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Topics in Family Medicine and Primary Care

10-Night Italy & Greek Isles Cruise Conference
Round-trip Rome (Civitavecchia), Italy
August 31 - September 10, 2018

This conference has already sailed, but that doesn't mean you have to miss the boat! Click here to see our complete schedule of upcoming programs.

<em>Celebrity Reflection</em> — *Celebrity Reflection*

COURSE CREDITS & HOURS

AMA PRA Category 1 Credits™
14 ACPE Credits

COURSE FEES

TARGET AUDIENCE

Nurses, Nurse Practitioners, Physicians, Physician Assistants, Nurses, Nurse Practitioners, Pharmacists

PROGRAM PURPOSE

Topics:

Optimizing Results through Teamwork
- Apply the characteristics of successful teams and tools to build teamwork and improve outcomes
- Describe how teamwork can improve chronic disease metrics
- List and explain stages of team formation
Preparing Your Patients for a Successful Transition to their Golden Years
- Improve the wellness of the elder patients seen
- Address preventive measures for elder patients
- Provide appropriate medication management for the elderly
- Improve communication strategies in discussing advance directives with patients
Medical Error Reduction: Optimizing Outcomes and Patient Safety
- Discuss types of medical errors that can result in increased morbidity and mortality
- Minimize potential cognitive error risks to result in improved outcomes and patient safety
- Explain how diagnosis momentum can result in medical errors
Travel Medicine: Prevention Goes International
- Discuss the scope of US travelers abroad
- Assess appropriately the medical risk to the traveler
- List commonly needed Immunizations for travelers
- Implement helpful travel preventative treatments
- Utilize travel medicine related website resources
Optimizing Patient Safety - Appropriate Opioid Prescribing
- Appropriately evaluate a patient for Chronic Pain
- Utilize general guidelines for prescribing Controlled Substances / Opioids, including the new CDC guidelines
- Implement the use of multiple modalities in managing chronic pain
- Explain the added risks when prescribing opioids in excess of 100 mg Morphine Equivalent Dosing (MED)
- Implement strategies to improve patient safety and compliance with guidelines in prescribing opioids and other Controlled Substances
Health Promotion: Encouraging a Healthy Body, Mind, and Spirit
- Assess the patient's current state of physical, psychological, and spiritual health.
- Analyze the patientÃâs current dietary and exercise practices.
- Discuss an individualized health-promotion strategy for each patient.
"Oh, My Aching Head!": Evaluation and Treatment of Migraine, Tension-Type, and Cluster Headaches
- Discuss the appropriate use of brain imaging in evaluating patients with headache.
- Describe the appropriate use of abortive and preventive medications in the treatment of migraine.
- Describe the distinguishing clinical characteristics of tension-type and cluster headaches.
Male Sexual Disorders: Hypogonadism, Erectile, and Ejaculatory Dysfunction
- Elicit a through, non-judgmental sexual history.
- Describe appropriate laboratory and radiologic testing in the evaluation of male sexual problems.
- Discuss the effects, risks, and benefits of testosterone replacement therapy.
"I'm Sick and Tired of Being Tired!": Approach to Chronic Fatigue
- Describe the exclusion and inclusion criteria for chronic fatigue syndrome and distinguish this syndrome from other types of chronic fatigue
- Elicit and address the diagnostic beliefs of patients regarding the etiology of their fatigue
- Apply specific principles of cognitive-behavioral therapy and graded exercise therapy in the treatment of patients with chronic fatigue
Hypertension: "What Goes Up Must Come Down"
- Describe the appropriate measurement and classification of hypertension.
- Discuss the laboratory testing and imaging needed to diagnose the most common causes of secondary hypertension.
- Describe the major classes of anti-hypertensive treatment and discuss the particular type of patient likely to benefit from each class of medication.
Enhancing Clinician-Patient
- Distinguish the technical , biomedical aspects of the clinician's role from the personal and psychosocial aspects of care.
- Describe specific attitudes and values needed to create a healing environment with patients.
- Apply techniques for establishing and maintaining rapport with patients and enhancing clinician-patient communication.
The Faith Factor: Practicing Spiritually-Sensitive Care
- Elicit a spiritual history in an ethically-appropriate manner.
- Analyze the physiologic, psychological, social, and lifestyle effects of religious beliefs upon health outcomes.
- Describe the spectrum of possible interventions available for addressing patients" spiritual needs.

