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Sample records for academic hospital medicine

  1. Challenges and Opportunities in Academic Hospital Medicine: Report from the Academic Hospital Medicine Summit

    Flanders, Scott A.; Centor, Bob; Weber, Valerie; McGinn, Thomas; DeSalvo, Karen; Auerbach, Andrew

    2009-01-01

    ABSTRACT BACKGROUND The field of hospital medicine is growing rapidly in academic medical centers. However, few organizations have explicitly considered the opportunities and barriers posed to hospital medicine’s development as an academic field in internal medicine. OBJECTIVE To develop consensus around key areas limiting or facilitating hospital medicine’s development as an academic discipline. DESIGN Consensus format conference of key stakeholders in academic hospital medicine. RESULTS The...

  2. Academic Hospitality

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  3. [A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

    Maisch, Bernhard

    2005-03-01

    1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state

  4. Women in Academic Medicine.

    Thibault, George E

    2016-08-01

    More than a decade ago, women achieved parity with men in the number of matriculants to medical school, nearly one-third of the faculty of medical schools were women, and there were some women deans and department chairs. These trends were promising, but today there are still significant differences in pay, academic rank, and leadership positions for women compared with men in academic medicine. Though there has been progress in many areas, the progress is too slow to achieve previously recommended goals, such as 50% women department chairs by 2025 and 50% women deans by 2030.The author points to the findings presented in the articles from the Research Partnership on Women in Biomedical Careers in this issue, as well as research being published elsewhere, as an evidence base for the ongoing discussion of gender equity in academic medicine. More attention to culture and the working environment will be needed to achieve true parity for women in academic medical careers. PMID:27306968

  5. Is laboratory medicine ready for the era of personalized medicine? A survey addressed to laboratory directors of hospitals/academic schools of medicine in Europe

    Malentacchi, F.; Mancini, I.; Brandslund, I.;

    2015-01-01

    the European Society of Pharmacogenomics and Personalised Therapy (ESPT). The answers of the participating laboratory medicine professionals indicate that they are aware that personalized medicine can represent a new and promising health model, and that laboratory medicine should play a key role in...

  6. Does Academic Medicine Matter?

    Papanikolaou, Panagiotis N.; Christidi, Georgia D.; John P.A. Ioannidis

    2006-01-01

    Editors' Summary Background. When people need medical treatment they may be given it in a “teaching hospital.” This is a place where student doctors and other trainee healthcare workers are receiving part of their education. They help give some of the treatment that patients receive. Teaching hospitals are usually large establishments and in most countries they are regarded as being among the very best hospitals available, with leading physicians and surgeons among the staff. It is usually as...

  7. Family medicine as a model of transition from academic medicine to academic health care: Estonia's experience.

    Maaroos, Heidi-Ingrid

    2004-10-01

    This paper presents the development of academic family medicine in an environment of traditional academic medicine at the Tartu University, Estonia. The introduction of university family medicine teachers to everyday practice and practitioners to academic teaching and research helps bridge the gap between theory and practice, and it shows changed approach to academic medicine. PMID:15495281

  8. Pre-hospital emergency medicine.

    Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E

    2015-12-19

    Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care. PMID:26738719

  9. Career Choice in Academic Medicine: Systematic Review

    Straus, Sharon E; Straus, Christine; Tzanetos, Katina

    2006-01-01

    Academic medicine is in crisis. Contributing factors include the failure to engage stakeholders in developing the research and education agendas and the declining interest in academic careers. To reinvigorate academic medicine, it is necessary to understand what factors influence career choice. Exposure of trainees to research opportunities and graduate programs stimulate interest in academia. The desire to teach, conduct research, and the intellectual stimulation provided in academia also in...

  10. Forum on the Future of Academic Medicine: Final Session--Implications of the Information Revolution for Academic Medicine.

    Iglehart, John

    2000-01-01

    Summarizes two speeches. William W. Stead offers three scenarios illustrating typical future interactions of consumers with a medical system based on informatics and information technology and then considers implications for academic medicine. Valerie Florance discusses a program that is exploring ways medical schools and teaching hospitals can…

  11. The market for hospital medicine in Denmark

    Gisela Hostenkamp

    2011-11-01

    Full Text Available Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.

  12. Changing academic medicine: strategies used by academic leaders of integrative medicine-a qualitative study.

    Witt, Claudia M; Holmberg, Christine

    2012-01-01

    In Western countries, complementary and alternative medicine (CAM) is more and more provided by practitioners and family doctors. To base this reality of health care provision on an evidence-base, academic medicine needs to be included in the development. In the study we aimed to gain information on a structured approach to include CAM in academic health centers. We conducted a semistructured interview study with leading experts of integrative medicine to analyze strategies of existing academic institutions of integrative medicine. The study sample consisted of a purposive sample of ten leaders that have successfully integrated CAM into medical schools in the USA, Great Britain, and Germany and the Director of the National Center for Alternative and Complementary Medicine. Analysis was based on content analysis. The prerequisite to foster change in academic medicine was a strong educational and professional background in academic medicine and research methodologies. With such a skill set, the interviewees identified a series of strategies to align themselves with colleagues from conventional medicine, such as creating common goals, networking, and establishing well-functioning research teams. In addition, there must be a vision of what should be needed to be at the center of all efforts in order to implement successful change. PMID:23093984

  13. Gender and academic medicine: impacts on the health workforce

    Reichenbach, Laura; Brown, Hilary

    2004-01-01

    Recent discussions about the “feminisation of medicine” raise critical questions for how academic medicine deals with gender issues. Addressing the gender dimensions of enrolment, curriculum, and promotion practices in academic medicine may be a good starting point

  14. The Priority of Intersectionality in Academic Medicine.

    Eckstrand, Kristen L; Eliason, Jennifer; St Cloud, Tiffani; Potter, Jennifer

    2016-07-01

    Recent societal events highlight inequities experienced by underrepresented and marginalized communities. These inequities are the impetus for ongoing efforts in academic medicine to create inclusive educational and patient care environments for diverse stakeholders. Frequently, approaches focus on singular populations or broad macroscopic concepts and do not always elucidate the complexities that arise at the intersection between multiple identities and life experiences. Intersectionality acknowledges multidimensional aspects of identity inclusive of historical, structural, and cultural factors. Understanding how multiple identity experiences impact different individuals, from patients to trainees to providers, is critical for improving health care education and delivery. Building on existing work within academic medicine, this Commentary outlines six key recommendations to advance intersectionality in academic medicine: embrace personal and collective loci of responsibility; examine and rectify unbalanced power dynamics; celebrate visibility and intersectional innovation; engage all stakeholders in the process of change; select and analyze meaningful metrics; and sustain the commitment to achieving health equity over time. Members of the academic medical community committed to advancing health equity can use these recommendations to promote and maintain meaningful changes that recognize and respond to the multidimensional voices and expressed needs of all individuals engaged in providing and receiving health care. PMID:27166867

  15. Nuclear medicine in district general hospitals.

    Staffurth, J. S.

    1983-01-01

    Nuclear medicine is a recognised clinical specialty both nationally and internationally. Compared with other countries, it is inadequately developed in Britain, particularly in district general hospitals. To create clinical radioisotope services at district level physicians or radiologists with experience in nuclear medicine need to be trained and appointed. Such appointments would allow facilities to evolve that would provide either a comprehensive nuclear medicine service formed around a ph...

  16. The Market for Hospital Medicine in Denmark

    Hostenkamp, Gisela

    2012-01-01

    increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital...

  17. ACADEMIC TRAINING Physics Technologies in Medicine

    Françoise Benz

    2002-01-01

    10, 11, 12, 13, 14 June LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 Physics Technologies in Medicine by G. K. Von Schulthess / Univ. of Z rich, S. Wildermuth, A. Buck / Univ. Hospital Z rich, K. Jäger / Univ. Hospital Basel, R. Kreis / Univ. Hospital Bern Modern medicine is a large consumer of physics technologies. The series of lectures covers medical imaging starting with an overview and the history of medical imaging. Then follows four lectures covering x-ray imaging positron emission tomography imaging blood flow by ultrasound magnetic resonance Monday 10 June 100 Years of Medical Imaging Pr. Gustav K. von Schulthess MD, PhD / University of Zurich History and overview of Medical Imaging Tuesday 11 June X-rays: still going strong Dr. Simon Wildermuth / MD, University Hospital Zurich Multidetector computed tomography: New developments and applications Wednesday 12 June Nuclear Medicine: PET Positron Emission Tomography Dr. Alfred Buck / MD, MSc, University Hospital Zurich Elucidati...

  18. ACADEMIC TRAINING: Physics Technologies in Medicine

    Françoise Benz

    2002-01-01

    10, 11, 12, 13, 14 June LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 Physics Technologies in Medicine by G. K. Von Schulthess / Univ. of Zürich, S. Wildermuth, A. Buck / Univ. Hospital Zürich, K. Jäger / Univ. Hospital Basel, R. Kreis / Univ. Hospital Bern Modern medicine is a large consumer of physics technologies. The series of lectures covers medical imaging starting with an overview and the history of medical imaging. Then follows four lectures covering x-ray imaging positron emission tomography imaging blood flow by ultrasound magnetic resonance Monday 10 June 100 Years of Medical Imaging Pr. Gustav K. von Schulthess MD, PhD / University of Zurich History and overview of Medical Imaging Tuesday 11 June X-rays: still going strong Dr. Simon Wildermuth / MD, University Hospital Zurich Multidetector computed tomography: New developments and applications Wednesday 12 June Nuclear Medicine: PET Positron Emission Tomography Dr. Alfred Buck / MD, MSc, University...

  19. Evidence-based medicine among internal medicine residents in a community hospital program using smart phones

    Ackerman Michael; Green Linda; Fontelo Paul; León Sergio A; Liu Fang

    2007-01-01

    Abstract Background This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information reso...

  20. Evidence-based medicine among internal medicine residents in a community hospital program using smart phones

    Ackerman Michael

    2007-02-01

    Full Text Available Abstract Background This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resources internal medicine residents were using and whether providing bedside, real-time access to medical information would be perceived useful for patient care and academic activities. Methods We equipped the medical teams in the hospital wards with smart phones (mobile phone/PDA hybrid devices to provide immediate access to evidence-based resources developed at the National Library of Medicine as well as to other medical Websites. The emphasis of this project was to measure the convenience and feasibility of real-time access to current medical literature using smart phones. Results The smart phones provided real-time mobile access to medical literature during daily rounds and clinical activities in the hospital. Physicians found these devices easy to use. A post-study survey showed that the information retrieved was perceived to be useful for patient care and academic activities. Conclusion In community hospitals and ambulatory clinics without wireless networks where the majority of physicians work, real-time access to current medical literature may be achieved through smart phones. Immediate availability of reliable and updated information obtained from authoritative sources on the Web makes evidence-based practice in a community hospital a reality.

  1. The business of pediatric hospital medicine.

    Percelay, Jack M; Zipes, David G

    2014-07-01

    Pediatric hospital medicine (PHM) programs are mission driven, not margin driven. Very rarely do professional fee revenues exceed physician billing collections. In general, inpatient hospital care codes reimburse less than procedures, payer mix is poor, and pediatric inpatient care is inherently time-consuming. Using traditional accounting principles, almost all PHM programs will have a negative bottom line in the narrow sense of program costs and revenues generated. However, well-run PHM programs contribute positively to the bottom line of the system as a whole through the value-added services hospitalists provide and hospitalists' ability to improve overall system efficiency and productivity. This article provides an overview of the business of hospital medicine with emphasis on the basics of designing and maintaining a program that attends carefully to physician staffing (the major cost component of a program) and physician charges (the major revenue component of the program). Outside of these traditional calculations, resource stewardship is discussed as a way to reduce hospital costs in a capitated or diagnosis-related group reimbursement model and further improve profit-or at least limit losses. Shortening length of stay creates bed capacity for a program already running at capacity. The article concludes with a discussion of how hospitalists add value to the system by making other providers and other parts of the hospital more efficient and productive. PMID:24977676

  2. Academic Training: Physics technologies in medicine

    Françoise Benz

    2005-01-01

    24, 25, 26, 27 January 2004-2005 ACADEMIC TRAINING PROGRAMME LECTURE SERIES from 11.00 to 12.00 hrs - Main Auditorium, bldg. 500 Physics technologies in medicine M. GILARDI / Univ. of Milano, I. - U. AMALDI / Univ. of Milano Bicocca and TERA Foundation - M. SCHOLZ / GSI, Darmstadt, D. - O. JÄKEL / Deutsches Krebsforschungszentrum, Heidelberg, D Monday 24 January The frontiers of medical imaging M. GILARDI / Univ. of Milano, I. The lecture will deal with the evolution of diagnostic imaging techniques, focussing on tomographic methods (x rays Computerized Tomography, CT, Magnetic Resonance Imaging. MRI, Positron Emission Tomography, PET). The physical parameters characterizing the performance of current generation scanners and their potential future improvement will be discussed. The clinical diagnostic value of multi modal imaging and the relevance of image fusion to image guided radiotherapy will be also presented. Tuesday 25 January From the discovery of X-rays to CT/PET diagnostics and co...

  3. Academic Training: Physics technologies in medicine

    Françoise benz

    2005-01-01

    24, 25, 26, 27 January 2004-2005 ACADEMIC TRAINING PROGRAMME LECTURE SERIES from 11.00 to 12.00 hrs - Main Auditorium, bldg. 500 Physics technologies in medicine M. GILARDI / Univ. of Milano, I. - U. AMALDI / Univ. of Milano Bicocca and TERA Foundation - M. SCHOLZ / GSI, Darmstadt, D. - O. JÄKEL / Deutsches Krebsforschungszentrum, Heidelberg, D Monday 24 January The frontiers of medical imaging M. GILARDI / Univ. of Milano, I. Tuesday 25 January From the discovery of X-rays to CT/PET diagnostics and conformal radiation therapy U. AMALDI / Univ. of Milano Bicocca and TERA Foundation Wednesday 26 January The increased biological effectiveness of heavy charged particle radiation: from cell culture experiments to biophysics modelling M. SCHOLZ / GSI, Darmstadt, D. Thursday 27 January Medical Physics aspects of radiotherapy with ions O. JÄKEL / Deutsches Krebsforschungszentrum, Heidelberg, D The lectures are open to all those interested, without application. The abstract of the lectures...

  4. Changing Academic Medicine: Strategies Used by Academic Leaders of Integrative Medicine—A Qualitative Study

    Claudia M Witt; Christine Holmberg

    2012-01-01

    In Western countries, complementary and alternative medicine (CAM) is more and more provided by practitioners and family doctors. To base this reality of health care provision on an evidence-base, academic medicine needs to be included in the development. In the study we aimed to gain information on a structured approach to include CAM in academic health centers. We conducted a semistructured interview study with leading experts of integrative medicine to analyze strategies of existing academ...

  5. Criteria for medicines management in hospitals

    Eriksson, Tommy; Söderlund, Lars-Åke; Alenius, Malin

    2011-01-01

    Study objectives: The aim of this study was to develop quality criteria for further development and use in the Medicines Management(MM) process in European hospitals. Methods: Criteria for MM were developed in three steps using a modified two-stage Delphi-technique. In the first step a literature search was performed and 300 topics were listed. These topics were grouped into three dimensions, eight main and 23 sub areas, rephrased and a questionnaire including 114 criteri...

  6. Hospital Intranet and Extranet in nuclear medicine

    Since two years ago nuclear medicine service of Laennec Hospital has implemented transmission and distribution networks of scintigraphic images. A new stage was reached at present by developing an Intranet and Extranet system for nursing units and other services of nuclear medicine. The Intranet link to the services of Laennec Hospital and AP HP is based on a image server connected to the service gamma camera and, after a possible post-processing, the images are transmitted in PCX format by e-mail, attached to the medical record. For communication between nuclear medicine services, a heavier procedure making use of a program for image processing under inter-file standards has been implemented. To achieve the Extranet link with services and physicians of town, exterior to AP HP, a procedure was installed which allows reaching any nursing unit or town physicians having at their disposal e-mail on a secured network. This procedure will be generalized when the Health secured network, linking the medical bodies to Health insurance institutions, will be operational. The interactive tele-medicine will be achieved by means of a procedure based on Internet cooperative tools (wild cards, video- and vision-conferences) which will permits in all situations an interactive work on all the transmitted patient files

  7. Does stereotype threat affect women in academic medicine?

    Burgess, Diana Jill; Joseph, Anne; van Ryn, Michelle; Carnes, Molly

    2012-04-01

    Multiple complex factors contribute to the slow pace of women's advancement into leadership positions in academic medicine. In this article, the authors propose that stereotype threat--under which individuals who are members of a group characterized by negative stereotypes in a particular domain perform below their actual abilities in that domain when group membership is emphasized--may play an important role in the underrepresentation of women in leadership positions in academic medicine. Research to objectively assess the impact of stereotype threat for women in academic medicine is feasible and necessary to confirm this hypothesis. Still, a number of conditions present in the academic medicine community today have been shown to trigger stereotype threat in other settings, and stereotype threat fits with existing research on gender in academic medicine. In the meantime, academic health centers should implement relatively simple measures supported by experimental evidence from other settings to reduce the risk of stereotype threat, including (1) introducing the concept of stereotype threat to the academic medicine community, (2) engaging all stakeholders, male and female, to promote identity safety by enacting and making faculty aware of policies to monitor potential instances of discrimination, and training faculty to provide performance feedback that is free of gender bias, (3) counteracting the effects of sex segregation at academic health centers by increasing exposure to successful female leaders, (4) reducing gender stereotype priming by avoiding stereotypically male criteria for promotion, grants, and awards, and (5) building leadership efficacy among female physicians and scientists. PMID:22361794

  8. Leadership in academic medicine: reflections from administrative exile.

    Naylor, C David

    2006-01-01

    Physicians are drawn into diverse leadership roles in academic medicine, but little in our education and training prepares us for these responsibilities. Fortunately, there is growing convergence in the literature on the attributes of successful leaders for knowledge-based organisations. Top-performing leaders seem to be self-effacing team-builders who eschew rapid-cycle strategic planning and management trends, focusing instead on strategic and incremental changes that will gradually transform their organisations. Academic physicians and search committees often concentrate on personal achievement and intellectual or technical mastery in research and clinical care. In contrast, the literature on leadership suggests other-directed skills matter more, eg mentorship, learning and teaching competencies, and so-called emotional intelligence. As a corollary, teaching hospitals, universities, and professional colleges or societies are long-term organisations with a rich history. Leadership in such a context demands stewardship of tradition along with patient pursuit of changes required to ensure that the organisation evolves successfully. PMID:17080898

  9. Does Stereotype Threat Affect Women in Academic Medicine?

    Burgess, Diana Jill; Joseph, Anne; van Ryn, Michelle; Carnes, Molly

    2012-01-01

    Multiple complex factors contribute to the slow pace of women’s advancement into leadership positions in academic medicine. In this article, the authors propose that stereotype threat--under which individuals who are members of a group characterized by negative stereotypes in a particular domain perform below their actual abilities in that domain when group membership is emphasized--may play an important role in the underrepresentation of women in leadership positions in academic medicine. Re...

  10. Changing Academic Medicine: Strategies Used by Academic Leaders of Integrative Medicine—A Qualitative Study

    Claudia M. Witt

    2012-01-01

    Full Text Available In Western countries, complementary and alternative medicine (CAM is more and more provided by practitioners and family doctors. To base this reality of health care provision on an evidence-base, academic medicine needs to be included in the development. In the study we aimed to gain information on a structured approach to include CAM in academic health centers. We conducted a semistructured interview study with leading experts of integrative medicine to analyze strategies of existing academic institutions of integrative medicine. The study sample consisted of a purposive sample of ten leaders that have successfully integrated CAM into medical schools in the USA, Great Britain, and Germany and the Director of the National Center for Alternative and Complementary Medicine. Analysis was based on content analysis. The prerequisite to foster change in academic medicine was a strong educational and professional background in academic medicine and research methodologies. With such a skill set, the interviewees identified a series of strategies to align themselves with colleagues from conventional medicine, such as creating common goals, networking, and establishing well-functioning research teams. In addition, there must be a vision of what should be needed to be at the center of all efforts in order to implement successful change.

  11. Academic Medicine Meets Traditional African Healing

    Lindow, Megan

    2008-01-01

    Cyril Naidoo, who directs the department of family medicine at the University of KwaZulu-Natal's Nelson R. Mandela School of Medicine, conducts workshops to traditional healers on how to help patients with AIDS and HIV. In Dr. Naidoo's workshop, the group discusses how to counsel patients about HIV and AIDS, how to refer them for testing, and then…

  12. Preparing an Academic Medical Center to Manage Patients Infected with Ebola: Experiences of a University Hospital

    Schultz, Ch.; Koenig, KL; Alassaf, W

    2015-01-01

    © 2015 Society for Disaster Medicine and Public Health, Inc. As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered t...

  13. Women in hospital medicine: career choices and opportunities.

    Fitzgerald, R C; Black, C

    2001-12-01

    A significant number of women now enter hospital medicine. However, many do not make the expected progression within the medical specialties. The Royal College of Physicians set up a working party to examine and collect evidence on the career choices and progression of women in the hospital medical specialties under its remit and published a report of this evidence. This article outlines the findings of the report and the implications for hospital medicine. PMID:11810739

  14. Roles and methods of performance evaluation of hospital academic leadership.

    Zhou, Ying; Yuan, Huikang; Li, Yang; Zhao, Xia; Yi, Lihua

    2016-01-01

    The rapidly advancing implementation of public hospital reform urgently requires the identification and classification of a pool of exceptional medical specialists, corresponding with incentives to attract and retain them, providing a nucleus of distinguished expertise to ensure public hospital preeminence. This paper examines the significance of academic leadership, from a strategic management perspective, including various tools, methods and mechanisms used in the theory and practice of performance evaluation, and employed in the selection, training and appointment of academic leaders. Objective methods of assessing leadership performance are also provided for reference. PMID:27061556

  15. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    Wilcox, Susan R.; Tania D. Strout; Jeffrey I. Schneider; Mitchell, Patricia M.; Smith, Jessica; Lutfy-Clayton, Lucienne; Marcolini, Evie G.; Aydin, Ani; Seigel, Todd A.; Jeremy B. Richards

    2016-01-01

    Introduction: Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) education or clinical practice. The objective of this study was to quantify EM attendings’ education, experience, and knowledge regarding mechanical ventilation in the emergency department. Methods: We developed a survey of academic EM attendings’ educational experiences with ventilators and a knowledge assessme...

  16. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    Wilcox, Susan R.; Tania D. Strout; Jeffrey I. Schneider; Mitchell, Patricia M.; Jessica Smith; Lucienne Lutfy-Clayton; Marcolini, Evie G.; Ani Aydin; Seigel, Todd A.; Jeremy B. Richards

    2016-01-01

    Introduction: Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM) education or clinical practice. The objective of this study was to quantify EM attendings’ education, experience, and knowledge regarding mechanical ventilation in the emergency department. Methods: We developed a survey of academic EM attendings’ educational experiences with ventilators and a knowledge assessment tool with nine ...

  17. [Alternative medicine: really an alternative to academic medicine?].

    Happle, R

    2000-06-01

    Numerous courses on alternative medicine are regularly advertised in Deutsches Arzteblatt, the organ of the German Medical Association. The present German legislation likewise supports this form of medicine, and this explains why Iscador, an extract of the mistletoe, is found in the Rote Liste, a directory of commercially available medical drugs, under the heading "cytostatic and antimetastatic drugs" although such beneficial effect is unproven. To give another example, a German health insurance fund was sentenced to pay for acupuncture as a treatment for hepatic failure. This judgement is characteristic of the present German judicial system and represents a victory of "oracling irrationalism" (Popper). The astonishing popularity of alternative medicine can be explained by a revival of romanticism. An intellectually fair opposite position has been delineated by Karl Popper in the form of critical rationalism. It is important to realize, however, that our decision to adhere to rational thinking is made in the innermost depth of our heart but not on the basis of rational arguing. Rather, the decision in favor of reason has a moral dimension. PMID:10907162

  18. Forum on the future of academic medicine: Session II--Finances and culture.

    Iglehart, J

    1997-09-01

    The second meeting of the Forum on the Future of Academic Medicine in March 1997 was devoted to two issues. In a changing and increasingly competitive health care marketplace, (1) how do academic medical centers (i.e., medical schools and their associated teaching hospitals) fund their complex activities and manage their resources; and (2) what issues arise regarding the multiple missions, values, and cultures of academic medical centers (AMCs)? Regarding the first issue, one speaker made clear that medical schools must more closely link their financial statements with their strategic plans, and must find ways to more accurately gauge their financial health. Discussion of various aspects of this task included the need for schools to formulate business strategies; there was general agreement that academic medicine needs to have a better grasp of its enterprise and how much its components cost. Regarding the culture of academic medicine, participants debated the degree to which it must be adapted to recognize the new market-driven environment. More than one speaker stated that culture is a major obstacle to change. The lively discussions and presentations, detailed in this article, make clear that no one has much certainty about how AMCs-particularly medical schools-should be adapted to operate in a more commercial marketplace and what future role government should assume in this transformation. More than one statement was made that the AMC culture would be hard to change, and one speaker disagreed that AMCs' salvation would be found in adopting the principles of private business. The group's reporter closes this article by reflecting on several issues raised in the meeting, and stating that academic medicine is moving into a period when demands for rewriting its social contract will increase. PMID:9311315

  19. Academic Emergency Medicine Physicians’ Knowledge of Mechanical Ventilation

    Susan R. Wilcox

    2016-05-01

    Full Text Available Introduction: Although emergency physicians frequently intubate patients, management of mechanical ventilation has not been emphasized in emergency medicine (EM education or clinical practice. The objective of this study was to quantify EM attendings’ education, experience, and knowledge regarding mechanical ventilation in the emergency department. Methods: We developed a survey of academic EM attendings’ educational experiences with ventilators and a knowledge assessment tool with nine clinical questions. EM attendings at key teaching hospitals for seven EM residency training programs in the northeastern United States were invited to participate in this survey study. We performed correlation and regression analyses to evaluate the relationship between attendings’ scores on the assessment instrument and their training, education, and comfort with ventilation. Results: Of 394 EM attendings surveyed, 211 responded (53.6%. Of respondents, 74.5% reported receiving three or fewer hours of ventilation-related education from EM sources over the past year and 98 (46% reported receiving between 0-1 hour of education. The overall correct response rate for the assessment tool was 73.4%, with a standard deviation of 19.9. The factors associated with a higher score were completion of an EM residency, prior emphasis on mechanical ventilation during one’s own residency, working in a setting where an emergency physician bears primary responsibility for ventilator management, and level of comfort with managing ventilated patients. Physicians’ comfort was associated with the frequency of ventilator changes and EM management of ventilation, as well as hours of education. Conclusion: EM attendings report caring for mechanically ventilated patients frequently, but most receive fewer than three educational hours a year on mechanical ventilation, and nearly half receive 0-1 hour. Physicians’ performance on an assessment tool for mechanical ventilation is

  20. Importance of international networking in academic family medicine

    Zalika Klemenc-Ketiš

    2014-05-01

    Full Text Available European family medicine/general practice (FM/GP has travelled the long and successful journey of profiling the discipline and has produced valuable position papers on education and research. Nowadays, academic medicine is one of the pillars in the future development of FM/GP in Europe. A common European curriculum on undergraduate and postgraduate family medicine is needed. Also, a sound international platform of teaching institutions and/or teachers of family medicine would foster the further development of family medicine as an academic discipline. This would stimulate students and teachers to engage in international exchange to gain new knowledge and experiences, present their work and ideas abroad and prepare the conditions for further exchange of students and teachers. Conclusion. Established departments of FM/GP, led by a teacher who is a family physician/general practitioner, at each Medical School in Europe should provide students with knowledge and skills related to the core attributes of FM/GP. International exchanges of teachers and students should foster the development of a common curriculum on FM in Europe and foster improvement in the quality of FM education.

  1. Hospital medicine (Part 2): what would improve acute hospital care?

    Kellett, John

    2009-09-01

    There are so many obvious delays and inefficiencies in our traditional system of acute hospital care; it is clear that if outcomes are to be improved prompt accurate assessment immediately followed by competent and efficient treatment is essential. Early warning scores (EWS) help detect acutely ill patients who are seriously ill and likely to deteriorate. However, it is not known if any EWS has universal applicability to all patient populations. The benefit of Rapid Response Systems (RRS) such as Medical Emergency Teams has yet to be proven, possibly because doctors and nurses are reluctant to call the RRS for help. Reconfiguration of care delivery in an Acute Medical Assessment Unit has been suggested as a "proactive" alternative to the "reactive" approach of RRS. This method ensures every patient is in an appropriate and safe environment from the moment of first contact with the hospital. Further research is needed into what interventions are most effective in preventing the deterioration and\\/or resuscitating seriously ill patients. Although physicians expert in hospital care decrease the cost and length of hospitalization without compromising outcomes hospital care will continue to be both expensive and potentially dangerous.

  2. Education in geriatric medicine for community hospital staff.

    O'Hanlon, Shane

    2010-12-01

    Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing staff in Irish community hospitals to examine this area in more detail. Staff in all 18hospitals in the Health Service Executive (South) area were invited to participate. The response rate was 100%. Sixteen of the 18 respondents (89%) felt staff did not have enough education in geriatric medicine. Just over half of hospitals had regular staff education sessions in the area, with a minority of sessions led by a geriatrician, and none by GPs. Geriatrician visits were valued, but were requested only every 1-3 months. Staff identified challenging behaviour and dementia care as the areas that posed most difficulty.

  3. The unbooked maternity patient in an academic hospital in Durban

    R. Gcaba

    1992-09-01

    Full Text Available This paper examines the unbooked maternity patient in an academic hospital in Durban, Natal; This hospital is the biggest hospital serving the underprivileged population of this area. Of the 16000 annual deliveries in this hospital, about 12% are unbooked patients. The health belief model of Rosenstock, as interpreted by Mikhail and Cox’s interaction model of client health behaviour were used as a theoretical framework for this research. A qualitative case study methodology was undertaken and semi-structured interviews were conducted with unbooked mothers who had utilized appropriate health services in a previous pregnancy. The aim of such interviews was to explore reasons given by mothers for non-use of facilities in the current pregnancy. The basic trends reflected in the findings regarding non-utilization of health services were client instability, health service failure and socio-cultural constraints, The study is innovative and addresses the problem from a social-cultural and midwifery perspective.

  4. How one teaching hospital system and one medical school are jointly affirming their academic mission.

    Rosenblatt, M; Rabkin, M T; Tosteson, D C

    1997-06-01

    The economic forces that are reshaping the practice of medicine and the funding of medical research will have great impact on clinical education and research in teaching hospitals and their associated medical schools. Changes in the setting of and approach to medical education will need to be made in order to continue to train physicians at the same high level as in the past and to maintain the productivity of our national biomedical research enterprise and its contributions to health. Academic leaders, such as department chiefs who have clinical service responsibilities, are finding it more and more difficult to manage simultaneously the demands of the clinical business, education, and research. In an effort to organize a teaching hospital and a medical school in a manner that would position them to maintain more effectively their common academic mission front and center with the clinical business, Harvard Medical School and the Beth Israel Hospital created a joint venture in 1996. The new nonprofit Institute for Education and Research has education and research as its top (and only) mission. It is designed to provide additional and specific academic leadership and to enable the joint venture to undertake strategic planning for the academic mission. In addition to the challenges it faces from changes in the external environment, the Institute for Education and Research will need to establish a new pattern of interactions internally within the parent institutions. Collaborations with department chairs and faculty are an essential ingredient for its success. It is hoped that this structure will prove to be a useful template for organizing other medical school-hospital collaborations on behalf of the academic mission. PMID:9200578

  5. Health care financing policy for hospitalized pulmonary medicine patients.

    Muñoz, E; Barrau, L; Goldstein, J; Benacquista, T; Mulloy, K; Wise, L

    1989-01-01

    Several federal bodies provide ongoing analyses of the Medicare DRG prospective hospital payment system. Many states are using DRG prospective "all payor systems" for hospital reimbursement (based on the federal model). In All Payor Systems, Medicare, Medicaid, Blue Cross and other commercial insurers pay by the DRG mode; New York State has been All Payor since 1/1/88. This study simulated DRG All Payor methods on a large sample (n = 1,662) of pulmonary medicine patients for a two-year period using both federal and New York DRG reimbursement now in effect at our hospital. Medicare patients had (on average) a longer hospital length of stay and total hospital cost compared to patients from Medicaid, Blue Cross, and other commercial payors. Medicare patients also had a greater severity of illness compared to patients from Blue Cross Medicaid or other payors. All payors, however, (Medicaid, Blue Cross, Medicare and commercial insurers) generated significant financial risk under the DRG All Payor scheme. These data suggest that federal, state, and private payors may be underreimbursing for the care of the hospitalized pulmonary medicine patients using the DRG prospective hospital payment scheme. Health care financing policy, as demonstrated in this study, may limit both the access and quality of care for many pulmonary medicine patients in the future. PMID:2491799

  6. Quality Improvement Practices in Academic Emergency Medicine: Perspectives from the Chairs

    DelliFraine, Jami L

    2010-12-01

    Full Text Available Objective: To assess academic emergency medicine (EM chairs’ perceptions of quality improvement (QI training programs.Methods: A voluntary anonymous 20 item survey was distributed to a sample of academic chairs of EM through the Association of Academic Chairs of Emergency Medicine. Data was collected to assess the percentage of academic emergency physicians who had received QI training, the type of training they received, their perception of the impact of this training on behavior, practice and outcomes, and any perceived barriers to implementing QI programs in the emergency department.Results: The response rate to the survey was 69% (N = 59. 59.3% of respondents report that their hospital has a formal QI program for physicians. Chairs received training in a variety of QI programs. The type of QI program used by respondents was perceived as having no impact on goals achieved by QI (χ2 = 12.382; p = 0.260, but there was a statistically significant (χ2 = 14.383; p = 0.006 relationship between whether or not goals were achieved and academic EM chairs’ perceptions about return on investment for QI training. Only 22% of chairs responded that they have already made changes as a result of the QI training. 78.8% of EM chairs responded that quality programs could have a significant positive impact on their practice and the healthcare industry. Chairs perceived that QI programs had the most potential value in the areas of understanding and reducing medical errors and improving patient flow and throughput. Other areas of potential value of QI include improving specific clinical indicators and standardizing physician care.Conclusion: Academic EM chairs perceived that QI programs were an effective way to drive needed improvements. The results suggest that there is a high level of interest in QI but a low level of adoption of training and implementation.[West J Emerg Med. 2010; 11(5:479-485.

