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Cryptorchidism, also known as undescended testis, affects 3–5% of full term male infants at birth and 23% of preterm or low birth weight infants. Current guidelines recommend that all boys with cryptorchidism without testicular descent by 6 months of age be referred to an appropriate specialist for evaluation, with surgery preferably performed by 18 months. We aim to examine areas of controversy still being debated by reviewing published articles, in order to provide primary providers with a practical guide to diagnosis and management of the undescended testis. Our review examined published articles from 2000 to 2018, related to undescended testes, and their management. 32 articles were reviewed from 2000 to 2018 and showed with a high level of evidence that failure of testicular descent by 6 months of age (gestational) should prompt referral to an appropriate specialist. Physical exam is crucial. The main concerns for patients with cryptorchidism are the increased risk of testicular cancer and sub fertility. Routine use of scrotal ultrasound is not recommended in the evaluation of cryptorchidism. Diagnostic laparoscopy serves to confirm the presence of an intra-abdominal testicle. Surgical intervention within 18 months of age is imperative. Cryptorchidism should be corrected surgically between 6 months and 18 months of age. Early detection with diagnostic laparoscopy is the standard of care for treatment of palpable, undescended testis.
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The purpose of the article is to present the results of testing the emotional intelligence of the future physicians who tend to hide professional mistakes. The article is based on the study involving 129 students who are studying in the specialties “Medical business”, “Medical psychology”, “Pediatrics”, “Dentistry” at the medical-psychological, dental and medical faculties of the O.O. Bohomolets National Medical University. During the study, the following methods were used: 1) The Error-Oriented Motivation Scale (EOMS) in order to measure a tendency to hide professional mistakes; 2) The Emotional Intelligence Scale in order to determine the level of emotional intelligence. Statistical processing of the study results was performed using 1) descriptive statistics (percentages, arithmetic means, standard deviations); 2) Student’s T-test to compare the emotional intelligence level in the groups of future physicians with different levels of propensity to hide professional mistakes. The study has found that a significant number of future physicians (53.5%) showed a tendency to hide their professional mistakes. The respondents in this group are characterized with low and medium levels of emotional intelligence compared to future physicians who strive to learn from their mistakes. This study has demonstrated that the vast majority of future physicians believe that professional errors should be hidden, which, in turn, does not contribute to their professional development; the future physicians who tend to hide professional mistakes have low levels of emotional awareness, ability to manage one’s emotions, self-motivation, empathy, ability to manage other people’s emotions. The development of emotional intelligence would apparently contribute to a more conscious attitude of future physicians to professional activities as well as more common-sense attitude to mistakes, and this poses new challenges for medical education to form emotional intelligence of future medical professionals.
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Content available Etyka w pracy przedstawiciela medycznego
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Over the last few years, the pharmaceutical industry intensified marketing activity in Poland. One of the most important ways of promotion are visits by pharmaceutical sales representatives in physicians’ offices. Representatives during those meetings are using different sorts of tactics to manipulate physicians such as: gift-giving, free meals, travel subsidies, “fake” research, ‘white Saturdays’, sponsored teaching and conferences. An ethical ambiguity can be easily find in this work. The paper describes briefly the results of the research concerning the influence of the relationship between physicians with the pharmaceutical companies on prescribing habits which were conducted in other countries. The article presents law regulations and ethical codes present in Poland, but it concentrate on describing the results of 31 in-depth interviews with pharmaceutical sales representatives conducted between the June – November 2007. The main aim of this paper is to show how important are ethical and law standards for the pharmaceutical sales representative. Do they know it? Does companies take care about proper training and information in the area for their employees? Work ethics of the pharmaceutical sales representative is very important, and should be discussed. Drugs are special kind of goods which can influence people health and sometimes even lives so we should pay attention to the ways medicaments are advertise and promote.
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This paper attempts an overview on the ethical issues of pharmaceutical industry gift-giving in the United States of America. The article shows that law is not the only way in which the relationship between physicians and pharmaceutical industry can be regulated. Most important professional associations of physicians, pharmacists, residents etc. consider industry gifts as a conflict of interest. They created different ethical guidelines for this complicated issue. The paper demonstrates various solutions of ethical matters in the relationship between physicians and pharmaceutical industry by analyzing codes and guidelines of different associations. On the one hand it shows organizations which allow exchanging of gifts of no value. On the other hand it presents associations that forbid physicians accepting even a pen. The article also shows various attitudes of these associations to situations like inviting physicians to dinner, accepting drug samples, taking subsidies from the company to defray the cost of the conference etc. The problem of those relations has been neglected for long time. From society’s point of view it is important for physicians to be informed about the rules and ways that pharmaceutical companies try to influence physicians’ prescription habits.