IMPORTANT INFORMATION

PLEASE NOTE: To attend the conference, participants must book their cruise accommodations through Continuing Education, Inc. This ensures we can provide full conference services and complimentary social amenities to meeting participants and guests. Participants' family and friends are welcome to book within our group allotment to take advantage of our typically excellent rates. Thanks for your cooperation. We look forward to welcoming you aboard!

BIAS FREE CME - No Commercial Support was provided for this CME activity.

Faculty

Dale A. Matthews, MD, FACP

Dale A. Matthews, MD, FACP
Associate Professor of Medicine (retired)
Georgetown University School of Medicine
Executive Healthcare Services (retired)

Dale A. Matthews, MD, FACP has served on the faculties of Yale University, the University of Connecticut, and Georgetown University and has lectured at over 30 medical schools. He gives lectures on primary care general internal medicine, the doctor-patient relationship, and the psychological and spiritual dimensions of medicine, including the role of religion, faith, and prayer in clinical care. He is the author of The Faith Factor: Proof of the Healing Power of Prayer (Viking, 1998), a four-volume research work (The Faith Factor: An Annotated Bibliography of Clinical Research on Spiritual Subjects), three documentaries, and over 65 peer-reviewed scientific articles, book chapters, and other publications. Dr. Matthews is a graduate of Princeton (AB, cum laude, Romance Languages, 1976) and Duke University School of Medicine (1980). His internship and residency in internal medicine took place at the University of Connecticut (1980-3) and he completed the Robert Wood Johnson Foundation Clinical Scholar Program and Fellowship in Clinical Epidemiology at Yale (1983-5). In 1989, he was named the George Morris Piersol Teaching and Research Scholar of the American College of Physicians. He has received many awards for his compassionate patient care, including Washingtonian Magazine Top Doctor recognition. He has appeared on numerous television shows, including the Oprah Winfrey Show, Larry King Live, and Good Morning America. He lives in McLean, Virginia with his wife, Demetra, a certified public accountant. He has two adult children and three grandchildren. He enjoys family and church activities, Bible study and teaching, golf, baseball, piano, singing, songwriting, ballroom dancing, travel, and photography.

Tim Munzing, MD, FAAFP

Family Medicine Residency Program Director
Kaiser Permanente Orange County Family Medicine Residency Program
Santa Ana, California

Dr. Timothy Munzing has been a family physician with Kaiser Permanente in Orange County, California for the past 33-1/2 years, over 30 years as the founding Program Director of the KP-OC Family Medicine Residency Program. Dr. Munzing serves on the national ACGME Family Medicine Review Committee, responsible for the accreditation of over 600 Family Medicine residency programs. He has had a clinical practice for over three decades and has taught hundreds of Family Medicine residents and thousands of medical students. Dr. Munzing was the recipient of the 2017 National Family Medicine Outstanding Residency Program Director of the Year Award and the 2017 California Academy of Family Physicians Hero of Family Medicine Award. He holds the appointment of full Clinical Professor at the University of California, Irvine College of Medicine and Professor at the developing Kaiser Permanente School of Medicine, opening Summer 2020.

Dr. Munzing is a leading national expert on appropriate (legal vs. illegal) Opioid and Controlled Substance Prescribing, recently receiving a major national Medical Director’s Award by the National Health Care Anti-Fraud Association. He has served as a medical expert reviewer for the DEA, FBI, and Medical Board of California for 15 years, having reviewed over 200 cases (100+ criminal) in over sixteen states across the United States.

