Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

BACKGROUND: Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources of scientific information that are used by family physicians to keep their medical knowledge up to date and barriers to use these sources. Our main objective was to examine medical knowledge translation (KT) practices of Swiss family physicians. METHODS: The population consisted of French- and German-speaking private practice physicians specialised in family medicine. We conducted four interviews and three focus groups (n = 25). The interview guides of the semi-structured interviews and focus groups focused on (a) ways and means used by physicians to keep updated with information relevant to clinical practice; (b) how they consider their role in translating knowledge into practice; (c) potential barriers to KT; (d) solutions proposed by physicians for effective KT. RESULTS: Family physicians find themselves rather ambivalent about the translation of knowledge based on scientific literature, but generally express much interest in KT. They often feel overwhelmed by "information floods" and perceive clinical practice guidelines and other supports to be of limited usefulness for their practice. They often combine various formal and informal information sources to keep their knowledge up to date. Swiss family physicians report considering themselves as artisans, caring for patients with complex needs. CONCLUSION: Improved performance of KT initiatives in family medicine should be tailored to actual needs and based on high quality evidence-based sources.

L'informatique: un outil remarquable pour l'enseignement de la médecine interne générale [The informatics: a remarkable tool for teaching general internal medicine].

INTERMED training implies a three week course, integrated in the "primary care module" for medical students in the first master year at the school of medicine in Lausanne. INTERMED uses an innovative teaching method based on repetitive sequences of e-learning-based individual learning followed by collaborative learning activities in teams, named Team-based learning (TBL). The e-learning takes place in a web-based virtual learning environment using a series of interactive multimedia virtual patients. By using INTERMED students go through a complete medical encounter applying clinical reasoning and choosing the diagnostic and therapeutic approach. INTERMED offers an authentic experience in an engaging and safe environment where errors are allowed and without consequences.

Accélération de la guérison fracturaire par le tériparatide: série de 22 cas et revue de la littérature [Improvement of fracture healing with teriparatide: series of 22 cases and review of the literature].

La pseudarthrose est définie comme une fracture qui ne guérit pas sans intervention additionnelle neuf mois après le traumatisme et en l'absence de progression radiologique pendant les trois derniers mois. Les fractures ostéoporotiques sont à plus grand risque de complications chirurgicales. On se pose de plus en plus souvent la question d'ajouter un traitement médicamenteux pour accélérer le processus de guérison fracturaire. Il existe des données montrant que le tériparatide (anabolisant osseux issu de l'hormone parathyroïdienne) accélère la guérison osseuse et améliore le devenir fonctionnel, avec ou sans chirurgie, dans des situations de fractures typiques ou atypiques. Les risques liés à ce traitement sont faibles, mais la prescription nécessite l'accord de l'assurance-maladie dans cette indication. Nous rapportons notre expérience sur l'utilisation de cette molécule, hors indication officielle, dans des cas complexes de non-guérison fracturaire. Pseudoarthrosis is defined as a non healing fracture 9 months after trauma and without radiological progression within the last three months. Osteoporotic fractures have a greater risk of chirurgical complications. The question of giving a medical treatment in the purpose of accelerating fracture healing is an increasing concern. There are data showing that with teriparatide (bone anabolic treatment derived from the parathyroid hormone) bone healing and functional status are improved, with or without surgery, in the case of either typical or atypical fractures. The risks of this treatment are low but health insurance agreement is needed in this indication. We report our experience with the use of this molecule, out of the official indication, in complex situations of non healing fractures.

Aux sources de l'orthopédie clinique : l'histoire revisitée de Jean-André Venel, "père de l'orthopédie" (fin XVIIIe-début XIXe siècle)

(ENGLISH VERSION BELOW) En 1780, le médecin Jean-André Venel fonde à Orbe, dans le canton de Vaud, le premier institut orthopédique connu dans le monde, proposant une version clinique d'un savoir-faire médical ancestral. A travers des sources qui réactualisent les travaux consacrés à Venel, cet article retrace les origines de son institution et de sa pensée médicale, dans un contexte de production et de diffusion d'un savoir particulier en termes de technique du corps et de médecine de l'enfant. Revisitant la figure légendaire - ou mythique ? - de ce que l'histoire de la médecine a retenu comme étant le « père de l'orthopédie », l'article s'interroge par la même occasion sur les conditions d'émergence d'une spécialité médicale au sortir de l'Ancien Régime, et de son impact dans les premières décennies du XIXe siècle. In 1780, the physician Jean-André Venel creates in Orbe (canton of Vaud) the first orthopedic institute of the world, offering a clinical version of an ancient medical savoir-faire. By using sources that enable us to update the scholarship on Venel, this article traces the origins of his institute and of his medical thought, in the context of the production and diffusion of a specialized knowledge on the body and on children. With this new perspective on the legendary, if not mythical, figure, whom the history of medicine has canonized as the "father of orthopedia", this article also examines the conditions of emergence of a medical specialization at the end of the Ancien Régime and its impact in the first decades of the nineteenth century.

Educational resources offered by the European Board of Physical and Rehabilitation Medicine (EBPRM)

Background .- Physical and Rehabilitation Medicine (PRM) is a very demanding medical speciality. To ensure high standard of research and care in PRM all across Europe, it is crucial to attract gifted trainees and offer them high quality education. At undergraduate level, many medical schools in Europe omit to offer teaching on disabled persons and on basic PRM knowledge. Thus PRM is hardly known to medical students. For postgraduate trainees access to evidence-based knowledge as well as teaching of research methodology specific to PRM, rehabilitation methodology, disability management and team building also need to be strengthened to increase the visibility of PRM. Action .- To address these issues the EBPRM proposes presently a specific undergraduate curriculum in PRM including the issues of disability, participation and handicap as a basis for general medical practice and postgraduate rehabilitation training. For PRM trainees many educational documents are now available on the EBPRM website. A growing number of educational sessions for PRM trainees take place during international and national PRM Congresses which can be accessed at low cost. Educational papers published regularly in European rehabilitation journals and European PRM Schools are offered free or at very low cost to trainees.

