and some have been accepted, but none of these concerns the GP sui generis, let alone his vocational training. The UEMO and the Comite Permanent are most anxious that the directives contain some reference to general practice, perhaps even a recommendation by the Council of Ministers to the governments that they promote, for the sake of a good health care system in the EEC, the necessary vocational training for general practice. This training should be postgraduate and full-time and of a minimum duration of two years, of which six months should be spent in general practice. It should lead to registration in a special register for trained GPs and to a protected title, mutually recognized within the EEC.

Management of heart disease in the elderly.

Abstract: Many factors have to be considered when treating heart disease in the elderly if quality of life is to be maintained. Cessation of smoking or rigorous weight loss may not be worthwhile in these patients, since there is little medical evidence showing much improvement after these measures have been taken. Medication should be prescribed with particular reference to cost, since many drugs are too expensive for pensioners to buy.

The glaucomas - a review.

Abstract: The author reviews the group of disease entities called glaucoma. He delineates current thinking about the various forms of glaucoma in black-and-white. In actuality, some of the stated views still remain in the grey zone in ophthalmological circles. The author discusses the four major types of glaucoma, and what the family physician should know about them.

Medical Aspects of Drug Abuse

Abstract: Interestingly, medical aspects of drug abuse that you really wait for now is coming. It's significant to wait for the representative and beneficial books to read. Every book that is provided in better way and utterance will be expected by many peoples. Even you are a good reader or not, feeling to read this book will always appear when you find it. But, when you feel hard to find it as yours, what to do? Borrow to your friends and don't know when to give back it to her or him.

The Partnership Agreement.

Abstract: Through this Partnership Agreement, the Associations recognise each other as independent and incorporated professional organisations, both working at national level to improve the quality and reach of environmental/sustainability education – including marine education. The agreed timeframe for this agreement is the three year period 1 October 2006to 30 September 3

The family physician and the dying patient.

Abstract: Abstract Sixty-eight family physicians in Toronto were personally interviewed and reported the drugs they prescribed for a list of functional ailments, estimated extent of their per-patient prescribing of psychoactive drugs, also their attitudes toward emotionally disturbed or neurotic patients. Numerous variables were explored, but the only important correlation with lower prescribing rates was the period of graduation (1955 or later), irrespective of the patient population composition. Attitudes toward neurotics had no connection with per-patient prescribing, older graduates holding as favorable attitudes as more recent ones. An unfavorable attitude did, however, correlate with a greater number of patients seen on an average day. Background characteristics, professional associations and types of practices are described. Some irrational elements in prescribing are discussed.

Family practitioners and the prescription of psychoactive drugs.

Abstract: Sixty-eight family physicians in Toronto were personally interviewed and reported the drugs they prescribed for a list of functional ailments, estimated extent of their per-patient prescribing of psychoactive drugs, also their attitudes toward emotionally disturbed or neurotic patients. Numerous variables were explored, but the only important correlation with lower prescribing rates was the period of graduation (1955 or later), irrespective of the patient population composition. Attitudes toward neurotics had no connection with per-patient prescribing, older graduates holding as favorable attitudes as more recent ones. An unfavorable attitude did, however, correlate with a greater number of patients seen on an average day. Background characteristics, professional associations and types of practices are described. Some irrational elements in prescribing are discussed.

The family physician and the periodic health examination.

Abstract: This article attempts to answer six questions about the periodic health examination in order to establish whether it is of enough value to warrant the time spent. Such elements as early detection, risk factors, health behavior, disease outcome, evaluation methods and effects of long term therapy are considered, the conclusion being that while screening has some value, existing programs have little hope of reducing risk or even maintaining health in the general population. National and provincial bodies should support research into the effectiveness of various screening methods.

Early detection and mass screening for cancer.

Abstract: The author reviews the evidence for the efficacy of early detection and mass screening programs in reducing morbidity and mortality from cancer. In cancer of the cervix, although screening reduces morbidity, we still do not have evidence for reduction in mortality. In cancer of the breast, one study suggests a reduction in mortality in the 50-59 year age group following screening by clinical examination and mammography. In other sites, especially lung, there is no evidence at present to support the adoption of mass screening programs. It is important that such programs should be carefully evaluated in the population, preferably in controlled studies.

Sex counselling for your geriatric patients.

Abstract: The geriatric population has traditionally received less attention by family physicians than any other segment of society. Sexual counselling is of necessity an important sphere of family medicine. The geriatric patient is entitled to and should receive empathy and support in this area. The physician must use basic sexual advice tailored to the special needs of this group. These needs are reviewed and certain truths and fallacies are discussed.

Emotional problems - a family affair.

Abstract: It is important for the family physician to be able to utilize family treatment concepts to help him understand the families in his care. He should recognize how family dysfunction contributes to the problems of his individual patients. He should be able to help these families recognize and deal with many of their problems and should be aware of his own limitations and when consultation is indicated.

Skating injuries and their treatment.

Abstract: There are approximately 682 figure skating clubs in Canada (not including hockey or general recreational figure skating), with anywhere up to 600 or more members. This means that there are probably over 200,000 figure skaters in Canada today. This article deals with the general and specific medical problems that face these skaters, and what a physician should know about treating them.