Dr. Munzing published a peer reviewed article entitled “Guide to Appropriate Opioid Prescribing for Noncancer Pain" in May 2017 in the Permanente Journal, which is now being used nationally by physicians, law enforcement, and prosecutors. Dr. Munzing has lectured on the subject to thousands of physicians and healthcare providers, law enforcement (DEA, FBI, other state and federal law enforcement), and prosecutors across the United States.

Accreditation

	Credit Designation for Nurses: Continuiung Education, Inc. designates this continuing nursing education activity for 12 contact hours. Accredited status does not imply endorsement by Continuing Education, Inc./University at Sea® or ANCC of any commercial products displayed or used with an activity.
	Nurse Practitioners: can claim either ANCC Contact Hours or AMA PRA Category 1 Credits™ as needed. Pharmacology credits are identified on individual activities.

	In support of improving patient care, Continuing Education, Inc./University at Sea® is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

	Credit Designation for Physicians: Continuing Education, Inc. designates this live activity for 14 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Osteopathic Physicians: This program is eligible for Category 2 credit with the American Osteopathic Association (AOA).

	Credit Designation for Nurses: Continuiung Education, Inc. designates this continuing nursing education activity for 14 contact hours. Accredited status does not imply endorsement by Continuing Education, Inc./University at Sea® or ANCC of any commercial products displayed or used with an activity. Nurse Practitioners: Can claim either ANCC Contact Hours or AMA PRA Category 1 Credits^TM as needed. Pharmacology credits are identified on individual activities.

	Royal College of Physicians and Surgeons of Canada: Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

	Credit Designation for Pharmacists: This knowledge-based activity is approved for 14 hours of pharmacy continuing education credit.

Osteopathic Physicians: This program is eligible for Category 2 credit with the American Osteopathic Association (AOA).

US or Canadian Family Physicians: Please let us know if you require AAFP Prescribed Credits.

Nurse Practitioners: can claim either ANCC Contact Hours or AMA PRA Category 1 Credits^TM as needed.
Pharmacology credits are identified on individual activities.

	Credit Designation for Nurses: Continuiung Education, Inc. designates this continuing nursing education activity for 14 contact hours. Accredited status does not imply endorsement by Continuing Education, Inc./University at Sea® or ANCC of any commercial products displayed or used with an activity.
	Nurse Practitioners: can claim either ANCC Contact Hours or AMA PRA Category 1 Credits™ as needed. Pharmacology credits are identified on individual activities.

ITINERARY

DATE	PORT OF CALL	ARRIVE	DEPART
Fri Aug 31	Rome (Civitavecchia), Italy	-	5:00 pm
Sat Sep 01	Messina, Sicily	10:00 am	7:00 pm
Sun Sep 02	Valletta, Malta	8:00 am	6:00 pm
Mon Sep 03	At Sea - Cruising	-	-
Tue Sep 04	Mykonos, Greece	7:00 am	6:00 pm
Wed Sep 05	Rhodes, Greece	7:30 am	6:00 pm
Thu Sep 06	Santorini, Greece	7:00 am	6:00 pm
Fri Sep 07	Athens (Piraeus), Greece	6:00 am	6:00 pm
Sat Sep 08	At Sea - Cruising	-	-
Sun Sep 09	Naples, Italy	7:00 am	6:30 pm
Mon Sep 10	Rome (Civitavecchia), Italy	5:00 am	-

PORTS OF CALL

Rome (Civitavecchia), Italy

Let’s begin with the essential truth of this port call: Rome is one of the world’s most magnificent destinations, but your ship docks in Civitavecchia, a working port about 60-90 minutes away. This distance is the single most important factor in planning your day. A visit to the Eternal City from a cruise ship is not a casual stroll; it’s a tactical operation, and a brilliant one if planned correctly.

With limited time, you must choose your focus. Trying to conquer all of Rome in eight hours is a recipe for exhaustion. Instead, choose one or two core experiences. For a deep dive into antiquity, dedicate your day to the epic trio of the Colosseum, Roman Forum, and Palatine Hill. Pre-booking tickets is not a suggestion; it is an absolute necessity to avoid spending half your day in a queue. Standing inside the Colosseum is a moment that truly transcends tourism.

