There are notable differences between the dominant Western medical model of health and the model of CAM, and looking at these differences may provide a greater understanding around doctors’ views towards CAM and its place in the wider health system. The purpose of this dissertation is to provide a systematic literature review into how doctors view complementary and alternative medicine, and to see if this has changed since the 1970s through to 2009. A systematic review of the literature was conducted, mainly using online original research Journal articles from medical databases. The internet was the main tool used in locating data, and literature was included or excluded based on relevance. This was evaluated on the relevance of time period, such as 1970, subject, such as chiropractic, or theme, such as attitudes of doctors to CAM. Literature from the 1970s was scarce on this research question, but this review noted a significant increase in literature on this topic since the 1990s, identifying this research area as a relatively new field of study, with much potential for further exploration into beliefs and attitudes of doctors towards CAM. Scientific research papers that were published highlighted a strong emphasis towards doctors’ requirement for further scientific research on the efficacy of CAM. Randomised controlled trials (RCTs) were the preferred method of testing; however this review also discusses appropriate methodology to test both CAM and doctors’ views and beliefs. The difference between the Western medical model and the CAM model highlights the differences between both concepts; from which this author provides a possible interpretation of doctors’ indifferent views towards CAM using the psychological theory of cognitive dissonance (Festinger, 1957). This theory suggests that a person cannot hold two conflicting beliefs simultaneously, without the presence of cognitive ‘dissonance.’ “The existence of dissonance, being psychologically uncomfortable, will motivate the person to try to reduce the dissonance and achieve consonance” (Festinger, 3: 1957). This systematic review then provides a discussion around how this could explain doctors’ views towards CAM. . This then leads to the question of whether ‘successful integration of Western medicine and CAM is therefore possible’? The systematic review concludes with the highlighting of important issues in regard to the study design and methodology on effectively testing CAM, and on effectively testing doctors’ beliefs: also, the issues around integration and further scientific literature on CAM in a bid to potentially reduce the ‘moderate tone of answering’ that is reported in the literature in regard to doctors’ views towards CAM.

Background: In South Africa there data is lacking on the health of the older population. This study aims to report on actions taken by general practitioners on abnormal blood pressure, blood glucose and osteoporosis screen identified by registered nurses, conducting home based visits to older clients. Methods An agency piloted the Comprehensive geriatric assessment (CGA) tool in an urban affluent population. In this cross sectional secondary study analysis, 465 participants aged 60 years and over had a nurse visit in their homes and a subsequent General Practitioner (GP) visit. The prevalence of specific geriatric problems was assessed as well as the frequency of initiated procedures by the GP. This study will focus on initiated actions by the General Practitioners in response to abnormal blood pressures, blood glucose, and osteoporosis screen. Results Frequency tables were utilised to identify prevalence of the abnormal blood pressures, blood glucose and osteoporosis screen. . Abnormal blood pressures were detected (230/465, 49%) of the subjects , the GP initiated actions on only 15/465 (3.2%) of clients. Abnormal blood sugars were detected 106/465 (23%) of the GP initiated actions on 23/465 (5%) of clients. Clinical risk factors for the development of osteoporosis were detected in 252 /465 (54%) subjects GP initiated actions on 11/465 (3%) Conclusion This study explored the relationships between comprehensive geriatric assessment and subsequent GP actions and found using the CGA in this population will be successful in identifying abnormal health findings which will enable intervention. However, due to challenges in the communications and marketing of this service, GP’s were not well informed of their role and did not act on majority of the abnormal findings detected by nurses / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