  7. An Integrated Framework for Gender Equity in Academic Medicine.

    Westring, Alyssa; McDonald, Jennifer M; Carr, Phyllis; Grisso, Jeane Ann

    2016-08-01

    In 2008, the National Institutes of Health funded 14 R01 grants to study causal factors that promote and support women's biomedical careers. The Research Partnership on Women in Biomedical Careers, a multi-institutional collaboration of the investigators, is one product of this initiative.A comprehensive framework is needed to address change at many levels-department, institution, academic community, and beyond-and enable gender equity in the development of successful biomedical careers. The authors suggest four distinct but interrelated aspects of culture conducive to gender equity: equal access to resources and opportunities, minimizing unconscious gender bias, enhancing work-life balance, and leadership engagement. They review the collection of eight articles in this issue, which each address one or more of the four dimensions of culture. The articles suggest that improving mentor-mentee fit, coaching grant reviewers on unconscious bias, and providing equal compensation and adequate resources for career development will contribute positively to gender equity in academic medicine.Academic medicine must adopt an integrated perspective on culture for women and acknowledge the multiple facets essential to gender equity. To effect change, culture must be addressed both within and beyond academic health centers (AHCs). Leaders within AHCs must examine their institutions' processes, resources, and assessment for fairness and transparency; mobilize personnel and financial resources to implement evidence-based initiatives; and assign accountability for providing transparent progress assessments. Beyond AHCs, organizations must examine their operations and implement change to ensure parity of funding, research, and leadership opportunities as well as transparency of assessment and accreditation. PMID:27276008

  8. Hospital Medicine's Evolution: Literature Search and Interview Study with Practices

    Greenwald, Ruth; Novelli, Marianne; Lorence, Tom

    2011-01-01

    Introduction: Hospital medicine is a young specialty that is still evolving. In its early years, research focused on clinical outcomes, efficiency, and cost effectiveness. As the specialty matures, increasing attention is being given to the patient and hospitalist experience with the hospitalist model of care.

  9. Women's Health and Women's Leadership in Academic Medicine: Hitting the Same Glass Ceiling?

    Carnes, Molly; Morrissey, Claudia; Geller, Stacie E.

    2008-01-01

    The term “glass ceiling” refers to women's lack of advancement into leadership positions despite no visible barriers. The term has been applied to academic medicine for over a decade but has not previously been applied to the advancement of women's health. This paper discusses (1) the historical linking of the advances in women's health with women's leadership in academic medicine, (2) the slow progress of women into leadership in academic medicine, and (3) indicators that the advancement of ...

  10. Quality Improvement Practices in Academic Emergency Medicine: Perspectives from the Chairs

    DelliFraine, Jami L.; Langabeer, James; King, Brent

    2010-01-01

    Objective: To assess academic emergency medicine (EM) chairs’ perceptions of quality improvement (QI) training programs. Methods: A voluntary anonymous 20 item survey was distributed to a sample of academic chairs of EM through the Association of Academic Chairs of Emergency Medicine. Data was collected to assess the percentage of academic emergency physicians who had received QI training, the type of training they received, their perception of the impact of this training on behavior...

  11. Trends in Clinically Significant Pain Prevalence Among Hospitalized Cancer Patients at an Academic Hospital in Taiwan

    Wang, Wei-Yun; Ho, Shung-Tai; Wu, Shang-Liang; Chu, Chi-Ming; Sung, Chun-Sung; Wang, Kwua-Yun; Liang, Chun-Yu

    2016-01-01

    Abstract Clinically significant pain (CSP) is one of the most common complaints among cancer patients during repeated hospitalizations, and the prevalence ranges from 24% to 86%. This study aimed to characterize the trends in CSP among cancer patients and examine the differences in the prevalence of CSP across repeated hospitalizations. A hospital-based, retrospective cohort study was conducted at an academic hospital. Patient-reported pain intensity was assessed and recorded in a nursing information system. We examined the differences in the prevalence of worst pain intensity (WPI) and last evaluated pain intensity (LPI) of ≥4 or ≥7 points among cancer inpatients from the 1st to the 18th hospitalization. Linear mixed models were used to determine the significant difference in the WPI and LPI (≥4 or ≥7 points) at each hospitalization. We examined 88,133 pain scores from the 1st to the 18th hospitalization among cancer patients. The prevalence of the 4 CSP types showed a trend toward a reduction from the 1st to the 18th hospitalization. There was a robust reduction in the CSP prevalence from the 1st to the 5th hospitalization, except in the case of LPI ≥ 7 points. The prevalence of a WPI ≥ 4 points was significantly higher (0.240-fold increase) during the 1st hospitalization than during the 5th hospitalization. For the 2nd, 3rd, and 4th hospitalizations, there was a significantly higher prevalence of a WPI ≥ 4 points compared with the 5th hospitalization. We also observed significant reductions in the prevalence of a WPI ≥ 7 points during the 1st to the 4th hospitalizations, an LPI ≥ 4 points during the 1st to the 3rd hospitalizations, and an LPI ≥ 7 points during the 1st to the 2nd hospitalization. Although the prevalence of the 4 CSP types decreased gradually, it is impossible to state the causative factors on the basis of this observational and descriptive study. The next step will examine the factors that determine the CSP prevalence among

  12. The Hospital Medicine Reengineering Network (HOMERuN): A learning organization focused on improving hospital care

    Auerbach, Andrew D.; Patel, Mitesh S.; Metlay, Josh; Schnipper, Jeffrey; Williams, Mark V.; Robinson, Edmondo; Kripalani, Sunil; Lindenauer, Peter K.

    2016-01-01

    Converting the health care delivery system into a learning organization is a key strategy for improving health outcomes. While the learning organization approach has been successful in neonatal intensive care units and disease specific collaboratives there are few examples in general medicine and fewer still have leveraged the role of hospitalists to implement improvements. This paper describes the rationale for and early work of the Hospital Medicine Reengineering Network (HOMERuN), a collaborative of hospitals, hospitalists, and care teams whose overarching purpose is to use data to guide collaborative efforts aimed at improving the care of hospitalized patients. We review HOMERuN’s collaborative model, which focuses on a community-based participatory approach modified to include hospital-based as well as the larger community, and HOMERuN’s initial project focusing on care transition improvement using perspectives from the patient and caregiver. PMID:24448050

  13. Complementary and Alternative Medicine Use among Physicians in Oriental Medicine Hospitals in Vietnam: A Hospital-Based Survey

    Duong Duc Pham

    2013-01-01

    Full Text Available Interest in complementary and alternative medicine (CAM is growing worldwide, even in Vietnam where traditional medicine is considered mainstream. We conducted a survey of the knowledge, attitudes, and practices of CAM therapies among physicians in oriental medicine (OM hospitals in Vietnam. A two-stage random selection process selected 337 physicians who were interviewed using a face-to-face method with a standardized structured questionnaire. Data from 312 physicians who completed the questionnaire suggested that oriental herbal medicine and acupuncture (Vietnamese OM version were the more commonly used CAM modalities compared with Vietnamese folk medicine and other forms of CAM. A broad range of CAM modalities, particularly chiropractice, diet supplements, and dietary therapy, and an excessive proportion of western medication were employed in conjunction with OM in the physicians’ daily practice. Their daily practice was influenced by the source of knowledge, education level, medical specialty, and working environment. These findings suggest that physicians in OM hospitals in Vietnam have interests in various forms of CAM therapies besides traditional modes.

  14. Radioprotection in nuclear medicine department of 'Porto Alegre Clinical Hospital'

    The use of ionizing radiation in medicine allows great benefits. Nuclear Medicine uses ionizing radiation for medical diagnostic, such as: tumor, cancer, and dysfunctions location. However the use of ionizing radiation must be controlled in order to avoid likely biological effects in human beings. In order to extremely minimize that these effects appear, the Medical Physics Department of the Porto Alegre Clinical Hospital has implemented some procedures to assure that handling and use of radioactive material are in a safe way. This preoccupation is considered in all the places of nuclear medicine sector since the moment when the radioactive material is brought into including its manipulation and retirement, the exam process being accompanied. (authors). 4 refs

  15. Alternative funding for academic medicine: experience at a Canadian Health Sciences Center.

    Rosenbaum, Paul; Shortt, S E D; Walker, D M C

    2004-03-01

    In 1994 the School of Medicine of Queen's University in Kingston, Ontario, its clinical teachers, and the three principal teaching hospitals initiated a new approach to funding, the Alternative Funding Plan, a pragmatic response to the inability of fee-for-service billing by clinical faculty to subsidize the academic mission of the health sciences center. The center was funded to provide a package of service and academic deliverables (outputs), rather than on the basis of payment for physician clinical activity (inputs). The new plan required a new governance structure representing stakeholders and raised a number of important issues: how to reconcile the preservation of physician professional autonomy with corporate responsibilities; how to gather requisite information so as to equitably allocate resources; and how to report to the Ontario Ministry of Health and Long-term Care in order to demonstrate accountability. In subsequent iterations of the agreement it was necessary to address issues of flexibility resulting from locked-in funding levels and to devise meaningful performance measures for departments and the center as a whole. The authors conclude that the Alternative Funding Plan represents a successful innovation in funding for an academic health sciences center in that it has created financial stability, as well as modest positive effects for education and research. The Ontario government hopes to replicate the model at the province's other four health sciences centers, and it may have applicability in any jurisdiction in which the costs of medical education outstrip the capacity of faculty clinical earnings. PMID:14985191

  16. After the "Doc Fix": Implications of Medicare Physician Payment Reform for Academic Medicine.

    Rich, Eugene C; Reschovsky, James D

    2016-07-01

    The Medicare Access and CHIP Reauthorization Act (MACRA) introduces incentives for clinicians serving Medicare patients to move away from traditional "fee-for-service" and into alternative payment models (APMs) such as accountable care organizations and bundled payment arrangements. Thus, MACRA creates strong reasons for various teaching clinical services to participate in APMs, not only for Medicare patients but for other public and private payers as well. Unfortunately, different APMs may be more or less applicable to the diverse teaching physician roles, academic clinical programs, and patient populations served by medical schools and teaching hospitals. Therefore, this time of transition will complicate the work of academic clinical program leaders endeavoring to sustain the tripartite mission of patient care, health professional education, and research. Nonetheless, payment reforms promoted by MACRA can reward efforts to reinvent medical education to better incorporate value into medical decision making, as well as to give clinical learners the tools and insights needed to recognize their personal financial (and other) conflicts and navigate these to meet their patients' needs. This post-MACRA environment may intensify the need for researchers in academic medicine to stay independent of the short-term financial interests of affiliated clinical institutions. Health sciences scholars must be able to study effectively and speak forcefully regarding the actual benefits, risks, and costs of health care services so that educators and clinicians can identify high-value care and deliver it to their patients. PMID:27224297

  17. Hospital Medicine (Part 1): what is wrong with acute hospital care?

    Kellett, John

    2009-09-01

    Modern hospitals are facing several challenges and, over the last decade in particular, many of these institutions have become dysfunctional. Paradoxically as medicine has become more successful the demand for acute hospital care has increased, yet there is no consensus on what conditions or complaints require hospital admission and there is wide variation in the mortality rates, length of stay and possibly standards of care between different units. Most acutely ill patients are elderly and instead of one straightforward diagnosis are more likely to have a complex combination of multiple co-morbid conditions. Any elderly patient admitted to hospital is at considerable risk which must be balanced against the possible benefits. Although most of the patients in hospital die from only approximately ten diagnoses, obvious life saving treatment is often delayed by a junior doctor in-training first performing an exhaustive complete history and physical, and then ordering a number of investigations before consulting a senior colleague. Following this traditional hierarchy delays care with several "futile cycles" of clinical activity thoughtlessly directed at the patient without any benefit being delivered. If acute hospital medicine is to be improved changes in traditional assumptions, attitudes, beliefs and practices are needed.

  18. The Hospital Medicine Reengineering Network (HOMERuN): a learning organization focused on improving hospital care.

    Auerbach, Andrew D; Patel, Mitesh S; Metlay, Joshua P; Schnipper, Jeffrey L; Williams, Mark V; Robinson, Edmondo J; Kripalani, Sunil; Lindenauer, Peter K

    2014-03-01

    Converting the health care delivery system into a learning organization is a key strategy for improving health outcomes. Although the collaborative learning organization approach has been successful in neonatal intensive care units and disease-specific collaboratives, there are few examples in general medicine and none in adult medicine that have leveraged the role of hospitalists nationally across multiple institutions to implement improvements. The authors describe the rationale for and early work of the Hospital Medicine Reengineering Network (HOMERuN), a collaborative of hospitals, hospitalists, and multidisciplinary care teams founded in 2011 that seeks to measure, benchmark, and improve the efficiency, quality, and outcomes of care in the hospital and afterwards. Robust and timely evaluation, with learning and refinement of approaches across institutions, should accelerate improvement efforts. The authors review HOMERuN's collaborative model, which focuses on a community-based participatory approach modified to include hospital-based staff as well as the larger community. HOMERuN's initial project is described, focusing on care transition measurement using perspectives from the patient, caregiver, and providers. Next steps and sustainability of the organization are discussed, including benchmarking, collaboration, and effective dissemination of best practices to stakeholders. PMID:24448050

  19. Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

    Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. PMID:26444698

  20. Quality of Life in Emergency Medicine Specialists of Teaching Hospitals

    Afshin Amini

    2014-08-01

    Full Text Available Introduction: Quality of life (QOL of emergency medicine specialists can be effective in providing services to patients. The aim of the present study was evaluating the lifestyle of emergency medicine practitioners, understanding their problems, and addressing the solutions to enhance and improve their lifestyles, in teaching hospitals in Iran. Method: This descriptive cross-sectional study was conducted on emergency medicine physicians in 10 teaching hospitals of Iran in 2011. Emergency physicians with at least three years of experience who interested in the study, were enrolled in the project. All participants filled out the consent form and QOL questionnaires, then underwent physical examinations and some medical laboratory tests. Categorical variables were reported as percentages, while continuous variables expressed as means and standard deviations. p <0.05 was considered statistically significant. Results: Totally, 100 subjects participated in the study, of whom 48 were male. The mean and standard deviation of the physicians’ age were 38.7±5.1 years. 43% of physicians had an average QOL, while 37% good. 96% of studied physicians had a good condition regarding habitual history, while 93% of them had a poor condition in performing screening tests. Exercise program and personal health in individuals with normal BMI were correlated with higher levels of QOL. BMI was higher in 40-50 years old subjects than youngers. Hypertension was present in five cases (5%, hypercholesterolemia in six (6%, hypertriglyceridemia in six (6%, increased LDL in four (4%, low HDL in four (4%, and impaired FBS in 4 (4%. Conclusion: The findings showed that 63% of studied emergency physicians had an average level of QOL and other ones good. The majority of physicians had undesirable situation regarding the performance of screening tests.

  1. Women in Academic Medicine Leadership: Has Anything Changed in 25 Years?

    Rochon, Paula A; Davidoff, Frank; Levinson, Wendy

    2016-08-01

    Over the past 25 years, the number of women graduating from medical schools in the United States and Canada has increased dramatically to the point where roughly equal numbers of men and women are graduating each year. Despite this growth, women continue to face challenges in moving into academic leadership positions. In this Commentary, the authors share lessons learned from their own careers relevant to women's careers in academic medicine, including aspects of leadership, recruitment, editorship, promotion, and work-life balance. They provide brief synopses of current literature on the personal and social forces that affect women's participation in academic leadership roles. They are persuaded that a deeper understanding of these realities can help create an environment in academic medicine that is generally more supportive of women's participation, and that specifically encourages women in medicine to take on academic leadership positions. PMID:27306972

  2. Commentary: doctors without boundaries: the ethics of teacher-student relationships in academic medicine.

    Larkin, Gregory Luke; Mello, Michael J

    2010-05-01

    Possessed of both instinct and intellect, physician teachers are required to be respectful exemplars of professionalism and interpersonal ethics in all environments, be it the hospital, classroom, or outside the educational setting. Sometimes, even while protecting the sanctity of the teacher-student relationship, they may surreptitiously find themselves in the throes of consensual intimacy, boundary violations, student exploitation, or other negative interpersonal and/or departmental dynamics. One may question how an academic can consistently resolve this tension and summon the temperance, humility, charity, and restraint needed to subdue lust, pride, abuse, and incontinence in the workplace. One important answer may lie in an improved understanding of the moral necessity of social cooperation, fairness, reciprocity, and respect that is constitutive of the physician-teacher role. Although normative expectations and duties have been outlined in extant codes of ethics and conduct within academic medicine, to date, few training programs currently teach faculty and residents about the ethics of appropriate pedagogic and intimate relations between teaching staff and students, interns, residents, researchers, and other trainees. This essay highlights examples from history, literature, and medical ethics as one small step toward filling this void. PMID:20520021

  3. Pediatric hospital medicine: a strategic planning roundtable to chart the future.

    Rauch, Daniel A; Lye, Patricia S; Carlson, Douglas; Daru, Jennifer A; Narang, Steve; Srivastava, Rajendu; Melzer, Sanford; Conway, Patrick H

    2012-04-01

    Given the growing field of Pediatric Hospital Medicine (PHM) and the need to define strategic direction, the Society of Hospital Medicine, the American Academy of Pediatrics, and the Academic Pediatric Association sponsored a roundtable to discuss the future of the field. Twenty-one leaders were invited plus a facilitator utilizing established health care strategic planning methods. A "vision statement" was developed. Specific initiatives in 4 domains (clinical practice, quality of care, research, and workforce) were identified that would advance PHM with a plan to complete each initiative. Review of the current issues demonstrated gaps between the current state of affairs and the full vision of the potential impact of PHM. Clinical initiatives were to develop an educational plan supporting the PHM Core Competencies and a clinical practice monitoring dashboard template. Quality initiatives included an environmental assessment of PHM participation on key committees, societies, and agencies to ensure appropriate PHM representation. Three QI collaboratives are underway. A Research Leadership Task Force was created and the Pediatric Research in Inpatient Settings (PRIS) network was refocused, defining a strategic framework for PRIS, and developing a funding strategy. Workforce initiatives were to develop a descriptive statement that can be used by any PHM physician, a communications tool describing "value added" of PHM; and a tool to assess career satisfaction among PHM physicians. We believe the Roundtable was successful in describing the current state of PHM and laying a course for the near future. PMID:21994159

  4. Robotics and medicine: A scientific rainbow in hospital.

    Jeelani, S; Dany, A; Anand, B; Vandana, S; Maheswaran, T; Rajkumar, E

    2015-08-01

    The journey of robotics is a real wonder and astonishingly can be considered as a scientific rainbow showering surprising priceless power in the era of future technologies. The astonishing seven technologies discussed in this paper are da Vinci Robotic surgical system and sperm sorters for infertility, Veebot for blood investigation, Hanako the robotic dental patient for simulating the dental patient and helping a trainee dentist, RP-7 robot who is around-the-clock physician connecting the physician and patient, Robot for Interactive Body Assistance (RIBA) who is a RIBA serving as a nurse, Bushbot serving as a brilliant surgeon, and Virtibot helping in virtual autopsy. Thus, robotics in medicine is a budding field contributing a great lot to human life from before birth to afterlife in seven forms thus gracefully portraying a scientific rainbow in hospital environment. PMID:26538882

  5. Differences between first and fourth year medical students’ interest in pursuing careers in academic medicine

    Carter, Mary

    2016-01-01

    Objectives The purpose of this pilot study was to assess the differences in the attitudes of first and fourth-year medical students regarding careers in academics. We also sought to identify any factors associated with an increased interest in academic medicine. Methods A cross-sectional study was conducted during October 2013 at the University of Louisville.  All first and fourth year medical students were invited to complete an online survey utilizing a survey instrument developed through literature review.  Demographic data and information about background experiences were collected in addition to participants' perceptions regarding careers in academia using a 5-point Likert scale. Participants were also queried about their current interest in a career in academics and the likelihood they would pursue academic medicine. Results Of the 330 potential participants, 140 (42.4%) agreed to participate. Overall, fourth-years reported a higher likelihood of pursuing an academic career than first-years. Research experience, publications, distinction track interest or involvement, and belief that a career in academics would reduce salary potential were positively correlated with reported likelihood of pursuing academic medicine. Conclusions Findings from this pilot study demonstrate differences in interest in academic medicine between junior and senior medical students. Additionally, several factors were associated with a high likelihood of self-reported interest in academic. Based on these findings, efforts to increase medical students’ interest in academic medicine careers could be supported by providing more research and teaching opportunities or distinction track options as a structured part of the medical school curriculum. PMID:27219295

  6. Admission Scores as a Predictor of Academic Success in the Fiji School of Medicine

    Ezeala, Christian C.; Swami, Niraj S.; Lal, Nilesh; Hussain, Shagufta

    2012-01-01

    Secondary education in Fiji ends with the Form 7 examination. Predictive validity for academic success of Form 7 scores which form the basis for admission into the Bachelor of Medicine Bachelor of Surgery programme of the Fiji School of Medicine was examined via a cohort of 129 students. Success rates for year 1 in 2008, 2009, and 2010 were 90.7…

  7. A Qualitative Study of Work-Life Choices in Academic Internal Medicine

    Isaac, Carol; Byars-Winston, Angela; McSorley, Rebecca; Schultz, Alexandra; Kaatz, Anna; Carnes, Mary L.

    2014-01-01

    The high attrition rate of female physicians pursuing an academic medicine research career has not been examined in the context of career development theory. We explored how internal medicine residents and faculty experience their work within the context of their broader life domain in order to identify strategies for facilitating career…

  8. Evaluation of Radiation Protection in Nuclear Medicine Department in Namazi Hospital According to Global Accepted Standards

    Mohammad Mehdi Movahedi; Alireza Mehdizadeh

    2013-01-01

    Background & Objective: In the recent years, nuclear medicine has enjoyed remarkable growth thanks to such novel technologies as SPECT-CT and PET, which are utilized for the recognition of new detectable molecules and radiopharmaceutical medicines. Therefore, the current regulations on radiation protection require revision. Namazi Hospital of Shiraz is one of the first nuclear medicine centers in Iran. Many patients visit this hospital every year; consequently, radiation protection must b...

  9. Do follow-on therapeutic substitutes induce price competition between hospital medicines? Evidence from the Danish hospital sector

    Hostenkamp, Gisela

    2013-01-01

    Objective The pricing of follow-on drugs, that offer only limited health benefits over existing therapeutic alternatives, is a recurring health policy debate. This study investigates whether follow-on therapeutic substitutes create price competition between branded hospital medicines. Methods New...... pioneer products were significantly reduced as a reaction to competition from follow-on drugs. Conclusion Competition between patented therapeutic substitutes did not seem to increase price competition and containment of pharmaceutical expenditures in the Danish hospital market. Strengthening hospitals...

  10. Analysis of Prescribing Pattern and the Availability of Medicines at General Hospitals in Indonesia

    Selma Siahaan

    2014-08-01

    Full Text Available Objective: The study aim to provide description analyses of prescribing pattern and the availability of medicines ingeneral hospital as access components to medicines. Methods: This is non-intervention analysis using data from national health facilities research 2011. Samples: 40 items of essential medicines were surveyed at all general hospitals that belong to government in all districts in Indonesia. Bivariate and descriptive analyses intent to analyses the availability of medicines in hospital in Indonesia and pattern of drug prescription. Results: The availability of drugs in the government’s hospital is quite good, except fixed dose combination for tuberculosis, vitamin A and vaccines. Those are program’s medicines of health ministries. The results also show that the prescription using generic medicines for adults and childrenin the hospital were 62.1% and 62.6%. The prescription using essential medicines for adults and children were 32.6% and 35.2%. Conclusion: Drug prescription pattern have not been rational. Recommendation: Based on the results, the use of rational medicines should be keep promoting by the government. In line with this the incentive should be provided to thedoctors and pharmacist who serve the patient with the rational use medicines.

  11. Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital.

    Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

    2016-01-01

    This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely. PMID:27077874

  12. Of Sophists and Spin-Doctors: Industry-Sponsored Ghostwriting and the Crisis of Academic Medicine

    Leemon McHenry

    2010-01-01

    Full Text Available Ghostwriting for medical journals has become a major, but largely invisible, factor contributing to the problem of credibility in academic medicine. In this paper I argue that the pharmaceutical marketing objectives and use of medical communication firms in the production of ghostwritten articles constitute a new form of sophistry. After identifying three distinct types of medical ghostwriting, I survey the known cases of ghostwriting in the literature and explain the harm done to academic medicine and to patients. Finally, I outline steps to address the problem and restore the integrity of the medical literature.

  13. Perceptions and Development of Political Leadership Skills of Women in Academic Medicine: A Study of Selected Women Alumnae of the Hedwig Van Ameringen Executive Leadership in Academic Medicine (ELAM) Program

    Evers, Cynthia D.

    2014-01-01

    Despite women having much to offer in the field of academic medicine, women may not be sufficiently attuned to developing their political leadership skills, which are crucial for successful leadership (Ferris, Frink, & Galang, 1993; Ferris & Perrewe, 2010). The study's purpose was to examine how 14 women in academic medicine perceived…

  14. Barriers to Research Utilization among Registered Nurses in Traditional Chinese Medicine Hospitals: A Cross-Sectional Survey in China

    Fen Zhou

    2015-01-01

    Full Text Available Background. As there might be relevant differences with regard to research utilization in the general hospitals, we aimed to study research utilization among registered nurses working in traditional Chinese medicine hospitals. Methods. A total of 648 registered nurses from 4 tertiary-level hospitals in China were recruited for participation. A modified BARRIERS Scale and self-designed questionnaires were used for data collection. Data were analyzed with descriptive statistics, t-tests, and one-way ANOVAs and Spearman correlation analysis. Results. Overall, items which belong to the subscale “Research” were identified as the most important barriers. Among the individual items, the lack of time on the job was ranked as the top barrier, followed by the lack of knowledgeable colleagues and by overwhelming research publications. Clinical experience, working pressure, job satisfaction, and research experience could be identified as associated factors for barriers to research utilization. Conclusions. Registered nurses in traditional Chinese medicine hospitals felt high barriers to research utilization. Reducing registered nurses’ working pressure, promoting their positive attitude to nursing, and improving research training might be helpful for increasing research utilization. Close cooperation between clinical and nursing schools or academic research centres might facilitate the necessary change in nursing education and routine.

  15. Shaping the Future of Academic Health Centers: The Potential Contributions of Departments of Family Medicine

    Newton, Warren P.; DuBard, C Annette

    2006-01-01

    Academic health centers (AHCs) must change dramatically to meet the changing needs of patients and society, but how to do this remains unclear. The purpose of this supplement is to describe ways in which departments of family medicine can play leadership roles in helping AHCs evolve. This overview provides background for case studies and commentaries about the contribution of departments of family medicine in 5 areas: (1) ambulatory and primary care, (2) indigent care, (3) education in commun...

  16. Improving interunit transitions of care between emergency physicians and hospital medicine physicians: a conceptual approach.

    Beach, Christopher; Cheung, Dickson S; Apker, Julie; Horwitz, Leora I; Howell, Eric E; O'Leary, Kevin J; Patterson, Emily S; Schuur, Jeremiah D; Wears, Robert; Williams, Mark

    2012-10-01

    Patient care transitions across specialties involve more complexity than those within the same specialty, yet the unique social and technical features remain underexplored. Further, little consensus exists among researchers and practitioners about strategies to improve interspecialty communication. This concept article addresses these gaps by focusing on the hand-off process between emergency and hospital medicine physicians. Sensitivity to cultural and operational differences and a common set of expectations pertaining to hand-off content will more effectively prepare the next provider to act safely and efficiently when caring for the patient. Through a consensus decision-making process of experienced and published authorities in health care transitions, including physicians in both specialties as well as in communication studies, the authors propose content and style principles clinicians may use to improve transition communication. With representation from both community and academic settings, similarities and differences between emergency medicine and internal medicine are highlighted to heighten appreciation of the values, attitudes, and goals of each specialty, particularly pertaining to communication. The authors also examine different communication media, social and cultural behaviors, and tools that practitioners use to share patient care information. Quality measures are proposed within the structure, process, and outcome framework for institutions seeking to evaluate and monitor improvement strategies in hand-off performance. Validation studies to determine if these suggested improvements in transition communication will result in improved patient outcomes will be necessary. By exploring the dynamics of transition communication between specialties and suggesting best practices, the authors hope to strengthen hand-off skills and contribute to improved continuity of care. PMID:23035952

  17. Introduction to the role of model of value-based medicine in the development of private hospitals

    Shou-ping CHEN

    2014-01-01

    Full Text Available Value-based medicine is the tendency of modern medicine.This paper elaborated the properties of value-based medicine,analyzed the role of model of value-based medicine in modern medicine,and put forward ideas and related measures with the model of value-based medicine to promote the development of private hospitals, which provided some reference for development of private hospitals

  18. Job Stress and Burnout among Academic Career Anaesthesiologists at an Egyptian University Hospital

    Tarek Shams; Ragaa El-Masry

    2013-01-01

    Objectives: There is compelling evidence that anaesthesiology is a stressful occupation and, when this stressful occupation is associated with an academic career, the burnout level is high. This study aimed to assess the predictors and prevalence of stress and burnout, associated sociodemographic characteristics, and job-related features. Methods: A cross-sectional survey study was carried out at Mansoura University Hospital in Egypt among 98 anaesthesiologists who had academic careers. The E...

  19. Touriam Health Care Center of Xiyuan Hospital China Academy of Traditioal Chinese Medicine

    2000-01-01

    Brief Introduction to Xiyuan Hospital Xiyuan Hospital of China Academy of Traditional Chinese Medicine (TCM) was founded in 1955.It is a large comprehensive hospital directly attached to the Chinese Ministry of Health and State Administration of TOM. This hospital governs First Clinical Medical Institute, Gerontology Institute and Clinical Pharmacological Institute of China Academy of TOM, and Clinical Pharmacological Base of the Health Ministry. It is a component of WHO Collaborating Center for Traditional Medicine. It also administers the Agency of Chinese Journal of Integrated Traditional Chinese and Western Medicine, the Society of Clinical Pharmacology of Chinese Drugs of China TOM Association, the Professional Committee of Hematology and Activating Blood-circulation and Removing Blood Stasis of Chinese Society of Integrated Traditional Chinese and Western Medicine.

  20. Model for collaboration: a rural medicine and academic health center teleradiology project

    Van Slyke, Mark A.; Eggli, Douglas F.; Prior, Fred W.; Salmon, William; Pappas, Gregory; Vanatta, Fred; Goldfetter, Warren; Hashem, Said

    1996-05-01

    A pilot project was developed to explore the role of subspecialty radiology support to rural medicine sites over a long-distance network. A collaborative relationship between 2 rural radiology practices and an academic health was established. Project objectives included: (1) Does the subspecialty consultation significantly change diagnosis patterns at the rural site? (2) Is there value added as measured by improved clinical care or an overall decreased cost of care? (3) Can a collaborative model be economically self-supportive? (4) Does the collaborative model encourage and support education and collegial relationships? Two rural hospitals were selected based on the level of imaging technology and willingness to cooperate. Image capture and network technology was chosen to make the network process transparent to the users. DICOM standard interfaces were incorporated into existing CT and MRI scanners and a film digitizer. Nuclear medicine images were transferred and viewed using a proprietary vendor protocol. Relevant clinical data was managed by a custom designed PC based Lotus Notes application (Patient Study Tracking System: PaSTS) (Pennsylvania Blue Shield Institute). All data was transferred over a Frame Relay network and managed by the Pennsylvania Commonwealth sponsored PA Health Net. Images, other than nuclear medicine, were viewed on a GE Advantage viewing station using a pair of 2 X 2.5 K gray scale monitors. Patient text data was managed by the PaSTS PC and displayed on a separate 15' color monitor. A total of 476 radiology studies were networked into the AHC. Randomly chosen research studies comprised 82% of the case work. Consultative and primary read cases comprised 17% and 1% respectively. The exercise was judged effective by both rural sites. Significant findings and diagnoses were confirmed in 73% of cases with discrepant findings in only 4%. One site benefited by adopting more advanced imaging techniques increasing the sophistication of radiology

  1. Developing an Organizational Understanding of Faculty Mentoring Programs in Academic Medicine in Major American Research Universities

    Fischer Zellers, Darlene

    2013-01-01

    This study examines the organizational and contextual factors associated with faculty mentoring programs in academic medicine within major research institutions in the United States, and explores the usefulness of organizational behavior theory in understanding these relationships. To date, many formal faculty mentoring programs are in operation…

  2. Academic Feedback in Veterinary Medicine: A comparison of School Leaver and Graduate Entry cohorts

    Hughes, Kirsty Jean; McCune, Velda; Rhind, Susan

    2013-01-01

    This study analysed the expectations and experiences of students on a five-year undergraduate ("n"?=?91) and four-year graduate entry ("n"?=?47) veterinary medicine degree programme relating to academic feedback. Qualitative and quantitative methodologies were used to explore new students' expectations and prior experiences of feedback and capture…

  3. Trends in Clinically Significant Pain Prevalence Among Hospitalized Cancer Patients at an Academic Hospital in Taiwan: A Retrospective Cohort Study.

    Wang, Wei-Yun; Ho, Shung-Tai; Wu, Shang-Liang; Chu, Chi-Ming; Sung, Chun-Sung; Wang, Kwua-Yun; Liang, Chun-Yu

    2016-01-01

    Clinically significant pain (CSP) is one of the most common complaints among cancer patients during repeated hospitalizations, and the prevalence ranges from 24% to 86%. This study aimed to characterize the trends in CSP among cancer patients and examine the differences in the prevalence of CSP across repeated hospitalizations. A hospital-based, retrospective cohort study was conducted at an academic hospital. Patient-reported pain intensity was assessed and recorded in a nursing information system. We examined the differences in the prevalence of worst pain intensity (WPI) and last evaluated pain intensity (LPI) of ≥ 4 or ≥ 7 points among cancer inpatients from the 1st to the 18th hospitalization. Linear mixed models were used to determine the significant difference in the WPI and LPI (≥ 4 or ≥ 7 points) at each hospitalization. We examined 88,133 pain scores from the 1st to the 18th hospitalization among cancer patients. The prevalence of the 4 CSP types showed a trend toward a reduction from the 1st to the 18th hospitalization. There was a robust reduction in the CSP prevalence from the 1st to the 5th hospitalization, except in the case of LPI ≥ 7 points. The prevalence of a WPI ≥ 4 points was significantly higher (0.240-fold increase) during the 1st hospitalization than during the 5th hospitalization. For the 2nd, 3rd, and 4th hospitalizations, there was a significantly higher prevalence of a WPI ≥ 4 points compared with the 5th hospitalization. We also observed significant reductions in the prevalence of a WPI ≥ 7 points during the 1st to the 4th hospitalizations, an LPI ≥ 4 points during the 1st to the 3rd hospitalizations, and an LPI ≥ 7 points during the 1st to the 2nd hospitalization. Although the prevalence of the 4 CSP types decreased gradually, it is impossible to state the causative factors on the basis of this observational and descriptive study. The next step will examine the factors that determine the CSP prevalence among cancer

  4. Designing and Publishing Indoor Maps for Patients and Visitors in an Academic Teaching Hospital

    Ryder, Kerry J

    2015-01-01

    Introduction. This project aims to improve the service user experience by designing and publishing an accessible indoor map in an academic teaching hospital. On a daily basis approximately 600 service users will be disoriented in the hospital resulting in 18 hours/day staff time spent helping patients find their way. 84% (n=109) of staff categorised indoor maps as a service improvement. Patients who get lost can feel anxiety, shame and even panic. Maps can improve patient autonomy¹. Internati...