Alternatively, you can immerse yourself in the grandeur of the Vatican. A visit to St. Peter's Basilica (note the modest dress code), the Vatican Museums, and Michelangelo’s Sistine Chapel is a profound artistic pilgrimage. Again, advance, skip-the-line tickets are mandatory. The sheer scale of the art and history here can be overwhelming, so consider a guided tour to provide context and navigate the vast collections efficiently.

If you prefer a more atmospheric experience, focus on the iconic landmarks of the city center. A classic walk could include tossing a coin into the Trevi Fountain, gazing up through the Pantheon's oculus, and admiring Bernini’s fountains in the Piazza Navona. This route allows for more spontaneity—stopping for a perfect espresso, discovering a hidden courtyard, or indulging in a scoop of world-class gelato. A day in Rome is a whirlwind, but it offers a powerful, unforgettable glimpse into a city that has shaped the very foundations of Western civilization.

Messina, Sicily

Messina serves as the bustling gateway to eastern Sicily’s most celebrated treasures, offering a compelling choice between iconic excursions and authentic city life. For many, the primary draw is Taormina, a stunning hilltop town that lives up to its reputation. Its Greco-Roman theater offers one of the world's great views, framing the Ionian Sea and the often snow-capped peak of Mount Etna. Beyond the theater, Taormina’s charm unfolds along the Corso Umberto, a pedestrian-only street lined with chic boutiques, cafes, and hidden courtyards leading to breathtaking coastal overlooks.

For a more elemental experience, an excursion to Mount Etna reveals the raw power of Europe's most active volcano. Ascending its slopes, the landscape transforms into a stark, lunar-like environment of black lava rock and volcanic craters. Wineries thriving in the fertile, mineral-rich soil on the volcano's lower flanks offer tastings that provide a literal taste of the terroir.

However, Messina itself should not be overlooked. It presents a grittier, more workaday Sicilian reality. The city’s heart is the Piazza del Duomo, home to a magnificent Norman cathedral and the world's largest astronomical clock. Be sure to arrive just before noon to witness the captivating spectacle as its gilded bronze figures animate to tell stories from the city’s history. A short walk from the port, you can savor classic Sicilian street food like arancini or a refreshing granita, experiencing a slice of local life far from the polish of Taormina. Messina offers a genuine crossroads: choose world-famous beauty or stay for a taste of an authentic port city.

Valletta, Malta

Sailing into Valletta’s Grand Harbour is one of the most dramatic arrivals in the Mediterranean. You are immediately enveloped by immense, honey-colored limestone fortifications rising from the sea—a fitting introduction to a city built by the Knights of St. John that is itself a UNESCO World Heritage site.

The city is a compact, walkable grid, making it ideal for a day of exploration. The primary destination for most is St. John's Co-Cathedral. Its austere façade belies a jaw-dropping interior of High Baroque opulence, with every surface covered in intricate carvings, gold leaf, and marble. The cathedral’s true masterpiece is Caravaggio’s monumental painting, “The Beheading of Saint John the Baptist,” a profoundly moving work that is worth the visit alone.

For the best views, head to the Upper Barrakka Gardens, which offer a stunning panorama of the Grand Harbour and the historic Three Cities across the water. Time your visit for the daily cannon firing from the Saluting Battery below. Beyond the major sites, the real joy of Valletta is in wandering its streets, admiring the traditional enclosed wooden balconies (*gallariji*), and perhaps stopping for a *pastizz*—a flaky, savory pastry filled with ricotta or peas.

For those seeking a quieter, medieval atmosphere, a taxi ride to the fortified city of Mdina is a worthwhile alternative. Known as the “Silent City,” its labyrinthine alleys and noble palaces offer a peaceful contrast to the energy of the capital.

At Sea - Cruising

Mykonos, Greece

Mykonos is the quintessential Cycladic island, and while its nightlife is legendary, a day visit reveals its more profound charms. Your first priority should be an unscripted exploration of Mykonos Town (Chora). This is where the island’s magic truly resides. Allow yourself to get lost in the labyrinth of narrow, whitewashed alleyways, where vibrant bougainvillea spills over balconies and every turn reveals a hidden chapel, a chic boutique, or a welcoming café. The goal isn’t a specific destination, but the joy of the wander itself.

