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See detailTeaching and learning Quaternary prevention
Gomes, Luís Filipe; Gusso, Gustavo; Jamoulle, Marc ULg

in Revista Brasileira de Medicina de Família e Comunidade (2015), 10(35), 1-14

This article presents an overview of different techniques and skills required for teaching and learning quaternary prevention (P4). It adopts the Expertise Model that defines the competences required in ... [more ▼]

This article presents an overview of different techniques and skills required for teaching and learning quaternary prevention (P4). It adopts the Expertise Model that defines the competences required in P4 for each level: novice, competent, proficient, and expert. This should be used as a step-wise roadmap for teachers in order to achieve high standard levels of performance. This is complemented by a list of methods used in teaching and assessment of learners’ performance and competence. By covering a range of learning and teaching issues, those who aim to teach quaternary prevention can explore the proposed framework. Quaternary prevention is a research and teaching fertile medical field that requires the integration of different areas such as health service organization, epidemiology, communication skills, and andragogy either at the macro or the micro levels health related activities. [less ▲]

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See detailThe words of prevention, part I: changing the model
Jamoulle, Marc ULg; Gavilan, Enrique; Cardoso, Raquel Val et al

in Revista Brasileira de Medicina de Família e Comunidade (2015), 10(35), 1-9

ABSTRACT Objective: This part I article explores the different meanings of relevant keywords for General Practice/Family Medicine (GP/FM) in the prevention domain. The aim is to contribute to information ... [more ▼]

ABSTRACT Objective: This part I article explores the different meanings of relevant keywords for General Practice/Family Medicine (GP/FM) in the prevention domain. The aim is to contribute to information process in GP/FM by keeping in line with the main terms used in health care organization. Methods: Important keywords for GP/FM in the prevention domain were selected. Then, a search was carried out on the main sources in GP/FM databases, as well as in Medical Subject Heading and major terminological databases available online. Results and Discussion: There is discrepancy between the conceptual contents of major prevention models amongst the usual bibliographic sources of knowledge in GP/FM in particular and medicine in general. Conclusion: For GP/FM, distribution of preventive activities is now firmly established on a new constructivist model, privileging the doctor-patient relationships and introducing a cybernetic thinking on the health care activities with a special commitment to ethics and the positive duty of beneficence. [less ▲]

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See detailThe words of prevention, part II: ten terms in the realm of quaternary prevention
Jamoulle, Marc ULg; Gavilan, Enrique; Cardoso, Raquel Val et al

in Revista Brasileira de Medicina de Família e Comunidade (2015), 10(35), 1-9

ABSTRACT Objective: This part II article about the ‘words of prevention’ presents in a terminological way the content of ten current concepts used in the prevention domain which are closely linked to ... [more ▼]

ABSTRACT Objective: This part II article about the ‘words of prevention’ presents in a terminological way the content of ten current concepts used in the prevention domain which are closely linked to quaternary prevention: (1) overinformation, (2) overdiagnosis, (3) medically unexplained symptoms, (4) overmedicalisation, (5) incidentaloma, (6) overscreening, (7) overtreatment, (8) shared decision making, (9) deprescribing, and (10) disease mongering. Methods: with the support of the laboratory team of the University of Rouen, France, which is dedicated to medical terminology and semantic relationships, it was possible to utilize a graphic user interface (called DBGUI) allowing the construction of links for each of chosen terms, and making automatic links to MeSH, if any. Those concepts are analyzed in their environment in current literature, as well as in their MeSH counterparts, if any, and related semantic online terminologies. Results and Discussion: The rules in terminological development aspire to cover the whole field of a concept and in the meantime, it helps to avoid the noise due to proxy and not exactly related issues. This refers to exhaustivity and specificity in information retrieval. Our finds show that referring to MeSH only in information retrieval in General Practice/Family medicine can induce much noise and poor adequacy to the subject investigated. Conclusion: Gathering concepts in specially prepared terminologies for further development of ontologies is a necessity to enter in the semantic web area and the era of distributed data. [less ▲]

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See detailQuaternary prevention: first, do not harm - Editorial
Jamoulle, Marc ULg

in Revista Brasileira de Medicina de Família e Comunidade (2015), 10(35), 1-3

Clinical prevention, under the influence of public health, has been organised in a chronological manner since the middle of the 20th century. A paradigm shift from a chronological to a constructivist ... [more ▼]

Clinical prevention, under the influence of public health, has been organised in a chronological manner since the middle of the 20th century. A paradigm shift from a chronological to a constructivist relationship-based preventive pattern of care offers new insights into the practice of doctors. This paradigm shift brings to light the concept of quaternary prevention, a critical look at medical activities with an emphasis on the need not to harm. Quaternary prevention addresses the fundamental question of what constitutes too much or too little medicine. It is the fourth form of disease prevention, but also the fourth frame of action for family doctors [less ▲]

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See detailPrevenção quaternária: primeiro não causar dano - Editorial
Jamoulle, Marc ULg

in Revista Brasileira de Medicina de Família e Comunidade (2015), 10(35), 1-3

A prevenção clínica, sob a influência da saúde pública, foi organizada de forma cronológica, desde meados do século XX. No entanto, uma mudança de paradigma de uma ordem cronológica para um padrão ... [more ▼]

A prevenção clínica, sob a influência da saúde pública, foi organizada de forma cronológica, desde meados do século XX. No entanto, uma mudança de paradigma de uma ordem cronológica para um padrão construtivista fundamentado em uma relação preventiva de atendimento, oferece novas,reflexões à prática dos médicos. Essa mudança de paradigma traz à tona o conceito de prevenção quaternária, um olhar crítico sobre as atividades médicas, com ênfase na necessidade de não causar danos. A prevenção quaternária aborda a questão principal do que se constitui como ‘muita’ ou ‘pouca’ medicina. Ela é a quarta forma de prevenção de doenças, e também a quarta etapa de ação dos médicos de família [less ▲]

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See detailManifesto de Curitiba: pela Prevenção Quaternária e por uma Medicina sem conflitos de interesse
Silva, André Luiz da; Mangin, Derelie; Pizzanelli, Miguel et al

in Revista Brasileira de Medicina de Família e Comunidade (2014), 9(33), 371-374

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See detailPrevenção Quaternária e limites em medicina
Jamoulle, Marc ULg; Gomes, Luis

in Revista Brasileira de Medicina de Família e Comunidade (2014), 9(31),

O conceito de Prevenção Quaternária, um questionamento sobre a base da ação médica, nasceu na articulação da relação médico-paciente. Refere-se a toda a atividade médica, sendo uma importante ferramenta ... [more ▼]

O conceito de Prevenção Quaternária, um questionamento sobre a base da ação médica, nasceu na articulação da relação médico-paciente. Refere-se a toda a atividade médica, sendo uma importante ferramenta para a medicina de família. É uma interrogação ética sobre os excessos da demasiada e demasiadamente pouca medicina e fornece algumas respostas. [less ▲]

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See detailComentário sobre o artigo de Pizzanelli
Jamoulle, Marc ULg

in Revista Brasileira de Medicina de Família e Comunidade (2014), 9(31),

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