  5. Tradition meets innovation: transforming academic medical culture at the University of Pennsylvania's Perelman School of Medicine.

    Pati, Susmita; Reum, Josef; Conant, Emily; Tuton, Lucy Wolf; Scott, Patricia; Abbuhl, Stephanie; Grisso, Jeane Ann

    2013-04-01

    Traditional performance expectations and career advancement paths for academic physicians persist despite dramatic transformations in the academic workflow, workload, and workforce over the past 20 years. Although the academic physician's triple role as clinician, researcher, and educator has been lauded as the ideal by academic health centers, current standards of excellence for promotion and tenure are based on outdated models. These models fail to reward collaboration and center around rigid career advancement plans that do little to accommodate the changing needs of individuals and organizations. The authors describe an innovative, comprehensive, multipronged initiative at the Perelman School of Medicine at the University of Pennsylvania to initiate change in the culture of academic medicine and improve academic productivity, job satisfaction, and overall quality of life for junior faculty. As a key part of this intervention, task forces from each of the 13 participating departments/divisions met five times between September 2010 and January 2011 to produce recommendations for institutional change. The authors discuss how this initiative, using principles adopted from business transformation, generated themes and techniques that can potentially guide workforce environment innovation in academic health centers across the United States. Recommendations include embracing a promotion/tenure/evaluation system that supports and rewards tailored individual academic career plans; ensuring leadership, decision-making roles, and recognition for junior faculty; deepening administrative and team supports for junior faculty; and solidifying and rewarding mentorship for junior faculty. By doing so, academic health centers can ensure the retention and commitment of faculty throughout all stages of their careers. PMID:23425986

  6. Practical radiation protection in hospitals. A view at the nuclear medicine departement of the University Hospital of Cologne

    Radiation protection plays a predominant role in nuclear medicine departments as they are installations dealing with open radioactive substances. Many experts in radiation protection who are not directly involved in nuclear medicine may only have a vague insight into the daily routine of such installations. This contribution would like to give an impression by making a virtual tour through the nuclear medicine department of the University Hospital of Cologne - a department that covers a large part of the ability spectrum of this discipline. This tour will show some specialities concerning radiation protection in diagnostic and therapeutic procedures. (orig.)

  7. Balancing Two Cultures: American Indian/Alaska Native Medical Students' Perceptions of Academic Medicine Careers.

    Sánchez, John Paul; Poll-Hunter, Norma; Stern, Nicole; Garcia, Andrea N; Brewster, Cheryl

    2016-08-01

    American Indians and Alaska Natives (AI/AN) remain underrepresented in the academic medicine workforce and little is known about cultivating AI/AN medical students' interest in academic medicine careers. Five structured focus groups were conducted including 20 medical students and 18 physicians. The discussion guide explored factors influencing AI/AN trainees' academic medicine career interest and recommended approaches to increase their pursuit of academia. Consensual qualitative research was employed to analyze transcripts. Our research revealed six facilitating factors, nine dissuading factors, and five recommendations towards cultivating AI/AN pursuit of academia. Facilitators included the opportunity to teach, serving as a role model/mentor, enhancing the AI/AN medical education pipeline, opportunities to influence institution, collegiality, and financial stability. Dissuading factors included limited information on academic career paths, politics, lack of credit for teaching and community service, isolation, self-doubt, lower salary, lack of positions in rural areas, lack of focus on clinical care for AI/AN communities, and research obligations. Recommendations included heighten career awareness, recognize the challenges in balancing AI/AN and academic cultures, collaborate with IHS on faculty recruitment strategies, identify concordant role models/mentors, and identify loan forgiveness programs. Similar to other diverse medical students', raising awareness of academic career opportunities especially regarding teaching and community scholarship, access to concordant role models/mentors, and supportive institutional climates can also foster AI/AN medical students' pursuit of academia. Unique strategies for AI/AN trainees include learning how to balance AI/AN and academic cultures, collaborating with IHS on faculty recruitment strategies, and increasing faculty opportunities in rural areas. PMID:26896055

  8. Academic career in medicine – requirements and conditions for successful advancement in Switzerland

    Stamm Martina

    2009-04-01

    Full Text Available Abstract Background Within the framework of a prospective cohort study of Swiss medical school graduates a sample of young physicians aspiring to an academic career were surveyed on their career support and barriers experienced up to their sixth year of postgraduate training. Methods Thirty-one junior academics took part in semi-structured telephone interviews in 2007. The interview guideline focused on career paths to date, career support and barriers experienced, and recommendations for junior and senior academics. The qualitatively assessed data were evaluated according to Mayring's content analysis. Furthermore, quantitatively gained data from the total cohort sample on person- and career-related characteristics were analyzed in regard to differences between the junior academics and cohort doctors who aspire to another career in medicine. Results Junior academics differ in terms of instrumentality as a person-related factor, and in terms of intrinsic career motivation and mentoring as career-related factors from cohort doctors who follow other career paths in medicine; they also show higher scores in the Career-Success Scale. Four types of career path could be identified in junior academics: (1 focus on basic sciences, (2 strong focus on research (PhD programs followed by clinical training, (3 one to two years in research followed by clinical training, (4 clinical training and research in parallel. The interview material revealed the following categories of career-supporting experience: making oneself out as a proactive junior physician, research resources provided by superior staff, and social network; statements concerning career barriers encompassed interference between clinical training and research activities, insufficient research coaching, and personality related barriers. Recommendations for junior academics focused on mentoring and professional networking, for senior academics on interest in human resource development and being role

  9. Expert Systems in Medicine: Academic Illusion or Real Power?

    KS Metaxiotis

    2000-02-01

    Full Text Available From the very earliest moments in the modern history of the computer, scientists have dreamed of creating advanced systems that would simulate human thinking and reasoning. Of all the modern technological quests, research to create artificially intelligent computer systems has been one of the most ambitious and fascinating. Although attempts were made more than thirty years ago to develop and apply such systems to the medical sciences, the field languished for decades. In this context, this paper aims to share thoughts about and assessments of the important role of expert systems in medicine and address their future as well as the trends that are foreseen in this area.

  10. Design of radioactive waste receiver system for nuclear medicine facility at hospitals

    Faeces waste receivers for patients who conducted examination for disease diagnosis and radiotherapy use radioisotopes and nuclear medicine facility at hospitals. This plan was made to solve radioactive waste management which increases in quality in accordance with the increase of radioisotopes application in the health field at the hospitals

  11. Cultural Diversity in the Curriculum: Perceptions and Attitudes of Irish Hospitality and Tourism Academics

    Devine, Frances; Hearns, Niamh; Baum, Tom; Murray, Anna

    2008-01-01

    Academics are facing significant challenges in preparing indigenous students for employment in the multicultural working environment of hospitality and tourism organisations. In dealing with the impact of the new skills and flexibilities demanded by increasing globalisation, the indigenous workforce needs to possess a multicultural perspective and…

  12. Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England.

    Lichtner, Valentina; Hibberd, Ralph; Cornford, Tony

    2016-01-01

    Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system. PMID:27332165

  13. Race-Conscious Professionalism and African American Representation in Academic Medicine.

    Powers, Brian W; White, Augustus A; Oriol, Nancy E; Jain, Sachin H

    2016-07-01

    African Americans remain substantially less likely than other physicians to hold academic appointments. The roots of these disparities stem from different extrinsic and intrinsic forces that guide career development. Efforts to ameliorate African American underrepresentation in academic medicine have traditionally focused on modifying structural and extrinsic barriers through undergraduate and graduate outreach, diversity and inclusion initiatives at medical schools, and faculty development programs. Although essential, these initiatives fail to confront the unique intrinsic forces that shape career development. America's ignoble history of violence, racism, and exclusion exposes African American physicians to distinct personal pressures and motivations that shape professional development and career goals. This article explores these intrinsic pressures with a focus on their historical roots; reviews evidence of their effect on physician development; and considers the implications of these trends for improving African American representation in academic medicine. The paradigm of "race-conscious professionalism" is used to understand the dual obligation encountered by many minority physicians not only to pursue excellence in their field but also to leverage their professional stature to improve the well-being of their communities. Intrinsic motivations introduced by race-conscious professionalism complicate efforts to increase the representation of minorities in academic medicine. For many African American physicians, a desire to have their work focused on the community will be at odds with traditional paths to professional advancement. Specific policy options are discussed that would leverage race-conscious professionalism as a draw to a career in academic medicine, rather than a force that diverts commitment elsewhere. PMID:26760060

  14. Medicine utilization review at a university teaching hospital in New Delhi

    M Aqil

    2012-01-01

    Full Text Available Objective: A prospective medicine usage evaluation based on prescription monitoring was conducted in the medicine OPD of our university teaching hospital to know prescribing trends of different categories of medicines. Materials and Methods: A total of 600 patients were included in the study comprising of 339 (56.5% males and 261 (43.5% females. The data were recorded within the OPD by a registered pharmacist on a medicine usage evaluation form, approved by The University Institutional Review Board (IRB. Results: A total of 2365 medicines were prescribed to 600 patients during the 3 months study period. The mean number of medicines per prescription were found to be 3.94. Medicines were most frequently prescribed as solid dosage forms (85.62%, especially tablets (70.82%, and liquid formulations (14.12%. Oral route (96.17% was the most preferred mode of administration, followed by topical (2.11% and parenteral (1.60% routes. Combination therapy (94.33% was more prevalent than monotherapy (5.66%. An overwhelming tendency for prescribing medicines by brand names (99% was observed by the physicians. The most frequently prescribed class of medicines were antimicrobials > analgesics > cardiovascular > gastrointestinal agents. The most prescribed individual medicines among various therapeutic classes included isoniazid (antimicrobial, amlodipine (cardiovascular, metformin (hypoglycemic, cetirizine (antiallergic, rabeprazole (GI medicine, atorvastatin (hypolipidemic, dextromethorphan (respiratory medicine, alprazolam (sedative-hypnotic, paracetamol (analgesic. Conclusions: There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be developed for the purpose. The number of medicines to be included per prescription should be judged rationally and polypharmacy ought to be curbed. Use of antimicrobial also needs to be rationalized as over

  15. "Personalizing" academic medicine: opportunities and challenges in implementing genomic profiling.

    Tweardy, David J; Belmont, John W

    2009-12-01

    BCM faculty members spearheaded the development of a first-generation Personal Genome Profile (Baylor PGP) assay to assist physicians in diagnosing and managing patients in this new era of medicine. The principles that guided the design and implementation of the Baylor PGP were high quality, robustness, low expense, flexibility, practical clinical utility, and the ability to facilitate broad areas of clinical research. The most distinctive feature of the approach taken is an emphasis on extensive screening for rare disease-causing mutations rather than common risk-increasing polymorphisms. Because these variants have large direct effects, the ability to screen for them inexpensively could have a major immediate clinical impact in disease diagnosis, carrier detection, presymptomatic detection of late onset disease, and even prenatal diagnosis. In addition to creating a counseling tool for individual "consumers," this system will fit into the established medical record and be used by physicians involved in direct patient care. This article describes an overall framework for clinical diagnostic array genotyping and the available technologies, as well as highlights the opportunities and challenges for implementation. PMID:19931194

  16. [Pre-hospital medicine and medical control system in Japan].

    Tanabe, Seizan

    2016-02-01

    It is necessary to treat the patient from the site of the emergency to raise a lifesaving rate of the patient. As a prime example would be out-of-hospital cardiac arrest. Once you start the treatment after hospital arrival, cardiac arrest patient can't be life-saving. It is necessary to start the chest compression, etc. from the site of the emergency. Medical care to be carried out on the scene of emergency is the pre-hospital care. In recent years, improvement of the pre-hospital care is remarkable in Japan. It is because of that the quantity and quality of the emergency life-saving technician are being enhanced. And also doctor-helicopter system have been enhanced. Medical control is a critical component of the improvement. PMID:26915258

  17. The Evolution of the Council of Academic Hospitals of Ontario Statement of Principles--A Successful Harmonization Initiative

    Porter, Katie; Lampson, Sarah

    2011-01-01

    To improve efficiency, consistency and transparency in clinical trial contract negotiations with industry sponsors, a Council of Academic Hospitals of Ontario (CAHO) committee facilitated the development of standard principles for member hospitals to follow during contract negotiation. Hospitals were encouraged to provide a link to the CAHO…

  18. Society of Behavioral Medicine position statement: elementary school-based physical activity supports academic achievement

    Buscemi, Joanna; Kong, Angela; Fitzgibbon, Marian L.; Bustamante, Eduardo E.; Davis, Catherine L.; Pate, Russell R.; Wilson, Dawn K.

    2014-01-01

    The Society of Behavioral Medicine (SBM) urges elementary schools to provide children with ample opportunities to engage in physical activity during school hours. In addition to promoting overall child health, physical activity also supports academic achievement. In addition to improving their aerobic fitness, regular physical activity improves cognitive function, influences the brain, and improves mood in children. Better aerobic fitness and physical activity are associated with increased gr...

  19. Society of Behavioral Medicine position statement: elementary school-based physical activity supports academic achievement.

    Buscemi, Joanna; Kong, Angela; Fitzgibbon, Marian L; Bustamante, Eduardo E; Davis, Catherine L; Pate, Russell R; Wilson, Dawn K

    2014-12-01

    The Society of Behavioral Medicine (SBM) urges elementary schools to provide children with ample opportunities to engage in physical activity during school hours. In addition to promoting overall child health, physical activity also supports academic achievement. In addition to improving their aerobic fitness, regular physical activity improves cognitive function, influences the brain, and improves mood in children. Better aerobic fitness and physical activity are associated with increased grade point averages and standardized test scores. Despite the documented relationship between physical activity, fitness, and academic achievement, few schools have implemented physical activity as a tool to improve academic performance. SBM recommends that elementary schools provide children with the recommended 60 min of moderate-to-vigorous physical activity during school hours. Further, SBM urges schools to work with the local school districts and state education departments to mandate minimum physical activity time for elementary school physical education. PMID:25584093

  20. Women's health and women's leadership in academic medicine: hitting the same glass ceiling?

    Carnes, Molly; Morrissey, Claudia; Geller, Stacie E

    2008-11-01

    The term "glass ceiling" refers to women's lack of advancement into leadership positions despite no visible barriers. The term has been applied to academic medicine for over a decade but has not previously been applied to the advancement of women's health. This paper discusses (1) the historical linking of the advances in women's health with women's leadership in academic medicine, (2) the slow progress of women into leadership in academic medicine, and (3) indicators that the advancement of women's health has stalled. We make the case that deeply embedded unconscious gender-based biases and assumptions underpin the stalled advancement of women on both fronts. We conclude with recommendations to promote progress beyond the apparent glass ceiling that is preventing further advancement of women's health and women leaders. We emphasize the need to move beyond "fixing the women" to a systemic, institutional approach that acknowledges and addresses the impact of unconscious, gender-linked biases that devalue and marginalize women and issues associated with women, such as their health. PMID:18954235

  1. Striving for Gender Equity in Academic Medicine Careers: A Call to Action.

    Bates, Carol; Gordon, Lynn; Travis, Elizabeth; Chatterjee, Archana; Chaudron, Linda; Fivush, Barbara; Gulati, Martha; Jagsi, Reshma; Sharma, Poonam; Gillis, Marin; Ganetzky, Rebecca; Grover, Amelia; Lautenberger, Diana; Moses, Ashleigh

    2016-08-01

    Women represent approximately half of students entering medical schools and more than half of those entering PhD programs. When advancing through the academic and professional fields, however, women continually face barriers that men do not. In this Commentary, the authors offer ideas for coordinating the efforts of organizations, academic institutions, and leaders throughout the scientific and medical professions to reduce barriers that result in inequities and, instead, strive for gender parity. Specific areas of focus outlined by the authors include facilitating women's access to formal and informal professional networks, acknowledging and addressing the gender pay gap as well as the lack of research funding awarded to women in the field, and updating workplace policies that have not evolved to accommodate women's lifestyles. As academic institutions seek access to top talent and the means to develop those individuals capable of generating the change medicine and science needs, the authors urge leaders and change agents within academic medicine to address the systemic barriers to gender equity that impede us from achieving the mission to improve the health of all. PMID:27332868

  2. [Hospitalization reduction by an asthma tele-medicine system].

    Kokubu, F; Nakajima, S; Ito, K; Makino, S; Kitamura, S; Fukuchi, Y; Mano, K; Sano, Y; Inoue, H; Morita, Y; Fukuda, K; Akiyama, K; Adachi, M; Miyamoto, T

    2000-01-01

    We examined an effectiveness of a new asthma telemedicine system in reducing hospitalizations using a multi-site randomized control study. In this program, a nurse under physician supervision monitors the patient's airway status at home and provides instructions to individuals via the telephone, helping them manage exacerbations as well as reinforcing proper use of a zone-controlled management plan. Patients with a high risk for hospitalization were screened based on the numbers of emergency room visits and hospitalizations found in a previous study and randomly assigned to either the telemedicine or control group. After a six-month study period, an 83% reduction in hospitalization was demonstrated in the telemedicine group versus the control group, with a P value of 0.01. Improvement of peak expiratory flow and symptoms were also shown in the study group. We conclude that the key success factors in home asthma management for poorly controlled asthma patients are early detection of exacerbations through daily peak flow monitoring, compliance with prescribed daily prophylactic anti-inflammatory steroid medications, and immediate action as specified by a zone-controlled action plan upon the first signs of deterioration. PMID:10707475

  3. Positioning academic medical centers and teaching hospitals to thrive in the next decade.

    Morris, D E

    1985-06-01

    Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification. PMID:10271804

  4. An Academic Medical Center Experience with a Computerized Hospital Information System: The First Four Years

    Reynolds, Robert E.; Heller, Edward E.

    1980-01-01

    Rush-Presbyterian-St. Luke's Medical Center (RPSLMC) obtained and implemented an on-line, real time medical information system (MIS), SPECTRA 2000, in 1976 in its branch hospital, the Sheridan Road Pavilion. After several years of successful operation and minor modifications, the system was evaluated with regard to installing it throughout the rest of the RPSLMC. A group of specified enhancements were outlined to make the system suitable to the needs of the large academic medical center. Impl...

  5. Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital

    Hong-Bo Wang; Qing-Zhao Zhang; Zhen Zhang; Chang-Song Hou; Wen-Liang Li; Hui Yang; Quan-Fu Sun

    2016-01-01

    This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures ad...

  6. The design of diagnostic imaging and nuclear medicine facilities in a major new teaching hospital

    Full text: The design of the layout and radiation shielding for diagnostic imaging and nuclear medicine facilities in a modern teaching hospital requires the collaboration of persons from a number of professions including architects, engineers, radiologists, nuclear medicine physi cians, medical imaging technologists and medical physicists. This paper discusses the design of such facilities, including PET/CT and T-131 ablation therapy suites for a major new tertiary hospital in Perth. The importance of involving physicists on the planning team from the earliest stages of the design process is stressed, design plans presented, and some of the problems which may present themselves and their solutions are illustrated.

  7. Knowledge sharing in Chinese hospitals identifying sharing barriers in traditional Chinese and Western medicine collaboration

    Zhou, Lihong

    2015-01-01

    This book aims to identify, understand and qualify barriers to the patient-centred knowledge sharing (KS) in interprofessional practice of Traditional Chinese Medicine (TCM) and Western Medicine (WM) healthcare professionals in Chinese hospitals.  This collaboration is particularly crucial and unique to China since, contrary to Western practice, these two types of professionals actually work together complimentary in the same hospital. This study adopted a Grounded Theory approach as the overarching methodology to guide the analysis of the data collected in a single case-study design.  A public hospital in central China was selected as the case-study site, at which 49 informants were interviewed by using semi-structured and evolving interview scripts.  The research findings point to five categories of KS barriers: contextual influences, hospital management, philosophical divergence, Chinese healthcare education and interprofessional training.  Further conceptualising the research findings, it is identifie...

  8. Factors related to complications among adult patients with intellectual disabilities hospitalized at an academic medical center.

    Ailey, Sarah H; Johnson, Tricia J; Fogg, Louis; Friese, Tanya R

    2015-04-01

    People with intellectual disabilities (ID) represent a small but important group of hospitalized patients who have higher rates of complications than do patients without ID hospitalized for the same reasons. Complications are potentially avoidable conditions, such as healthcare-acquired infections, healthcare-acquired skin breakdown, falls, and medication errors and reactions. Addressing factors related to complications can focus efforts to improve hospital care. The purpose of this exploratory study was to analyze data from reviews of academic medical center charts (N  =  70) about complications and to examine patient and hospitalization characteristics in relation to complications among adult patients (age ≥ 18 years) with ID hospitalized for nonpsychiatric reasons. Adults with ID tended to be twice as likely to have complications (χ2  =  2.893, df  =  1, p  =  .09) if they had a surgical procedure and were nearly four times as likely to have complications (χ2  =  6.836, df  =  1, p  =  .009) if they had multiple chronic health conditions (three of the following: history of cerebral palsy, autism spectrum symptoms, aggressive behavior, respiratory disorder, and admission through the emergency department). Findings suggest preliminary criteria for assessing risk for complications among hospitalized people with ID and the need for attention to their specific needs when hospitalized. PMID:25860449

  9. Commentary: Missing the elephant in my office: recommendations for part-time careers in academic medicine.

    Helitzer, Deborah

    2009-10-01

    Several recent articles in this journal, including the article by Linzer and colleagues in this issue, discuss and promote the concept of part-time careers in academic medicine as a solution to the need to achieve a work-life balance and to address the changing demographics of academic medicine. The article by Linzer and colleagues presents the consensus of a task force that attempted to address practical considerations for part-time work in academic internal medicine. Missing from these discussions, however, are a consensus on the definition of part-time work, consideration of how such strategies would be available to single parents, how time or resources will be allocated to part-time faculty to participate in professional associations, develop professional networks, and maintain currency in their field, and how part-time work can allow for the development of expertise in research and scholarly activity. Most important, the discussions about the part-time solution do not address the root cause of dissatisfaction and attrition: the ever-increasing and unsustainable workload of full-time faculty. The realization that an academic full-time career requires a commitment of 80 hours per week begs the question of whether part-time faculty would agree to work 40 hours a week for part-time pay. The historical underpinnings of the current situation, the implications of part-time solutions for the academy, and the consequences of choosing part-time work as the primary solution are discussed. Alternative strategies for addressing some of the problems facing full-time faculty are proposed. PMID:19881414

  10. Faculty Self-reported Experience with Racial and Ethnic Discrimination in Academic Medicine

    Peterson, Neeraja B; Friedman, Robert H; Ash, Arlene S; Franco, Shakira; Carr, Phyllis L

    2004-01-01

    BACKGROUND Despite the need to recruit and retain minority faculty in academic medicine, little is known about the experiences of minority faculty, in particular their self-reported experience of racial and ethnic discrimination at their institutions. OBJECTIVE To determine the frequency of self-reported experience of racial/ethnic discrimination among faculty of U.S. medical schools, as well as associations with outcomes, such as career satisfaction, academic rank, and number of peer-reviewed publications. DESIGN A 177-item self-administered mailed survey of U.S. medical school faculty. SETTING Twenty-four randomly selected medical schools in the contiguous United States. PARTICIPANTS A random sample of 1,979 full-time faculty, stratified by medical school, specialty, graduation cohort, and gender. MEASUREMENTS Frequency of self-reported experiences of racial/ethnic bias and discrimination. RESULTS The response rate was 60%. Of 1,833 faculty eligible, 82% were non-Hispanic white, 10% underrepresented minority (URM), and 8% nonunderrepresented minority (NURM). URM and NURM faculty were substantially more likely than majority faculty to perceive racial/ethnic bias in their academic environment (odds ratio [OR], 5.4; P < .01 and OR, 2.6; P < .01, respectively). Nearly half (48%) of URM and 26% of NURM reported experiencing racial/ethnic discrimination by a superior or colleague. Faculty with such reported experiences had lower career satisfaction scores than other faculty (P < .01). However, they received comparable salaries, published comparable numbers of papers, and were similarly likely to have attained senior rank (full or associate professor). CONCLUSIONS Many minority faculty report experiencing racial/ethnic bias in academic medicine and have lower career satisfaction than other faculty. Despite this, minority faculty who reported experiencing racial/ethnic discrimination achieved academic productivity similar to that of other faculty. PMID:15009781

  11. Use of complementary and alternative medicine at Norwegian and Danish hospitals

    Launsø Laila

    2011-01-01

    Full Text Available Abstract Background Several studies have found that a high proportion of the population in western countries use complementary and alternative medicine (CAM. However, little is known about whether CAM is offered in hospitals. The aim of this study was to describe to what extent CAM is offered in Norwegian and Danish hospitals and investigate possible changes in Norway since 2001. Methods A one-page questionnaire was sent to all included hospitals in both countries. The questionnaire was sent to the person responsible for the clinical activity, typically the medical director. 99 hospitals in the authority (85% in Norway and 126 in Denmark (97% responded. Given contact persons were interviewed. Results CAM is presently offered in about 50% of Norwegian hospitals and one-third of Danish hospitals. In Norway CAM was offered in 50 hospitals, 40 of which involved acupuncture. 19 hospitals gave other alternative therapies like biofeedback, hypnosis, cupping, ear-acupuncture, herbal medicine, art therapy, homeopathy, reflexology, thought field therapy, gestalt therapy, aromatherapy, tai chi, acupressure, yoga, pilates and other. 9 hospitals offered more than one therapy form. In Denmark 38 hospitals offered acupuncture and one Eye Movement Desensitization and Reprocessing Light Therapy. The most commonly reported reason for offering CAM was scientific evidence in Denmark. In Norway it was the interest of a hospital employee, except for acupuncture where the introduction is more often initiated by the leadership and is more based on scientific evidence of effect. All persons (except one responsible for the alternative treatment had a medical or allied health professional background and their education/training in CAM treatment varied substantially. Conclusions The extent of CAM being offered has increased substantially in Norway during the first decade of the 21st century. This might indicate a shift in attitude regarding CAM within the conventional

  12. Integrating traditional Chinese medicine into mainstream healthcare system in Hong Kong, China-A model of integrative medicine in the HKU-SZ Hospital

    Lixing Lao; Zhipeng Ning

    2015-01-01

    The European Congress for Integrative Medicine 2015 Global Summit on Integrative Medicine and Healthcare in Greater Copenhagen has successfully promoted integrative medicine to the public once again. Integrative medicine, which is called the art and science of healthcare by Nordic Integrative Medicine, has been widely used in the world. In Hong Kong, integrated traditional Chinese and Western medicine, which is also known as the Chinese version of integrative medicine, provides a valuable reference for the development of integrative medicine in the world. In this article, we introduce the development of traditional Chinese medicine in Hong Kong and an integrated traditional Chinese and Western medicine model in the University of Hong Kong-Shenzhen Hospital.

  13. Integrating traditional Chinese medicine into mainstream healthcare system in Hong Kong, China-A model of integrative medicine in the HKU-SZ Hospital.

    Lao, Lixing; Ning, Zhipeng

    2015-11-01

    The European Congress for Integrative Medicine 2015 Global Summit on Integrative Medicine and Healthcare in Greater Copenhagen has successfully promoted integrative medicine to the public once again. Integrative medicine, which is called the art and science of healthcare by Nordic Integrative Medicine, has been widely used in the world. In Hong Kong, integrated traditional Chinese and Western medicine, which is also known as the Chinese version of integrative medicine, provides a valuable reference for the development of integrative medicine in the world. In this article, we introduce the development of traditional Chinese medicine in Hong Kong and an integrated traditional Chinese and Western medicine model in the University of Hong Kong-Shenzhen Hospital. PMID:26559359

  14. Public health, academic medicine, and the alcohol industry's corporate social responsibility activities.

    Babor, Thomas F; Robaina, Katherine

    2013-02-01

    We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry's economic interests. PMID:23237151

  15. Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital

    Fraser, Traci N.; Blumenthal, Daniel M; Bernard, Kenneth; Iyasere, Christiana

    2015-01-01

    Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of r...

  16. Implementing an Interoperable Personal Health Record in Pediatrics: Lessons Learned at an Academic Children's Hospital.

    Anoshiravani, Arash; Gaskin, Gregory; Kopetsky, Ed; Sandborg, Christy; Longhurst, Christopher A

    2011-07-10

    This paper describes the development of an innovative health information technology creating a bidirectional link between the electronic medical record (EMR) of an academic children's hospital and a commercially available, interoperable personal health record (PHR). The goal of the PHR project has been to empower pediatric patients and their families to play a more active role in understanding, accessing, maintaining, and sharing their personal health information to ultimately improve health outcomes. The most notable challenges proved more operational and cultural than technological. Our experience demonstrates that an interoperable PHR is technically and culturally achievable at a pediatric academic medical center. Recognizing the complex social, cultural, and organizational contexts of these systems is important for overcoming barriers to a successful implementation. PMID:21853160

  17. The academic trend of Oriental Medicine during the Japanese colonial period as observed through the publication of medical books

    KIM Nam-il

    2006-06-01

    Full Text Available This thesis examines the academical trend of Oriental Medicine in the Japanese colonial period observed through medical books published during the Japanese colonial period.This is a period in which Western Medicine was introduced,and due to the lean-to-one-side policy by the Japanese, Western Medicine became the mainstream medical science while Oriental Medicine was pushed to the outskirts.Even after all this,the academic activity was flourishing during this period compared to any other periods. This article is divided into various chapters each with its own theme in order to understand the academic trend of Oriental Medicine during the Japanese colonial period.Focusing on the publication of medical books, this article is divided and observed according to various themes such as the study of Dong-Eui-Bo-Gam(東醫寶鑑,the study of Bang-Yak-Hap- Pyeun(方藥合編,the study of Sang-Han-Ron(傷寒論,the study of Sa-sang (四象constitutional medicine,the study of Eui-Hak-Ip-Mun (醫學入門,the study about Bu-Yang-Ron(扶陽論,On-Bo-Ron(溫補論,and pediatrics, compromise between Western and Oriental Medicine,the study of experience medicine,the study of acupuncture and moxibustion,and etc.

  18. Physician clinical alignment and integration: a community-academic hospital approach.

    Salas-Lopez, Debbie; Weiss, Sandra Jarva; Nester, Brian; Whalen, Thomas

    2014-01-01

    An overwhelming need for change in the U.S. healthcare delivery system, coupled with the need to improve clinical and financial outcomes, has prompted hospitals to direct renewed efforts toward achieving high quality and cost-effectiveness. Additionally, with the dawn of accountable care organizations and increasing focus on patient expectations, hospitals have begun to seek physician partners through clinical alignment. Contrary to the unsuccessful alignment strategies of the 1990s, today's efforts are more mutually beneficial, driven by the need to achieve better care coordination, increased access to infrastructure, improved quality, and lower costs. In this article, we describe a large, academic, tertiary care hospital's approach to developing and implementing alignment and integration models with its collaboration-ready physicians and physician groups. We developed four models--short of physicians' employment with the organization--tailored to meet the needs of both the physician group and the hospital: (1) medical directorship (group physicians are appointed to serve as medical directors of a clinical area), (2) professional services agreement (specific clinical services, such as overnight admissions help, are contracted), (3) co-management services agreement (one specialty group co-manages all services within the specialty service lines), and (4) lease arrangement (closest in scope to employment, in which the hospital pays all expenses and receives all revenue). Successful hospital-physician alignment requires careful planning and the early engagement of legal counsel to ensure compliance with federal statutes. Establishing an integrated system with mutually identified goals better positions hospitals to deliver cost-effective and high-quality care under the new paradigm of healthcare reform. PMID:24988674

  19. Adverse drug reactions in internal medicine units at a university hospital: A descriptive pilot study

    Luis Carlos López

    2010-09-01

    Full Text Available Introduction: Adverse drug reactions (ADRs are an important cause of morbidity and mortality among hospitalized patients. Objectives: This study was designed to describe the frequency, severity, and causality of ADRs in internal medicine units at a third-level university hospital. Materials and methods: A descriptive study was performed at internal medicine units, by means of a structured format, review of clinical records, and interview of hospitalized patients. The Naranjo algorithm was applied to patient adverse events to define causality. Additionally, ADRs were classified according to the Rawlins and Thompson criteria. Results: One hundred patients (50 men and 50 women were included in the study. Ninety nine (99 adverse events were found among the patients. The Naranjo algorithm was applied to adverse events, resulting in twenty nine (29 probable ADRs, twenty (20 possible ADRs and fifty (50 doubtful ADRs. Cardiovascular drugs and antibiotics were the most frequent therapeutic groups associated with ADRs. In addition, two preventable medication errors were identified. Conclusions: Frequency of ADRs was similar to the number reported in other studies in internal medicine units. It is necessary to systematize efforts of pharmacological surveillance in hospital wards, toward an opportune detection and prevention of ADRs.

  20. Adverse drug reactions in internal medicine units at a university hospital: A descriptive pilot study

    Luis Carlos López

    2010-03-01

    Full Text Available Introduction: Adverse drug reactions (ADRs are an important cause of morbidity and mortality among hospitalized patients.Objectives: This study was designed to describe the frequency, severity, and causality of ADRs in internal medicine units at a third-level university hospital.Materials and methods: A descriptive study was performed at internal medicine units, by means of a structured format, review of clinical records, and interview of hospitalized patients. The Naranjo algorithm was applied to patient adverse events to define causality. Additionally, ADRs were classified according to the Rawlins and Thompson criteria.Results: One hundred patients (50 men and 50 women were included in the study. Ninety nine (99 adverse events were found among the patients. The Naranjo algorithm was applied to adverse events, resulting in twenty nine (29 probable ADRs, twenty (20 possible ADRs and fifty (50 doubtful ADRs. Cardiovascular drugs and antibiotics were the most frequent therapeutic groups associated with ADRs. In addition, two preventable medication errors were identified.Conclusions: Frequency of ADRs was similar to the number reported in other studies in internal medicine units. It is necessary to systematize efforts of pharmacological surveillance in hospital wards, toward an opportune detection and prevention of ADRs.

  1. Radiology reporting in an academic children's hospital: what referring physicians think

    Transcribed reports are the radiologist's most conspicuous and enduring product, yet relatively little investigation of report quality has been undertaken by radiologists. This paper reports the results of a survey of 266 referring physicians in an academic children's hospital regarding their needs and assessments of the quality of radiology reporting. The results outline the range and relative importance of report features from referring physicians' points of view, provide specific suggestions for how to improve reporting performance, and generally indicate that reporting should receive more attention in training and practice than it currently does. (orig.)

