scholarly journals The Identity of Psychiatry and the Challenge of Mad Activism: Rethinking the Clinical Encounter

2020 ◽  
Vol 45 (6) ◽  
pp. 598-622
Author(s):  
Mohammed Abouelleil Rashed
Keyword(s):  
Medical Specialty ◽  
Clinical Encounter ◽  
Medical Speciality ◽  
Hypostatic Abstraction ◽  
Medical Specialities

Abstract Central to the identity of modern medical specialities, including psychiatry, is the notion of hypostatic abstraction: doctors treat conditions or disorders, which are conceived of as “things” that people “have.” Mad activism rejects this notion and hence challenges psychiatry’s identity as a medical specialty. This article elaborates the challenge of Mad activism and develops the hypostatic abstraction as applied to medicine. For psychiatry to maintain its identity as a medical speciality while accommodating the challenge of Mad activism, it must develop an additional conception of the clinical encounter. Toward elaborating this conception, this article raises two basic framing questions: For what kind of understanding of the situation should the clinical encounter aim? What is the therapeutic aim of the encounter as a whole? It proposes that the concepts of “secondary insight” (as the aim of understanding) and of “identity-making” (as a therapeutic aim) can allow the clinical encounter to proceed in a way that accommodates the challenge of Mad activism.

Radio Medical Advice ‒ the Danish experience

1995 ◽  
Vol 81 (1) ◽  
pp. 12-15
Author(s):  
H H Strange-Vognsen ◽  
N Knudstorp
Keyword(s):  
Intravenous Infusion ◽  
Short Distance ◽  
Medical Officer ◽  
Medical Advice ◽  
Medical Speciality ◽  
Traumatic Lesions ◽  
Danish Experience ◽  
Medical Specialities ◽  
New Education ◽  
Advice Service

AbstractFrom 1980 to 1993, the Danish Radio Medical Advice Service (RMAS) had 1136 contacts from overseas Danish merchant ships and 213 contacts from Danish territorial waters. The diagnoses were almost always of acute conditions. The distributions of the diagnoses in the overseas contacts were; disease in the digestive and genitourinary system 30%, traumatic lesions 23%, infectious diseases 14% and diseases in the cardiovascular and respiratory system 9%. The only trend over the years was a significant (P = 0.01) decreases in psychiatric diagnosis. Evacuation from the ship was recommended in 53% and medicine was prescribed in 61% of the contacts. The medicine was antibiotics in 40% and analgesics in 29% of the contacts. Intravenous infusion was evaluated as relevant in 5% of the cases and this procedure will be included in the new education of officers on the ships. In the contacts from Danish territorial waters, where many shhips are recreational yachts, evaccuation was recommended in 79% and medicine was prescribed in 28% of the contacts. This was probably due to the short distance to the nearest harbour and the variation in medical equipment and knowledge. The medical speciality for doctors participating in RMAS shhould be general surgery or orthopaedic surgery but access to advice from all other medical specialities should be available. Experience as a nnaval medical officer would be beneficial. The education of the officers on the ships should be more comprehensive including e. g. intravenous infusion. Commmunication should be by telephone and television would be an advanntage.

scholarly journals The compelling arguments for the need of medical vascular physicians in Europe

VASA ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 487-491 ◽  
Author(s):  
Christian Heiss ◽  
Juraj Madaric ◽  
Jill Belch ◽  
Marianne Brodmann ◽  
Lucia Mazzolai
Keyword(s):  
Treatment Guidelines ◽  
Vascular System ◽  
Public Awareness ◽  
Vascular Diseases ◽  
Medical Specialty ◽  
Adverse Outcomes ◽  
European Countries ◽  
The European Union ◽  
Vascular Medicine ◽  
Medical Speciality

Summary. The burden of vascular diseases is growing worldwide, as the population ages, prompting a call to action not only in terms of awareness but also and most urgently in recognizing the need for vascular physicians, also called angiologists. Vascular medicine views the vascular system (arteries, veins, and lymphatics) as a whole, unique, and independent entity requiring specialized competencies. Vascular physicians offer a holistic and comprehensive approach to vascular patients including provision of interventional procedures, management of a heterogeneous group of multi-morbid and frail patients affected by multi-vessel diseases, and connecting different specialists in a multidisciplinary effort. Vascular medicine practise varies across European countries. While it is a firmly accepted medical speciality in many European countries it is not formally recognized by the European Union limiting adoption in the other countries. The lack of vascular physicians likely accounts for inequality of care of vascular patients as compared for example to patients with heart disease and might contribute to adverse outcomes and healthcare costs associated with vascular diseases. To move forward in the struggle to provide efficient care for multimorbid poly-vascular patients, it is essential to establish vascular medicine programs in Europe and worldwide. Important steps to achieve this goal include improving public awareness of vascular diseases, attain formal recognition by the EU of angiology/vascular medicine as a medical specialty, creating specialized treatment guidelines, and to harmonize vascular care in Europe.