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Background. Antimicrobial resistance is an emerging problem worldwide, having a negative influence on patient outcomes. As compared to high and upper middle-income countries, the condition is miserable in low- and middle-income countries, including Pakistan. Objectives. This study aims to assess the perception of physicians concerning antibiotic use and resistance, the factors influencing the prescription of antibiotics and interventions to improve the prescribing behavior in Pakistan. Material and methods. A cross-sectional survey was performed among physicians practicing in different hospitals of Lahore, Pakistan. A 60-item survey instrument was developed in consultation with a group of experts after a literature review of previous comparable studies. The questionnaire was distributed to physicians practicing in different healthcare settings of Lahore, Pakistan. Results. A total population of 200 physicians filled in the questionnaire, with a response rate of 72.7%. The majority of physicians were younger (n = 124, 62%), with an age group of 23–29 years. Most of the physicians reported that antibiotics are overused nationally (n = 190, 95%). However, they did not always agree that antibiotics are overused in their own institutions. A majority of physicians believed that strong knowledge of antibiotics is important in their career (n = 184, 92%). Of the total, 176 (88%) physicians believed that inappropriate use of antibiotics is professionally unethical. Conclusions. Our findings showed that physicians are well aware of the importance of antibiotic resistance and reported that rational use of antibiotics will aid in resolving this issue. Therefore, the introduction of educational sessions regarding antibiotic use and its resistance and innovative approaches to attract healthcare practitioners’ attention towards antibiotic stewardship programs are urgently needed
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Within last twenty years in the European Union much regulation concerning advertisements of drugs changed. The aggressive marketing operations of producers of medicines caused that new solutions, not only legal but also ethical, had appeared. The European Union is imposing reliable solutions upon its members in the form of directives to which they must adapt their law. They can however decide to choose stricter law than the one which is recommended to them. The European Federation of Pharmaceutical Industry and Associations – voluntary organization consisting associations of pharmaceutical companies from lots of countries is acting on similar principles. Each of the members belonging to it can implement its own, more restrictive regulation in the national ethical code than a Federation is ordering. Main purpose of this article is reading what legal and ethical solutions of pharmaceutical marketing were accepted in selected countries of the European Union. Whether they are stricter than the ones imposed upon them by European Union? How in this background Polish regulations are looking like? In the article also examples of the law-breaking and ethical principles by producers of medicines in the European Union will be presented. It will show sanctions taken out towards them for this reason. A question will be put: are various penalties able effectively to scare the pharmaceutical industry off the unethical or even unlawful advertising?
EN
This article demonstrates that journalists and their publications influenced the rise of ethical standards of pharmaceutical marketing in Poland. Nowadays media perform a substantial role in creating and changing reality. In this article, investigations of Polish journalists concerning the relation of doctors with medical sales representatives are described. The author analyses Polish pharmaceutical law and existence of the self-regulation of ethical organizations of pharmaceutical companies and of doctors in Poland. It also presents the results of in-depth interviews with medical sales representatives and shows their opinion whether journalistic investigations and other disapproving publications in the media influenced their work and the functioning of their company. Before reporters started revealing possible reservations about the cooperation of physicians with industry representatives, this subject was largely neglected. Published press reports caused further examinations, and often led to the arrest of persons associated with corruption. It is possible that first journalistic, and then prosecutor’s investigations sharpened the the Polish pharmaceutical law of 2007.
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Background. Some studies on the decision of patients to choose their primary healthcare physician demonstrate that the ability to choose their physician is associated with increased patient satisfaction, confidence in the doctor and quality healthcare. Objectives. The study was aimed at evaluating factors effecting the decision to change the family physician. Material and methods. In the study, a questionnaire was used to examine the socio-demographic characteristics of the individuals, and the EUROPEP scale was used to measure the satisfaction with primary health services. Moreover, the Individual Innovativeness Scale was used in order to evaluate the innovativeness of individuals. Results. In people who apply to change their family physician, satisfaction with the previous family physician was found to be 69%. Distance (52.7%), education (25.8%) and gender (16%) were declared as the most important reasons to change the family physician. An individual’s innovation seeking behavior did not affect on their decisions to change the physician. Conclusions. In the present study, patient satisfaction was lower than the results reported in previous studies. Distance, education and gender are at the forefront in family physician preference. Patients prioritize receiving service from trained family physicians. These issues should be taken into account while planning the future of family practice.
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Introduction. Patient satisfaction surveys are still popular tools for obtaining feedback on the quality of health care. Nonetheless, there is a paucity of data to indicate whether health care providers even want patients to assess the quality of care delivered. Neither it is certain whether patients are interested in participating in such surveys. Aim. To present and compare the perspectives of doctors, nurses, and patients on the validity of health care customer satisfaction surveys. Material and methods. A cross-sectional survey design was used. The questionnaires were administered to doctors, nurses and patients in three hospitals of different sizes (small, medium, and large), all in the north-east of Poland. Each sample group was given 200 questionnaires; responses were received from 95 doctors (47.5%), 190 nurses (95%), and 182 patients (91%), and included in the final analyses. Results. Most respondents (doctors - 64.2%; nurses - 61.6%; patients - 87.4%) answered ‘Yes’ to the question ‘Do you think that patients should evaluate the quality of health care?’ Analysis of data allowed to identify the following main reasons why patients should evaluate the quality of health care: 1. to enhance the quality of care; 2. to recognise patients as evaluators; 3. to motivate providers to work more efficiently; and 4. to emphasise the impact of evaluation on a core value, i.e. health. Doctors and nurses outlined reasons why they did not advocate conducting patient satisfaction surveys: satisfaction surveys are redundant; negative evaluations; unwillingness to be evaluated by patients; satisfaction surveys hamper effective work with patients; surveys are not objective; survey results are not communicated to providers. Conclusions. Patient satisfaction surveys are desirable tools for evaluating the quality of health care delivery despite the fact that they frequently raise concerns amongst providers and patients. There is, therefore, a definite need for providers to experience the benefits of measuring patient satisfaction. Another important practical implication is that patients need to be convinced that their opinions do matter and contribute to improving the quality of services.