  2. Translational science and the hidden research system in universities and academic hospitals: a case study.

    Lander, Bryn; Atkinson-Grosjean, Janet

    2011-02-01

    Innovation systems (IS) and science policy scholarship predominantly focus on linkages between universities and industry, and the commercial translation of academic discoveries. Overlooked in such analyses are important connections between universities and academic hospitals, and the non-commercial aspects of translational science. The two types of institutions tend to be collapsed into a single entity-'the university'-and relational flows are lost. Yet the distinctions and flows between the two are crucial elements of translational science and the biomedical innovation system. This paper explores what has been called the 'hidden research system' that connects hospitals, universities, and their resources, with the clinical and scientific actors who make the linkages possible. Then, using a novel conceptual model of translational science, we examine the individual interactions and dynamics involved in a particular example of the biomedical innovation system at work: the diagnosis of IRAK-4 deficiency, a rare immunological disorder, and the translational flows that result. Contra to conventional IS analyses, we are able to point to the strong role of public-sector institutions, and the weak role of the private-sector, in the translational processes described here. Our research was conducted within a Canadian network of scientists and clinician-scientists studying the pathogenomics of immunological disorders and innate immunity. PMID:21168250

  3. Changing the culture of academic medicine to eliminate the gender leadership gap: 50/50 by 2020.

    Valantine, Hannah; Sandborg, Christy I

    2013-10-01

    Central to the daily struggles that successful working women face is the misalignment of the current work culture and the values of the workforce. In addition to contributing to work-life integration conflicts, this disconnect perpetuates the gender leadership gap. The dearth of women at the highest ranks of academic medicine not only sends a clear message to women that they must choose between career advancement and their personal life but also represents a loss of talent for academic health centers as they fail to recruit and retain the best and the brightest. To close the gender leadership gap and to meet the needs of the next generation of physicians, scientists, and educators, the authors argue that the culture of academic medicine must change to one in which flexibility and work-life integration are core parts of the definition of success. Faculty must see flexibility policies, such as tenure clock extensions and parental leaves, as career advancing rather than career limiting. To achieve these goals, the authors describe the Stanford University School of Medicine Academic Biomedical Career Customization (ABCC) model. This framework includes individualized career plans, which span a faculty member's career, with options to flex up or down in research, patient care, administration, and teaching, and mentoring discussions, which ensure that faculty take full advantage of the existing policies designed to make career customization possible. The authors argue that with vision, determination, and focus, the academic medicine community can eliminate the gender leadership gap to achieve 50/50 by 2020. PMID:23969359

  4. Prospective investigation of complementary and alternative medicine use and subsequent hospitalizations

    Ryan Margaret AK; Smith Besa; Smith Tyler C

    2008-01-01

    Abstract Background The prevalence of complementary and alternative medicine (CAM) use has been estimated to be as high as 65% in some populations. However, there has been little objective research into the possible risks or benefits of unmanaged CAM therapies. Methods In this prospective study of active duty US Navy and Marine Corps personnel, the association between self-reported practitioner-assisted or self-administered CAM use and future hospitalization was investigated. Cox regression m...

  5. Complexity of patients with chronic obstructive pulmonary disease hospitalized in internal medicine: a survey by FADOI

    Carlo Nozzoli; Luigi Anastasio; Leonardo M. Fabbri; Pietro Marino; Roberto Nardi; Antonio Sacchetta; Franco Mastroianni; Giovanni Mangano; Fabrizio Lombardini; Angela Zappaterra; Antonella Valerio; Giorgio Vescovo; Giancarlo Agnelli; Mauro Campanini; for the Research Department of FADOI

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is one of the most frequent pathologies among patients hospitalized in Internal Medicine (IM) Departments. COPD is frequently associated with concomitant diseases, which represent major causes of death, and affect disease management. Objectives of our study are to assess the prevalence of COPD patients in IM, to evaluate their comorbidity status, and to describe their complexity, by means of the validated multidimensional prognostic index (MPI) sco...

  6. The 2015 Academic College of Emergency Experts in Indias INDO-US Joint Working Group White Paper on Establishing an Academic Department and Training Pediatric Emergency Medicine Specialists in India.

    Mahajan, Prashant; Batra, Prerna; Shah, Binita R; Saha, Abhijeet; Galwankar, Sagar; Aggrawal, Praveen; Hassoun, Ameer; Batra, Bipin; Bhoi, Sanjeev; Kalra, Om Prakash; Shah, Dheeraj

    2015-12-01

    The concept of pediatric emergency medicine (PEM) is virtually nonexistent in India. Suboptimally organized prehospital services substantially hinder the evaluation, management, and subsequent transport of the acutely ill and/or injured child to an appropriate facility. Furthermore, the management of the ill child at the hospital level is often provided by overburdened providers who, by virtue of their training, lack experience in the skills required to effectively manage pediatric emergencies. Finally, the care of the traumatized child often requires the involvement of providers trained in different specialities, which further impedes timely access to appropriate care. The recent recognition of Doctor of Medicine in Emergency Medicine as an approved discipline of study as per the Indian Medical Council Act provides an unprecedented opportunity to introduce PEM as a formal academic program in India. PEM has to be developed as a 3 year superspeciality course after completion of MD Diplomate of National Board (DNB) Pediatrics or MD DNB in EM. The National Board of Examinations that accredits and administers postgraduate and postdoctoral programs in India also needs to develop an academic program DNB in PEM. The goals of such a program would be to impart theoretical knowledge, training in the appropriate skills and procedures, development of communication and counseling techniques, and research. In this paper, the Joint Working Group of the Academic College of Emergency Experts in India (JWG ACEE India) gives its recommendations for starting 3 year DM DNB in PEM, including the curriculum, infrastructure, staffing, and training in India. This is an attempt to provide an uniform framework and a set of guiding principles to start PEM as a structured superspeciality to enhance emergency care for Indian children. PMID:26713991

  7. Hospital structure and technical efficiency in the production of nuclear medicine. Doctoral thesis

    The relationship of hospital structure to production efficiency is explored. The hospital subindustry on which this research centers is nuclear medicine. The hypotheses generated were that technical efficiency is reduced by increased competitive intensity, by a lack of profit incentive, by a broader service range, and by in-house training of technical personnel. Most data employed in the study were gathered from the American College of Radiology and the Energy Research and Development Administration Census of Nuclear Medicine. More specific information came from questionnaires sent to 2,050 short-term general hospitals known to have a nuclear medicine facility. Of the responses 1,362 were usable for the study. A major study finding was that over half of the variations observed in technical efficiency were attributable to the structural elements being studied. The research indicated that competition for staff physicians has a role in reducing technical efficiency; that the output effect of in-house manpower training was relatively unimportant; and that profit incentives do have a significant impact. It is suggested that increased technical efficiency could be achieved through reduced competitive intensity, stronger profit orientation, and reduced service range. A bibliography is included

  8. Adverse Drug Reactions in a Complementary Medicine Hospital: A Prospective, Intensified Surveillance Study

    M. Süsskind

    2012-01-01

    Full Text Available Background. Anthroposophic medicine is one of the widely used approaches of complementary and alternative medicine. However, few prospective studies have generated safety data on its use. Objectives. We aimed to assess adverse drug reactions (ADRs caused by anthroposophical medicines (AMEDs in the anthroposophical Community Hospital Havelhoehe, GERMANY. Study Design and Methods. Between May and November 2007, patients of six medical wards were prospectively assessed for ADRs. Suspected ADRs occurring during hospitalization were documented and classified in terms of organ manifestation (WHO SOC-code, causality (according to the Uppsala Monitoring Centre WHO criteria, and severity. Only those ADRs with a severity of grade 2 and higher according to the CTCAE classification system are described here. Results. Of the 3,813 patients hospitalized, 174 patients (4.6% experienced 211 ADRs (CTCAE grade 2/3 n=191, 90.5%, CTCAE grade 4/5 n=20, 9.5% of which 57 ADRs (27.0% were serious. The median age of patients with ADRs (62.1% females was 72.0 (IQR: 61.0; 80.0. Six patients (0.2% experienced six ADRs (2.8% of ADRs caused by eight suspected AMEDs, all of which were mild reactions (grade 2. Conclusion. Our data show that ADRs caused by AMEDs occur rarely and are limited to mild symptoms.

  9. Hospital Intranet and Extranet in nuclear medicine; Intranet et Extranet hospitalier en medecine nucleaire

    Gambini, D.J.; Baum, T.P.; Spector, M.; Dumas, F.; Elgard, M.C.; Collington, M.A.; Barritault, L. [Service de Medecine Nucleaire, Hopital Laennec, Paris (France)

    1997-12-31

    Since two years ago nuclear medicine service of Laennec Hospital has implemented transmission and distribution networks of scintigraphic images. A new stage was reached at present by developing an Intranet and Extranet system for nursing units and other services of nuclear medicine. The Intranet link to the services of Laennec Hospital and AP HP is based on a image server connected to the service gamma camera and, after a possible post-processing, the images are transmitted in PCX format by e-mail, attached to the medical record. For communication between nuclear medicine services, a heavier procedure making use of a program for image processing under inter-file standards has been implemented. To achieve the Extranet link with services and physicians of town, exterior to AP HP, a procedure was installed which allows reaching any nursing unit or town physicians having at their disposal e-mail on a secured network. This procedure will be generalized when the Health secured network, linking the medical bodies to Health insurance institutions, will be operational. The interactive tele-medicine will be achieved by means of a procedure based on Internet cooperative tools (wild cards, video- and vision-conferences) which will permits in all situations an interactive work on all the transmitted patient files

  10. History of education in medicine and surgery, first hospitals development of urology in danzig/Gdańsk.

    Zajączkowski, Tadeusz

    2014-01-01

    The aim of the study is to present the development of hospital services and the teaching of medicine, and the development of urology in Danzig (Gdańisk). Well known Danzig surgeons who were interested in surgery of the genitourinary system are also presented. The beginning of urological surgery and its development within the framework of the department of surgery and as an independent facility at the Medical Academy of Gdafisk in the post-war period is also described. Extensive research was undertaken for the collection of literature and documents in German and Polish archives and libraries in order to prepare this study. The history of hospitals in Danzig goes back to the arrival of the Teutonic Knights in 1308. The earliest institution, according to historical sources, was the Hospital of the Holy Spirit, built in the years 1310-1311. It was run by the Hospitalet Order until 1382, and was intended for the sick, elderly and disabled people, orphans and needy pilgrim, and the poor. Later centuries saw the further development of hospital services in Danzig. In the 19th century, the city's increas ing population, the development of the sciences, and rapid advances in medicine subsequently led to the establishment of three more hospitals in Gdafisk: The Hospital for Obstetrics and Gynaecological Disease (1819), the Holy Virgin Hospital (1852), and the Evangelical Hospital of Deaconess Sisters (1857), in addition to the old Municipal Hospital. In 1911, new modern buildings of Municipal Hospital in Danzig were finished. On the basis of the Municipal Hospi- tal, the Academy of Practical Medicine was established in 1935. It was known under the name Staatliche Akademie fiir Praktische Medizin in the Free City of Danzig. Five years later (in 1940) the Academy was developed and changed to the Medical Academy of Danzig (Medizinische Akad- emie Danzig - MAD). The beginning of medical teaching at the middle level in Danzig (Gdafsk) dates back to the 16th century. It had its

  11. Prospective investigation of complementary and alternative medicine use and subsequent hospitalizations

    Ryan Margaret AK

    2008-05-01

    Full Text Available Abstract Background The prevalence of complementary and alternative medicine (CAM use has been estimated to be as high as 65% in some populations. However, there has been little objective research into the possible risks or benefits of unmanaged CAM therapies. Methods In this prospective study of active duty US Navy and Marine Corps personnel, the association between self-reported practitioner-assisted or self-administered CAM use and future hospitalization was investigated. Cox regression models were used to examine risk of hospitalization due to any cause over the follow-up period from date of questionnaire submission, until hospitalization, separation from the military, or end of observation period (June 30, 2004, whichever occurred first. Results After adjusting for baseline health, baseline trust and satisfaction with conventional medicine, and demographic characteristics, those who reported self-administering two or more CAM therapies were significantly less likely to be hospitalized for any cause when compared with those who did not self-administer CAM (HR = 0.38; 95% CI = 0.17, 0.86. Use of multiple practitioner-assisted CAM was not associated with a significant decrease or increase of risk for future hospitalization (HR = 1.86; 95 percent confidence interval = 0.96-3.63. Conclusion While there were limitations to these analyses, this investigation utilized an objective measure of health to investigate the potential health effects of CAM therapies and found a modest reduction in the overall risk of hospitalization associated with self-administration of two or more CAM therapies. In contrast, use of practitioner-assisted CAM was not associated with a protective effect.

  12. A Retrospective Analysis of Patients’ Conditions Using Acupuncture in a Traditional Korean Medicine Hospital

    Kyung-Jin Yun

    2015-01-01

    Full Text Available Objective. The aim of this study was to identify the patient demographics, health issues, and type of acupuncture treatments who visited a traditional Korean medical hospital for acupuncture treatment. Methods. We retrospectively analysed the data using the electronic medical records (EMRs of patients treated with at least one treatment of acupuncture from 1 January 2010 to December 2012 in the Chung-Ju Korean hospital at Semyung University. Results. The total number of identified patients was 1189 inpatients and 10138 outpatients. The 50–59 age group received acupuncture treatment in the hospital the most, followed by the 40–49 age group. Among the patients undergoing acupuncture treatment because of a diagnosis of pain, 82.74% were outpatients and 72.85% were inpatients. Additionally, all patients with a spine condition received acupuncture treatment. The most common musculoskeletal conditions of patients at the traditional Korean medicine (TKM hospital were associated with spine conditions, such as low back pain and neck pain. Various treatments have been performed at the hospital in conjunction with acupuncture. The study results show a high prevalence of acupuncture treatment for diagnosed diseases. Conclusion. Our study suggests the need to investigate additional TKM hospitals to analyse characteristics of patients who received specific treatments. Analysis of the characteristics of patients treated with Korean acupuncture at the TKM hospital in this study will help future researchers who want to implement strong clinical evidence. However, we cannot completely discount all symptoms because of the retrospective nature of this study, and only one hospital was used, which limits the generalisation of our findings.

  13. Review on pharmacological pain management in trauma patients in (pre-hospital) emergency medicine in the Netherlands

    Dijkstra, B.M.; Berben, S.A.A.; Dongen, R.T.M. van; Schoonhoven, L.

    2014-01-01

    Pain is one of the main complaints of trauma patients in (pre-hospital) emergency medicine. Significant deficiencies in pain management in emergency medicine have been identified. No evidence-based protocols or guidelines have been developed so far, addressing effectiveness and safety issues, taking

  14. The alchemists: a case study of a failed merger in academic medicine.

    Mallon, William T

    2003-11-01

    The changing environment in health care delivery and reimbursement in the United States in the late 1980s and 1990s caused a massive overhaul in the organizational structure of health care institutions. Hospital mergers were commonplace. Physician practices were bought and sold. Once stand-alone institutions developed integrated delivery systems. The academic medical community investigated and pursued a number of strategies to address changes in the marketplace, including streamlining and reengineering business practices; centralizing and integrating operations and decision making; creating separate clinical enterprises; creating new public authorities or nonprofit corporations to govern hospitals; building networks of providers; and acquiring physician practices. Perhaps the most hyped strategy was consolidation. In 1997, Pennsylvania State University's Hershey Medical Center and Geisinger Health System in Danville, Pennsylvania, announced plans to merge into one large clinical enterprise. The merger unwound three years later. Based on extensive interviews and document analysis, this case study examines six aspects of the merger and de-merger between Pennsylvania State University and Geisinger: (1) the environment and historical context that preceded the merger; (2) the reasons for the merger; (3) the structure of the merged system; (4) the outcomes for the new organization; (5) the reasons for the dissolution; and (6) the lessons learned from this series of events. PMID:14604867

  15. Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.

    Berkowitz, Scott A; Ishii, Lisa; Schulz, John; Poffenroth, Matt

    2016-03-01

    Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context. PMID:26535867

  16. Applying quality improvement methods to address gaps in medicines reconciliation at transfers of care from an acute UK hospital

    Marvin, Vanessa; Kuo, Shirley; Poots, Alan J; Woodcock, Thomas; Vaughan, Louella; Bell, Derek

    2016-01-01

    Objectives Reliable reconciliation of medicines at admission and discharge from hospital is key to reducing unintentional prescribing discrepancies at transitions of healthcare. We introduced a team approach to the reconciliation process at an acute hospital with the aim of improving the provision of information and documentation of reliable medication lists to enable clear, timely communications on discharge. Setting An acute 400-bedded teaching hospital in London, UK. Participants The effec...

  17. Software engineering in medical informatics: the academic hospital as learning environment.

    Prins, H; Cornet, R; van den Berg, F M; van der Togt, R; Abu-Hanna, A

    2002-01-01

    In 2001, the revised course Software Engineering has been implemented in the Medical Informatics curriculum at the Academic Medical Center, Amsterdam. This 13 weeks, full-time course consists of three parts: internship, theory and project. All parts are provided in problem-oriented manner with special attention for relevant skills such as project management, documentation and presentation. During the internship, students observe how health care professionals at several hospital wards work and how information supply is organized. In the theory part, students study concepts and methods of software engineering by means of case descriptions and self-directed learning. During the project, they apply their acquired knowledge to an observed, clinical information problem and complete several stages of the software engineering process. Evaluation by inquiry showed that, compared to other courses, students spent more time, and distributed their time more evenly, during the whole period of the course. In conjunction with theory, a combination of internship and project in a hospital seems to provide a surplus value compared to a practical in a computer laboratory. The integration of software theory, clinical practice and problem-based approach, contributed to the enthusiastic, intensive and realistic way students learned in this important topic that might be chosen as a future profession. PMID:15460769

  18. Activity of medicinal plant extracts against hospital isolates of methicillin-resistant Staphylococcus aureus.

    Voravuthikunchai, S P; Kitpipit, L

    2005-06-01

    Aqueous and ethanolic extracts of ten traditional Thai medicinal plants were investigated for their ability to inhibit 35 hospital isolates of methicillin-resistant Staphylococcus aureus (MRSA). Nine medicinal plants displayed activity against all isolates tested. Ethanolic extracts of Garcinia mangostana, Punica granatum and Quercus infectoria were most effective, with MICs for MRSA isolates of 0.05-0.4, 0.2-0.4 and 0.2-0.4 mg/mL, respectively, and for S. aureus ATCC 25923 of 0.1, 0.2 and 0.1 mg/mL, respectively. MBCs for MRSA isolates were 0.1-0.4, 1.6-3.2 and 0.4-1.6 mg/mL, and for S. aureus ATCC 25923 were 0.4, 3.2 and 1.6 mg/mL, respectively. PMID:15882206

  19. Census of Ligurian Internal Medicine Wards of non-teaching hospitals

    Micaela La Regina

    2014-12-01

    Full Text Available What is the future of internal medicine in Italy? Which competencies? Which potentialities? To this aim Ligurian FADOI Regional Society performed a census among 18 Internal Medicine Wards (IMWs in non-teaching Ligurian Hospital. We administered, by email, a questionnaire to the heads of IMWs. Data about staffing, equipment, skills, competencies and productivity during 2011 were collected from 1st to 31st November 2012. A total of 15/18 (83.3% chiefs answered to the questionnaire. The number of beds was largely variable among the wards. In 2011, mean diagnosis-related group (DRG-weight was 1.09 (range 0.91-1.6 and that revenues/costs ratio much higher than 1.5. Staff was quite adequate to standards defined by current law, only 33% has got a doctor:patients ratio superior to 1:6.4. However, annual hospitalizations exceed the availability of beds in medicine and the complexity of the patients would require a lower doctor:patients ratio, at least for a group of patients. In fact, 4 wards have a progressive care organization with a defined area for more seriously ill patients. Mean length of stay was 10 days. Expertise was wide, covering almost all medical sub-specialties. Acquired skills such as abdominal, heart and vascular ultrasounds, invasive procedures and their comprehensive knowledge make internists complete and cost-effective specialists. IMWs, as a concentrate of medical knowledge and skills, are the natural destination of current patients with co-morbidities. Staffing and number of beds should be revised according to this new demand. Their revenues/costs ratio resulted favorable and their global approach to patients and not to disease can be useful for resource rationalization. Wider and further studies are needed to improve the awareness of stakeholders about Internal Medicine.

  20. Spatial map dose of nuclear medicine service of the Clinical Hospital of Botucatu, SP, Brazil

    This study was conducted to describe levels of occupational and environmental exposure of the Nuclear Medicine Service of the Clinical Hospital of Botucatu. To this end, measurements were made of the radiometric levels of points strategically defined, in all the environments, for a period of six months, sampling different days and times, during operation normal routine of the sector. The results allow to estimate the expected dose for each environment, comparing them to the dose limitation established by the National Commission of Nuclear Energy (CNEN), allowing better targeting of occupationally exposed individuals, indicating the points where the occupation should be the minimum required, enabling the reduction of risks to potential exposures. (author)

  1. Designing HIGH-COST medicine: hospital surveys, health planning, and the paradox of progressive reform.

    Perkins, Barbara Bridgman

    2010-02-01

    Inspired by social medicine, some progressive US health reforms have paradoxically reinforced a business model of high-cost medical delivery that does not match social needs. In analyzing the financial status of their areas' hospitals, for example, city-wide hospital surveys of the 1910s through 1930s sought to direct capital investments and, in so doing, control competition and markets. The 2 national health planning programs that ran from the mid-1960s to the mid-1980s continued similar strategies of economic organization and management, as did the so-called market reforms that followed. Consequently, these reforms promoted large, extremely specialized, capital-intensive institutions and systems at the expense of less complex (and less costly) primary and chronic care. The current capital crisis may expose the lack of sustainability of such a model and open up new ideas and new ways to build health care designed to meet people's health needs. PMID:20019312

  2. Estimation of Internal Radiation Dose to Nuclear Medicine Workers at Siriraj Hospital

    Every type of work performed in a nuclear medicine department will make a contribution to both external and internal exposure of the worker. The purpose of this study is to evaluate the potential risks of internal contamination to staff members during nuclear medicine practices and to conclude about the requirement of a routine internal monitoring. Following the method describes in the ICRP Publication 78 and the IAEA Safety Standard Series No. RS- G-1.2, in vivo thyroid bioassays using NaI(Tl) thyroid probe were performed to determine the intake estimates on 7 groups of nuclear medicine personnel working with I-131 and Tc-99m, based on working conditions and amount of radionuclides being handled. Frequency of measurements was between 7 and 14 days. These include (1) physicians and physicists, (2) radiochemists (3) technologists, (4) nurses and assistant nurses, (5) imaging room assistants, (6) hot lab workers and (7) hospital ward housekeepers/cleaners. Among all workers, the intake estimates of I-131 in the thyroid ranged from 0 to 76.7 kBq and of the technetium-99m from 0 to 35.4 MBq. The mean committed effective dose equivalent (CEDE) from both I-131 and Tc-99m were 0.63, 1.44 0.53, 0.57, 0.73, 0.98, and 1.36, mSv, for group 1 through group 7 respectively. However, the highest mean CEDE of 1.44 (max. 1.75) and 1.36 (max. 2.11) mSv observed in groups of radiochemists and hospital ward housekeepers were within the permissible level. Our results showed that CEDE for internal exposure in this study were less than investigate level of 5 mSv according to the ICRP Publication 78 and the IAEA Basic Safety Standards. However, the mean CEDE for radiochemists and hospital ward housekeepers were considered in exceed of the limits of recording level (1 mSv).The increasing use of I-131 and Tc-99m in nuclear medicine poses significant risks of internal exposure to the staff. This study suggests that a routine monitoring program for internal exposures should be implemented for

  3. A Reliable Billing Method for Internal Medicine Resident Clinics: Financial Implications for an Academic Medical Center

    Kapa, Suraj; Beckman, Thomas J.; Cha, Stephen S.; Meyer, Joyce A.; Robinet, Charlotte A.; Bucher, Diane K.; Hardy, Jeanne M.; McDonald, Furman S.

    2010-01-01

    Background The financial success of academic medical centers depends largely on appropriate billing for resident-patient encounters. Objectives of this study were to develop an instrument for billing in internal medicine resident clinics, to compare billing practices among junior versus senior residents, and to estimate financial losses from inappropriate resident billing. Methods For this analysis, we randomly selected 100 patient visit notes from a resident outpatient practice. Three coding specialists used an instrument structured on Medicare billing standards to determine appropriate codes, and interrater reliability was assessed. Billing codes were converted to US dollars based on the national Medicare reimbursement list. Inappropriate billing, based on comparisons with coding specialists, was then determined for residents across years of training. Results Interrater reliability of Current Procedural Terminology components was excellent, with κ ranging from 0.76 for examination to 0.94 for diagnosis. Of the encounters in the study, 55% were underbilled by an average of $45.26 per encounter, and 18% were overbilled by an average of $51.29 per encounter. The percentages of appropriately coded notes were 16.1% for postgraduate year (PGY) 1, 26.8% for PGY-2, and 39.3% for PGY-3 residents (P < .05). Underbilling was 74.2% for PGY-1, 48.8% for PGY-2, and 42.9% for PGY-3 residents (P < .01). There was significantly less overbilling among PGY-1 residents compared with PGY-2 and PGY-3 residents (9.7% versus 24.4% and 17.9%, respectively; P < .05). Conclusions Our study reports a reliable method for assessing billing in internal medicine resident clinics. It exposed large financial losses, which were attributable to junior residents more than senior residents. The findings highlight the need for educational interventions to improve resident coding and billing. PMID:21975617

  4. A pharmacovigilance study of antihypertensive medicines at a South Delhi hospital

    Hussain A

    2009-01-01

    Full Text Available The aim of the present study was to monitor adverse drug reactions associated with antihypertensive drugs. The study was conducted in medicine out patient department of 150-bed Majeedia Hospital at Hamdard University Campus in New Delhi. The study was conducted by way of one to one patient interview by a registered pharmacist using a questionnaire-based Adverse Drug Reaction Monitoring Form drafted according to the World Health Organisation Monitoring Guidelines. A total of 34 adverse drug reactions were observed in 250 hypertensive patients during the four month study. A high percentage of adverse drug reactions occurred in middle aged and female patients. Of the 34 adverse drug reactions, 18 (52.9% were mild, 14 (41.2% moderate and only 2 (5.8% were classified as severe. Combination therapy was associated with significantly high occurrence (P < 0.05 of adverse drug reactions, with a total of 21 (61.8% as compared to monotherapy (n=13, 38.2%. Cardiovascular adverse drug reactions constituted a major component, followed by gastrointestinal and respiratory complaints. Beta-blockers were the drug category associated with majority of adverse drug reactions, followed by angiotensin-converting enzyme inhibitors and calcium channel blockers. The above pharmacovigilance study presents the adverse drug reaction profile of antihypertensive medicines prescribed in our University Teaching Hospital. It was concluded that calcium channel blockers were the most frequently prescribed drug category but beta blockers were associated with higher frequency of adverse drug reactions.

  5. System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

    Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

  6. [Laboratory medicine in the post-genome era: experiences in Chiba University Hospital].

    Nomura, Fumio

    2008-12-01

    Since the completion of the human genome project, there is growing interest in the clinical application of genome sciences. For this purpose, particular attention toward identifying at-risk individuals and understanding the complexities of the testing process are essential. In this article, I describe the importance of clinical genetics and genetic counseling, and explain how and why the division of laboratory medicine is involved in these tasks in Chiba University Hospital. Our genetic counseling team consists of a clinical laboratory physician qualified as a clinical geneticist, medical technologist qualified as a genetic counselor, clinical psychologists, and a medical social worker. We treat more than 100 cases including late-onset, incurable neurological diseases, hereditary tumors, prenatal diagnosis, and chromosomal abnormalities. The sequencing of the human genome has paved the way for comprehensive transcriptome and proteome analyses. Since the detailed understanding of biological processes, both in healthy and pathological states, requires the direct study of relevant proteins, proteomics bridges the gap between the information coded in the genome sequence and cellular behavior. Therefore, proteomics is among the most promising technologies for the development of novel diagnostic tools. Recent advances in sophisticated technologies in proteomics should identify promising ways to discover novel markers in various fields of clinical medicine. In this presentation, I will give a definition of the proteome, and outline the basic methodologies for proteome analyses. I will also present our experiences in identifying novel biomarker candidates in hepatobiliary diseases, and discuss future perspectives of clinical proteomics in laboratory medicine. PMID:19175078

  7. HIV and Infectious Disease Care in Jails and Prisons: Breaking Down the Walls with the Help of Academic Medicine

    Flanigan, Timothy P.; Zaller, Nickolas; Taylor, Lynn; BECKWITH, CURT; Kuester, Landon; Rich, Josiah; Carpenter, Charles C. J.

    2009-01-01

    Health care within correctional facilities has traditionally been marginalized from excellence in academic medicine. The armamentarium of a medical school, which includes excellence in research, teaching and clinical care, can be successfully applied to the correctional setting both in the United States and internationally. At any one time, there are over 2 million people incarcerated in the US who are disproportionately poor and from communities of color. Rates of human immunodeficiency viru...

  8. The prevalence and effects of urinary incontinence in women working in the Universitas Academic Hospital, Bloemfontein

    Veronique C. Bailey

    2010-03-01

    Full Text Available Urinary incontinence affects 30% of women by the time they reach 50 years of age and continues to increase thereafter. Symptoms vary in severity and adversely impact on the physical and psychosocial wellbeing of affected individuals. By means of a self-administered questionnaire, the study investigated the prevalence of urinary incontinence and its effects on the quality of life in women working at the Universitas Academic Hospital in Bloemfontein in 2007. Pregnant women were not included in the study. One hundred and nine questionnaires were analysed. Participants were 24–62 years of age (mean age 44.4 years. Of these, 27.5% reported symptoms of urinary incontinence. Only one affected individual was younger than 30 years. Three-quarters of affected women rated their symptoms as light to moderate. In 34.6% of the affected women, the condition did not interfere with everyday activities at all, but 11.5% reported severe interference. Information regarding urinary incontinence, precautionary measures, such as Kegel exercises, and its associated psychosocial consequences, should be disseminated to women of all ages.

  9. In hospital pediatrics hospitalized sufferer sugar skin quality hormone medicine is used medicine circumstance analysis%我院儿科住院患者糖皮质激素类药物用药情况分析

    成美

    2014-01-01

    Objective:Understand my use circumstance and existence problem of hospital pediatrics hospitalized sufferer sugar skin quality hormone medicine, and carry on an analytical discussion. Methods:Random sample my hospital July, 2010 to June, 2011 hospitalized department the pediatrics medical history is 351, to the medical history species that implies sugar skin quality hormone medicine piece, the proportion had, to the medicine path, use medicine amount of, use circumstance and use of to should diagnose, rationality etc. carry on a statistics analysis. Result:Sugar skin quality hormone medicine at my hospital pediatrics is in the hospitalized sufferer use extensively, the medical history utilization rate has 58.9%;Sprinkling a sour sodium of nylon amber to inject a liquid use by AN among them is the most, the utilization rate has 63.8% of implying sugar skin quality hormone medicine pediatrics medical history;Sugar skin quality hormone medicine gives in the medical history medicine path with the vein drop note for main, have 60.4%;Parts of pediatrics medical history existence absurdities are used a medicine phenomenon, go together with five in the adaption, medicine respectively, the medicine Be allied to exist a problem with etc. Conclusion:Strengthen to my medicine supervision and education of using of the hospital pediatrics sugar skin quality hormone medicine, the exaltation helps the reasonable to use a medicine to the understanding that misuses sugar skin quality hormone harm.%目的:了解我院儿科住院患者糖皮质激素类药物的使用情况及存在问题,并进行分析讨论。方法:随机抽取我院2010年7月~2011年6月住院部儿科病历351份,对含有糖皮质激素类药物的病历品种个数、所占比例、给药途径、用药剂量、使用情况、使用的对应诊断、合理性等进行统计分析。结果:糖皮质激素类药物在我院儿科住院患者中使用广泛,病历使用率占58.9%

  10. Complexity in hospital internal medicine departments: what are we talking about?

    Roberto Nardi

    2013-09-01

    Full Text Available Internal medicine (IM patients are mostly elderly, with multiple complex co-morbidities, usually chronic. The complexity of these patients involves the intricate entanglement of two or more systems (e.g. body and disease, family-socio-economic and environmental status, coordination of care and therapies and this requires comprehensive, multi-dimensional assessment (MDA. Despite attempts to improve management of chronic conditions, and the availability of several MDA tools, defining the complex patient is still problematic. The complex profile of our patients can only be described through the best assessment tools designed to identify their characteristics. In order to do this, the Federation of Associations of Hospital Doctors on Internal Medicine FADOI has created its own vision of IM. This involves understanding the different needs of the patient, and analyzing diseases clusters and the possible relationships between them. By exploring the real complexity of our patients and selecting their real needs, we can exercise holistic, anthropological and appropriate choices for their treatment and care. A simpler assessment approach must be adopted for our complex patients, and alternative tools should be used to improve clinical evaluation and prognostic stratification in a hierarchical selection of priorities. Further investigation of complex patients admitted to IM wards is needed.

  11. Complexity of patients with chronic obstructive pulmonary disease hospitalized in internal medicine: a survey by FADOI

    Carlo Nozzoli

    2015-05-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is one of the most frequent pathologies among patients hospitalized in Internal Medicine (IM Departments. COPD is frequently associated with concomitant diseases, which represent major causes of death, and affect disease management. Objectives of our study are to assess the prevalence of COPD patients in IM, to evaluate their comorbidity status, and to describe their complexity, by means of the validated multidimensional prognostic index (MPI score. COMPLEXICO is an observational, prospective, multicenter study, enrolling consecutive patients hospitalized for any cause in IM, with diagnosis of COPD documented by spirometry. A total of 1002 patients in 43 IM Units in Italy were enrolled. The prevalence of COPD in IM was found to be 18.1%, and 72.8% of patients had at least three chronic diseases other than COPD. The mean MPI was 0.43±0.15, and according to a stratification algorithm 31.8% of patients were classified as having low-risk, 58.9% moderate-risk and 9.3% severe-risk of adverse outcome. More than two-thirds of COPD patients in our study present moderate to severe risk of poor outcome according to the MPI stratification.

  12. Hospital doctors' self-rated skills in and use of evidence-based medicine - a questionnaire survey

    Oliveri, Roberto S; Gluud, Christian; Wille-Jørgensen, Peer A

    2004-01-01

    Problems in understanding basic aspects of evidence-based medicine (EBM) may form barriers to its implementation into clinical practice. We examined hospital doctors' skills in EBM terms and related these skills to their use of information sources, critical appraisal, and implementation of EBM in...