Eventually, your path will lead you to the island’s most iconic sights. Make your way to the Kato Mili (Lower Windmills), a row of 16th-century windmills standing sentinel on a hill overlooking the sea—the classic postcard view. Just below, you’ll find the waterfront neighborhood of “Little Venice,” where colorful, Venetian-style houses with wooden balconies hang directly over the water. It’s a perfect spot for a coffee or a light lunch while watching the waves crash just feet away.

For those with a deep interest in history, we cannot overstate the importance of the nearby island of Delos. A short ferry ride away, this UNESCO World Heritage site is one of the most significant archaeological sites in Greece, the mythological birthplace of Apollo and Artemis. A half-day excursion here offers a profound glimpse into the ancient world. For beach lovers, while Mykonos has famous shores like Paradise and Super Paradise, reaching them requires a bus or taxi. A more time-efficient option might be the closer, family-friendly beaches of Ornos or Platis Gialos. Mykonos delivers a brilliant, energetic, and stunningly beautiful day in port.

Rhodes, Greece

Rhodes offers one of the most compelling arrivals in the Mediterranean. Your ship docks directly beside the monumental stone walls of its Old Town, a UNESCO World Heritage site and one of the best-preserved medieval cities in Europe. The primary experience here is simply to get lost within its labyrinthine, cobblestone streets.

The main artery is the Street of the Knights, a remarkably intact medieval thoroughfare leading to the imposing Palace of the Grand Master. This fortress-palace, rebuilt by the Italians in the 20th century, offers a glimpse into the lives of the Knights of St. John with its grand halls and Hellenistic mosaics. The nearby Archaeological Museum, housed in the former Hospital of the Knights, provides further context to the island's rich history.

For those seeking classical antiquity, a short taxi ride uphill leads to the Acropolis of Rhodes on Monte Smith, where the remains of a Temple of Apollo, a stadium, and a small theater offer panoramic views over the city and sea. The Mandraki Harbour, where the legendary Colossus of Rhodes is said to have stood, is now a pleasant waterfront promenade marked by statues of deer.

Many are tempted by the famous village of Lindos, with its whitewashed houses and clifftop acropolis. It is undeniably stunning, but be aware that the one-hour drive each way, combined with significant crowds, will consume the majority of your day. A choice must be made: a deep, immersive exploration of the magnificent Old Town, or a dedicated excursion to Lindos. For a truly rewarding day, embracing the historical tapestry at your feet in Rhodes Town is often the more satisfying option.

Santorini, Greece

Santorini is every bit as breathtaking as the postcards suggest; its sun-bleached villages clinging to volcanic cliffs are a sight you won’t forget. However, as your advocates, we want you to know that a successful day here requires a smart plan. Your ship will anchor in the magnificent caldera, and you’ll tender to the small port at the base of the cliffs below the main town of Fira. From here, you have three options to ascend: a cable car (expect long lines), a strenuous walk up 588 steps, or a donkey ride.

Our advice is to have a strategy. To bypass the initial bottleneck, consider a ship-sponsored tour or a pre-booked private excursion that arranges your transport. Once atop the cliffs, the island is yours to explore. The village of Oia is the crown jewel, famous for its blue-domed churches and labyrinthine pathways. It is undeniably stunning, but be prepared to share its beauty with many fellow admirers. For a different perspective, the main town of Fira offers its own dramatic views, excellent shopping, and wonderful cafes.

For those seeking a deeper cultural experience, the remarkably preserved Bronze Age settlement of Akrotiri—often called the “Minoan Pompeii”—is a world-class archaeological site. Alternatively, for a more relaxed pace, consider a tour of one of the island's unique wineries to sample the crisp, local Assyrtiko wine while enjoying the caldera views. Santorini isn't a port for casual wandering; it's a world-class destination that rewards planning. With the right approach, its dramatic beauty is truly unforgettable.