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Payable medical services and other separate (non-therapeutic) activity of independent public health care institution can be classified as business activity, if they are provided as an organized, ongoing and for-profit activity (Article 4, para. 1 of the Act on Freedom of Economic Activity). Therefore, running by the Deputy of an independent health care institution, carrying out operations with the use of state or municipal property, may violate Article 34 para. 1 of the Act on the Exercise of the Mandate of a Deputy or Senator.
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Content available remote Disorder and Civilization: The Future(s) of Ukrainian Medicine
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Post-socialist societies are full of uncertainty, fragmentation, and competing discourses on social justice [Steinberg and Wanner 2008; Zigon 2011]. This article focuses on how Ukrainian physicians envision the future, present, and past of the health-care system and make sense of social change in their professional lives and society more broadly. The Ukrainian healthcare system has remained largely untouched by post-socialist reforms, but it is nevertheless undergoing profound changes. These changes are occurring on the level of everyday practice and are shifting responsibility away from the state and onto the individual. The author traces how physicians navigate the persisting structures of the old system, and what hopes they carry for the present and the future. Post-socialist health care is bursting with competing interests, commitments, and notions of how health-care providers should relate to each other, their patients, administrations, and the state in general. This article therefore draws on physicians’ narratives of the disorder in health care through the interpretive prism of ‘ruination … as a process that weighs on the future and shapes the present’ and that represents a ‘vital reconfi guration’ [Stoler 2008: 194] or crafting of ‘hope’ [Lindquist 2006].
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In their daily work, medical professionals often encounter emotionally and mentally challenging situations, such as sudden health deterioration or death of their patients. The concern to ensure the highest possible level of healthcare and meet all the standards despite the limitations that come with working under the pressure of time, the interactions with other individuals, the physical burden and stress, as well as with the (sometimes limited) support from superiors and lack of satisfaction with salary may, as a result, translate into a higher risk of burnout. Research indicates a potential effectiveness of coaching with respect to medical personnel. However, there are no publications available concerning nurse-oriented coaching, which would be intended to reduce the risk of burnout in this professional group. The objective of this paper is to present coaching as a method that makes it possible to reduce the risk related to burnout in medical professionals.
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Introduction. Initially, a transplant coordinator assisted in the process of removal and transplantation of organs. The most important rule in the Polish legislation is the Act of July 17th, 2009, amending the Act on removal, preservation, and transplantation of cells, tissues, and organs. Professional qualifications of a transplant coordinator are specified by the Regulation of the Minister of Health of December 4th, 2009 on detailed conditions of removal, preservation, and transplantation of cells, tissues, and organs. Aim. The study aimed to assess the knowledge of medical personnel about the function of a transplant coordinator with reference to the current Polish legislation. Material and methods. The study was conducted in April 2013 among 100 selected health professionals (25 physicians, 62 nurses, and 13 persons representing other medical professions) with the use of a questionnaire comprising 42 close-ended simple choice questions and one multiple-choice question. They were referring to various aspects associated with the legal axiology of transplantation, procedure of organ donation, and tasks of a donation coordinator, as well as one open-ended question about the age of respondents. Results. Statistically significant differences between the occupational groups were found in relation to questions about legal and medical aspects. As many as 21 nurses (34%), 26 physicians (92%), and 6 persons representing other medical professions (46%) (p<0.000) provided the correct answer to a question referring to determination of death, and 19 nurses (31%), 7 physicians (28%), and 5 persons representing other medical professions (p<0.021) answered correctly to a question about the key premise to determine brain death. Conclusions. 1. The knowledge of medical personnel about the function of a transplant coordinator and the legal provisions concerning brain death determination needs to be supplemented. 2. There is a need of constantly supplementing knowledge of medical personnel about the clinical aspects of transplantation
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Content available remote Ekonomie nemoci a milosrdenství ve středověku
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The study focuses on the relation of the medieval person to illness and physicians, particularly taking into account the economic accessibility of treatment and the overall social dimension of the issue. It first deal with the costs for medical care and the different treatment methods, which considered the social position of the patient. It further also introduces the possibility of community, care in spittal fields, and last but not least also the influence of magical practices and faith in the miraculous abilities of the saints.
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