  13. VIEWS OF PRIMARY HEALTH CARE TRAINEES ON THEIR HOSPITAL TRAINING IN INTERNAL MEDICINE AND PEDIATRICS IN SAUDI ARABIA

    Al-Rowais, Norah; Al-Ghamdi, Essam

    2000-01-01

    Objective: The aim of this study is to assess the perception and satisfaction of primary health care (PHC) trainees regarding their hospital training in Internal Medicine and Pediatrics. Methodology: A cross-sectional study was conducted by means of a self-administered questionnaire distributed to the trainees who had finished Medicine and/or Pediatrics rotation in 4 PHC training centers in Riyadh, Al-Khobar, Jeddah and Al-Medina during January 1996. Results: Trainees were more satisfied with the Pediatric rotation than the Internal Medicine rotation. Significant relationship (p<0.05) was found between trainee satisfaction in Internal Medicine rotation and both the quality of training and the relevance of training to the needs of PHC trainees. On the other hand, in Pediatrics, the only variable which was related significantly to the trainees’ satisfaction was the duration of the rotation, which was found to be sufficient (p<0.05). Trainees’ dissatisfaction with the rotation was due to many factors, such as the imbalance between service work and educational sessions and the lack of awareness of other specialists about PHC as a career. Conclusion: Attention and effort should be directed towards the improvement of hospital training through a close collaboration between the decision-makers for PHC training and the hospital consultants. Also the needs of trainees should be taken into account during planning of hospital training. PMID:23008621

  14. The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

    Elisangela da Costa Lima-Dellamora

    2015-03-01

    Full Text Available Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee (DTC is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection. The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system. Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.

  15. Comparing Academic Library Spending with Public Libraries, Public K-12 Schools, Higher Education Public Institutions, and Public Hospitals between 1998-2008

    Regazzi, John J.

    2012-01-01

    This study compares the overall spending trends and patterns of growth of Academic Libraries with Public Libraries, K-12 schools, higher education institutions, and hospitals in the period of 1998 to 2008. Academic Libraries, while showing a growth of 13% over inflation for the period, far underperformed the growth of the other public institutions…

  16. Toward a sustainable and wise healthcare approach: potential contributions from hospital Internal Medicine Departments to reducing inappropriate medical spending

    Roberto Nardi

    2013-04-01

    Full Text Available All countries are facing the question of how to maintain quality of care with shrinking health budgets, in the presence of a persistent increase in life expectancy, and with a significant growing demand for health care from aging populations and chronically ill patients. Current implementation of legislative measures is largely presented as a cost-cutting policy. With this political approach, there is a risk of services and the number of hospital beds being drastically reduced, mainly to detriment of the most vulnerable groups of the population and without considering the results obtained by each regional healthcare organization according to explicit evaluation markers. In our Scientific Society of Internal Medicine (the Federation of Associations of Hospital Doctors on Internal Medicine, FADOI, we want to support good medical practice because essential medicine is still a goal to be achieved throughout medical hospital care. We are looking for original ways to implement a sustainable and frugal hospital Internal Medicine policy by searching for wise and efficient clinical methodology to be applied in the care of patients admitted to internal medicine wards according to their real needs. We firmly believe that reinforcing a common agenda between medicine and public health, and sharing a common vision among professionals and decision makers in the planning of care, may be the greatest opportunity for any every health care reform. The future of the health care system cannot be restricted to mere cost reduction, but should aim to deliver better health care in relation to the money spent. Even in this period of austerity, new opportunities can still be found and doctors must lead efforts to meet this challenge.

  17. Scribe Impacts on Provider Experience, Operations, and Teaching in an Academic Emergency Medicine Practice

    Jeremy J. Hess

    2015-10-01

    Full Text Available Introduction: Physicians dedicate substantial time to documentation. Scribes are sometimes used to improve efficiency by performing documentation tasks, although their impacts have not been prospectively evaluated. Our objective was to assess a scribe program’s impact on emergency department (ED throughput, physician time utilization, and job satisfaction in a large academic emergency medicine practice. Methods: We evaluated the intervention using pre- and post-intervention surveys and administrative data. All site physicians were included. Pre- and post-intervention data were collected in fourmonth periods one year apart. Primary outcomes included changes in monthly average ED length of stay (LOS, provider-specific average relative value units (RVUs per hour (raw and normalized to volume, self-reported estimates of time spent teaching, self-reported estimates of time spent documenting, and job satisfaction. We analyzed data using descriptive statistics and appropriate tests for paired pre-post differences in continuous, categorical, and ranked variables. Results: Pre- and post-survey response rates were 76.1% and 69.0%, respectively. Most responded positively to the intervention, although 9.5% reported negative impressions. There was a 36% reduction (25%-50%; p<0.01 in time spent documenting and a 30% increase (11%-46%, p<0.01 in time spent in direct patient contact. No statistically significant changes were seen in job satisfaction or perception of time spent teaching. ED volume increased by 88 patients per day (32-146, p=0.04 pre- to post- and LOS was unchanged; rates of patients leaving against medical advice dropped, and rates of patients leaving without being seen increased. RVUs per hour increased 5.5% and per patient 5.3%; both were statistically significant. No statistically significant changes were seen in patients seen per hour. There was moderate correlation between changes in ED volume and changes in productivity metrics

  18. Does Admission to Medicine or Orthopaedics Impact a Geriatric Hip Patient’s Hospital Length of Stay?

    Greenberg, Sarah E.; VanHouten, Jacob P.; Lakomkin, Nikita; Ehrenfeld, Jesse; Jahangir, Amir Alex; Boyce, Robert H.; Obremksey, William T.; Sethi, Manish K.

    2016-01-01

    Objectives The aim of our study was to determine the association between admitting service, medicine or orthopaedics, and length of stay (LOS) for a geriatric hip fracture patient. Design Retrospective. Setting Urban level 1 trauma center. Patients/Participants Six hundred fourteen geriatric hip fracture patients from 2000 to 2009. Interventions Orthopaedic surgery for geriatric hip fracture. Main Outcome Measurements Patient demographics, medical comorbidities, hospitalization length, and admitting service. Negative binomial regression used to determine association between LOS and admitting service. Results Six hundred fourteen geriatric hip fracture patients were included in the analysis, of whom 49.2% of patients (n = 302) were admitted to the orthopaedic service and 50.8% (3 = 312) to the medicine service. The median LOS for patients admitted to orthopaedics was 4.5 days compared with 7 days for patients admitted to medicine (P medicine (n = 92, 29.8%) than for those admitted to orthopaedics (n = 70, 23.1%). After controlling for important patient factors, it was determined that medicine patients are expected to stay about 1.5 times (incidence rate ratio: 1.48, P medicine service compared with the orthopaedic service increases a geriatric hip fractures patient’s expected LOS. Since LOS is a major driver of cost as well as a measure of quality care, it is important to understand the factors that lead to a longer hospital stay to better allocate hospital resources. Based on the results from our institution, orthopaedic surgeons should be aware that admission to medicine might increase a patient’s expected LOS. PMID:26371621

  19. What is an appropriate radiotherapy technology? A Pretoria Academic Hospital perspective

    Full text: The opportunity to design a new radiation oncology facility only presents itself once in a professional lifetime (if you're lucky). The new Pretoria Academic Hospital evolved over a period of more than ten years of planning. Since there were no clear guidelines or budget presented during the acquisition of equipment we posed the question: what is appropriate? The factors determining appropriateness will be discussed and the various options tested against these. The recent experience of our facility with new equipment will be used as the basis for the arguments. Although there were national and regional plans available for oncology services, we were left in limbo with regard to budgets, expected service levels and time frames. Our department drew up a plan loosely based on the replacement of current technology with the equivalent new technology and rough estimates of expected patient numbers. We opted for a high tech approach. The next hurdle was to work within the tender system to draw up appropriate specifications and to manage the acquisition process. A sophisticated evaluation was done based on cost of ownership over a seven year period. The lessons learned from this experience will be shared. Commissioning of equipment and new techniques presented a huge challenge since it had to be performed with available resources while normal patient treatment had to be maintained. The whole philosophy of the department changed and we dragged a number of personnel kicking and screaming into the 21st century. As of today IMRT and SRS have become a routine part of life and IGRT capabilities are being developed. The experience in our department has shown how a high tech approach can be implemented successfully in a developing world setting to improve productivity and personnel morale. However, the needs and expectations vary between centres and our findings will be extrapolated to different scenarios. The answer to this question is neither clear cut nor static and

  20. Implementing an Interoperable Personal Health Record in Pediatrics: Lessons Learned at an Academic Children’s Hospital

    Anoshiravani, Arash; Gaskin, Gregory; Kopetsky, Ed; Sandborg, Christy; Longhurst, Christopher A.

    2011-01-01

    Summary This paper describes the development of an innovative health information technology creating a bidirectional link between the electronic medical record (EMR) of an academic children’s hospital and a commercially available, interoperable personal health record (PHR). The goal of the PHR project has been to empower pediatric patients and their families to play a more active role in understanding, accessing, maintaining, and sharing their personal health information to ultimately improve health outcomes. The most notable challenges proved more operational and cultural than technological. Our experience demonstrates that an interoperable PHR is technically and culturally achievable at a pediatric academic medical center. Recognizing the complex social, cultural, and organizational contexts of these systems is important for overcoming barriers to a successful implementation. PMID:21853160

  1. Pattern of use of antibiotics in hospitalized patients in the medicine department of a tertiary care hospital

    Muniza Bai

    2015-10-01

    Conclusion: Ceftriaxone, doxycycline, and metronidazole are commonly used antibiotics and significant proportion of the cost of drugs is spent for antimicrobials in a medicine unit. [Int J Basic Clin Pharmacol 2015; 4(5.000: 888-894

  2. Academic career in medicine – requirements and conditions for successful advancement in Switzerland

    Stamm Martina; Buddeberg-Fischer Barbara; Buddeberg Claus

    2009-01-01

    Abstract Background Within the framework of a prospective cohort study of Swiss medical school graduates a sample of young physicians aspiring to an academic career were surveyed on their career support and barriers experienced up to their sixth year of postgraduate training. Methods Thirty-one junior academics took part in semi-structured telephone interviews in 2007. The interview guideline focused on career paths to date, career support and barriers experienced, and recommendations for jun...

  3. [Attitudes of health personnel in a university hospital toward evidence-based medicine].

    Markulin, Helena; Petrak, Jelka

    2010-01-01

    Over the last few years the concepts and methods of the evidence-based medicine (EBM) have been increasingly recognized and applied in the Croatian medical community. Central Medical Library at Zagreb university Medical School has been developing a web-based service aimed to help practitioners find best evidence for solving specific clinical problems. Therefore, the health personnel affiliated to a teaching hospital were surveyed. The questionnaire included 18 questions evaluating attitudes towards EBM. It was displayed by the library's information desk. There were 204 respondents, 62% of them clinical specialists. Most respondents agreed that EBM is useful in clinical decision making (57.4%) as well as in improving patient care (55.4%). Lack of personal time (60.8%) and insufficient skills (60.3%) were percieved as the main barriers to practising EBM. The vast majority of respondents (96.6%) reported never having received EBM training. The study results show that medical librarians can play an expanded role in saving the practitioners' time by searching EBM resources and assessing the quality of the information. PMID:20857805

  4. 50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

    Lertakyamanee, Jariya

    2016-05-01

    Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters. We look after pre-anesthesia assessment, inside and outside operating room anesthesia, post-operative pain relief Intensive Care Unit, and chronic pain management. The number of patients and their diseases increase; so do the complexities of surgeries. There are tremendous changes in drugs and equipment. There is the fourth mission on administration, IT and resource management. And the fifth mission which is corporate social responsibility. However, we still believe that compassion, responsibility and integrity are most important. We have taught and tried to live by the teaching of HRH the King's Father. And these will contribute to our progress and shine in the next 50 years. PMID:27501620

  5. Preparing for the aged in investigative medicine in a General Hospital setting

    Full text: The inequalities which exist today between the health of various sectors of society have grown partly out of the different rates of improvement experienced during the 18th, 19th and 20th Centuries. This is especially so for social class, racial and regional differences. Differential health problems between various age groups and disease groups have probably arisen for other reasons. People can now expect to live well into their 70s or early 80s. Many things have contributed to these health gains, including improved public health measures, high quality clinical treatment services, social and environmental conditions and lifestyle changes. The purpose of this paper is to highlight the major health problems of the community served by the Department of Nuclear Medicine at the Launceston General Hospital (Northern Regional Health) with the following perspectives: (i) How an ageing population is impacting in the level of service; (ii) How the aged are to be managed during investigation, after care and follow-up; and (iii) Major areas of investigations and age group analysis

  6. Radiological zoning of a nuclear medicine department: Example of the military hospital Sainte-Anne

    According to the ministerial order of May 15, 2006 (transposition of the EURATOM directive 96/29 from May 13, 1996), each person in charge of a medical institution is compelled to classify the working areas dealing with sources of ionizing radiation. The approach to the delineation of radiological areas should appear in an internal document combining the analysis of heath risks. Without waiting for the publication of the official guidelines as announced in the notice DGT/ASN no. 1 of January 18, 2008 and in accordance with the above mentioned order, we have already formalized the different steps towards a zoning in the new nuclear medicine department in the Military Hospital Ste Anne of Toulon by using a detailed methodology to measure exposition and contamination levels. The methodology is largely based on measurements and consideration of normal envelopes. Analysis of integrated doses over an hour in a room can ultimately determine radiological areas. We apply the new recommended values to define the different classified zones according to their specificity and discuss this new way of assessment of exposure risks as well as the consequences on the different staff categories concerned. (authors)

  7. Changing Environment and the Academic Medical Center: The Johns Hopkins Hospital.

    Heyssel, Robert M.

    1989-01-01

    Johns Hopkins Hospital expanded its health care delivery capabilities and strengthened its position in the marketplace by acquisitions of and mergers with other hospitals and a health maintenance organization. The resulting conglomerate has achieved its goals of expanding patient care, broadening the patient base, and enlarging the asset base and…

  8. Complementary alternative medicine use among patients with dengue fever in the hospital setting: a cross-sectional study in Malaysia

    Ching, SiewMooi; Ramachandran, Vasudevan; Gew, Lai Teck; Lim, Sazlyna Mohd Sazlly; Sulaiman, Wan Aliaa Wan; Foo, Yoke Loong; Zakaria, Zainul Amiruddin; Samsudin, Nurul Huda; Lau, Paul Chih Ming Chih; Veettil, Sajesh K; Hoo, Fankee

    2016-01-01

    Background In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expen...

  9. Working towards implementation of a nuclear medicine accreditation program in a South African teaching hospital

    Full text: Introduction: Quality assurance in Nuclear Medicine is of utmost importance in order to ensure optimal scintigraphic results and correct patient management and care. The implementation of a good quality assurance program should address all factors that playa role in the optimal functioning of a department. It should be developed by scientific findings as well as national and international guidelines. Aim: To develop a tailor made program that can be managed according to the individual needs and requirements of a Nuclear Medicine department in a teaching hospital. This program is aimed at international accreditation of the department. Materials and methods: Auditing of the following aspects was conducted: organizational, clinical and technical, personnel satisfaction, patient experience and satisfaction, referring physicians experience and satisfaction. Information was collected by means of questionnaires to groups and individuals for opinion polls; one-to-one interviews with personnel and patients; technical evaluation of equipment according to manufacturer's specifications and international standards; laboratory equipment evaluation according to precompiled guidelines and investigation of laboratory procedures for standardization and radiation safety. Existing procedure protocols were measured against international guidelines and evaluated for possible shortcomings of technical as well as cosmetic details, and data storage facilities were evaluated in terms of user friendliness, viability and cost effectiveness. A number of international accreditation experts were also visited to establish the validity of our results. Results: Patient questionnaires indicated overall satisfaction with personal service providing, but provision of written and understandable information, long waiting periods and equipment must receive attention. Staff questionnaires indicated a general lack of communication between different professional groups and the need for

  10. Prevalence of potential drug-drug interactions among internal medicine ward in University of Gondar Teaching Hospital, Ethiopia

    Akshaya Srikanth Bhagavathula; Alemayehu Berhanie; Habtamu Tigistu; Yishak Abraham; Yosheph Getachew; Tahir Mehmood Khan; Chandrashekhar Unakal

    2014-01-01

    Objective: To determine the prevalence, clinical significance and the associated risk factors of potential drug-drug interactions (DDIs) at internal medicine ward of University of Gondar (UOG) hospital.Method:medicine ward of UOG hospital from April 29, 2013 to June 2, 2013. Data was collected from medical records and by interviewing the patients face to face. Descriptive analysis was conducted for back ground characteristics and logistic regression was used to determine the associated risk factors.Result:A prospective cross-sectional study was conducted on patients treated in internal interacting combinations with 4.13 potential DDIs per patient. Among 413 potential DDIs most were of moderate interactions 61.2% (n=253) followed by 26% (n=107) of minor interactions and 12.8% (n=53) of major interactions. There was significant association of occurrence of potential DDIs only with taking three or more medications.Conclusion:We have recorded a high rate of prevalence of potential DDI in the internal In our study, we have identified a total number of 413 potential DDIs and 184 types of medicine ward of UOG hospital and a high number of clinically significant DDIs which the most prevalent DDI were of moderate severity. Careful selection of drugs and active pharmaceutical care is encouraged in order to avoid negative consequences of these interactions.

  11. Quality control programme established in the Nuclear Medicine Department of the Vancouver Coastal Health Authority Hospitals

    The Vancouver Coastal Health Authority (VCH) covers a large area of Southern British Columbia that includes 14 hospitals. Five of them have Nuclear Medicine (NM) departments with a total of 18 cameras of different ages and produced by different manufacturers. A flawless operation of these cameras is of paramount importance for the accuracy of diagnostic studies. Consequently, a comprehensive quality control (QC) programme has been designed to detect changes in their performance that might degrade the accuracy of clinical images. The most extensive testing is done at acceptance of the new equipment, simpler tests continue regularly throughout the whole period of camera operation. The tests are based on the National Electrical Manufacturers Association (NEMA) recommendations on how to perform QC experiments and how to analyse the results. The QC programme in all five NM departments follows the same principles. It is supervised by a 'regional' physicist. Initially, however, problems were encountered. At first, analysis of the QC data coming from these different cameras was seriously hindered by the lack or rigidity of the proprietary manufacturers' software. In particular, it was very difficult, if not impossible, to reliably compare the performance of different systems. An additional problem was caused by the large distances between hospital departments which made regular consultations by the physicist and test supervision difficult. In this paper, we present a practical solution to these problems and discuss our particular implementation of a QC programme that covers 18 cameras and unites five busy NM departments. To address the first problem and make the analysis of test results reliable and camera independent, we have developed a software application 'Nuclear Medicine QC' (NMQC) which implements the basic scintillation camera QC analyses and follows exactly the most recent NEMA standard. Our software allows multiple types of QC tests to be analysed within a single

  12. Review on pharmacological pain management in trauma patients in (pre-hospital) emergency medicine in the Netherlands.

    Dijkstra, B M; Berben, S A A; van Dongen, R T M; Schoonhoven, L

    2014-01-01

    Pain is one of the main complaints of trauma patients in (pre-hospital) emergency medicine. Significant deficiencies in pain management in emergency medicine have been identified. No evidence-based protocols or guidelines have been developed so far, addressing effectiveness and safety issues, taking the specific circumstances of pain management of trauma patients in the chain of emergency care into account. The aim of this systematic review was to identify effective and safe initial pharmacological pain interventions, available in the Netherlands, for trauma patients with acute pain in the chain of emergency care. Up to December 2011, a systematic search strategy was performed with MeSH terms and free text words, using the bibliographic databases CINAHL, PubMed and Embase. Methodological quality of the articles was assessed using standardized evaluation forms. Of a total of 2328 studies, 25 relevant studies were identified. Paracetamol (both orally and intravenously) and intravenous opioids (morphine and fentanyl) proved to be effective. Non-steroidal anti-inflammatory drugs (NSAIDs) showed mixed results and are not recommended for use in pre-hospital ambulance or (helicopter) emergency medical services [(H)EMS]. These results could be used for the development of recommendations on evidence-based pharmacological pain management and an algorithm to support the provision of adequate (pre-hospital) pain management. Future studies should address analgesic effectiveness and safety of various drugs in (pre-hospital) emergency care. Furthermore, potential innovative routes of administration (e.g., intranasal opioids in adults) need further exploration. PMID:23737462

  13. Rapid Implementation of Inpatient Electronic Physician Documentation at an Academic Hospital

    Hahn, J S; Bernstein, J.A.; McKenzie, R.B.; King, B. J.; Longhurst, C.A.

    2012-01-01

    Electronic physician documentation is an essential element of a complete electronic medical record (EMR). At Lucile Packard Children’s Hospital, a teaching hospital affiliated with Stanford University, we implemented an inpatient electronic documentation system for physicians over a 12-month period. Using an EMR-based free-text editor coupled with automated import of system data elements, we were able to achieve voluntary, widespread adoption of the electronic documentation process. When give...

  14. Development of a Hospital-based Massage Therapy Course at an Academic Medical Center

    Dion, Liza J.; Cutshall, Susanne M.; Rodgers, Nancy J.; Hauschulz, Jennifer L.; Dreyer, Nikol E.; Thomley, Barbara S.; Bauer, Brent

    2015-01-01

    Background: Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substanti...

  15. Academic doctors' views of complementary and alternative medicine (CAM and its role within the NHS: an exploratory qualitative study

    Shaw Alison

    2007-05-01

    Full Text Available Abstract Background There has been a marked increase in the use of complementary and alternative medicine (CAM in the UK population in recent years. Surveys of doctors' perspectives on CAM have identified a variety of views and potential information needs. While these are useful for describing the proportions of doctors who hold particular attitudes towards CAM, they are less helpful for understanding why. In addition, while the views of non-academic doctors have begun to be studied, the perspective and rationales of academic doctors remains under-researched. It seems important to investigate the views of those with a research-orientation, given the emphasis on the need for more scientific evidence in recent debates on CAM. Methods This exploratory study used qualitative methods to explore academic doctors' views of CAM and the rationales they provided for their views. A purposeful sampling strategy was used to identify doctors with a dual clinical and academic role in the Bristol area, with an anticipated variety of views on CAM. Semi-structured interviews were conducted with nine doctors. The data were analysed thematically, drawing on the Framework Approach. Results The doctors expressed a spectrum of views on CAM, falling into three broad groups: the 'enthusiasts', the 'sceptics' and the 'undecided'. Scepticism or uncertainty about the value of CAM was prominent, except among those practising a form of CAM. A variety of rationales underpinned their perspectives on CAM, a key recurring rationale being their perspective on the scientific evidence base. The main themes arising included: the role of doctors' professional experiences of conventional medicine and CAM in shaping their attitudes towards CAM, doctor-patient communication about CAM and patient disclosure, whether there is a need for training and education in CAM for doctors, a hierarchy of acceptability of CAM and the nature of evidence; and the role of CAM within the NHS. Conclusion

  16. Over-the-counter medicine and dietary supplement consumption among academic youth in Poland.

    Bochenek, Tomasz; Godman, Brian; Lipowska, Katarzyna; Mikrut, Karolina; Zuziak, Sandra; Pedzisz, Magdalena; Nowak, Aneta; Pilc, Andrzej

    2016-04-01

    Over-the-counter (OTC) medicines and dietary supplements are increasingly popular in Poland, potentially improving but also potentially posing a threat to public health. The study goal is to characterize and assess behaviors related to use of OTC medicines and dietary supplements among Polish university students. A questionnaire-based survey was performed with students divided into groups (gender, subjects studied, period of studies). The majority of students declared using the products, significantly more females and younger students in their early years. Females tended to be more attentive to product information. Students with a background in biological or medical sciences were also more attentive and less influenced by advertising. The authors present that the differences between the defined groups of students should be utilized in tailored educational activities, aiming to rationalize high consumption of OTC medicines and dietary supplements. Targeting other, especially low-socioeconomic and less-educated, groups should follow. PMID:26886826

  17. Hospitals

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  18. Applying quality improvement methods to address gaps in medicines reconciliation at transfers of care from an acute UK hospital

    Marvin, Vanessa; Kuo, Shirley; Vaughan, Louella

    2016-01-01

    Objectives Reliable reconciliation of medicines at admission and discharge from hospital is key to reducing unintentional prescribing discrepancies at transitions of healthcare. We introduced a team approach to the reconciliation process at an acute hospital with the aim of improving the provision of information and documentation of reliable medication lists to enable clear, timely communications on discharge. Setting An acute 400-bedded teaching hospital in London, UK. Participants The effects of change were measured in a simple random sample of 10 adult patients a week on the acute admissions unit over 18 months. Interventions Quality improvement methods were used throughout. Interventions included education and training of staff involved at ward level and in the pharmacy department, introduction of medication documentation templates for electronic prescribing and for communicating information on medicines in discharge summaries co-designed with patient representatives. Results Statistical process control analysis showed reliable documentation (complete, verified and intentional changes clarified) of current medication on 49.2% of patients' discharge summaries. This appears to have improved (to 85.2%) according to a poststudy audit the year after the project end. Pharmacist involvement in discharge reconciliation increased significantly, and improvements in the numbers of medicines prescribed in error, or omitted from the discharge prescription, are demonstrated. Variation in weekly measures is seen throughout but particularly at periods of changeover of new doctors and introduction of new systems. Conclusions New processes led to a sustained increase in reconciled medications and, thereby, an improvement in the number of patients discharged from hospital with unintentional discrepancies (errors or omissions) on their discharge prescription. The initiatives were pharmacist-led but involved close working and shared understanding about roles and responsibilities

  19. The postgraduate hospital educational environment measure (PHEEM questionnaire identifies quality of instruction as a key factor predicting academic achievement

    Joaquim Edson Vieira

    2008-01-01

    Full Text Available OBJECTIVE: This study analyzes the reliability of the PHEEM questionnaire translated into Portuguese. We present the results of PHEEM following distribution to doctors in three different medical residency programs at a university hospital in Brazil. INTRODUCTION: Efforts to understand environmental factors that foster effective learning resulted in the development of a questionnaire to measure medical residents' perceptions of the level of autonomy, teaching quality and social support in their programs. METHODS: The questionnaire was translated using the modified Brislin back-translation technique. Cronbach's alpha test was used to ensure good reliability and ANOVA was used to compare PHEEM results among residents from the Surgery, Anesthesiology and Internal Medicine departments. The Kappa coefficient was used as a measure of agreement, and factor analysis was employed to evaluate the construct strength of the three domains suggested by the original PHEEM questionnaire. RESULTS: The PHEEM survey was completed by 306 medical residents and the resulting Cronbach's alpha was 0.899. The weighted Kappa was showed excellent reliability. Autonomy was rated most highly by Internal Medicine residents (63.7% ± 13.6%. Teaching was rated highest in Anesthesiology (66.7% ± 15.4%. Residents across the three areas had similar perceptions of social support (59.0% ± 13.3% for Surgery; 60.5% ± 13.6% for Internal Medicine; 61.4% ± 14.4% for Anesthesiology. Factor analysis suggested that nine factors explained 58.9% of the variance. CONCLUSIONS: This study indicates that PHEEM is a reliable instrument for measuring the quality of medical residency programs at a Brazilian teaching hospital. The results suggest that quality of teaching was the best indicator of overall response to the questionnaire.

  20. Epidemiology, species distribution, antifungal susceptibility and outcome of candidemia among Internal Medicine Wards of community hospitals of Udine province, Italy

    Federico Silvestri

    2014-09-01

    Full Text Available Candidemia is an emerging problem among patients hospitalized in Internal Medicine Wards (IMW. We performed a retrospective study to assess the epidemiology, species distribution, antifungal susceptibility and outcome of candidaemia recorded over a 3-year period (2010-2012 among IMW of community hospitals of Udine province in Italy: forty-eight patients were identified, with an overall incidence of 1.44 cases/1000 hospital admissions/year. Candida albicans was the most frequent species, followed by Candida parapsilosis that accounted for 42.9% of Tolmezzo cases. All isolates were susceptible to amphotericin and caspofungin, while 11.4% of strains were not-susceptible to voriconazole and 14.3% to fluconazole. Crude mortality was 41.7%. In conclusion, in community hospitals overall incidence of candidemia is similar to tertiary care hospitals, but 80% of cases are detected in IMW. Candida species distribution is overlapping, but differences in local epidemiology were found and should be taken into consideration. No resistance to amphotericin and caspofungin was found while resistance to azoles was observed. Knowledge of this data might be useful when planning the best therapeutic strategy.

  1. Free Medicines Thanks to Retirement: Impact of Coinsurance Exemption on Pharmaceutical Expenditures and Hospitalization Offsets in a national health service.

    Puig-Junoy, Jaume; García-Gómez, Pilar; Casado-Marín, David

    2016-06-01

    This paper examines the impact of coinsurance exemption for prescription medicines applied to elderly individuals in Spain after retirement. We use a rich administrative dataset that links pharmaceutical consumption and hospital discharge records for the full population aged 58 to 65 years in January 2004 covered by the public insurer in a Spanish region, and we follow them until December 2006. We use a difference-in-differences strategy and exploit the eligibility age for Social Security to control for the endogeneity of the retirement decision. Our results show that this uniform exemption increases the consumption of prescription medicines on average by 17.5%, total pharmaceutical expenditure by 25% and the costs borne by the insurer by 60.4%, without evidence of any offset effect in the form of lower short term probability of hospitalization. The impact is concentrated among consumers of medicines for acute and other non-chronic diseases whose previous coinsurance rate was 30% to 40%. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26082341

  2. The Model of Integration of Traditional Medicine with Modern Medicine in Hospitals of Traditional Medicine in Vietnam:Present Status and Prospective Plan

    2008-01-01

    @@ REVIEW ON VIETNAMESE TRADITIONAL PHARMACO-MEDICINE Vietnam has a 4000-year old traditional system of pharmaco-medicine which was founded during the Hung King era (2879-257 B.C.).Vietnamese traditional medicine (TM) came from the society and was developed during the long years of living,working and struggling for existence among the Vietnamese people among 54 ethnic groups under extremely severe natural conditions,conflicts,and interaction with local neighboring nations such as China,Laos,Cambodia,India,etc.All of those form the foundations to shape the diversity,abundance and specialty of Vietnamese TM.Valuable experiences in TM have been transmitted from generation to generation,which is an important part of Vietnamese culture.

  3. Prophylactic Antibiotic Management of Surgical Patients Noted as "Allergic" to Penicillin at Two Academic Hospitals.

    Epstein, Richard H; Jacques, Paul St; Wanderer, Jonathan P; Bombulie, Mark R; Agarwalla, Niraj

    2016-05-01

    We studied prophylactic antibiotics administered at 2 academic medical centers during a 6-year period where a cephalosporin was indicated but an "allergy" to penicillin was noted. Another drug (typically vancomycin or clindamycin) was substituted approximately 80% of the time; this occurred frequently even when symptoms unrelated to acute hypersensitivity were listed. In >50% of cases, the reaction was either omitted or vague (e.g., simply "rash"). Given the estimated 1% cross-reactivity between penicillins and cephalosporins with similar R1 side chains, many of these patients could have received either the prescribed cephalosporin or another cephalosporin with a different R1 side chain. PMID:26556109

  4. Monitoring of Adverse Drug Reactions Associated with Antihypertensive Medicines at a University Teaching Hospital in New Delhi

    Fowad Khurshid

    2012-09-01

    Full Text Available Aim To monitor the adverse drug reactions (ADRs caused by antihypertensive medicines prescribed in a university teaching hospital.Methods:he present work was an open, non-comparative, observational study conducted on hypertensive patients attending the Medicine OPD of Majeedia Hospital, Jamia Hamdard, New Delhi, India by conducting patient interviews and recording the data on ADR monitoring form as recommended by Central Drugs Standard Control Organization (CDSCO, Government of India.Results:A total of 21 adverse drug reactions were observed in 192 hypertensive patients. Incidence of adverse drug reactions was found to be higher in patients more than 40 years in age, and females experienced more ADRs (n = 14, 7.29 % than males, 7 (3.64 %. Combination therapy was associated with more number of adverse drug reactions (66.7 % as against monotherapy (33.3 %. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n = 7, followed by diuretics (n = 5, and beta- blockers (n = 4. Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 7, followed by torasemide (n = 3. Adverse drug reactions associated with central nervous system were found to be the most frequent (42.8 % followed by musculo-skeletal complaints (23.8 % and gastro-intestinal disorders (14.3 %. Conclusions:The present pharmacovigilance study represents the adverse drug reaction profile of the antihypertensive medicines prescribed in our university teaching hospital. The above findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions.

  5. Should the "in situ" simulation become the new way in Belgium? Experience of an academic hospital.

    Pospiech, Audrey; Lois, Fernande; Van Dyck, Michel; Kahn, David; Kock, Marc De

    2013-01-01

    The place of simulation in medical education, particularly in anesthesia, appears to be more and more evident. However, the history of simulation in Belgium showed that the associated costs remain a barrier. The use of 'in situ' simulation, defined as the practice of simulation in the usual workplace, could solve the problem of providing access to this educational tool. Indeed, it allows reducing equipment and manpower costs: the needed equipment comes from the hospital, and supervision and o...

  6. Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China.

    Yang, Lianping; Liu, Chaojie; Ferrier, J Adamm; Zhang, Xinping

    2015-11-01

    This study identifies potential organizational barriers associated with the implementation of the Chinese National Essential Medicines Policy (NEMP) in rural primary health care institutions. We used a multistage sampling strategy to select 90 township hospitals from six provinces, two from each of eastern, middle, and western China. Data relating to eight core NEMP indicators and institutional characteristics were collected from January to September 2011, using a questionnaire. Prescription-associated indicators were calculated from 9000 outpatient prescriptions selected at random. We categorized the eight NEMP indicators using an exploratory factor analysis, and performed linear regressions to determine the association between the factor scores and institution-level characteristics. The results identified three main factors. Overall, low levels of expenditure of medicines (F1) and poor performance in rational use of medicines (F2) were evident. The availability of medicines (F3) varied significantly across both hospitals and regions. Factor scores had no significant relationship with hospital size (in terms of number of beds and health workers); however, they were associated with revenue and structure of the hospital, patient service load, and support for health workers. Regression analyses showed that public finance per health worker was negatively associated with the availability of medicines (p expenditure (p governments may reduce medicine stock lines of township hospitals and lead them to seek alternative sources of income, jeopardizing their capacity to meet the needs of local consumers. PMID:26360408

  7. Automated system of control of radioactive liquid effluents of patients submitted to therapy in hospitals of nuclear medicine (SACEL)

    Different hospitals of nuclear medicine require of the technical attendance for the design, construction and instrumentation of an effluents retention system coming from the room dedicated to the medical application of iodine 131, with the one object of giving execution to the normative requirements of radiological protection, settled down in the General Regulation of Radiological Safety (RGSR) emitted by the CNSNS in November, 1988 and in the corresponding official standards. An automatic system of flow measurement, the activity concentration of the effluents to the drainage, the discharges control and the automated report it will allow the execution of the national regulations, also the elimination of unhealthy activities as the taking of samples, analysis of those same and the corresponding paperwork, its will allow that the SACEL is capable of to carry out registrations that are to consult in an automated way. The changes in the demands of the National Commission of Nuclear Safety and Safeguards in relation to the liberation of radioactive material in hospitals by medical treatments, it has created the necessity to develop a system that quantifies and dose the liquid effluents of people under thyroid treatment with iodine-131 to the drainage. The Automated System of Control of radioactive liquids effluents generated in Hospitals of Nuclear Medicine (SACEL) developed in the National Institute of Nuclear Research, it fulfills this regulation, besides improving the work conditions for the medical and technical personnel of the hospital in that are installed, since this system has the advantage of to be totally automated and to require of a minimum of attendance. The SACEL is an electro-hydraulic system of effluents control, based in the alternate operation of two decay deposits of the activity of the material contaminated with iodine-131. The system allows to take a registration of those volumes and liberated dose, besides being able to be monitoring in remote

  8. Respiratory Medicine and Research at Mcgill University: A Historical Perspective

    Martin, James G; Kevin Schwartzman

    2015-01-01

    The history of respiratory medicine and research at McGill University (Montreal, Quebec) is tightly linked with the growth of academic medicine within its teaching hospitals. Dr Jonathan Meakins, a McGill medical graduate, was recruited to the Royal Victoria Hospital in 1924; as McGill’s first full-time clinical professor and Physician-in-Chief at the Royal Victoria Hospital. His focus on respiratory medicine led to the publication of his first book, Respiratory Function in Disease, in 1925. ...

