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See detailLe concept de prévention quaternaire et la responsabilité sociétale des facultés de médecine.
Jamoulle, Marc ULiege; La Valle, Ricardo

in Cauli, M; Ladner, J; Boelen, C (Eds.) Dictionnaire francophone de responsabilité sociale en santé (2019)

La prévention organisée sur la maladie La prévention a d’abord été affaire de commerce. Il fallait transporter les biens sans les maladies . La prévention clinique ou prévention médicalisée est une ... [more ▼]

La prévention organisée sur la maladie La prévention a d’abord été affaire de commerce. Il fallait transporter les biens sans les maladies . La prévention clinique ou prévention médicalisée est une création de la moitié du 20eme siècle. Les termes de prévention primaire, secondaire et tertiaire ont été proposés par Leavell et Clark dans les années 50 à partir des phases de la Syphilis et sont devenus un standard dans le monde de la santé publique . Dans cette perspective, le patient est l'objet de procédures de soins le long de la ligne de temps. La maladie est au centre de l’organisation. Le terme prévention primaire est utilisé avant qu’un problème ne se pose. La place de la prévention secondaire n'est pas claire. Les cardiologues utilisent ce terme en tant que prévention après un événement, ce qui est en réalité la prévention tertiaire. Cette vision chronologique a incité Bury à utiliser le concept de prévention quaternaire pour définir les soins palliatifs . Toujours dans les années 50 les combats entre les industries du beurre, de la margarine et du sucre aux USA font émerger, après la découverte d’un nouveau processus rapide de fabrication de la margarine , la notion de facteur de risque et celle de prévention du risque cardiovasculaire. Le marché pharmaceutique y trouve une extension fantastique . La prévention organisée selon la relation Nous avons proposé une vision relationnelle de la prévention. Notre modèle, conçu en 1986, est construit sur un tableau à double entrée, sous influence de Illitch , Balint ou McWinney. La prévention y est résultante des relations entre patient et médecin au long du temps. Le croisement entre science et conscience délimite quatre nébuleuses, traduisant la limite floue entre santé et maladie. Cependant, dans la pratique au jour le jour, la distinction est utilisée et on représente quatre domaines d'activité. La ligne du temps y traverse la table en oblique. Patients et médecins se retrouvent à la fin et meurent ensemble (point Ω) (voir Figure 1) [less ▲]

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See detailImplications éthiques, pédagogiques, socio-politiques et anthropologiques de la prévention quaternaire
Jamoulle, Marc ULiege; Roland, Michel; Bae, Jong-Myon et al

in Revue Médicale de Bruxelles (2018), 39

The concept of quaternary prevention, resulting from a reflection on the doctor-patient relationship, is presented as a renewal of the age-old ethical requirement: first, a doctor must do no harm; second ... [more ▼]

The concept of quaternary prevention, resulting from a reflection on the doctor-patient relationship, is presented as a renewal of the age-old ethical requirement: first, a doctor must do no harm; second, the doctor must control himself/herself. The origin of the concept, its endorsement by the World Organization of Family Doctors (WONCA) and the European Union of General Practitioners (UEMO), its dissemination, and the debates to which it has given rise, are presented by a panel of authors from 10 countries. This collective text deals more specifically with : the ethics of prevention, the importance of teaching Quaternary prevention and Evidence Based Medicine, the social and political implications of the concept of Quaternary prevention, and its anthropological dimensions. [less ▲]

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See detailRound table. Quaternary Prevention(P4) or first do not harm.
Jamoulle, Marc ULiege; Widmer, Daniel; La Valle, Ricardo et al

Conference (2017, September 09)

Quaternary prevention (P4), born from a reflection on the doctor-patient relationship, began as an answer of family doctors facing overmedicalization. It aims to protect the patient or population against ... [more ▼]

