MedGenMed : Medscape general medicine
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The purpose of this article is to discuss an evidence-based algorithm that can be implemented by the primary care physician in his/her daily clinical practice for the treatment of patients with neuropathic pain conditions. ⋯ Patients presenting with neuropathic pain are becoming a more frequent occurrence for the primary care physician as the population ages. Evidence-based treatment options allow for the most efficient and effective pharmacotherapy regimen to be implemented.
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The World Health Organization (WHO) can be considered the primary agency of the United Nations that promotes global public health. This article provides a general overview of WHO by exploring the history, current, and future practices of the organization, and by addressing its major roles and functions in the present day. ⋯ Srimathy Vijayan is a fourth-year medical student at the University of East Anglia, Norwich, United Kingdom. She interned at the WHO headquarters in Geneva during the summer of 2007.
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Consumer-directed health information resources hold great potential for improving public health and easing the demand on health systems. Their value, however, depends largely on the ability of their intended users to access and use them effectively. Little is known about whether British Columbia's ethnocultural communities are using the British Columbia (BC) Ministry of Health's BC HealthGuide (BCHG) program, and if so, when and for what purposes they use the services, as well as level of satisfaction with and users' perceptions of the resources. This study investigated attitudes toward and perceptions of the BCHG program, as well as use patterns and satisfaction levels, within the Iranian community of the Greater Vancouver Area (GVA)--among BC's largest and fastest-growing Middle Eastern immigrant communities--and explored a model for introducing the BCHG program to ethnic communities in the GVA and BC. ⋯ The findings of this study strongly suggest that Iranians living in the GVA are open to alternatives to routine healthcare services, including the use of preventive and self-care resources. However, awareness levels and utilization rates of the BCHG program among the GVA's Iranian immigrant population have until now been low. The noticeable and sustained improvement to attitudes, perceptions, and self-reported utilization rates of the BCHG program among Iranian participants in this study after watching culturally appropriate promotional videos indicates the potential to modify cultural beliefs in regard to the delivery of preventive health information if the relevant messages are delivered appropriately. By carefully considering the demographic and cultural characteristics of the various ethnic communities living in BC, and by targeting promotional activities and services directly to these individual communities, the BCHG program could improve awareness and utilization rates within these communities.
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Many chaplains and most chaplaincy programs in the United States--with encouragement from their accrediting organization, the Association for Clinical Pastoral Education (ACPE)--have begun to assume a more proactive stance toward patients, healthcare professionals, and healthcare facilities. Some chaplains and chaplaincy programs have begun to engage in activities that have ranged from initiating conversations with and perusing the medical records of patients who have not requested their services to proposing that they be permitted to do "spiritual assessments" on patients--in some instances whether these patients have been explicitly informed and have agreed to this beforehand. ⋯ It would appear that such novel activities are being justified by a questionable set of claims and assumptions that includes: (1) the claim that chaplains have a spiritual--as opposed to purely religious--expertise that entitles them to interact with patients and/or significant others (even those who have not requested a chaplain)--presumably without in the least compromising patient autonomy or the confidentiality of the patient/healthcare professional relationship; (2) the assumption that the terms "spirituality" and "religiosity" mutually entail one another; (3) the claim that the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) mandates "spiritual assessments" (which it does not); (4) the assumption that chaplains are full-fledged members of the healthcare team; and (5) the claim that chaplains must, therefore, be permitted access to patients and patients' medical records both to gather information and to make notations of their own. We consider such claims and assumptions disquieting, and suggest that it is high time we revisit the terms "chaplaincy," "healthcare professional," and "member of the healthcare team" in reassessing what our professional commitments to respect and protect the bio-psycho-social integrity of patients require.