  9. Improving identification and documentation of pressure ulcers at an urban academic hospital

    Dahlstrom, Marcus; Best, Thomas; Baker, Christine; Doeing, Diane; Davis, Andrew; Doty, Judith; Arora, Vineet M.

    2012-01-01

    Background A two-year quality improvement campaign at a single teaching hospital was launched to improve the identification, documentation, and treatment of pressure ulcers (PUs) after Centers for Medicare & Medicaid Services (CMS) declared severe hospital-acquired PUs are “never-events.” Method The campaign included (1) reference materials, (2) new documentation templates, (3) staff education, and (4) hospital-wide mattress replacement. An ongoing retrospective chart review of frail older patients determined the presence of PU documentation, which provider (nurse or physician) documented the PU, and which descriptors (stage, size, or location) were used. Results The campaign significantly increased the proportion of PUs completely documented by nurses from 27% to 55% following mattress replacement and resident education (OR 3.68, p = 0.001, 95% CI: 1.68–8.08). A similar improvement was observed for physician documentation increasing from 12% to 36% following the same interventions however this change was not statistically significant (OR 2.11, p = 0.12, 95% CI: 0.82–5.39). These improvements were short-lived due to the implementation of electronic medical records (EMR) for nursing notes. Although the percentage of PUs completely documented by nurses decreased following EMR implementation, it increased in the following months, above the pre-campaign baseline as nurses adapted to the new documentation system. However, after EMR implementation, complete PU documentation by physicians fell to a nadir of 0% and did not recover. Discussion A multi-component campaign to improve the quality of PU documentation by both physicians and nurses can yield positive gains. However, these improvements were short-lived due to EMR implementation, which acutely worsened documentation of PUs. This emphasizes the importance of frequent and repeated interventions to sustain quality improvement successes. PMID:21500755

  10. Becoming a leader in patient satisfaction: changing the culture of care in an academic community hospital.

    Deitrick, Lynn M; Capuano, Terry A; Paxton, Stuart S; Stern, Glenn; Dunleavy, Jack; Miller, William L

    2006-01-01

    In the context of the current health care payer system, quality of care standards, financial incentives and consumer choice are not well aligned, yet competition for increased admissions has become a matter of survival. Satisfaction and loyalty are two constructs that are the most meaningful measures in the context of sustaining and increasing admissions. Lehigh Valley Hospital and Health Network (LVHHN) launched an ambitious patient satisfaction improvement initiative in 2001. LVHHN augmented existing patient service excellence programs with an ethnographic study of a representative unit. Interview and observational data were analyzed using NVivo software. These results (four distilled domains of patient experience) can then be used to identify key components of the care environment that made meaningful differences in the perceptions of patients and their satisfaction. A designated interdepartmental task force can then develop interventions from those learnings, track outcomes through the Press Ganey scores, and ultimately yield increased admissions through unit-specific process change across the hospital. Admissions for fiscal year 2001 to fiscal year 2003 increased from 5,817 to 7,795 patients. The clear value and return on this initiative for our organization included a 34% increase in patient admissions over a four-year period. Improvements in both patient satisfaction and loyalty were demonstrated by a 24% increase for the question, "Likelihood of your recommending this hospital to others" as measured by the Press Ganey Inpatient survey. This initiative demonstrates the successful application of qualitative methods in a clinical microsystem to better understand patient perceptions that determine their satisfaction with medical care. PMID:18681198

  11. Collection and removal of radioactive waste, coming from universities, high schools and academic hospitals

    In radionuclide laboratories of universities, radionuclides are employed for biomedical, chemical and physical research. In university hospitals, radionuclides are employed in vivo for diagnostic and therapeutic purposes and in vitro in tracer methods in chemical analysis. In general it concerns radioactive materials in dispersive form such as gases, fluids or powders (open sources). During operation with open sources radioactive waste originates with low specific activity. Regulations and recommendations concerning the collection and separation, transport, processing and eventual storage of this low-level radioactive waste are dealt with. 17 refs.; figs.; tabs

  12. Assessment of radiation exposure at the nuclear medicine module from the Vladimir Ilich Lenin Hospital

    The work evaluates the exposure to radiation during the last years in which radioactive substances had been employed. A statistical analysis was applied to evaluate radiological protection performance at the Hospital. Main elements from each study made are given

  13. A Retrospective Analysis of Patients’ Conditions Using Acupuncture in a Traditional Korean Medicine Hospital

    Kyung-Jin Yun; Ju Ah Lee; Jiae Choi; Mi Mi Ko; Cham-kyul Lee; Myeong Soo Lee; Eun-Yong Lee

    2015-01-01

    Objective. The aim of this study was to identify the patient demographics, health issues, and type of acupuncture treatments who visited a traditional Korean medical hospital for acupuncture treatment. Methods. We retrospectively analysed the data using the electronic medical records (EMRs) of patients treated with at least one treatment of acupuncture from 1 January 2010 to December 2012 in the Chung-Ju Korean hospital at Semyung University. Results. The total number of identified patients w...

  14. Cancer Imaging at the Crossroads of Precision Medicine: Perspective From an Academic Imaging Department in a Comprehensive Cancer Center.

    Van den Abbeele, Annick D; Krajewski, Katherine M; Tirumani, Sree Harsha; Fennessy, Fiona M; DiPiro, Pamela J; Nguyen, Quang-Dé; Harris, Gordon J; Jacene, Heather A; Lefever, Greg; Ramaiya, Nikhil H

    2016-04-01

    The authors propose one possible vision for the transformative role that cancer imaging in an academic setting can play in the current era of personalized and precision medicine by sharing a conceptual model that is based on experience and lessons learned designing a multidisciplinary, integrated clinical and research practice at their institution. The authors' practice and focus are disease-centric rather than imaging-centric. A "wall-less" infrastructure has been developed, with bidirectional integration of preclinical and clinical cancer imaging research platforms, enabling rapid translation of novel cancer drugs from discovery to clinical trial evaluation. The talents and expertise of medical professionals, scientists, and staff members have been coordinated in a horizontal and vertical fashion through the creation of Cancer Imaging Consultation Services and the "Adopt-a-Radiologist" campaign. Subspecialized imaging consultation services at the hub of an outpatient cancer center facilitate patient decision support and management at the point of care. The Adopt-a-Radiologist campaign has led to the creation of a novel generation of imaging clinician-scientists, fostered new collaborations, increased clinical and academic productivity, and improved employee satisfaction. Translational cancer research is supported, with a focus on early in vivo testing of novel cancer drugs, co-clinical trials, and longitudinal tumor imaging metrics through the imaging research core laboratory. Finally, a dedicated cancer imaging fellowship has been developed, promoting the future generation of cancer imaging specialists as multidisciplinary, multitalented professionals who are trained to effectively communicate with clinical colleagues and positively influence patient care. PMID:26774886

  15. Basic Geriatrics Knowledge Among Internal Medicine Trainees in a Teaching Hospital in Saudi Arabia.

    Al-Aama, Tareef

    2016-06-01

    To assess the basic knowledge of medical trainees, in the absence of a structured geriatrics curriculum, around a variety of geriatric medicine components that are considered essential for the care of the rapidly increasing elderly population. Eighty-three trainees at different levels of training in internal medicine were asked about a variety of common geriatric conditions. Those included: delirium, falls, geriatric syndromes, pain, cognitive impairment, and medications. The trainees' knowledge about common geriatric condition was overall poor. The most pronounced deficits included: the lack of familiarity in diagnosing geriatric syndromes (63 %) or managing them (67 %), the underestimation of the prevalence of delirium (49 %), and the tendency to undertreat pain (64 %). Poor familiarity with polypharmacy and its impact, as well as inappropriate prescription practices in the elderly were also observed. In the absence of a structured geriatric medicine curriculum, internal medicine trainees' knowledge about important geriatric conditions is poor, even if their internal medicine knowledge is overall adequate. This would translate into suboptimal care for this vulnerable and rapidly expanding segment of the population. PMID:27033085

  16. Exercises in therapy--neurological gymnastics between Kurort and hospital medicine, 1880-1945.

    Guenther, Katja

    2014-01-01

    This article focuses on the convergence of sports and medicine in the practice of neurological gymnastics (Übungstherapie) in the German-speaking world at the turn of the twentieth century. It shows how Übungstherapie first found receptive ground within the peripheral medical space of the spa town (Kurort). Übungstherapie appealed to Kurort patients because, as a form of neurological gymnastics, it drew on the cultural capital of the broader German gymnastics movement. Only later did Übungstherapie find a place in more mainstream medicine, recasting itself as an integral part of neurological practice. Recuperating the therapeutic aspects of neurology, this article suggests that the development of Übungstherapie contributed to the formation of neurology as an independent specialty, distinct from psychiatry and internal medicine. It thus demonstrates the importance of expanding the scope of historical study beyond the traditional boundaries of the mainstream in order to understand clinical, institutional, and disciplinary change. PMID:24769804

  17. Should the "in situ" simulation become the new way in Belgium? Experience of an academic hospital.

    Pospiech, A; Lois, F; Van Dyck, M; Kahn, D; De Kock, M

    2013-01-01

    The place of simulation in medical education, particularly in anesthesia, appears to be more and more evident. However, the history of simulation in Belgium showed that the associated costs remain a barrier. The use of 'in situ' simulation, defined as the practice of simulation in the usual workplace, could solve the problem of providing access to this educational tool. Indeed, it allows reducing equipment and manpower costs: the needed equipment comes from the hospital, and supervision and organization are provided by staff members. It also provides access to simulation for a larger number of individuals on site. The environment is more realistic because the participants operate in their usual workplace, with their customary equipment and team. Furthermore, 'in situ' simulation allows participation of the paramedical staff. This allows developing skills related to teamwork and communication. Despite those numerous advantages, several difficulties persist. The associated logistic and organizational constraints can be cumbersome. PMID:24605415

  18. The Harvard Joint Center for Radiation Therapy, 1968-1999: a unique concept and its relationship to the prevailing times in academic medicine

    Purpose: Institutional structure, function, and philosophy reflect the organizational needs, and tend to mirror societal values of the times. For many years, the field of radiation oncology had among its major academic centers, an organization that served as a model for collaboration among health care institutions in an effort to serve the common good of its patients, hospitals, professional colleagues, and community. For over three decades, the Joint Center for Radiation Therapy (JCRT) was a leader in developing new organizational approaches for academic and clinical radiation oncology through the philosophy of collaboration in patient care, education, and research. Methods and Results: In tracing the development and changes in organizational philosophy and structure of the JCRT, one can see the impact on academic oncology and cancer care through the emergence of both radiation and medical oncology as independent subspecialties, the importance of the National Cancer Act of 1971 accompanied by the growth of the NIH research and training programs and, more recently, the effect of the changing attitudes and approaches of hospitals, academicians, practitioners, and policy makers to health care delivery, structures, and cooperation. Conclusion: Lessons learned from the 31-year history of the JCRT may help provide organizational insight useful in guiding academic oncology and academic medical centers through periods of change

  19. Drug utilization pattern in geriatric inpatients of medicine department in a Tertiary Care Teaching Hospital

    Swapna R. Nayaka

    2015-06-01

    Conclusion: Thus, irrational prescribing and polypharmacy were prevalent among elderly. Drug utilization data can help in assessing the quality of care given to the geriatric patients and promote rational use of medicines. [Int J Basic Clin Pharmacol 2015; 4(3.000: 568-573

  20. Prevalency of major depressive disorder in patients older than 50 hospitalized yearsin a service of internal medicine

    Johana Patricia Mogollón Díaz

    2005-05-01

    Full Text Available The biggest depressive disorder (TDM is moreprevalente of the mental disorders in the general population. Inpatients of consultation external and hospitalized with illnessesdoctors of long evolution, the prevalency is major than in populationgeneral. Target: To determine the prevalency of TDM inhospitalized patients. Method: A transverse study was realizedof prevalency, which it included 100 patients older than 50 yearshospitalized of a service of internal medicine (ME;they were describedvariables sociodemográfi cas and the clinical interview was realizedstructured for disorders of the axis the Ist (SCID-I for diagnosisof TDM and the familiar APGAR to evaluate the grade of function ofthis one. Results: The prevalency of TDM was a 38 %, she wasstrong affiliation with chronic illness, to have more than fourmedical diagnoses, to be used and without partner. Conclusions:The prevalency of TDM in patients hospitalized by ME is highand the presence of illnesses more than four diagnosesdoctors, to be used and without partner collaborates with TDMin hospitalized patients.

  1. Hospital post-intensive management of major trauma: a pilot study in Internal Medicine

    Valerio Verdiani

    2013-04-01

    Full Text Available BACKGROUND Major trauma is the fourth cause of death in Western countries, and the first one in patients aged 35 years or younger. In-hospital post-intensive care represents a crucial step in the comprehensive medical assistance for these patients, but no data is available. AIM OF THE STUDY To evaluate an hospital post-intensive clinical pathway for patients with major trauma discharged from Intensive Care Unit (ICU. PATIENTS AND METHODS We designed a clinical pathway project for patients with major trauma discharged from an ICU at Careggi Hospital, in Florence. Patients were admitted in two Internal Medical wards of the same hospital. Nurses and physicians were trained to the management of devices and essential critical problems. We analysed characteristics of patients, APACHE score, devices, clinical and biochemical parameters. We determined medical complicances, ICU readmissions and hospital mortality. After a three months follow-up we evaluated hospital readmission, mortality and residual disability. RESULTS AND DISCUSSION We studied 92 patients (mean age 41 ± 20 years; 70 male with major trauma discharged from ICU (82.6% of patients underwent invasive mechanic ventilation. On admission, tracheotomy tube was present in 21 patients (22.8%. During internal wards stay, tracheotomy tube was removed in 16 patients. Medical complicances were identified and treated in more than 80% of patients. Four patients (4.3% were readmitted to ICU, one patient (1.1% died. Mean internal medical ward stay was 13 ± 9.6 days. After three months follow-up: three patients (3.2% died; the rate of planned hospital readmission for orthopedic or surgery interventions was 14.7%; 70% of patients did not have any disability. CONCLUSIONS Patients with major trauma discharged from ICU often have medical complications and are managed by the use of multiple devices. Results of our pilot study suggest that a post-intensive clinical pathway in internal wards for patients with

  2. Academic medicine change management: the power of the liaison committee on medical education accreditation process.

    Chandran, Latha; Fleit, Howard B; Shroyer, A Laurie

    2013-09-01

    Stony Brook University School of Medicine (SBU SOM) used a Liaison Committee on Medical Education (LCME) site visit to design a change management approach that engaged students, revitalized faculty, and enabled significant, positive institutional transformation while flexibly responding to concurrent leadership transitions. This "from-the-trenches" description of novel LCME site-visit-related processes may provide an educational program quality improvement template for other U.S. medical schools. The SBU SOM site visit processes were proactively organized within five phases: (1) planning (4 months), (2) data gathering (12 months), (3) documentation (6 months), (4) visit readiness (2 months), and (5) visit follow-up (16 months). The authors explain the key activities associated with each phase.The SBU SOM internal leadership team designed new LCME-driven educational performance reports to identify challenging aspects of the educational program (e.g., timeliness of grades submitted, midcourse feedback completeness, clerkship grading variability across affiliate sites, learning environment or student mistreatment incidents). This LCME process increased institutional awareness, identified the school's LCME vulnerabilities, organized corrective actions, engaged key stakeholders in communication, ensured leadership buy-in, and monitored successes. The authors' strategies for success included establishing a strong internal LCME leadership team, proactively setting deadlines for all phases of the LCME process, assessing and communicating vulnerabilities and action plans, building multidisciplinary working groups, leveraging information technology, educating key stakeholders through meetings, retreats, and consultants, and conducting a mock site visit. The urgency associated with an impending high-stakes LCME site visit can facilitate positive, local, educational program quality improvement. PMID:23887000

  3. The characteristics of HIV and AIDS patients with deep vein thrombosis at Dr. George Mukhari Academic Hospital

    Indiran Govender

    2015-02-01

    Full Text Available Background: Deep vein thrombosis (DVT is 10 times more prevalent in HIV and AIDS patients than in the general population and is more common in patients with severe immune suppression (CD4 < 200 cells/mL. Opportunistic infections render HIV and AIDS patients susceptible to a hypercoaguable state, including lower protein S levels. Aim and setting: To present the profile of HIV and AIDS patients who developed DVT in the primary care wards of Dr. George Mukhari Academic Hospital (DGMAH, Garankuwa. Methods: Cross-sectional study of clinical records of admitted HIV and AIDS patients without DVT to the primary care wards, DGMAH, from 01 February 2010 to 31 January 2011. Results: Two hundred and twenty-nine patients were admitted and 17 (7.4% developed DVT. Of those that developed DVT, eight (47% had infection with tuberculosis (TB, four (24% had pneumonia and four (24% had gastroenteritis. The risk of developing DVT was 8/94 (8.5% in those with TB, 4/53 (7.5% in those with gastroenteritis and 4/75 (5.3% in those with pneumonia. The mean duration of stay was 14.1 days in those with DVT versus 4.0 days in those without. Conclusion: HIV (and AIDS is a hypercoaguable state and the risk of DVT is relatively high in patients with opportunistic infections. HIV and AIDS patients who are admitted to hospital with opportunistic infections may benefit from anti-thrombotic prophylaxis and further studies are needed to evaluate this.

  4. Health Literacy and Complementary and Alternative Medicine Use Among Underserved Inpatients in a Safety Net Hospital

    Gardiner, Paula; Mitchell, Suzanne; Amanda C. Filippelli; Sadikova, Ekaterina; White, Laura F.; Paasche-Orlow, Michael K; Jack, Brian W.

    2013-01-01

    Little is known about the relationship between health literacy and complementary and alternative medicine (CAM) use in low-income racially diverse patients. The authors conducted a secondary analysis of baseline data from 581 participants enrolled in the Re-Engineered Discharge clinical trial. The authors assessed sociodemographic characteristics, CAM use, and health literacy. They used bivariate and multivariate logistic regression to test the association of health literacy with four pattern...

  5. Integrating Digital Imaging and Communications In Medicine (DICOM)-structured reporting into the hospital environment

    Csipo, Dezso; Dayhoff, Ruth E.; Kuzmak, Peter M.

    2001-01-01

    The Digital Imaging and Communications in Medicine (DICOM) Standards Committee has balloted and accepted a new class of objects dealing with the generation, distribution, and management of reports. The structured reporting (SR) objects bridge the traditional separation between imaging and information systems. The DICOM SR objects offer a higher level of integration of the medical enterprise, providing practitioners with an effective tool to cover all aspects of the medical process from admiss...

  6. Cost-analysis of the WHO Essential Medicines List in A Resource-Limited Setting: Experience from A District Hospital in India.

    Alvarez-Uria, Gerardo; Thomas, Dixon; Zachariah, Seeba; Byram, Rajarajeshwari; Kannan, Shanmugamari

    2014-05-01

    The World Health Organization (WHO) has been publishing the essential medicines list (EML) since 1977. The EML includes the most efficacious, safe and cost-effective drugs for the most relevant public health conditions worldwide. The WHO performs a cost-effectiveness analysis within each therapeutic group, but very little is known about which therapeutic groups are costliest for hospitals that adopt the WHO EML concept. In this study, we have described the annual consumption of medicines in a district hospital in India, that limited the list of available drugs according to the WHO EML concept. Only 21 drugs constituted 50% of the hospital spending. Anti-infective medicines accounted for 41% of drug spending, especially antiretrovirals which were used to treat HIV infection. Among other therapeutic groups, insulin had the highest impact on the hospital budget. We identified medicines used in perinatal care, which included anti-D immunoglobulin and lung surfactants, that were used rarely, but bore a relatively high cost burden. The results of this study indicate that, in district that adopt the WHO EML, antiretrovirals and antibiotics were the top therapeutic groups for the drug hospital budgets. PMID:24995196

  7. Sources of information of the business consumer: the purchase of medicines by hospitals

    Paulo Fernando Burlamaqui

    2008-07-01

    Full Text Available The source of search for information accomplished by the business consumer can affect decisevely on the choice of a supplier. The understanding of how the search of information is undertaken during purchase can present a strategic situation for the marketing professionals in identifying the needs of business consumers. This study analysed how this search is done by organizational buyers by observing the behaviour of this consumer through a survey conducted with buyers for hospitals in the state of Rio Grande do Sul, Brazil. The research identifyed the strong utilization of the following sources of information: commercial, media, personal and experimental. It was observed that the main source is commercial. The conclusion hás indicated also that the buyer can understand how his organization (hospital behaves before these variables.

  8. PREVALENCE OF DIABETIC RETINOPATHY IN PATIENT TYPE 2 DIABETES MELLITUS AT INTERNAL MEDICINE POLICLINIC SANGLAH HOSPITAL

    Ni Made Sintia Anggia Sari; Made Ratna Saraswati

    2013-01-01

    One of the complications that can occur in microvaskular diabetes mellitus is diabetic retinopathy. This research was carried out to know the prevalence of diabetic retinopathy in patients type 2 diabetes mellitus at internal divison of Sanglah Hospital. The method used is cross sectional by collecting data from the questionnaire and secondary data of medical record patient's type 2 DM. On this research acquired 111 patients (35.1%) with diabetic retinopathy and (64,9%) nonretinopathy. In th...

  9. Sources of information of the business consumer: the purchase of medicines by hospitals

    Paulo Fernando Burlamaqui; Roberto Godoy

    2008-01-01

    The source of search for information accomplished by the business consumer can affect decisevely on the choice of a supplier. The understanding of how the search of information is undertaken during purchase can present a strategic situation for the marketing professionals in identifying the needs of business consumers. This study analysed how this search is done by organizational buyers by observing the behaviour of this consumer through a survey conducted with buyers for hospitals in the sta...

  10. The incidence of gastroenteritis diagnosis among sick dogs presented to the Onderstepoort Veterinary Academic Hospital correlated with meteorological data : research communication

    A.S. Shakespeare

    1999-07-01

    Full Text Available The number of sick dogs diagnosed with and without gastroenteritis presented to the Onderstepoort Veterinary Academic Hospital situated north of Pretoria is reported from counts extracted from the records of the Outpatients clinic for 6 years, 1988 to 1993. The average percentage of sick dogs diagnosed with gastroenteritis was 11.51 % and the average percentage of sick dogs that were admitted to the parvovirus isolation hospital ward was 2.8 %. A strong correlation exists between the number of dogs admitted to the parvovirus ward and average monthly wind speed and inverse humidity values.

  11. Hospitals

    Mullins, Michael

    2013-01-01

    is to minimize the negative effects of stress inducing environments based on research results. Which stress inducing factors? We can look around at some old hospitals and see they are noisy, confusing, ugly, monotonous, hard, cold, artificial, and dark; qualitative terms which can indicate what we shouldn...... in the navigation experience and wasted time of medical staff in providing directions. Space in hospitals: space can be divided into personal, social and outdoor space. Personal space: single rooms have been well documented in: admission length, mortality rates, comfort levels, sense of privacy, all users......’ satisfaction. Social space: attention to spatial qualities, volume and interior design in terms of encouraging physical contact between users in wards, waiting areas and semi-private rooms. Outdoor space: Landscape and gardens are not enough in themselves; they should be visible, centrally or strategically...

  12. The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model

    Julia E Moore; Grouchy, Michelle; Graham, Ian D; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E.

    2016-01-01

    Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. F...

  13. Characteristics of Older Adults Admitted to Hospital versus Those Discharged Home, in Emergency Department Patients Referred to Internal Medicine

    Hominick, Kathryn; McLeod, Victoria; Rockwood, Kenneth

    2016-01-01

    Background Frail older adults present to the Emergency Department (ED) with complex medical, functional, and social needs. When these needs can be addressed promptly, discharge is possible, and when they cannot, hospital admission is required. We evaluated the care needs of frail older adults in the ED who were consulted to internal medicine and seen by a geriatrician to determine, under current practices, which factors were associated with hospitalization and which allowed discharge. Methods We preformed a chart-based, exploratory study. Data were abstracted from consultation records and ED charts. All cases had a standard Comprehensive Geriatric Assessment (CGA which records a Clinical Frailty Scale (CFA) and allows calculation of a Frailty Index (FI). Results Of 100 consecutive patients, 2 died in the ED, 75 were admitted, and 23 were discharged, including one urgent placement. Compared with discharged patients (0.39 ± SD 0.16), those admitted had a higher mean FI-CGA (0.48 ± 0.13; p < .01). Greater mobility dependence (2% in discharged vs. 32% in admitted; p < .05) was notable. Conclusions Discharge decisions require assessment of medical, functional, and social problems. Ill, frail patients often can be discharged home when social and nursing support can be provided. The degree of frailty, impaired mobility, and likely delirium must be taken into account when planning for their care. PMID:27076860

  14. Career support in medicine: experiences with a mentoring program for junior physicians at a university hospital

    Mattanza, Guido

    2004-07-01

    Full Text Available Purpose: Until now, mentoring has hardly been used by the medical profession in German-speaking countries as a means of supporting junior physicians in their careers. The aim of the mentoring project described here was to obtain information for promoting and developing future mentoring programs at a university hospital.Method: A new integrated mentoring model was developed and implemented over a 12-month period. Peer groups were advised on the mentoring process by mentors and program managers. A total of eight mentoring groups (40 peers from four departments of a university hospital took part in the project: four voluntarily, and four on a compulsory basis. The evaluation was carried out using qualitative methods for analysis of the group protocols and the focus group interviews with the participants.Results: Group discussions revealed that individual mentees, young female physicians in particular, developed concrete career plans and initiated further career-relevant steps. Some mentees - again more women than men - were promoted to senior physician posts. Further measurable career steps were increased research and publishing activity, and research fellowships abroad. The group process developed in five typical phases (forming, storming, norming, performing, and finalizing, which differed according to whether the groups had been formed on a voluntary or compulsory basis. In the evaluation interviews, mentees emphasized the following as effective mentoring factors: Concrete definition of own career goals; exchange of experiences within the peer groups; support and motivation from the mentors; and fostering of the group process by the program managers.Conclusion: Participation in mentoring programs has to be voluntary. Mentees are motivated, autonomous, goal-oriented and prepared to take action. Mentors serve as examples and advisers. They derive satisfaction from being held in high esteem, as well as from the advancement of their own careers

  15. The 2014 Academic College of Emergency Experts in India′s Education Development Committee (EDC White Paper on establishing an academic department of Emergency Medicine in India - Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training

    Praveen Aggarwal

    2014-01-01

    Full Text Available Emergency medicine services and training in Emergency Medicine (EM has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers′ eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India has been a powerful advocate for developing Academic EM in India. The ACEE′s Education Development Committee (EDC was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM.

  16. The role of hospital information system in medical records management of Chinese medicine hospital%浅谈医院信息系统在中医医院病历档案管理中的作用

    张海霞; 高颖

    2012-01-01

    Hospital information management has penetrated into each aspect of hospital management.We discussed briefly the role of the hospital information system in medical records management in Chinese medicine hospital on information sharing,data statistics and convenience of case consulting and management,which improved greatly the efficiency of medical records management.%医院信息化已渗入医院管理的各个环节.本文从信息共享、病例查阅与管理、数据统计等几方面简述了医院信息管理系统(hospital information system,HIS)在中医医院病历档案管理中的具体应用,认为HIS可提高病例档案的管理工作效率.

  17. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People’s Republic of China

    Fang X; Zhu LL; Pan SD; Xia P; Chen M; Zhou Q

    2016-01-01

    Xu Fang,1,2 Ling-ling Zhu,3 Sheng-dong Pan,4 Ping Xia,4 Meng Chen,5 Quan Zhou51Office of Hospital Administration, 2Office of Party and Administration Council, 3Geriatric VIP Care Ward, Division of Nursing, 4Division of Medical Administration, 5Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of ChinaAbstract: Safe medication management and use of high-alert narcotics should arouse concern. Ris...

  18. Postgraduate training in public health medicine: St George's Hospital Medical School Library public health information service.

    Rook, R; Adshead, F

    2001-03-01

    This article examines the development of the St George's Hospital Medical School Library public health information service. Begun in 1997 as a pilot project to support Public Health Specialist Registrars in South Thames West, it is now an established part of postgraduate training in the region. An outline of the service is described, including the evolution of the post of Public Health Librarian. Issues influencing the development of the service, and the establishment of the Librarian as part of the public health network are discussed. This is a transferable model of public health information provision, which as a centralized resource makes best use of available funding. As a LIS model it is an effective and efficient way of maximizing resources, and delivering a service to a specialist user group that is spread across a wide geographical area. PMID:11260291

  19. Organized medicine and Scandinavian professional unionism: hospital policies and exit options in Denmark and Sweden.

    Heidenheimer, A J; Johansen, L N

    1985-01-01

    Strikes by junior hospital doctors over the issue of on-call remuneration in Denmark and Sweden in 1981 are analyzed to clarify the impact of public-sector cost-control policies on intra- and interprofessional solidarity within the Scandinavian professional peak associations. The junior doctors' grievances could find expression either through increased "voice" within the medical negotiating machinery, or by pursuing the exit option in having the medical associations quit the peak associations. The article explains why the "exit" option was selected in Denmark, while in Sweden the granting of additional voice helped persuade the medical association to withdraw its exit threat and to remain within the peak association. The two cases are interpreted as presaging a divergence in the paths being taken by the various Scandinavian welfare states. PMID:4045171

  20. Alternative models for academic family practices

    Yarnall Kimberly SH

    2006-03-01

    Full Text Available Abstract Background The Future of Family Medicine Report calls for a fundamental redesign of the American family physician workplace. At the same time, academic family practices are under economic pressure. Most family medicine departments do not have self-supporting practices, but seek support from specialty colleagues or hospital practice plans. Alternative models for academic family practices that are economically viable and consistent with the principles of family medicine are needed. This article presents several "experiments" to address these challenges. Methods The basis of comparison is a traditional academic family medicine center. Apart of the faculty practice plan, our center consistently operated at a deficit despite high productivity. A number of different practice types and alternative models of service delivery were therefore developed and tested. They ranged from a multi-specialty office arrangement, to a community clinic operated as part of a federally-qualified health center, to a team of providers based in and providing care for residents of an elderly public housing project. Financial comparisons using consistent accounting across models are provided. Results Academic family practices can, at least in some settings, operate without subsidy while providing continuity of care to a broad segment of the community. The prerequisites are that the clinicians must see patients efficiently, and be able to bill appropriately for their payer mix. Conclusion Experimenting within academic practice structure and organization is worthwhile, and can result in economically viable alternatives to traditional models.

  1. A report on the Academic Emergency Medicine 2015 consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization".

    Gunn, Martin L; Marin, Jennifer R; Mills, Angela M; Chong, Suzanne T; Froemming, Adam T; Johnson, Jamlik O; Kumaravel, Manickam; Sodickson, Aaron D

    2016-08-01

    In May 2015, the Academic Emergency Medicine consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization" was held. The goal of the conference was to develop a high-priority research agenda regarding emergency diagnostic imaging on which to base future research. In addition to representatives from the Society of Academic Emergency Medicine, the multidisciplinary conference included members of several radiology organizations: American Society for Emergency Radiology, Radiological Society of North America, the American College of Radiology, and the American Association of Physicists in Medicine. The specific aims of the conference were to (1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; (2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and (3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Through a multistep consensus process, participants developed targeted research questions for future research in six content areas within emergency diagnostic imaging: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. PMID:27234978

  2. Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital

    Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments

  3. Use of traditional eye medicines by corneal ulcer patients presenting to a hospital in South India

    Prajna Venkatesh

    1999-01-01

    Full Text Available Purpose: To investigate the nature and frequency of use of Traditional Eye Medicine (TEM for corneal ulcer in patients from predominantly rural background. Methods: We documented the the use of TEM by corneal ulcer patients presenting to a tertiary eye-care centre in South India during two months of 1996. Results: Of 283 patients enrolled in the study, 135 (47.7% of the patients used TEM. There was no difference with regard to age and sex distribution of patients using TEM and those who did. Patients with history of trauma were more likely to use TEM. Common forms of TEM used were human breast milk 61(45.2%, leafy matter 40(29.6%, castor oil 16 (11.9%, and hen′s blood 8 (5.9%. Conclusion: Though the awareness of intraocular lens implantation for cataract surgery is very high in this segment of the population, it is still tragic that an awareness of primary eye care following trauma has not been created. Health education is mandatory to prevent this avoidable cause of blindness.

  4. The Creation of a Biocontainment Unit at a Tertiary Care Hospital. The Johns Hopkins Medicine Experience.

    Garibaldi, Brian T; Kelen, Gabor D; Brower, Roy G; Bova, Gregory; Ernst, Neysa; Reimers, Mallory; Langlotz, Ronald; Gimburg, Anatoly; Iati, Michael; Smith, Christopher; MacConnell, Sally; James, Hailey; Lewin, John J; Trexler, Polly; Black, Meredith A; Lynch, Chelsea; Clarke, William; Marzinke, Mark A; Sokoll, Lori J; Carroll, Karen C; Parish, Nicole M; Dionne, Kim; Biddison, Elizabeth L D; Gwon, Howard S; Sauer, Lauren; Hill, Peter; Newton, Scott M; Garrett, Margaret R; Miller, Redonda G; Perl, Trish M; Maragakis, Lisa L

    2016-05-01

    In response to the 2014-2015 Ebola virus disease outbreak in West Africa, Johns Hopkins Medicine created a biocontainment unit to care for patients infected with Ebola virus and other high-consequence pathogens. The unit team examined published literature and guidelines, visited two existing U.S. biocontainment units, and contacted national and international experts to inform the design of the physical structure and patient care activities of the unit. The resulting four-bed unit allows for unidirectional flow of providers and materials and has ample space for donning and doffing personal protective equipment. The air-handling system allows treatment of diseases spread by contact, droplet, or airborne routes of transmission. An onsite laboratory and an autoclave waste management system minimize the transport of infectious materials out of the unit. The unit is staffed by self-selected nurses, providers, and support staff with pediatric and adult capabilities. A telecommunications system allows other providers and family members to interact with patients and staff remotely. A full-time nurse educator is responsible for staff training, including quarterly exercises and competency assessment in the donning and doffing of personal protective equipment. The creation of the Johns Hopkins Biocontainment Unit required the highest level of multidisciplinary collaboration. When not used for clinical care and training, the unit will be a site for research and innovation in highly infectious diseases. The lessons learned from the design process can inform a new research agenda focused on the care of patients in a biocontainment environment. PMID:27057583

  5. Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records

    Hee Seung Choi; Eun Hya Chi; Me-riong Kim; Jaehoon Jung; Jinho Lee; Joon-Shik Shin; In-Hyuk Ha

    2014-01-01

    Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP) and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patie...