The purpose of this study was to examine the controversial personage of Dr. Josef Mengele, who was the chief physician of the Third Reich's Polish extermination camp, Auschwitz-Birkenau. Until very nearly the completion of this project, virtually no scholarly research had been conducted pertaining to Mengele's life, and therefore, the value of this inquiry is easily discernable. After forty years of eluding Israeli assassins and Nazi hunters, principally in several South American countries, Mengele's alleged remains were discovered, and subsequently exhumed for forensic analysis, near Sao Paulo, Brazil, in early June 1985. In the aftermath of intensive forensic examination, performed by an international team of experts, which included American, West German, and Brazilian scientists, the skeletal remains were pronounced to be those of Mengele within a reasonable scientific certainty. Skeptics not only had misgivings about the initial reports of Mengele's death, but also questioned the veracity of the preliminary medical report, pointing to both errors of omission and commission contained in the report's findings. Despite additional dental evidence discovered nearly one year after the disinterment of the Brazilian remains, which incidentally provided positive identification of the remains as those of Mengele, skeptics continued to discount the expert's opinions and resumed the search for Mengele with renewed vigor. It was concluded that the Brazilian remains were indeed those of Mengele. While the uncertainty over Mengele's apparent death has been resolved, it is recommended that further research be conducted into Mengele's pre-war life, as well as his clandestine post-war existence.

Nationally, physicians have been slow to adapt to the use of the Internet as a tool of communication for the business of medicine. To understand the reasons for this and to determine if physicians in Indiana follow this national trend, a Q analysis was used to measure their attitudes toward the Internet. Q analysis allowed the researcher to quantify subjectivity.This study focused on physicians who are members of the Indiana State Medical Association, an organization representing nearly 8,000 of the state's doctors. Physicians were of different race, sex, age, specialty and geographic location as to be representative of Indiana physicians.For this study, twenty-eight physicians ranked a series of forty-eight statements along a bipolar continuum called a Q sort. Each subject was asked to rate the forty-eight statements on a nine-point most agree (+4) and least agreed (-4) scale.Analysis of the twenty-eight Q sorts collected for this study provided three factor types. Those who comprised Factor I were labeled the "Futurists." The view that emerged from this group was that the Internet is seeping into every facet of the American health experience and will change the business of medicine. The highest number of physicians fell into Factor 2. This group comprised 39 percent of the participants. Factor 2, named the "Skeptics," showed interest in the Internet along with many concerns. Those physicians from Factor 3 strongly disagree that the health care system is behind the times in the information revolution. Named "Easy Navigators," physicians in this group responded that they effortlessly find their way around the Internet. Analysis suggests Indiana physician attitudes toward the Internet are concurrent with those nationally. / Department of Journalism

The timely communication and access to a complete history of lab results is at the heart of patient diagnosis, monitoring, and treatment planning. When lab results are effectively shared, in a manner conducive to family physician processes and systems, the business and clinical processes are improved, with possible value to the care of the patient. Current lab result sharing occurs through disparate and often proprietary one-to-one connections, often non-electronically, making integration of results difficult. There is broad value in coordinating efforts and consolidating processes across organizations, through electronic health record solutions. Referencing the published literature, this paper evaluates the local context of Waterloo-Wellington counties in southwestern Ontario, stakeholders, and processes, and describes the applicable standards and existing solutions. Recommendations are made for how to progress towards interoperable lab result sharing with family physicians.

The General Medical Council has emphasised the importance of teaching communication skills to medical undergraduates. A two year follow-up study was undertaken, therefore, to assess the possible short-term and long-term benefits of the participation of cancer patients in communication skills training. Two hundred and forty nine third year students in the academic years 1992-1993 and 1993-94 received communication skills training (9 hours) in small groups: half the students were taught with patients who had cancer and the other half with patients who had another diagnosis. Each student was required to make a videotaped interview. These recorded interviews were evaluated by a trained rater. In addition, students completed a pre-course and post-course Attitude Questionnaire to assess their knowledge of and attitudes toward cancer and its management. Of the 1992-93 cohort of third year students, a sample of 54 students participated in the follow-up evaluation in fifth year. Fifty four Attitude Questionnaires were satisfactorily completed. All of the 54 students made a videotaped interview with a gynaecological cancer patient in a standardised setting. Each interview was rated independently by two raters. Analyses of the third year video recordings revealed differences in interview performance between the two groups. Following the course, between-group analyses and with-in group analyses identified various attitudinal differences. Analyses of the fifth year video recordings revealed that the interview performance of both groups had improved since their third year. However, those students originally taught with cancer patients were more likely to assess the impact of the symptoms on the patient's life. In addition, between-group and within-group analyses of the attitudinal data showed that both groups had retained positive attitudes with regard to the psychosocial aspects of cancer. These findings have implications for training medical undergraduates in communication skills.