Neurodermatitis: what is it?

Abstract: Neurodermatitis has so frequently been used to discuss any skin eruption associated with anxiety that it has become less specific as a diagnosis. It was intended to refer to localized circumscribed patches of lichenified skin associated with itching. Without proper knowledge of its etiology or its appearance it can be confused with many other conditions, resulting in poor management. The authors characterize the diagnosis as it was intended and give a capsule description of its appearance, differential diagnosis, prognosis and management.

Success of the Nurse's Role in Primary Health Care.

Abstract: This paper is based on some of the findings of a demonstration project which undertook to measure the level of patient and participant satisfaction with community nursing service in a family practice unit, as one indicator of the feasibility of nurses and physicians practicing in a complementary fashion at the source of primary family health care. In addition, descriptive data concerning the characteristics of the community nursing role and the factors influencing its development were gathered concurrently. A baccalaureate nurse gave family-centered nursing care, complementary to medical care, in a family practice unit. Methods of study were interviews with unit staff and a sample of 100 patients who had received community nursing service and review of patient records. This project was supported by funds provided by the Department of National Health and Welfare, National Health Grant No. 606-20-14.

Psychotropic drug use and driving risk.

Abstract: This review deals with studies of the incidence of psychotropic drugs in general populations, in samples of drivers and samples of accident drivers. Investigations have varied in terms of drugs studied, reliability of data collection procedures and criteria for choosing sample populations. This variability plus lack of replicative investigations makes the generation of conclusions tentative at this time. The studies cited did show that as high as 35 to 50 percent of the general population risk driving after drug use at least once per year and suggest that 11 to 15 percent of accident drivers have taken a psychotropic drug prior to their accident. Psychotropic drug use is most likely to be found among certain drinking driver groups, especially the fatally injured. The authors indicate that the veracity of drivers' statements about drug use is very low and drug use estimates derived from questioning are probably very conservative.

Exercise in a cold climate.

Abstract: Dr. Shephard reviews practical advice required by the winter sportsman in relation to more fundamental aspects of the bodily response to cold. Heat loss occurs by radiation, convection, conduction, and evaporation of sweat; this loss must be made good by metabolism if the body is not to be chilled. Convection is the main source of heat loss in the sportsman, and must be minimized by appropriate clothing. Chilling below a body temperature of 95 degrees F is undesirable; temperatures below 90 degrees F are rapidly fatal. Heat is restored to the body by warming, by the "waste" energy of physical activity, and by shivering.Problems of angina and bronchospasm can be minimized by warming and humidifying inspired gas. Aerobic power is affected only slightly by cold exposure. Liability to muscular injuries and frostbite, and the course of acclimatization to cold are briefly discussed.

Childhood urinary tract infections in family practice.

Abstract: During one year in a private practice, 102 cases of childhood urinary-tract infection (UTI) were detected. Presenting symptoms and signs are given, and the sex and age of the children are related to bacterial and pus-cell counts in the urine. The urine was cultured in 68 cases, and eight patients were further investigated. Routine urinalysis and the physician's unceasing alertness are essential to diagnose and treat UTI in its early stages in children, and thus prevent renal disease in later life. The authors describe a simple practical routine by which the family doctor can detect the infection in children, and they outline preferred treatment schedules.

Sports Injuries of the Ear

Abstract: The author describes common sports injuries involving the ear. Such injuries include hematoma, lacerations, foreign bodies (tattoo), and thermal injuries. Ear canal injuries include swimmer's ear and penetrating injuries. Tympanum injuries include tympanic membrane perforations, ossicular discontinuity, eustachian tube dysfunction, temporal bone fractures and traumatic facial nerve palsy. Inner ear injuries include traumatic sensorineural deafness. The author emphasizes the management of these injuries.

Appropriate appliances for the older arthritic patient.

Abstract: Many of the functional problems in the everyday life of the arthritic patient can be minimized by appliances. Examples of these are listed according to the job they do: altering height, improving leverage, enlarging handles, extending reach, improving safety, simplifying methods. The authors suggest sources of appliances, and mention measures such as structural alterations and patient education. Initial assessment of need, follow-up and planning in terms of overall rehabilitation are important; often an occupational therapist is best qualified to work out solutions.

Emotional care of the pregnant woman.

Abstract: Prenatal care affords an unparalleled opportunity, with a captive audience, to engage in prevention of primary mental health problems. Pregnancy and birth are family crises with much overt marital pathology and deviant parent-child relationships starting at this time. There is unfortunately little awareness of normal emotional reactions to pregnancy or of the pregnant woman's needs, and physician's attitudes and my ths can perpetuate this. The author suggests a range of interventive methods including use of community resources and involvement of other professionals.

Spectinomycin hydrochloride in the treatment of acute gonorrhea in males.

Abstract: The authors treated 217 cases (males) of acute gonorrheal urethritis with a two gram dose of intramuscular spectinomycin hydrochloride and report a bacteriological cure rate of 100 percent and a clinical cure rate of 99 percent. They consider this drug to be one of the most effective weapons in the treatment of acute gonorrhea. This is the first publication anywhere in the world of a clinical trial for spectinomycin hydrochloride.