  6. THE MANAGEMENT OF THE MEDICINES IN WARD PHARMACY OF PRIMARY HOSPITALS%浅谈基层医院病区药品的使用管理

    卢凤玲; 吴小萍; 鲁菊香

    2014-01-01

    Objective To discuss on the management of the medicines in ward pharmacy of primary hospitals and ex-plore effective measures to improve the quality of medicines management .Methods Based on the real situation , managing the quantity of medicines in inpatient pharmacy, including the setting of the reasonable quantity, the procedures of storing and de-livering, the quality control on the general medicines and the management of high -risk medicines, to improve the quality of management of the medicines in ward pharmacy .Conclusion The use of medicines in ward pharmacy of primary hospitals is becoming more and more standardized and rationalized by strengthening the management of the medicines in inpatient pharmacy .%目的:浅析基层医院病区药品管理的方式、方法,探讨提高药品管理质量的有效措施。方法根据本院的实际情况,通过对药品的数量(账目)管理,包括病区药品的基数合理设置、药品的入库、出库流程剖析,和对一般药品的质量管理,以及高危药品的管理,提高病区药品的管理质量。结论基层医院通过加强病区的药品管理,使病区药品是使用更趋于规范化、合理化。

  7. Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria

    Anarado Agnes N

    2007-09-01

    Full Text Available Abstract Background The use of Complementary and Alternative Medicine (CAM by cancer patients is very common and varies between populations. The referenced English literature has no local study from Africa on this subject. This study was conducted to define the prevalence, pattern of use, and factors influencing the use of CAM by cancer patients at the University of Nigeria Teaching Hospital Enugu (UNTH-E, Nigeria Method Face-to-face interviews using semi-structured questionnaire were used to determine the use of CAM by cancer patients. All consenting cancer patients were interviewed as they presented at the core surgical units of the UNTH- E, from June 2003 to September 2005. Results 160 patients were interviewed; 68 (42.5% were males and 94 (57.5% were females. Ages ranged from 13–86 years. Breast, urogenital system, gastrointestinal system, and soft tissue cancers predominated. One hundred and four patients (65.0% have used CAM at some time during their current cancer illness; 56 (35.0% patients have not used any form of CAM. There were more females than males among the non-CAM users. The use of CAM was not affected by age, marital status, level of education, religious affiliation, or socioeconomic status. The most frequently used CAMs were herbs (51.9%, faith/prayer healing (49.4%, aloe vera (23.1%, Forever Living Products (16.3%, medicinal tea (14.4%, and Blackstone (12.5%. Over 23% of those who used CAM were satisfied, but 68.3% were disappointed. Most users (67.3% did not see any benefit from the CAM, but 25% could describe some specific benefits. More than 21% of users reported various unwanted effects. While 86.5% of CAM users will use orthodox medicine instead of CAM in the future, 9.6% will use the two together to help each other. Most users (79.8% will not repeat CAM or recommend its use for cancer. The majority of patients (55.8% did not mention their use of CAM to their doctors – mostly because the doctor did not ask

  8. 医院中药房动物类药材的质量管理%Quality management of hospital pharmacy animal medicinal materials

    汪姣

    2014-01-01

    Objective To study the quality control method of animal drugs in the hospital pharmacy.Method The existence of quality management research hospital pharmacy animal me-dicinal materials problems.Result Comprehensive management measures to establish a mature system of hospital pharmacy.Conclusion Strengthen quality management of pharmacy animal medi-cine hospitals should take various ef ective measures,loss and improve the quality of animal drugs to reduce the medicine,so as to improve the curative ef ects of the tcm.%目的:探讨医院中药房的动物类药材的质量管理方法。方法调查研究医院中药房动物类药材的质量管理存在的问题。结果医院中药房建立成熟的系统的综合管理措施。结论医院应该加强中药房动物类药材的质量管理,采取各种有效措施提高动物类药材的质量以减小药材的损耗,提高药材的疗效。

  9. Gist of classical Chinese sexual medicine and its academic features%古典性医学梗概及其学术特色

    徐升阳

    1997-01-01

    Based on nine important ancient Chinese books,the gist of classical Chinese sexual medicine and its academic feature arc concluded as follows.First,health carein sexual intercourse,which underlines sperm preservation as its key point,including marriage at right age,moderate coital frequency and taboos against sexuality,Secondly,sexual pleasure,which is interpreted as the basis for maintaining marital harmony and morals in human relations,and moderateness in sexual pleasure is stressed.Thirdly,art of copulation,which embraces application of bionics and practice of qigong in sexual intercourse.Fourthly,procreation of healthier offspring,which involves prenatal training and precautions in pregnancy.The author expounds the scientific and ethical essence of the classical Chinese sexual medicine,which is of historical and real significance.

  10. 我院门诊中药处方分析%Analysis Of Prescriptions Of Traditional Chinese Medicines in our Hospital

    黄培艳

    2011-01-01

    Objective To analyze the utilization of traditional Chinese medicines in outpatient prescription of our hospital to offer guidance for pharmacy work and provide reference for rational use of traditional Chinese medicines in clinic. Methods The systematic analysis of the outpatient prescriptions of traditional Chinese medicines in 2009 was performed. Results Of checked 1 555 prescriptions, 112 prescriptions were unqualified, accounting for 7. 20%. The Chinese medicinal materials involved in the prescriptions were 313 varieties. The usual drugs were mainly tonifying deficiency medicines. Conclusion The prescription writing in our hospital is basically qualified. Clinical doctors should enhance their own professional skills and reduce the irrational prescriptions as possible.%目的 了解医院门诊中药处方用药状况,为中药房工作和中医临床用药提供参考.方法 对2009年门诊中药处方进行系统分析.结果 调查门诊处方共1555张,其中不合格处方112张,占处方总数的7.20%;处方涉及中药材313种,常用药物以补虚药为主.结论 处方书写基本合格,医生应加强专业知识学习尽量减少不合理处方.

  11. Calibration measurements of the clinical whole-body counter in the Department of Nuclear Medicine of the General Hospital Vienna

    Whole-body counters are devices for the measuring and spectroscopy of small amounts of gamma emitting radionuclides in the human body. The Department of Nuclear Medicine of the General Hospital Vienna has such a device (clinical whole-body counter). It represents the type of a shadow shield whole-body counter with a scanning system. The patient is placed on a bed and is moved between four 6'' x 4'' NaI(Tl) detectors with adjustable slit collimators. The whole-body counter was calibrated with regard to channel number, full width at half maximum (FWHM) and efficiency in dependence of the gamma energy of some gamma reference sources. The measurements were performed using a human shaped 70 kg phantom made from water filled plastic bottles, which simulate the absorption and scattering of gamma rays in the human body. Results of the calibration measurements and characteristic quantities like ''minimum detectable activity'' (MDA) and ''minimum measureable activity'' (MMA) will be presented in dependence of the gamma energy. (orig.)

  12. Negotiating competency, professionalism and risk: the integration of complementary and alternative medicine by nurses and midwives in NHS hospitals.

    Cant, Sarah; Watts, Peter; Ruston, Annmarie

    2011-02-01

    This qualitative interview study examined the use of complementary and alternative medicine (CAM) by nurses and midwives in NHS hospital settings in 2008 in the UK. It showed that the groundswell of interest in CAM in the 1990s had diminished by this time due to changes to policy and funding, and increasingly stringent clinical governance. Nevertheless, CAM provided an opportunity for committed and self-motivated practitioners to extend their therapeutic repertoire and develop affective dimensions of practice. However, the integration of CAM did not afford the autonomy, status and material gains traditionally associated with a collective professional project. In practice, occupational strategies were individualistic, and grounded in the assertion of competency through expressions of professionalism rather than the credentialism which underpins classic professionalisation. Central to these strategies was CAM related risk, which became a means by which to claim occupational space. However, the extent to which the adoption of CAM enhanced the nurses' and midwives' roles was limited by traditional medical authority; the uncertain status of CAM knowledge; and the absence of collective strategies - which together often left practitioners in a position of vulnerability. PMID:21208701

  13. Use of Complementary and Alternative Medicine in Children with Cancer: A Study at a Swiss University Hospital.

    Tatjana Magi

    Full Text Available Though complementary and alternative medicine (CAM are frequently used by children and adolescents with cancer, there is little information on how and why they use it. This study examined prevalence and methods of CAM, the therapists who applied it, reasons for and against using CAM and its perceived effectiveness. Parent-perceived communication was also evaluated. Parents were asked if medical staff provided information on CAM to patients, if parents reported use of CAM to physicians, and what attitude they thought physicians had toward CAM.All childhood cancer patients treated at the University Children's Hospital Bern between 2002-2011 were retrospectively surveyed about their use of CAM.Data was collected from 133 patients (response rate: 52%. Of those, 53% had used CAM (mostly classical homeopathy and 25% of patients received information about CAM from medical staff. Those diagnosed more recently were more likely to be informed about CAM options. The most frequent reason for choosing CAM was that parents thought it would improve the patient's general condition. The most frequent reason for not using CAM was lack of information. Of those who used CAM, 87% perceived positive effects.Since many pediatric oncology patients use CAM, patients' needs should be addressed by open communication between families, treating oncologists and CAM therapists, which will allow parents to make informed and safe choices about using CAM.

  14. Engaging students and faculty: implications of self-determination theory for teachers and leaders in academic medicine

    Lyness, Jeffrey M; Lurie, Stephen J; Ward, Denham S.; Christopher J. Mooney; Lambert, David R.

    2013-01-01

    Background Much of the work of teachers and leaders at academic health centers involves engaging learners and faculty members in shared goals. Strategies to do so, however, are seldom informed by empirically-supported theories of human motivation. Discussion This article summarizes a substantial body of motivational research that yields insights and approaches of importance to academic faculty leaders. After identification of key limitations of traditional rewards-based (i.e., incentives, or ...

  15. Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year

    Peppas Theodoros A; Kotsini Vasiliki; Skliros Stathis A; Sotiropoulos Alexios; Tountas Charalambos; Tamvakos Elias; Pappas Stavros

    2001-01-01

    Abstract Background Out of 1705 patients hospitalised for various reasons in the 3rd Internal Medicine Department of the Regional General Hospital of Nikaea, in Piraeus, 146(8,5%) persons were admitted for drug intoxication between November 1999 and November 2000. Methods On average, these persons [male 50(34,2%) – female 96(65,8%)] were admitted to the hospital within 3.7 hours after taking the drug. Results The drugs that were more frequently taken, alone or in combination with other drugs,...

  16. Prevalence of cognitive impairment and depression among elderly patients attending the medicine outpatient of a tertiary care hospital in South India

    Naveen Kumar D; Sudhakar TP

    2013-01-01

    Background: Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology. The aim of the present work was to examine the prevalence of cognitive impairment and depression in elderly subjects above 60 years. Methods: A cross-sectional study on the prevalence of cognitive impairment and depression on elderly people (n=525) attending the General Medicine OPD of Sri Venkateswara Ram Narain Ruia Government General Hospital, Tirupati. Co...

  17. Prevalence of common canine digestive problems compared with other health problems in teaching veterinary hospital, Faculty of Veterinary Medicine, Cairo University, Egypt

    Rakha, Gamal M. H.; Abdl-Haleem, Mounir M.; Haithem A. M. Farghali; Hitham Abdel-Saeed

    2015-01-01

    Aim: The present study was conducted to ascertain the prevalence of common digestive problems compared to other health problems among dogs that were admitted to the teaching veterinary hospital, faculty of veterinary medicine, Cairo University, Egypt during 1 year period from January to December 2013. Also, study the effect of age, sex, breeds, and season on the distribution of digestive problems in dogs. Materials and Methods: A total of 3864 dogs included 1488 apparently healthy (included 8...

  18. A novel organizational model to face the challenge of multimorbid elderly patients in an internal medicine setting: a case study from Parma Hospital, Italy.

    Meschi, Tiziana; Ticinesi, Andrea; Prati, Beatrice; Montali, Arianna; Ventura, Antonio; Nouvenne, Antonio; Borghi, Loris

    2016-08-01

    Continuous increase of elderly patients with multimorbidity and Emergency Department (ED) overcrowding are great challenges for modern medicine. Traditional hospital organizations are often too rigid to solve them without consistently rising healthcare costs. In this paper we present a new organizational model achieved at Internal Medicine and Critical Subacute Care Unit of Parma University Hospital, Italy, a 106-bed internal medicine area organized by intensity of care and specifically dedicated to such patients. The unit is partitioned into smaller wards, each with a specific intensity level of care, including a rapid-turnover ward (mean length of stay <4 days) admitting acutely ill patients from the ED, a subacute care ward for chronic critically ill subjects and a nurse-managed ward for stable patients who have socio-economic trouble preventing discharge. A very-rapid-turnover ("come'n'go") ward has also been instituted to manage sudden ED overflows. Continuity, effectiveness, safety and appropriateness of care are guaranteed by an innovative figure called "flow manager," with skilled clinical experience and managerial attitude, and by elaboration of an early personalized discharge plan anticipating every patient's needs according to lean methodology principles. In 2012-2014, this organizational model, compared with other peer units of the hospital and of other teaching hospitals of the region, showed a better performance, efficacy and effectiveness indexes calculated on Regional Hospital Discharge Records database system, allowing a capacity to face a massive (+22 %) rise in medical admissions from the ED. Further studies are needed to validate this model from a patient outcome point of view. PMID:26846233

  19. Postgraduate training for family medicine in a rural district hospital in South Africa: Appropriateness and sufficiency of theatre procedures as a sentinel indicator

    Dawie Du Plessis

    2016-03-01

    Full Text Available Background: Since 2007, the postgraduate training of family physicians for South African district hospitals has been formalised. This training differs from European and North American programmes as up to 30% of the skills needed rely on district hospital surgical, obstetrics and anaesthetics procedures, particularly in rural areas, as outlined in the national unit standards. The aim of this study was to evaluate the appropriateness and sufficiency of learning opportunities for these skills in a rural district hospital.Methods: A descriptive, cross-sectional study was undertaken of the number and type of procedures performed in theatre for a 1-year period and compared with the required procedural skills stipulated in the national unit standards. Descriptive statistical analyses were used to analyse categorical data.Results: Three thousand seven hundred and forty-one procedures were performed during the study period. Anaesthesia was the most common procedure, followed by Caesarean section. There were adequate opportunities for teaching most core skills.Conclusions: Sufficient and appropriate learning opportunities exist for postgraduate family medicine training in all the core skills performed in a theatre according to the national unit standards.Keywords: Post Graduate Training, Family Medicine, Procedural Skills, Rural, District hospitals

  20. Assessment of Sleep Quality and Effects of Relaxation Exercise on Sleep Quality in Patients Hospitalized in Internal Medicine Services in a University Hospital: The Effect of Relaxation Exercises in Patients Hospitalized.

    Alparslan, Güler Balci; Orsal, Özlem; Unsal, Alaettin

    2016-01-01

    This study aims to assess sleep quality and determine the effects of relaxation exercise on sleep quality in patients hospitalized in internal medicine services. In total, 47 patients comprised the control group and did not engage in the exercise intervention-the progressive muscle relaxation exercise, whereas 235 patients were assigned to the intervention group (N = 282). In this study, Description Questionnaire Form and the Pittsburg Sleep Quality Index (PSQI) were used. Most patients (73.8%) had poor sleep quality. The mean pre- and postexercise PSQI scores of the patients in the interventional group were 8.7 ± 4.0 and 6.1 ± 3.3, respectively. The mean pre- and postexercise PSQI scores of the control patients were 6.6 ± 3.5 and 5.6 ± 2.7, respectively. According to this study, the exercises significantly enhanced the quality of sleep. Patients should be encouraged by nurses to perform relaxation exercises. PMID:27078810

  1. Analysis on academic community nursing service mode under translational medicine concept%转化医学理念下的学院式社区护理服务模式1)

    翟忠美; 杨友谊; 鲜于丽

    2014-01-01

    介绍了转化医学概念及社区护理模式,分析了学院式社区护理的特点及学院式社区护理模式,旨在促进转化医学在护理专业领域的推广。%It introduced the concept of translational medicine and com-munity nursing mode,analyzed the characteristic and mode of academ-ic community nursing.The purpose is to promote translational medi-cine in nursing field.

  2. Emergency medicine rural rotations: a program director's guide.

    Casaletto, Jennifer J; Wadman, Michael C; Ankel, Felix K; Bourne, Christina L; Ghaemmaghami, Chris A

    2013-05-01

    The Institute of Medicine's 2006 report titled "Hospital-Based Emergency Care: At the Breaking Point" called national attention to the lack of specialty-trained emergency care practitioners, particularly in rural America. One suggested strategy for narrowing the gap between the prevalence of residency-trained, board-certified emergency physicians practicing in rural and urban emergency departments is the development of rural clinical experiences for emergency medicine residents during the course of their training. This article addresses promotion of a rural emergency medicine rotation to hospital leadership and resident recruits, examines funding sources, discusses medical liability and disability insurance options, provides suggestions for meeting faculty and planned educational activity residency review committee requirements, and offers guidance about site selection to direct emergency medicine academic leaders considering or planning a new rural emergency medicine rotation. PMID:23083967

  3. Evaluation of the medicine procurement and supply management system in public hospitals in Lesotho / Matsepo Aniva Tema

    Tema, Matsepo Aniva

    2014-01-01

    In a well-functioning medicine supply chain management system, procurement forms an integral part that needs to be closely monitored and integrated with other functions. Good procurement practices in the public health sector ensure that good quality efficacious medicines are distributed in the country in the right quantities and at reasonable costs. Pharmaceutical procurement is a major determinant of drug availability and total health costs. It is indicated that medicine expenditure represen...

  4. A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions

    Justin Shmalberg; Memon, Mushtaq A.

    2015-01-01

    Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospit...

  5. Attendance and Achievement in Medicine: Investigating the Impact of Attendance Policies on Academic Performance of Medical Students

    Subramaniam, BS; Hande, S; Komattil, R

    2013-01-01

    Background: The attendance mandate for the medical course in Melaka Manipal Medical College, Manipal, India was increased from 75% to 90% based on the assumption that the mandatory increase will improve the students’ performance. Aims: To find out whether there is any correlation between class attendance and academic performance. Subjects and Methods: This was an institution based retrospective analytical study. Students who have completed Phase I (first two and a half years) of the MBBS cour...

  6. The Arrival and Diffusion of Academic Medicine in Rural Sweden: The Case of the Sundsvall Region in the late Nineteenth Century

    Stephan Curtis

    2011-01-01

    Full Text Available Midwives working in rural 19th-cetnruy Swedish parishes were essential to the introduction and acceptance of academic medicine. They were typically highly skilled and the full support of the state but numerous obstacles confronted them. None was greater than the struggle to gain the trust of local women and their families. This study demonstrates that midwives' ability to attract expectant mother away from traditional help-women depended less upon their age, level of skill or social background than it did upon the public's assessment of their abilities. News spread quickly if a midwife had used her skills to save a life or lives, or had attended a birth that had resulted in the death of the infant or mother. The strength of social networks either encouraged other women to call upon the services of that midwife or, alternatively, caused them to reassess the level of trust that they had bestowed upon her.

  7. 我院门诊3291张中药处方分析%Analysis of 3 291 Outpatient Prescriptions of Traditional Chinese Medicine in Our Hospital

    苏玉纯; 沈紧治; 王政

    2014-01-01

    OBJECTIVE:To investigate the outpatient use of traditional Chinese medicine so as to find out the regularity and the problems in drug use in our hospital for references of pharmacy and clinical medication of traditional Chinese medicine. METH-ODS:3 291 outpatient prescriptions of traditional Chinese medicine collected in every 3 working days in each month of 2013 in our hospital were analyzed statistically with regard to the standardization in prescription writing,rationality in drug use and the utili-zation data of traditional Chinese medicine. RESULTS:The outpatient use of traditional Chinese medicine in our hospital had prob-lems in clinical diagnosis,course of treatment,dosage&administration etc. The average consumption sum was 76.21 yuan per pre-scription and an average of 10.14 drugs were prescribed with licorice used most frequently and reinforcing drugs ranked the first in terms of consumption amount. CONCLUSIONS:The use of traditional Chinese medicine in our hospital was irrational in that the dosage of simple recipe and the number of drugs per prescription were on the high side although with rational consumption sum. It is urgent for the related management departments of our country and hospital to attach great importance to strengthen management on the prescriptions of traditional Chinese medicine and formulate effective administrative measures management to promote clinical rational use of traditional Chinese medicine.%目的:了解我院门诊中药处方用药情况,找出处方用药规律及存在问题,为中药房工作和中医临床用药提供参考。方法:抽取我院门诊2013年每月3个工作日的中药处方共3291张,从处方书写规范性、用药合理性、中药使用情况等方面进行统计分析。结果:我院中药处方在临床诊断、用药疗程、用法用量等方面存在问题,平均处方金额为76.21元、平均药味为10.14种,甘草使用率最高,补益药使用量最大。结论:我

  8. [Clinical aspects of AIDS at the Calmette hospital in Phnom Penh, Kingdom of Cambodia A report on 356 patients hospitalized in the Medicine "B" Department of the Calmette Hospital].

    Pichith, K; Chanroeun, H; Bunna, P; Nyvanny, N; Thavary, S; Kosal, S; Crepin, P

    2001-01-01

    A study on AIDS subjects carried out at the Calmette Hospital in Phnom-Penh between the 1st January 97 and the 30th December 98. The objective of this study was to describe the most frequent clinical manifestations as well as the opportunistic infections according to the 1993 CDC classification (purely clinical classification). Three hundred and fifty six AIDS patients hospitalized in medicine B were included in our study. A complete file was prepared for each subject, specifying his/her social and family situation, profession, sexual behavior and history. The clinical condition was specified and the paraclinical examinations were recorded. The average age was 35 years with 250 men and 106 women, i.e. a M/F sex ratio of 2.4. The majority of male contaminations were due to sexual relationships with multiple partners, 82%, and women with a single partner was of 78%. The use of condoms was of 60% (versus 40% occasional); the extent of drug-addiction was 1.12% (4 cases). A history of STD was found in 56% of cases. The presenting symptoms most frequently found were asthenia, anorexia, fever and weight-loss. In decreasing order, the clinical manifestations often associated were: weight-loss > 10% or a catechetic condition 58.70% (209/356), fever > 38 degrees C >1 month 53% (189/356), diarrhea (> one month) 41.60% (148/356). The most frequent opportunistic infections were: oral candidiasis 51.40% (183/356) and 40% are oro-oesophageal (oral candidiasis + dysphagia or odynphagia), pulmonary and extrapulmonary tuberculoses (TB) 43.50% (155/356) (pulmonary TB in 65.16%, TB of the lymph nodes 23.22% and disseminated TB and cerebral TB 11.61%), cryptococcal meningitis 11.80% (42/356) and pneumocystosis 6.50% (23/356), CMV retinitis 1.12% (4/356). The other opportunistic manifestations such as toxoplasmosis and Kaposis sarcoma are much more rarely encountered due to the difficulties of the paraclinical diagnosis. The mortality in the department was of 17.40% (62/356). In

  9. The role of general practitioners in the pre hospital setting, as experienced by emergency medicine technicians: a qualitative study

    Hjortdahl, Magnus; Zakariassen, Erik; Wisborg, Torben

    2014-01-01

    Background: Together with the ambulances staffed with emergency medical technicians (EMTs), general practitioners (GPs) on call are the primary resources for handling emergencies outside hospitals in Norway. The benefit of the GP accompanying the ambulance to pre-hospital calls is a matter of controversy in Norway. The purpose of the present study was to gain better insight into the EMT ’ s experiences with the role of the GPs in the care for critically ill patients in the pre-hospital ...

  10. Progress report on nuclear science and technology in China (Vol.2). Proceedings of academic annual meeting of China Nuclear Society in 2011, No.9--nuclear medicine sub-volume

    Progress report on nuclear science and technology in China (Vol. 2) includes 698 articles which are communicated on the second national academic annual meeting of China Nuclear Society. There are 10 books totally. This is the ninth one, the content is about nuclear medicine

  11. Field Note-Developing Suicide Risk Assessment Training for Hospital Social Workers: An Academic-Community Partnership

    Wharff, Elizabeth A.; Ross, Abigail M.; Lambert, Susan

    2014-01-01

    This article describes 1 large urban pediatric hospital's partnership with a university to provide suicide assessment and management training within its social work department. Social work administrators conducted a department-wide needs assessment and implemented a 2-session suicide assessment training program and evaluation. Respondents…

  12. Restructuring within an academic health center to support quality and safety: the development of the Center for Quality and Safety at the Massachusetts General Hospital.

    Bohmer, Richard M J; Bloom, Jonathan D; Mort, Elizabeth A; Demehin, Akinluwa A; Meyer, Gregg S

    2009-12-01

    Recent focus on the need to improve the quality and safety of health care has created new challenges for academic health centers (AHCs). Whereas previously quality was largely assumed, today it is increasingly quantifiable and requires organized systems for improvement. Traditional structures and cultures within AHCs, although well suited to the tripartite missions of teaching, research, and clinical care, are not easily adaptable to the tasks of measuring, reporting, and improving quality. Here, the authors use a case study of Massachusetts General Hospital's efforts to restructure quality and safety to illustrate the value of beginning with a focus on organizational culture, using a systematic process of engaging clinical leadership, developing an organizational framework dependent on proven business principles, leveraging focus events, and maintaining executive dedication to execution of the initiative. The case provides a generalizable example for AHCs of how applying explicit management design can foster robust organizational change with relatively modest incremental financial resources. PMID:19940570

  13. Spatial map dose of nuclear medicine service of the Clinical Hospital of Botucatu, SP, Brazil; Mapa espacial de dose do servico de medicina nuclear do Hospital das Clinicas de Botucatu

    Oliveira, Caio V.; Mendonca, Caroline; Silva, Eduardo T.; Moriguchi, Sonia M.; Koga, Katia H., E-mail: caiov_oliveira@yahoo.com.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina

    2013-12-15

    This study was conducted to describe levels of occupational and environmental exposure of the Nuclear Medicine Service of the Clinical Hospital of Botucatu. To this end, measurements were made of the radiometric levels of points strategically defined, in all the environments, for a period of six months, sampling different days and times, during operation normal routine of the sector. The results allow to estimate the expected dose for each environment, comparing them to the dose limitation established by the National Commission of Nuclear Energy (CNEN), allowing better targeting of occupationally exposed individuals, indicating the points where the occupation should be the minimum required, enabling the reduction of risks to potential exposures. (author)

  14. Assessment of adherence to cardiovascular medicines in rural population: An observational study in patients attending a tertiary care hospital

    Gouranga Santra

    2015-01-01

    Full Text Available Introduction: Nonadherence to cardiovascular medicines is a major concern. It increases the morbidity and mortality of cardiovascular patients. The work was conducted to evaluate the adherence to cardiovascular medicines in patients of rural India. Methods: The study was conducted in the Department of Medicine involving rural patients with essential hypertension (HTN, congestive cardiac failure (CCF, and ischemic heart disease (IHD over 12 months period. Patients were prescribed with cardiovascular medicines at the initial visit and adherence to medicines was assessed in the subsequent visit. Four items Morisky's Medication Adherence Scale (MMAS-4 was used for assessing medication adherence. Patients were considered adherent to medication if they answered negatively to all four questions. Results: Overall adherence to medication was 20.83%, 28.37% and 32% in HTN, CCF, and IHD patients, respectively. Nonadherence was highest in patients of HTN. Among the four reasons of nonadherence assessed by MMAS-4, carelessness was the most common and forgetfulness was the least common cause of nonadherence in all the three groups of patients. Conclusion: Patients of rural India adhere poorly to cardiovascular medicines. Nonadherence should be considered as a public health problem. Strategies for detecting the level of adherence of cardiovascular medicines, its barriers, and subsequent interventions should be developed by policy-makers to reduce morbidity and mortality due to cardiovascular disorders.

  15. Retrospective analysis of the role and performance of family medicine versus emergency medical services in the pre-hospital management of patients with AMI in Banja Luka

    Biljana Lakić

    2016-05-01

    Full Text Available Objective. The aim of this study was to investigate the differences in pre-hospital care of patients with acute myocardial infarction between emergency medical services and family medicine. Patients and methods. This retrospective descriptive study included patients treated for acute myocardial infarction at the University Clinical Centre of Banja Luka, in the period from 1st January to 31st December 2011. The patients were divided into two groups: patients who received a hospital referral from the family medicine service and those who received one from the emergency medical service. Results. The majority of patients (54.8% received pre-hospital care from emergency medical services, while in 24.8% of cases the care was provided by family medicine physicians. The analysis showed that the time that passed from the onset of symptoms to the visit to the health institution of first medical contact was shorter in the emergency medical service (p<0.001. The average time from the onset of symptoms to arrival at the family practice was 24 hours, and to the emergency service 2 hours. The patients who established their first medical contact with the emergency service reported more severe symptoms than the ones who visited a family practice over the same period of time. Conclusion. The severity of symptoms affected the patients’ decisions to seek help in a timely manner and to choose the facility of first medical contact. Interventions to decrease delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge of the benefits of early medical contact and treatment. Continuing education of family practitioners in this field is required.

  16. The radiation protection: a priority objective in the conception and the functioning of a new nuclear medicine service. The experience of the Bordeaux Hospitals

    The nuclear medicine has been formerly implanted in the Bordeaux Hospitals. During the years, it knew an important development in the in vivo field (scintigraphy) or in vitro field (radioimmunology). But this development has been often realized at the detriment both of personnel and environment. For three years an approach of radiation protection optimization is effective. This approach began with the initial conception of buildings to improve the radiation doses reduction. To reduce a little more these doses, a process of monitoring has been operating that allows to go beyond the regulatory monitoring. Then, the necessity to use an operational dosimetry appears an excellent mean to sensitize the personnel. (N.C.)

  17. Plant-based Complementary and alternative medicine used by breast cancer patients at the Hospital Universitario San Ignacio in Bogotá, Colombia.

    Marcela Mercado; Luisa Benitez Cardenas; Susana Fiorentino; Luz Angela Diaz; Lilian Torregrosa

    2012-01-01

    The present study estimates the frequency of the use of plant-based Complementary and Alternative Medicine (CAM) by breast cancer patients. From June to December of 2011, a self-administered questionnaire was given to 404 breast cancer patients receiving outpatient therapy at the Javeriana Oncology Center of the Hospital Universitario San Ignacio in Bogotá. The prevalence of patient CAM use was 57%, out of which 76% was based on plants like anamú, aloe, red fruits and soursop. Sixty-five perc...

  18. [Treatment for pulmonary arterial hypertension under the new French hospital financing system. Recommendations of the Pulmonary Vascular Diseases Working Group of the French Society of Pulmonary Medicine].

    Sitbon, O; Humbert, M; Simonneau, G

    2005-11-01

    Activity-based financing (that is, casemix-based hospital payments, known as T2A) is intended to harmonize and improve the fairness of remuneration of public and private hospitals. T2A will ultimately rely mainly on a flat rate per admission, set according to the diagnosis-related group (DRG). Although payment for drugs is usually included in the DRG price, some expensive drugs will be reimbursed on an additional cost basis after implementation of a "best practices" agreement. Four drugs used for treatment of pulmonary arterial hypertension are eligible for this additional reimbursement: 3 prostacyclin derivatives (intravenous epoprostenol, inhaled iloprost, and subcutaneous treprostinil), and oral bosentan, an endothelin receptor antagonist. The Pulmonary Vascular Diseases working group of the French Society of Pulmonary Medicine has developed guidelines for the best practices in use of these drugs. PMID:16301977

  19. The Usage of Traditional Chinese Medicine Injections in a Orthopaedic Hospital%骨科医院中药注射剂用药分析

    何广宏; 董然

    2014-01-01

    Objective To col ect the usage of traditional Chinese medicine injections in our hospital and then analysis,to promote rational usage of clinical drugs.Methods Col ect sales top ten usage data of the traditional Chinese medicine injections in our hospital from 2013,proceed a data analysis for sales amount,DDDs,DDC,order ratio of sales amount&DDDs (B/A),a statistical analysis of the traditional Chinese medicine injection amount of sales top three departments.Results The use of traditional Chinese medicine injection is more concentrated on blood circulation,maximum amounts are X and Y,B/A of sales top three varieties are al 1,showing that the sales amount and the DDDs are in good synchronization,usage is comparatively reasonable.Conclusion General y speaking, Chinese medicine injection usage in our hospital is reasonable.%目的:探讨中药注射剂的使用情况,以促进临床合理用药。方法收集我院2013年销售金额排名前10位中药注射剂的使用情况资料,对销售金额、用药频度(DDDs)、日均费用(DDC)、销售金额和 DDDs 排序比(B/A)进行统计分析,对销售中药注射剂金额排名前三位的科室进行统计分析。结果我院使用中药注射剂以活血化瘀为主,使用较为集中,以血栓通、丹红注射液用量最大,销量前三位的品种B/A均为1,即销售金额与DDDs同步较好,使用较为合理。结论我院中药注射剂使用总体较合理。

  20. Academic Life of He Pu-ren,the National Master of Chinese Medicine%国医大师贺普仁学术人生探讨

    贺小靖; 贺伯汉

    2011-01-01

    摘要:目的:探讨首届国医大师贺普仁教授的学术经历、医学成就与仁心大德。方法:从贺普仁教授拜师学医、临床创立“针灸三通法”的理论内容、学术主张、科研观点、医风医德等方面,全面回顾贺普仁教授的学术生涯,评述诊疗思想、学术创新、临床科研成就等。结果和结论:贺普仁教授是我国的针灸大师,是中医针灸领域承前启后的泰山北斗。贺普仁教授创立的“针灸三通法”,对于中医针灸事业发展有着重要的推动作用,为中国针灸事业做出了卓越贡献。%Objective:To explore the academic experiences,medical achievements and ethics of Professor He Puren, one of the first national Chinese medical science masters. Methods:Try to provide a comprehensive review of his academic career, with comments for his clinic thinking, academic innovation and clinical research achievements and so on from the aspects of medicine studying experiences, clinical establishment of "Santong Method of Acupuncture" ,the theoretical contents, academic ideas, research perspective and medical ethics of Professor He Puren. Results and conclusion:Professor He Puren is a master of acupuncture in China,who absorbed the essence and promoted the development of Chinese acupuncture. "Santong Methods of Acupuncture" created by Professor He Puren' s plays an important role in promoting the development of the Chinese acupuncture career and he has made an outstanding contribution to Chinese acupuncture.