The learning about imaging diagnosis technology

Objective To investigate the learning about management of the technology (efficient use, acquisition and maintenance of imaging diagnosis equipment) in the radiology residency program of Escola Paulista de Medicina - Universidade Federal de São Paulo, with a view to improving the education of radiologists. Materials and Methods Exploratory research where residents, faculty staff and tutors of the program were quantitative and qualitatively approached with Likert scale questionnaires (46), and deepening with recorded interviews (18) and categorization based upon meaning units (thematic analysis). Results Among the participants, 66% agreed that they had the opportunity of learning about the use of radiological equipment; for 61% the program should include knowledge on the importance of acquiring equipment; and 72% emphasized the lack of learning about equipment management and maintenance. Conclusion As the major moment in the education of specialists, the medical residency program provides residents with a favorable environment to the learning of the skills required to the future of their professional practice, but with limited emphasis on the management of the technology: efficient use, acquisition and mainly maintenance of equipment, still poorly explored. Both the investigated program and the medical residency in radiology should incorporate, whenever possible, the commitment with the training in supplementary skills related to equipment management, developing the competence of the future radiologists.

Dispositioefektin vaikutus yksityishenkilön rahastolunastuksissa

Tutkimuksen tarkoituksena on tutkia, käyttäytyvätkö suomalaiset rahastosijoittajat dispositioefektin mukaisesti realisoimalla mieluummin voitollisia kuin tappiollisia sijoituksia. Tutkimuksen kohteena ovat sijoittajien käyttäytyminen ja mandolliset sijoittajien psykologiset taipumukset ja käytösharhat. Aineistona on erään suomalaisen rahastoyhtiön henkilöasiakastietokanta vuosilta 2000 — 2007. Tutkimustulosten mukaan dispositioefekti ei ilmene niin selvästi rahastosijoittamisessa kuin suorissa osakesijoituksissa. Lääketieteellisessä rahastossa ei voida havaita viitteitä dispositioefektistä. Dispositioefekti havaitaan yhdistelmärahastossa sekä globaalissa osakerahastossa, mutta sen vaikutus näyttää häviävän tai jopa katoavan laskevilla markkinoilla. Verohyöty vaikuttaa euromääräisiin lunastuksiin joulukuussa vähentäen dispositioefektin ilmenemistä. Sijoituksen pitoajalla on selvä vaikutus sijoittajan saamiin tuottoihin. Sijoittajat näyttävät menettävän tuottoja pitämällä liian kauan tappiollisia sijoituksia ja realisoimalla liian nopeasti voitollisia sijoituksia. Kaikkien aikojen kurssihuiput markkinaindeksissä lisäävät lisäävät lunastuksia, kun taas kaikkien aikojen kurssipohjat vähentävät lunastuksia. Kuukauden takaisella kurssihuipulla tai notkolla näyttää olevan suurin merkitys lunastusten määrään

Nomenclatura na língua portuguesa em cromatografia multidimensional abrangente

Comprehensive Multidimensional Chromatography is a relatively new analytic technique, which is receiving growing attention in many parts of the world, including recently in Brazil. This work presents terms in Portuguese which are commonly used in Comprehensive Multidimensional Chromatography in order to help standardize the vocabulary employed in this area in the scientific literature. It also includes some symbols, their nominations, and explanation of some terms, whenever necessary. This proposal does not intend to be comprehensive or definitive; on the contrary, it intends to be a first step in the process of establishing a standardized nomenclature, serving as a base for a further sound discussion in the scientific community realm.

Perinnän tehokkuuteen vaikuttavat tekijät yritysten välisessä luottokaupassa

Tutkielma sai alkukipinän perinnän merkityksen korostumisesta yritysten välisessä luottokaupassa, tutkijan kiinnostuksesta aihetta kohtaan sekä tutkijan omasta perinnän alan työkokemuksesta. Tutkielma rakentui perinnän sekä luottokaupan käsitteiden ympärille ja sen tarkoituksena oli tutkia perinnän tehokkuuteen vaikuttavia tekijöitä. Tutkielmaa voidaan pitää käsiteanalyyttisena käsikirjamaisena teoksena, jonka empiirinen osio on toteutettu kvantitatiivisena tutkimuksena. Tutkielman teoreettisessa osassa tarkasteltiin ensin yleisellä tasolla perintäprosessiin liittyviä perinnän tehokkuuteen vaikuttavia tekijöitä, jonka jälkeen kvantitatiivisessa empiirisessä osiossa analysoitiin tutkielman kohdeyrityksen baltialaisten ja suomalaisten asiakasyritysten asiakaskohtaisten tekijöiden vaikutuksia perinnän tehokkuuteen. Tutkimuksessa havaittiin, että asiakasyritysten kotimaa sekä omavaraisuusaste vaikuttavat perinnän tehokkuuteen. Perintä oli tehottomampaa baltialaisilta asiakasyrityksiltä sekä asiakasyrityksiltä, joilla oli heikko omavaraisuusaste. Lisäksi havaittiin, että kohdeyrityksen eri toimialojen asiakasyritysten välillä oli eroja perinnän tehokkuudessa.