Athens (Piraeus), Greece

Let’s be direct: your arrival at the port of Piraeus is purely functional. It’s a massive, bustling commercial hub, and its primary virtue is its proximity to Athens, the cradle of Western civilization. A day here is an incredible opportunity, but it requires a smart plan.

Your first priority is getting into the city center efficiently. The metro (Green Line 1 from Piraeus station) is a direct and affordable option that bypasses all traffic. Taxis are plentiful, but be sure to agree on a fare or insist on using the meter to avoid surprises. Once in Athens, the Acropolis is the day's non-negotiable centerpiece. Seeing the Parthenon preside over the city is a profound experience that connects you directly to 2,500 years of history, philosophy, and art. We strongly advise pre-booking your tickets online to save precious time you’d otherwise spend in a queue under the Greek sun.

After descending from the Acropolis, the modern Acropolis Museum awaits at its base. This stunningly designed space provides essential context for what you’ve just seen, housing the original artifacts in a climate-controlled, brilliantly curated environment. From there, immerse yourself in the Plaka, the city’s oldest neighborhood. This labyrinth of cobblestone streets, draped in bougainvillea, is where you’ll find the true Athenian spirit. It’s the perfect place to find a traditional taverna for a leisurely lunch of classic Greek dishes.

Our best advice for a port day in Athens is to be strategic. Don’t try to see everything. Focus on the Acropolis, its museum, and a wonderful meal in the Plaka. By doing so, you will have experienced the profound essence of the city, rather than just rushing past its landmarks. Wear comfortable shoes, stay hydrated, and prepare for an unforgettable immersion into the foundations of our world.

Naples, Italy

Naples is less a polished tourist destination and more a vibrant, chaotic, and profoundly authentic slice of Southern Italy. As a port of call, it’s a world-class launchpad to some of history’s most significant sites and Europe’s most breathtaking coastlines. Your challenge isn't finding something to do; it's accepting you can't possibly do it all in one day.

For most, the primary draw lies just outside the city: the astonishing ruins of Pompeii. Buried by Vesuvius in A.D. 79, this ancient city offers an unparalleled window into Roman life. We strongly recommend a guided tour here; the site is vast, and an expert can bring the silent stones of its villas, temples, and brothels to life. For a more intimate and often better-preserved alternative, consider nearby Herculaneum, which was entombed in mud rather than ash, preserving incredible details like wooden beams and mosaics.

If you prefer legendary beauty to ancient history, the Bay of Naples delivers. A hydrofoil can whisk you across the water to the glamorous Isle of Capri, famed for its dramatic Faraglioni rocks, chic boutiques, and the ethereal Blue Grotto (weather permitting). Alternatively, a drive along the coast brings you to Sorrento, a charming town perched on cliffs with stunning views and a more relaxed atmosphere, perfect for sipping limoncello and soaking in the scenery.

Should you choose to dive into Naples itself, be prepared for an intense and rewarding experience. The city’s historic center is a UNESCO World Heritage site, a labyrinth of narrow streets, hidden courtyards, and baroque churches. The National Archaeological Museum is an absolute must, housing the priceless mosaics, frescoes, and artifacts recovered from Pompeii and Herculaneum. And, of course, there is the pizza. This is its birthplace, and enjoying an authentic Neapolitan pizza is not just a meal, but a cultural imperative. Naples is gritty, loud, and utterly unforgettable—a port that rewards the curious traveler with an experience of raw, unfiltered Italy.

Celebrity Reflection

PLEASE NOTE: To attend the conference, participants must book their cruise accommodations through Continuing Education, Inc. This ensures we can provide full conference services and complimentary social amenities to meeting participants and guests. Participants' family and friends are welcome to book within our group allotment and take advantage of our typically excellent rates. Thanks for your cooperation. We look forward to welcoming you aboard!

Request a Quote online or by voice at 800-422-0711 (US/Can) or direct/int'l tel: +1-727-526-1571.

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