This study seeks to understand how collaborative information communication technologies (cICT) are used to support knowledge translation and optimize physician’s roles in chronic pain management. A survey was developed and distributed to 170 physicians in two chronic pain mentoring networks in Ontario and Nova Scotia. With a response rate of 74.1% the study identified the use of a broad variety of cICTs; with email as the most used. A majority of respondents (85.0%) used email to support discussions and 69.8% found it to be valuable in learning about chronic pain management. A higher frequency of email (adjusted OR=10.70, 95% CI: 2.84-40.33) and number of cICTs (adjusted OR=2.93, 95% CI: 1.19-7.21) used to communicate in the networks were associated with more interactions. These results highlight how cICTs can support the interactions and learning that are part of the knowledge translation process in optimizing the roles of physicians in chronic pain management.

This study seeks to understand how collaborative information communication technologies (cICT) are used to support knowledge translation and optimize physician’s roles in chronic pain management. A survey was developed and distributed to 170 physicians in two chronic pain mentoring networks in Ontario and Nova Scotia. With a response rate of 74.1% the study identified the use of a broad variety of cICTs; with email as the most used. A majority of respondents (85.0%) used email to support discussions and 69.8% found it to be valuable in learning about chronic pain management. A higher frequency of email (adjusted OR=10.70, 95% CI: 2.84-40.33) and number of cICTs (adjusted OR=2.93, 95% CI: 1.19-7.21) used to communicate in the networks were associated with more interactions. These results highlight how cICTs can support the interactions and learning that are part of the knowledge translation process in optimizing the roles of physicians in chronic pain management.

Self-regulation capacity allows individuals to manage their thoughts, feelings, and actions to attain personal goals (e.g., well-being and performance), as well as adjust to their changing social and physical environment (Zimmerman, 2000). Self-regulation as a positive adaptive skill and process has not been examined in relation to well-being in the context of medicine. The purpose of the current study was to examine self-regulation with 37 medical students and 25 supervising physicians to determine whether or not it may enhance well-being and performance, and reduce stress and burnout. A mixed-methods design was used to collect and analyze the data, and findings from the quantitative and qualitative phases were presented in two separate articles. Self-regulation capacity appears to be an important skill that may help both physicians and medical students to meet the demands of the medical profession and maintain an adequate level of well-being and performance in their work and daily life.

The provision of medical care to top-level athletes in New Zealand comes with a number of challenging ethical issues. Some of these arise out of the commercial interest present in sport that links sporting success with funding, sponsorship deals and media interest. The requirement that athletes stay at peak physical function in order to be successful can, at times, be at odds with concepts of well-being and good health. The employment structure under which doctors are engaged by teams and the employment contracts which define these relationships can be the source of divided loyalty for doctors. For example, sharing health information beyond the doctor-athlete relationship may be in line with contractual obligations, but at odds with what the athlete requests. Divided loyalties also exist when athletes wish to participate in sport despite high risk of harm. Here there is a difference between what the doctor understands as the athlete�s best interest, and the athlete�s consideration of best interest. This thesis adopts two strategies for examining the area of sports medicine in elite athletes in New Zealand. The first section utilizes qualitative research. Sixteen sports doctors were interviewed and the data analysed. The next section involves normative reflection. Here two issues (where a range of behaviours were exhibited by participants) selected from the data are considered and discussion is presented on how doctors should respond to these issues. An examination of the level of guidance offered to sports doctors from the Australasian College of Sports Physician�s Code of Ethics follows. The level of guidance offered is considered inadequate and the thesis ends with a call to attend to these concerns.