Background: Many faculties of medicine now include programmes using early clinical exposure (ECE) to introduce medical students to important topics in medicine. Objective: To sketch the landscape of ECE in Europe, describing existing courses. Methods: A survey questionnaire was developed by the Basic Medical Education Committee of the European Academy of Teachers in General Practice (EURACT). This survey used the key informant interviews method, with EURACT Council members serving as key informants by filling in the questionnaire and gathering descriptive data on ECE programmes in their own countries. Results: We asked representatives of 32 EURACT member countries to complete the questionnaire in 2006. We received responses from 21 countries, and the programmes of 40 medical schools from 16 countries were included in the study. Thirty-two medical schools implemented ECE starting in the first year. The duration of ECE programmes ranged from 2 weeks to 2 years. The length of each session varied from 2 hours to a full day. Primary care played an important role in ECE. ECE programmes were implemented with a wide range of objectives.Conclusion: ECE is a new and rewarding trend in European medical schools, and general practice/family medicine (GP/FM) departments are widely involved in these teaching activities. This could help establish GP/FM departments in some countries that still do not have them in their medical schools.
This elicitation study shed light into GPs' beliefs regarding prescribing. Factors that are not common in the usual European setting were revealed, such as the influence of the patients' family and special situations during prescribing. Thus, various issues were highlighted that should inform the development of items for inclusion in a forthcoming TPB-based questionnaire. The results of this study revealed also certain issues that can affect the design of policies aiming at the rationalization of prescribing.
Background: Family Medicine/General Practice (FM/GP) has not developed in a similar way worldwide. In countries that are not primary care oriented, the discipline of FM/GP may be less developed because this is not a career option for medical graduates. In such a situation, FM/GP will not be regarded as a required clinical experience during medical school. Objectives: To defi ne the ' minimal requirements ' or ' minimal core content ' for a clerkship in FM/GP of very short duration, i.e. a basic curriculum for a clinical rotation in FM/GP, taking into account that in some European countries the time allocated for this rotation may not exceed one week. Method: The Delphi method was used. The study group was composed of 40 family physicians and medical educators who act as national representatives of all European countries -plus Israelin the Council of the European Academy of Teachers in General Practice and Family Medicine (EURACT). The representatives are elected among the EURACT members in their country. Results: After three Delphi rounds we obtained a consensual list of 15 themes regarded by the respondents as the most important to be included in a minimal core curriculum for FM/GP in undergraduate medical education. Conclusion:This list may be useful for teachers and institutions that are about to introduce GP/FM as a new topic in their medical faculty, having only limited time available for the course. They will be able to focus on topics chosen by a European expert panel as being the most important in such a situation.
Dual-energy X-ray absorptiometry (DXA), the "gold standard" for diagnosis of osteoporosis, is not recommended for population screening, and thus quantitative ultrasound (QUS) of the calcaneus is gaining popularity. The aim of the present study was to evaluate the relationship between QUS values and anthropometric and lifestyle factors, and to assess the diagnostic performance of QUS in predicting DXA-defined osteoporosis. Eight hundred and thirty-two women and 87 men aged 40-88 years were included in the study. Anthropometric measurements, the questionnaire, and QUS and DXA measurements were performed by trained physicians. Both QUS and DXA T-scores were lower for women than for men. Postmenopausal women had significantly lower QUS T-scores compared to premenopausal women (P < 0.001). Age over 50, female sex, sedentary lifestyle, fracture history, presence of chronic disease, and > or =5 years since menopause were associated with QUS T-scores lower than -1.00 by multivariate analysis. Low QUS T-scores were related to lack of direct sun exposure, high parity, fair skin color, and no education by univariate analysis (P < 0.005). A weak correlation was found between calcaneal QUS and DXA T-scores at lumbar spine (r = 0.310, P < 0.001) and femoral neck (r = 0.288, P < 0.001). The sensitivity and specificity of the QUS test were 73.7% and 57.4%, respectively, regarding the identification of osteoporotic patients. Lower QUS T-scores were associated with several osteoporotic risk factors, and the sensitivity and specificity of QUS for predicting DXA-defined osteoporosis were at optimum values at ages between 50 and 59 years. We conclude that, even though the accuracy of QUS for predicting DXA-defined osteoporosis is not remarkably high, it can be applied to identify subjects at risk in this age group in developing countries and rural districts who should be the focus of fracture prevention.
Background: Hypertension is an important public health problem, with some variability of its epidemiological properties in different populations. Objectives: The purpose of this study was to estimate the prevalence of hypertension and to determine the hypertension awareness, treatment and control rates in Aydın, a Turkish province. Methods: Of 1600 coincidentally selected people aged over 18 years in Aydın, 1480 (92.5%) had their blood pressure (BP) measured and answered a standard questionnaire in 1995. Results: Estimates of the prevalence of hypertension and its control were computed using two different criteria to define hypertension: BP у140/90 mm Hg or on treatment and BP у160/95 mm Hg or on treatment. Overall, the estimated prevalence of hypertension was 29.6%
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