Organizational aspects of osteopathic care provision in a specialized clinic of Moscow

2018 ◽  
pp. 6-13
Author(s):  
D. E. Mokhov ◽  
M. Y. Gerasimenko ◽  
O. V. Yaschina ◽  
L. V. Tumbinskaya ◽  
E. S. Tregubova
Keyword(s):  
Quality Criteria ◽  
Medical Specialty ◽  
Organizational Analysis ◽  
Care Provision ◽  
Sources Of Information ◽  
Research Papers ◽  
Regulatory Documents ◽  
Methodological Approaches ◽  
Intensive Development ◽  
Osteopathic Physicians

Introduction. Nowadays osteopathy is an offi cial medical specialty. Many years of experience accumulated by osteopathic physicians in our country have proven its effectiveness. The analysis of research papers of those countries where osteopathy is widely used allows to draw the following conclusion: osteopathy is one of the least dangerous therapeutic methods provided that patients deal with well-trained and certifi ed specialists who work in the frame of possibilities of osteopathy. Due to the intensive development of this specialty in Russia it is necessary to provide scientifi c justifi cation to organizational and methodological approaches aimed at ensuring effective and high-quality osteopathic care to the population.Goal of research - to develop proposals in order to improve the quality and effectiveness of osteopathic care provision for the population, taking into account the current situation in health care.Materials and methods. Authors used the following research methods: historical and medico-organizational analysis, literary data analysis, content analysis as well as methods of descriptive statistics.Results. The research presents characteristics of clinics declaring osteopathic care provision, as well as qualities of osteopathic physicians. It also describes patients seeking osteopathic care, and sources of information they use.Conclusion. Authors propose a number of measures aimed at improving the availability and effectiveness of osteopathic care for patients such as training of doctors, creating of regulatory documents, developing quality criteria for osteopathic care provision and popularization of osteopathy among patients.

Survey on European postgraduate medical assessments by the Council for European Medical Specialty Assessments (UEMS-CESMA)

MedEdPublish ◽  
2014 ◽  
Author(s):  
John Boorman ◽  
Danny G.P. Mathysen ◽  
Julie-Lyn Noël ◽  
Konrad Bloch ◽  
Jean-Baptiste Rouffet ◽  
...  
Keyword(s):  
Medical Specialty

scholarly journals ‘Motivational work’: a qualitative study of preventive health dialogues in general practice

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Broholm-Jørgensen ◽  
Siff Monrad Langkilde ◽  
Tine Tjørnhøj-Thomsen ◽  
Pia Vivian Pedersen
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Support System ◽  
Preventive Intervention ◽  
Digital Health ◽  
Clinical Encounter ◽  
Preventive Health ◽  
Structured Interviews ◽  
General Practices ◽  
Municipal Health

Abstract Background The aim of this article is to explore preventive health dialogues in general practice in the context of a pilot study of a Danish primary preventive intervention ‘TOF’ (a Danish acronym for ‘Early Detection and Prevention’) carried out in 2016. The intervention consisted of 1) a stratification of patients into one of four groups, 2) a digital support system for both general practitioners and patients, 3) an individual digital health profile for each patient, and 4) targeted preventive services in either general practice or a municipal health center. Methods The empirical material in this study was obtained through 10 observations of preventive health dialogues conducted in general practices and 18 semi-structured interviews with patients and general practitioners. We used the concept of ‘motivational work’ as an analytical lens for understanding preventive health dialogues in general practice from the perspectives of both general practitioners and patients. Results While the health dialogues in TOF sought to reveal patients’ motivations, understandings, and priorities related to health behavior, we find that the dialogues were treatment-oriented and structured around biomedical facts, numeric standards, and risk factor guidance. Overall, we find that numeric standards and quantification of motivation lessens the dialogue and interaction between General Practitioner and patient and that contextual factors relating to the intervention framework, such as a digital support system, the general practitioners’ perceptions of their professional position as well as the patients’ understanding of prevention —in an interplay—diminished the motivational work carried out in the health dialogues. Conclusion The findings show that the influence of different kinds of context adds to the complexity of prevention in the clinical encounter which help to explain why motivational work is difficult in general practice.

Variation in the management of Kawasaki disease

2019 ◽  
Vol 105 (10) ◽  
pp. 1004-1006 ◽  
Author(s):  
Audrey Dionne ◽  
David Burgner ◽  
Sarah De Ferranti ◽  
Davinder Singh-Grewal ◽  
Jane Newburger ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Initial Treatment ◽  
Coronary Aneurysm ◽  
Medical Specialty ◽  
Primary Treatment ◽  
Management Options ◽  
Necrosis Factor Alpha ◽  
Coronary Aneurysms ◽  
Factor Alpha ◽  
Collaborative Efforts

Intravenous immunoglobulin (IVIG) reduces coronary aneurysms in patients with Kawasaki disease (KD), but additional management options remain challenging, with no generalisable evidence-based recommendations. We performed a survey of 724 physicians from 73 countries to assess variation in practice. IVIG was the preferred initial treatment by 659 (91%) of respondents. Criteria for adjunctive primary treatment varied considerably and definitions of IVIG resistance varied markedly by geographical continent, Human Development Index tiers and medical specialty. A second dose of IVIG was used most often for patients with coronary aneurysm non-responsive to initial treatment (572, 79%), but corticosteroids (379, 52%) and tumour necrosis factor alpha inhibitors (208, 29%) were also frequently used. Our findings highlight the need for international collaborative efforts to optimise management of patients with KD worldwide.

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