Quaternary prevention (P4), born from a reflection on the doctor-patient relationship, began as an answer of family doctors facing overmedicalization. It aims to protect the patient or population against the danger of medicine. Harmful effects can appear with preventive activities (example: prostate cancer screening by PSA) as well as by therapeutic interventions (example: disruptive medicine). P4 promoted by the World Organization of Family Doctors (WONCA) is practiced in different ways around the world through the activity of the WONCA Special Interest Group on Quaternary Prevention and Overmedicalisation (P4&O). There are multiple initiatives and backgrounds of P4. All these multiple initiatives that lead to P4 have their origin in denouncing the inadequacies of the Hegemonic Medical Model and the excesses perpetrated in the pursuit of profit. There are many schools of thought that try to solve this situation, such as "Medicines Based on ..." These contributions are valuable but usually point to a single dimension of the problem so they do not change the situation too much. The P4, however, have understood the centrality of the political and economic dimensions and, that is why, P4 has become a movement. P4 has understood that the root causes far exceed the limits of medicine, have understood that the problem includes ethical, political, economic and epistemological aspects of medicine. It is for this reason that the definition of P4 has shifted to the function of foundational idea since the movement that has been generated around this concept has surpassed this initial definition centered in a, yet complex, but still medical vision. P4 has understood that a new model of medicine and a new pact with society is necessary. P4 is a counter-hegemonic movement with predominant development in peripheral countries. This movement includes many other perspectives developed in the central countries but is the only one that has an ideological position that discusses the current paradigm of medicine that legitimates the same causes that give rise to P4, proposing to think a new way of practice the medicine that includes Ethical values, other forms of knowledge and the return to human medicine for humans with place for uncertainty, compassion, the encounter between people and non-commodified. Justice in health care is a central aspect of this new way of conceiving the medicine that we propose. Remember what Rudolf Virchow said in the nineteenth century "Physicians are the natural advocates of the poor and social problems fall largely under their jurisdiction. Medicine is a social science, and politics is nothing more than medicine in large scale". We must reformulate our contract with society and for this we must be very clear that our loyalty must always be with the sick, the poor and those who are weak. For this new contract we must also take into account the magnitude of the power that has been given to us and to live up to such responsibility. In the Rio manifesto (2016) we propose to “Avoid and denounce the naturalization of: hunger, exclusion, manipulation, inequality, violence, racism, exploitation, which harm health more than "diseases"” . There is a better and fairer world, let's fight to get it! More about P4 on www.ph3c.org/p4 [less ▲]

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See detailPrevention Library and Resources in four languages (QP Library)
Comité de Bibliografía en Prevención Cuaternaria; WONCA SIG P4 & O; Pizanelli, Miguel et al

Textual, factual or bibliographical database (2017)

Since Quaternary Prevention is very extensive and complex, during the design process for database input, an indexing structure with the use of coding tools and categories was considered. This design will ... [more ▼]

Since Quaternary Prevention is very extensive and complex, during the design process for database input, an indexing structure with the use of coding tools and categories was considered. This design will allow the addition of materials and will provide easy access to them. To add documents, 13 data fields must be populated. To access the input data form, for the purpose of adding documents, use this link: http://j.tinyurl.com/P4-Library To avoid duplication of data entries, it is necessary to review and perform an audit. In the beginning, we will provide this tutorial to a few data entry collaborators. To become a data entry collaborator, please send an e-mail to the following address: quaternaryprevention@gmail.com Charts are available in eight languages to code with Q-Codes: http://3cgp.docpatient.net/tabular/ [less ▲]

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See detailTerminología multilingüe en medicina general y de familia - Versión en Español
Jamoulle, Marc ULiege; Mariño, María Ana; La Valle, Ricardo et al

Book published by Care Editions (2016)

Esta monografía reproduce la lista de códigos Q, versión 2.5, y sus definiciones bajo el nombre de “Terminología multilingüe en medicina general y de familia – versión española” La clasificación Códigos-Q ... [more ▼]

Esta monografía reproduce la lista de códigos Q, versión 2.5, y sus definiciones bajo el nombre de “Terminología multilingüe en medicina general y de familia – versión española” La clasificación Códigos-Q para artículos no clínicos de medicina general y de familia se ha diseñado en base al desarrollo de una ontología informática en el servidor web www.hetop.eu del Laboratorio de Bioinformática de la Universidad de Rouen, Francia. Los Códigos Q tienden a representar los conceptos organizacionales esenciales de la Medicina Familiar. Los Códigos Q forman un capítulo complementario en la Clasificación Internacional de Atención Primaria, segunda edición (CIAP-2). Ellos son parte del proyecto 3CGP (Core Content Classification in General Practice Family medicine - Clasificación del contenido esencial de la atención primaria). Por lo tanto, combina las 3CGP con la clasificación ICPC-2 y los Códigos Q con el propósito de la indexación documental en medicina general y de familia. El proyecto de un sistema específico de indexación en medicina familiar se explica con precisión así como la capacidad del servidor web HeTOP es desarrollada en detalle. Se describe a continuación una lista tabular de los Códigos-Q, sus definiciones y finalmente un índice terminológico. [less ▲]

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See detailLa prevención cuaternaria en la clínica cotidiana.
Jamoulle, Marc ULiege; Bernstein, Jorge; Pizzanelli, Miguel et al

Conference (2015, March 14)

Remue méninge sur les développements futur du concept de prévention quaternaire

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