  1. Evaluating the value of a web-based natural medicine clinical decision tool at an academic medical center

    Karpa Kelly

    2011-10-01

    Full Text Available Abstract Background Consumer use of herbal and natural products (H/NP is increasing, yet physicians are often unprepared to provide guidance due to lack of educational training. This knowledge deficit may place consumers at risk of clinical complications. We wished to evaluate the impact that a natural medicine clinical decision tool has on faculty attitudes, practice experiences, and needs with respect to H/NP. Methods All physicians and clinical staff (nurse practitioners, physicians assistants (n = 532 in departments of Pediatrics, Family and Community Medicine, and Internal Medicine at our medical center were invited to complete 2 electronic surveys. The first survey was completed immediately before access to a H/NP clinical-decision tool was obtained; the second survey was completed the following year. Results Responses were obtained from 89 of 532 practitioners (16.7% on the first survey and 87 of 535 (16.3% clinicians on the second survey. Attitudes towards H/NP varied with gender, age, time in practice, and training. At baseline, before having an evidence-based resource available, nearly half the respondents indicated that they rarely or never ask about H/NP when taking a patient medication history. The majority of these respondents (81% indicated that they would like to learn more about H/NP, but 72% admitted difficulty finding evidence-based information. After implementing the H/NP tool, 63% of database-user respondents indicated that they now ask patients about H/NP when taking a drug history. Compared to results from the baseline survey, respondents who used the database indicated that the tool significantly increased their ability to find reliable H/NP information (P Conclusions Our results demonstrate healthcare provider knowledge and confidence with H/NP can be improved without costly and time-consuming formal H/NP curricula. Yet, it will be challenging to make providers aware of such resources.

  2. A cross-sectional survey of complementary and alternative medicine use by children and adolescents attending the University Hospital of Wales

    Lim Alissa

    2006-05-01

    Full Text Available Abstract Background A high prevalence of CAM use has been documented worldwide in children and adolescents with chronic illnesses. Only a small number of studies, however, have been conducted in the United Kingdom. The primary aim of this study was to examine the use of CAM by children and adolescents with a wide spectrum of acute and chronic medical problems in a tertiary children's hospital in Wales. Methods Structured personal interviews of 100 inpatients and 400 outpatients were conducted over a 2-month period in 2004. The yearly and monthly prevalence of CAM use were assessed and divided into medicinal and non-medicinal therapies. This use was correlated with socio-demographic factors. Results There were 580 patients approached to attain 500 completed questionnaires. The use of at least one type of CAM in the past year was 41% (95% CI 37–46% and past month 26% (95% CI 23–30%. The yearly prevalence of medicinal CAM was 38% and non-medicinal 12%. The users were more likely to have parents that were tertiary educated (mother: OR = 2.3, 95%CI 1.6–3.3 and a higher family income (Pearson chi-square for trend = 14.3, p None of the inpatient medical records documented CAM use in the past month. Fifty-two percent of medicinal and 38% of non-medicinal CAM users felt their doctor did not need to know about CAM use. Sixty-six percent of CAM users did not disclose the fact to their doctor. Three percent of all participants were using herbs and prescription medicines concurrently. Conclusion There is a high prevalence of CAM use in our study population. Paediatricians need to ensure that they ask parents and older children about their CAM usage and advise caution with regard to potential interactions. CAM is a rapidly expanding industry that requires further evidence-based research to provide more information on the effectiveness and safety of many CAM therapies. Statutory or self-regulation of the different segments of the industry is important

  3. Shakespeare and the Words of Early Modern Physic: Between Academic and Popular Medicine. A Lexicographical Approach to the Plays

    Roberta Mullini

    2013-03-01

    Full Text Available The article aims at showing how Shakespeare relied on the medical vocabulary shared by his coeval society, which had, for centuries, been witnessing the continuous process of vernacularization of ancient and medieval scientific texts. After outlining the state of early modern medicine, the author presents and discusses the results of her search for relevant medical terms in nine plays by Shakespeare. In order to do this, a wide range of medical treatises has been analysed (either directly or through specific corpora such as Medieval English Medical Texts, MEMT 2005, and Early Modern English Medical Texts, EMEMT 2010, so as to verify the ancestry or the novelty of Shakespearean medical words. In addition to this, the author has also built a corpus of word types derived from seventeenth-century quack doctors’ handbills, with the purpose of creating a word list of medical terms connected to popular rather than university medicine, comparable with the list drawn out of the Shakespearean plays. The results most stressed in the article concern Shakespeare’s use of medical terminology already well known to his contemporary society (thus confuting the Oxfordian thesis about the impossibility for William Shakespeare the actor to master so many medical words and the playwright’s skill in transforming – rather than inventing – old popular terms. The article is accompanied by five tables that collect the results of the various lexicographical searches.

  4. Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network

    Woodhams Victoria

    2012-06-01

    Full Text Available Abstract Background Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare. Method We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN. We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops. Results We identified three types of intervention: pre-hospital; within the emergency department (ED; and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR – Patients at risk of readmission and ACG – Adjusted Clinical Groups sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission. Conclusions Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don’t change.

  5. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People's Republic of China.

    Fang, Xu; Zhu, Ling-Ling; Pan, Sheng-Dong; Xia, Ping; Chen, Meng; Zhou, Quan

    2016-01-01

    Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People's Republic of China during 2011-2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011. A 100% implementation rate of standard storage of narcotics has been achieved in the hospital since December 2012. A "Plan, Do, Check, Act" cycle was efficient because the ratio of number of inappropriate narcotics prescriptions to total number of narcotics prescriptions for inpatients decreased from August 2014 to December 2014 (28.22% versus 2.96%, P=0.0000), and it was controlled below 6% from then on. During the journey to good pain management ward accreditation by the Ministry of Health, People's Republic of China, (April 2012-October 2012), the medical oncology ward successfully demonstrated an increase in the pain screening rate at admission from 43.5% to 100%, cancer pain control rate from 85% to 96%, and degree of satisfaction toward pain nursing from 95.4% to 100% (all P-values person to 20.36 mg/person. A 100% implementation rate of independent double-check prior to narcotics dosing has been achieved since January 2013. From 2014 to 2015, the ratio of number of narcotics-related medication errors to number of discharged patients significantly decreased (6.95% versus 0.99%, P=0.0000). Taken together, continuous quality improvements have been achieved in safe medication management and use of narcotics by an integrated multidisciplinary collaboration during the journey to JCI accreditation and in the post-JCI accreditation era. PMID:27103812

  6. Medication safety during your hospital stay

    ... your medicine. This prescription goes to the hospital pharmacy. The hospital pharmacist reads and fills the prescription. The medicine ... medicine. Alternative Names ... Date 2/6/2016 Updated by: Laura J. ...

  7. Exploration of Clinical Pharmacy Model for Traditional Chinese Medicine Hospital%中医医院开展临床中药学工作初探

    顾晓玲; 朱江; 陈丽华

    2014-01-01

    In this paper , the current status of the development of clinical pharmacy in our hospital ( as a type A of grade two hospital of traditional Chinese medicine ) , especially the clinical Chinese material medica was analyzed . The training pattern of clinical pharmacist of Chinese medicine and the development strategy were discussed . The standardization of working mode of pharmaceutical ward round was explored , such as the combination of ward round with doctor and without doctor . A valuable reference was provided for clinical work and for the improvement of pharmaceutical service of pharmacist .%分析我院(二级甲等中医医院)临床药学开展的现状,特别是临床中药学,讨论临床中药师的培养模式及发展策略,探索规范化药学查房的工作模式---随医查房和独自查房相结合,为提高药师的临床药学服务质量提供参考。

  8. The FADOI (Federation of Associations of Hospital Doctors on Internal Medicine position paper on cardiovascular prevention in the higher risk complex patients

    Mauro Campanini

    2015-12-01

    Full Text Available Prevention is a very topical issue that any modern health system cannot ignore. The discussion about the concept of cardiovascular (CV prevention is very wide and has been lasting for a long time. In this context, the research has never been stopped. A schematic classification of different types of prevention, as well as raised by the literature, implies some limitations, not always suitable to our complex patients. According to evidence-based medicine we should refer to the best available guidelines. Unfortunately the quality of evidence-based guidelines is far from optimal. The Federation of Associations of Hospital Doctors on Internal Medicine (FADOI faced the problem of CV prevention in the higher risk complex patients with its experts in ischemic heart disease, heart failure, stroke, chronic kidney disease, peripheral arterial disease and diabetes mellitus, by asking the following questions: i which are the methods of risk assessment and prognostic stratification (also with respect to the existing comorbidities?; ii which are the tailored actions to implement for the individual patient? For the purposes of a CV risk evaluation in complex patient we cannot be satisfied with a single high baseline risk strategy: we should resize our assessment parameters to the real world, implementing a high multidimensional CV complexity risk assessment strategy, in respect of an anthropological approach to the complexity of our patients. Essentially, hospital internists are called to exercise a proactive role of experts for each single complex patient, also in CV prevention.

  9. The academic medical centre: an idea whose time has come.

    Sinclair, D G

    1993-01-01

    Interdependence of faculties of medicine or health sciences and teaching hospitals is central to the academic medical centre's three "products": education, research and clinical service. Whether a voluntary association, partnership, joint venture or single entity, the strength of the association of member institutions must lie in mutual dependency. With the potential of reducing costs and increasing effectiveness through administrative efficiency and rationalization, especially of planning an...

  10. Differences in care between general medicine and respiratory specialists in the management of patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease

    Kurugamage Wijayaratne

    2013-01-01

    Full Text Available Context: Hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD may be managed by either respiratory specialists (RS or general medicine physicians (GMP. While previous studies have audited the hospital AECOPD management of RS, only a small number of studies have evaluated the management of GMP. Aims: The aims of this study were to firstly examine the differences in AECOPD management of GMP and RS and secondly compare their care to national COPD guidelines. Methods: A retrospective review was undertaken of consecutive AECOPD patients admitted to two hospitals (one hospital where all AECOPD patients were managed by RS and another where all AECOPD patients were managed by GMP over a 3-month period. Electronic medical records, medical case notes, pathology and radiology data for the admission were reviewed. Results: There were 201 COPD exacerbations in 169 patients (49.7% male, mean age 72.3. GMP managed 84 (41.7% exacerbations. In comparison to RS, GMP performed fewer spirometry tests, blood gas analysis and less frequently treated patients with guideline-recommended medications. Referral to pulmonary rehabilitation was poor for both groups of clinicians. Median length of stay was shorter in GMP patients versus RS patients (3 days vs. 5 days, P = 0.001. There were no differences in the 12-month re-admission (41.7% vs. 38.5%, P = 0.664 and mortality rates (10.7% vs. 6%, P = 0.292 between both groups of patients. Conclusion: Our study found differences in the hospital AECOPD management of GMP and RS, but these did not translate into different clinical outcomes between their patients. We also found suboptimal adherence to national COPD guidelines, suggesting that there is scope for improvement in the AECOPD management of both groups of clinicians.

  11. Forum on the future of academic medicine: Session VI--Issues of change and quality in U.S. health care.

    Iglehart, J

    1999-07-01

    The sixth meeting of the AAMC's Forum on the Future of Academic Medicine, on September 10, 1998, opened with a talk by Paul B. Ginsburg, PhD, president of the Center for Studying Health System Change (HSC). He described a major longitudinal study by the HSC of the changing U.S. health care system and reviewed some preliminary findings on topics such as the variety of ways communities are responding to relatively uniform forces driving health care markets; the reasons that uninsured individuals have a much harder time securing needed care in some communities than in others; the changing role of employers as sponsors of workers' insurance; consumers' frequently limited knowledge of their health care plans; the continuing importance consumers attach to having access to a broad choice of providers and the effects of this on the marketplace (e.g., broadening of networks); the different organizational models of care that are evolving; and the changing relationships between primary care physicians and specialists. The second presentation was by Janet M. Corrigan, MD, MBA, who served as executive director of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. She discussed the commission's findings about the state of quality in the health care industry and the commission's strategy to address serious shortcomings (e.g., unevenness of quality; avoidable errors; misuse of services). She also commented on the exponential increase in medical knowledge and the need for systems to help practitioners obtain and use it, and discussed the quality of care inside and outside managed care settings (about the same). Both Dr. Ginsburg and Dr. Corrigan discussed how some of the issues and findings they presented apply to academic medical centers, and responded to penetrating questions and statements of forum members. PMID:10429584

  12. Risk Management for Injection of Medicines Brought into Hospital by Outpatients%门诊自备药物注射风险的管理

    俞培敏

    2014-01-01

    Objective To investigate the effect of the cooperation among doctor, pharmacist and nurse on strengthening risk management for injection of medicines brought into hospital by outpatients and ensuring drug safety. Method Doctors, pharmacists and nurses worked together to take effective prevention measures and make reasonable plan to help the patients in injection directed against the unstandardized medical document on the injection of medicines brought by outpatients, problems of drug quality and specifications, prevention of adverse drug reactions and patients' isolation for infectious disease. Results Through tripartite cooperation management, drug safety was ensured. Conclusion Injection of medicines brought into hospital by outpatients poses many risks and they can only be effectively prevented by close cooperation among doctor, pharmacist and nurse.%目的探讨门诊自备药物注射过程中医、药、护三方合作,加强风险管理,确保用药安全。方法针对门诊自备药物注射中存在的医疗文书不规范,药品质量和规格问题,药物不良反应防范,传染病患者隔离等风险,医、药、护三方合作,采取有效的防范措施,制订合理的代注流程。结果通过三方合作管理,确保了用药安全。结论门诊自备药物注射存在各方面的风险,只有医、药、护三方紧密合作,才能有效地防范风险。

  13. Security in transport, storage and disposal of radioactive materials, providing to the department of nuclear medicine in hospitals Rafael Angel Calderon Guardia, San Juan de Dios and Mexico

    The security is analysed for the transport and storage of radioactive sources and the management of radioactive waste product of practices and interventions in nuclear medicine services in hospitals Calderon Guardia, San Juan de Dios and Mexico. The objective is to assess the compliance with current regulations, the effectiveness and efficiency of the same. The security and compliance with current regulations were considered related to the transport of radioactive sources by the two private companies that provide this service, from the Juan Santamaria airport customs to three hospitals evaluated. Compliance with national and international rules on storage of radioactive sources and waste materials were analyzed. For this has been studied Costa Rican law and the recommendations of international organizations related to the subject matter, in the three nuclear medicine services valued. The national and international background related to radiological accidents occurred with radioactive sources during transport, storage and waste were revised, where highlights that in most cases, these accidents occurred for breach of the regulations established. Studies in Costa Rica on radioactive waste management were analysed, and the current status of nuclear medicine services in terms of radiation safety, which helped with the investigation. The compliance and regulations were analyzed by the result of observation and interviews during development, to finally make a series of findings and provide recommendations that are considered relevant. Various variants and indicators that are defined in the theoretical framework were used; also, the strategy of methodology is described. The purpose of the work has been to provide a scientific nature, and that methodology met the objectives, offering an approach from different angles and the actors involved, and a critical and objective analysis strictly in order to contribute to public health. The research is a valuable tool that provides

  14. A Model Longitudinal Observation Medicine Curriculum for an Emergency Medicine Residency.

    Wheatley, Matthew; Baugh, Christopher; Osborne, Anwar; Clark, Carol; Shayne, Philip; Ross, Michael

    2016-04-01

    The role of observation services for emergency department patients has increased in recent years. Driven by changing health care practices and evolving payer policies, many hospitals in the United States currently have or are developing an observation unit (OU) and emergency physicians are most often expected to manage patients in this setting. Yet, few residency programs dedicate a portion of their clinical curriculum to observation medicine. This knowledge set should be integrated into the core training curriculum of emergency physicians. Presented here is a model observation medicine longitudinal training curriculum, which can be integrated into an emergency medicine (EM) residency. It was developed by a consensus of content experts representing the observation medicine interest group and observation medicine section, respectively, from EM's two major specialty societies: the Society for Academic Emergency Medicine (SAEM) and the American College of Emergency Physicians (ACEP). The curriculum consists of didactic, clinical, and self-directed elements. It is longitudinal, with learning objectives for each year of training, focusing initially on the basic principles of observation medicine and appropriate observation patient selection; moving to the management of various observation appropriate conditions; and then incorporating further concepts of OU management, billing, and administration. This curriculum is flexible and designed to be used in both academic and community EM training programs within the United States. Additionally, scholarly opportunities, such as elective rotations and fellowship training, are explored. PMID:26806664

  15. Outline of LI Dong-yuan's Academic Thinking on Advocating the Application of "Wind Medicine"%李东垣倡风药应用学术思想述要

    张真全

    2012-01-01

    The history of using "wind medicine" was briefly elaborated through studying literature, especially Li Dong-yucai's academic thinking on using wind medicine was emphatically pointed out, in which he stresses primordial Qi, advocating the acquired constitution (spleen) nourishes the congenital one (kidney); stresses the spleen and stomach, advocating to invigorate the middle with the drugs of sweet and warm nature; stresses descending and ascending, advocating ShaoYang governs sprout and growth; stresses wind medicine, advocating wind medicine ascending Yang.%从文献角度梳理了"风药"使用的历史,重点阐述了金元四大家之一的李东垣重视风药应用的学术思想:重元气,倡后天养先天;重脾胃,倡甘温补中;重升降,倡少阳生发;重风药,倡风药升阳.

  16. Developing a Research Agenda to Optimize Diagnostic Imaging in the Emergency Department: An Executive Summary of the 2015 Academic Emergency Medicine Consensus Conference.

    Marin, Jennifer R; Mills, Angela M

    2015-12-01

    The 2015 Academic Emergency Medicine (AEM) consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The specific aims of the conference were to: 1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; 2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and 3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Over a 2-year period, the executive committee and other experts in the field convened regularly to identify specific areas in need of future research. Six content areas within emergency diagnostic imaging were identified prior to the conference and served as the breakout groups on which consensus was achieved: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. The executive committee invited key stakeholders to assist with planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were 164 individuals involved in the conference spanning various specialties, including emergency medicine (EM), radiology, surgery, medical physics, and the decision sciences. This issue of AEM is dedicated to the proceedings of the 16th annual AEM consensus conference as well as original research related to emergency diagnostic imaging. PMID:26581181

  17. The academic medical centre: an idea whose time has come.

    Sinclair, D G

    1993-05-01

    Interdependence of faculties of medicine or health sciences and teaching hospitals is central to the academic medical centre's three "products": education, research and clinical service. Whether a voluntary association, partnership, joint venture or single entity, the strength of the association of member institutions must lie in mutual dependency. With the potential of reducing costs and increasing effectiveness through administrative efficiency and rationalization, especially of planning and setting priorities, the academic medical centre can outstrip its individual member institutions in contributing to the solution of Canada's present and future challenges in health care. PMID:8477377

  18. Identifying Knowledge Sharing Barriers in the Collaboration of Traditional and Western Medicine Professionals in Chinese Hospitals: A Case Study

    Zhou, Lihong; Nunes, Miguel Baptista

    2012-01-01

    This paper reports on a research project that aims at identifying knowledge sharing (KS) barriers between traditional and western medicine practitioners co-existing and complementing each other in Chinese healthcare organisations. The study focuses on the tacit aspects of patient knowledge, rather than the traditional technical information shared…

  19. Beyond a curricular design of convenience: replacing the noon conference with an academic half day in three internal medicine residency programs.

    Batalden, Maren K; Warm, Eric J; Logio, Lia S

    2013-05-01

    Several residency programs have created an academic half day (AHD) for the delivery of core curriculum, and some program Web sites provide narrative descriptions of individual AHD curricula; nonetheless, little published literature on the AHD format exists. This article details three distinctive internal medicine residency programs (Cambridge Health Alliance, University of Cincinnati, and New York Presbyterian/Weill Cornell Medical College) whose leaders replaced the traditional noon conference curriculum with an AHD. Although each program's AHD developed independently of the other two, retrospective comparative review reveals instructive similarities and differences that may be useful to other residency directors. In this article, the authors describe the distinct approaches to the AHD at the three institutions through a framework of six core principles: (1) protect time and space to facilitate learning, (2) nurture active learning in residents, (3) choose and sequence curricular content deliberately, (4) develop faculty, (5) encourage resident preparation and accountability for learning, and (6) employ a continuous improvement approach to curriculum development and evaluation. The authors chronicle curricular adaptations at each institution over the first three years of experience. Preliminary outcome data, presented in the article, suggests that the transition from the traditional noon conference to an AHD may increase conference attendance, improve resident and faculty satisfaction with the curriculum, and improve resident performance on the In Training Examination. PMID:23524926

  20. Supporting the academic mission in an era of constrained resources: approaches at the University of Arizona College of Medicine.

    Joiner, Keith A; Libecap, Ann; Cress, Anne E; Wormsley, Steve; St Germain, Patricia; Berg, Robert; Malan, Philip

    2008-09-01

    The authors describe initiatives at the University of Arizona College of Medicine to markedly expand faculty, build research along programmatic lines, and promote a new, highly integrated medical school curriculum. Accomplishing these goals in this era of declining resources is challenging. The authors describe their approaches and outcomes to date, derived from a solid theoretical framework in the management literature, to (1) support research faculty recruitment, emphasizing return on investment, by using net present value to guide formulation of recruitment packages, (2) stimulate efficiency and growth through incentive plans, by using utility theory to optimize incentive plan design, (3) distribute resources to support programmatic growth, by allocating research space and recruitment dollars to maximize joint hires between units with shared interests, and (4) distribute resources from central administration to encourage medical student teaching, by aligning state dollars to support a new integrated organ-system based-curriculum. Detailed measurement is followed by application of management principles, including mathematical modeling, to make projections based on the data collected. Although each of the initiatives was developed separately, they are linked functionally and financially, and they are predicated on explicitly identifying opportunity costs for all major decisions, to achieve efficiencies while supporting growth. The overall intent is to align institutional goals in education, research, and clinical care with incentives for unit heads and individual faculty to achieve those goals, and to create a clear line of sight between expectations and rewards. Implementation is occurring in a hypothesis-driven fashion, permitting testing and refinement of the strategies. PMID:18728439

  1. Nuclear medicine

    Despite an aggressive, competitive diagnostic radiology department, the University Hospital, London, Ontario has seen a decline of 11% total (in vivo and in the laboratory) in the nuclear medicine workload between 1982 and 1985. The decline of in vivo work alone was 24%. This trend has already been noted in the U.S.. Nuclear medicine is no longer 'a large volume prosperous specialty of wide diagnostic application'

  2. The hospital Internal Medicine specialist today: a literature review and strength, weaknesses, opportunity, threats (SWOT analysis to develop a working proposal

    Emilio Scotti

    2013-12-01

    Full Text Available The aim of the paper is to identify the role of the hospital Internal Medicine specialist in the Internal Medicine Unit (IMU through a clinical and statistical analysis of the patients referred to them by identifying the activities that differentiate them from patients in General Medicine and Emergency Departments, i.e. diagnosis and treatment of complex patient with varying degrees of instability, identifying priorities in the acute problems of co-morbidities. The modified early warning score (MEWS, an internationally validated marker, was chosen to assess and stratify the clinical instability of patients referred to the IMU. A literature review was carried out, and a cut-off score of 3 was chosen to define the critical patients referred to the IMU; a MEWS value of 4 defines the need for transfer to the Intensive Care Unit (ICU or Intensive Cardiac Care Unit (CCU, considered the primary end point in most of the studies examined. To better characterize the internist’s role today, a strength, weaknesses, opportunity, threats (SWOT analysis was performed and examined, and commented upon. A total of 101 articles were reviewed and 5 were selected. The case histories relating to the IMU appear to be made up of complex patients with conditions that are, in most cases, acute and unstable. From 10% to 17% of patients present a MEWS of 3 or more that defines a condition of severe clinical instability requiring continuous observation and non-invasive multi-parametric monitoring. From 5% to 7% of cases present a MEWS of 4 or more and therefore require transfer to the ICU/CCU or risk rapid death. Approximately 40% of patients present MEWS of 1-2 and still have disease flare-up, but with a lesser degree of instability; however, these patients could experience a potentially negative disease development if not promptly and properly treated. Approximately 40% of patients have MEWS of 0 and represent the group of fragile patients that cannot be studied

  3. Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: a cross sectional survey

    Ahmed Waqas; Spogmai Khan; Waqar Sharif; Uzma Khalid; Asad Ali

    2015-01-01

    Introduction. Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements. Psychological stress, anxiety, depression and sleep disturbances are highly prevalent in medical students. Methods. This cross-sectional study was undertaken at the Combined Military Hospital Lahore Medical College and the Institute of Dentistry in Lahore (CMH LMC), Pakistan. Students enrolled in all yearly courses for the Bachelor of Medicine and...

  4. Rational use of Medicines in Relation to Pharmaceutical Supply System in Municipal Hospitals of Dar-es-salaam Region

    Protas, Bwile PB

    2011-01-01

    Pharmaceutical management involves set of practices aiming at ensuring timely availability and appropriate use of safe, effective and quality pharmaceuticals and services in any health care setting. Rational use of medicines is often associated efficiency of pharmaceutical supply system that operates in the health care system. Pharmaceutical supply system involves planning and programming for pharmaceutical requirements, procurement, storage and distribution which are the necessary steps towa...

  5. Establishment of cDNA Microarray Analysis at the Genomic Medicine Research Core Laboratory (GMRCL) of Chang Gung Memorial Hospital .

    Tzu-Hao Wang; Yun-Shien Lee; En-Shih Chen; Wei-Hsiang Kong; Lung-Kun Chen; Ding-Wei Hsueh; Min-Li Wei; Hsing-Shih Wang; Ying-Shiung Lee

    2004-01-01

    Background: Advances in molecular and computational biology have led to the developmentof powerful, high-throughput methods for analysis of differential geneexpression, which are opening up new opportunities in genomic medicine.DNA microarray technology has been enthusiastically integrated into basicbiomedical research and will eventually become a molecular monitoring toolfor various clinical courses.Methods: As a core research facility of Chang Gung University (CGU) and ChangGung Memorial Ho...

  6. Utilization of and Attitudes towards Traditional Chinese Medicine Therapies in a Chinese Cancer Hospital: A Survey of Patients and Physicians

    McQuade, Jennifer L.; ZhiQiang Meng; Zhen Chen; Qi Wei; Ying Zhang; WenYing Bei; J. Lynn Palmer; Lorenzo Cohen

    2012-01-01

    Background. In China, the use of traditional Chinese medicine (TCM) is very popular, but little is known about how it is integrated with conventional cancer care. We conducted parallel surveys of patients and physicians on TCM utilization. Methods. Two hundred forty-five patients and 72 allopathic physicians at the Fudan University Shanghai Cancer Center completed questions on their use of and attitude towards TCM. Results. Patient mean age was 51, with 60% female. Eighty-three percent of pa...

  7. A comparative study of knowledge and attitudes regarding biomedical waste (BMW management with a preliminary intervention in an academic hospital

    Violet N Pinto

    2014-01-01

    Full Text Available Aims: 1 To assess and compare the knowledge and attitudes regarding biomedical waste (BMW management in specialists, resident doctors, new medical interns, and final year nursing students. 2 To assess the effectiveness of a training program in changing the knowledge and attitudes regarding BMW management. Study Design: Stage 1-descriptive, Stage 2-quasi-experimental. Participants: Specialists, resident doctors, new medical interns, and final year nursing students. Setting: Tertiary hospital with attached medical college in Navi Mumbai. Data Collection tool: Pretested, precoded self-administered questionnaire. Intervention: Educational training program on BMW management, Period of Study: December 2010-March 2011. Statistical Analysis: Using software Statistical Package for Social Sciences (SPSS version 20, chi-square, analysis of variance (ANOVA, Tukey's post hoc, and Z tests applied. Results: There was a statistically significant difference in the knowledge scores between the groups as determined by a one-way ANOVA test (F (3,226 = 11.098, P < 0.001. A Tukey's post hoc test revealed that the specialists (20.82 ± 5.121 knowledge scores were significantly higher as compared to resident doctors (16.96 ± 5.268, medical interns (18.44 ± 4.293, and nursing group (15.33 ± 5.144. The positive attitude towards safe management of BMW was not found to be significant. After the training program in the medical interns' a statistically significant increase in their knowledge on BMW management was seen. Conclusion: The knowledge and attitudes between the groups of healthcare personnel varied and was not found to be satisfactory. Training programs with periodical sensitization sessions on BMW management are recommended, especially focusing at the junior level.

  8. Academics explore humidity's benefits.

    Mortimer, Dave

    2008-11-01

    The effects of humidification on hospital superbugs are being explored by some of the UK's top academics, in what Dave Mortimer, national sales manager for Vapac Humidity Control, explains are the UK's first such studies. PMID:19044148

  9. Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital. Measurable changes in academic quality indicators?

    Purpose: to evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. Materials and methods: after implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. Results: the evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. Conclusion: the evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological Univ. Hospital after implementation of a QM system according to DIN ISO 9001:2000. (orig.)

  10. An intensive monitoring of adverse drug reaction in indoor patients of medicine department at tertiary care teaching hospital

    Nishita H. Darji; Shilpa Jadav; Chintan Doshi; Rutvij Hedamba; Rusva Mistry; Hiren Trivedi

    2016-01-01

    Background: Use of drugs itself may result into illness and death due to their adverse effects. In India 10-20% of inpatients developed adverse drug reactions. Most of these problems can be overcome by undertaking hospital based intensive monitoring. Objective of this study was to estimate the incidence and document the spectrum of ADRs in studied patients in terms of causality, severity, frequency, type and preventability. A prospective, observational, single centre study conducted among the...

  11. Hospital variation in use of secondary preventive medicine after discharge for first acute myocardial infarction during 1995-2004

    Rasmussen, Søren; Abildstrom, Steen Z; Rasmussen, Jeppe N;

    2008-01-01

    during 1995-2004. OUTCOME MEASURES: At least 1 prescription claim for angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, or statins within 90 days of discharge for AMI. FINDINGS: The odds ratios between hospitals in the highest and lowest deciles, adjusted for age, gender, period, income......, comorbidity, concomitant, and prior pharmaceutical therapy, in 1995 were 8.5 [95% confidence interval (CI), 5.5-12.2] for beta-blockers, 3.0 (2.3-3.7) for ACE inhibitors, and 6.2 (4.1-8.8) for statins. By 2004, the hospital variation had decreased for beta-blockers (3.2; 2.3-4.0) and statins (4.2; 3.......0-5.5) but had increased for ACE inhibitors (3.8; 2.7-4.9). All the changes over time were significant (P < 0.001). Geographical characteristics of the hospital explained 32% of the variation in use of beta-blockers in 2004 and 27% in 1995, 39% of the variation in use of ACE inhibitors in 2004 and 3% in 1995...

  12. Heart Surgery Experience in Hitit University Faculty of Medicine Corum Research and Training Hospital: First Year Results

    Adem Diken

    2014-03-01

    Full Text Available Aim: We aimed to assess the clinical outcomes of our department of cardiac surgery which was newly introduced in Hitit University Corum Education and Research Hospital. Material and Method: Between November 2012 and November 2013, a total of 110 open-heart surgeries were performed. Ten out of these (9.1% were emergency operations for acute ST elevation myocardial infarction Off-pump technique was used in 31 (29.2% patients and cardiopulmonary bypass was used in 75 (70.8%. A total of 106 patients received coronary artery bypass grafting, 1 received mitral reconstruction, 1 received Bentall procedure, 1 received tricuspid valve repair, 1 received mitral valve replacement, 1 received aortic valve replacement with aortic root enlargement and 1 received aortic supracoronary graft replacement. Results: Hospital mortality occurred in 1 (0.9% patient. Four patients (3.6% who were on dual antiaggregants underwent a revision for bleeding on the day of the operation. Morbidities occurred in 3 (2.7% patients. Atrial fibrillation occurred in 11 (10% patients and the normal sinus rhythm was achieved by amiodarone. Intraaortic balloon counterpulsation was used in 5 (4.5% patients. Discussion: The newly introduced cardiac surgery department of the Hitit University Corum Education and Research Hospital, which provides tertiary care to a wide rural community, serves with low morbidity and mortality.

  13. Use of the Joint British Society cardiovascular risk calculator before initiating statins for primary prevention in hospital medicine: experience from a large university teaching hospital

    Pankaj Garg

    2010-11-01

    Full Text Available Pankaj Garg, Prashanth Raju, Ewa Sondej, Erwin Rodrigues, Gershan DavisAintree Cardiac Centre, University Hospital Aintree, Liverpool, UKIntroduction: Statin therapy is a well established treatment for hyperlipidemia. However, little is known about prescribing of statins for primary prevention in the real world, and even less about what happens to patients requiring primary prevention who are seen in a secondary care setting. The purpose of this research was to investigate the appropriateness of statin prescriptions by using the Joint British Society cardiovascular disease (JBS CVD risk score for primary prevention in a large secondary care center.Methods: We retrospectively analyzed 500 consecutive patients in whom a statin prescription was initiated over a four-month period. We excluded patients who met secondary prevention criteria. We used the JBS CVD risk prediction chart to calculate 10-year composite risk. We also studied which statins were prescribed and their starting doses.Results: Of 500 patients consecutively started on statins in secondary care, 51 patients (10.2% were treated for primary prevention. Of these, seven (14% patients had a 10-year composite cardiovascular event risk of more than 20% (high-risk category, and were hence receiving appropriate therapy. Three main statins were prescribed for primary prevention, ie, atorvastatin (22 patients, 43%, simvastatin (25 patients, 49%, and pravastatin (four patients, 8%. The statins prescribed were initiated mainly at the 40 mg dose.Conclusions: Statin prescribing in secondary care for primary prevention is limited to about 10% of initiations. There is some overprescribing, because 86% of these patients did not require statins when risk-stratified appropriately. The majority of the prescriptions were for simvastatin 40 mg and atorvastatin 40 mg.Keywords: statins, primary prevention, hypercholesterolemia, cardiovascular disease, retrospective

  14. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    Rebecca Levy

    2010-01-01

    Full Text Available Background: Electronic medical records (EMRs provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution′s initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting strategy within the EMR. Methods: A focus group of our hospital′s transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater real-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encountered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also

  15. Plant-based Complementary and alternative medicine used by breast cancer patients at the Hospital Universitario San Ignacio in Bogotá, Colombia.

    Marcela Mercado

    2012-12-01

    Full Text Available The present study estimates the frequency of the use of plant-based Complementary and Alternative Medicine (CAM by breast cancer patients. From June to December of 2011, a self-administered questionnaire was given to 404 breast cancer patients receiving outpatient therapy at the Javeriana Oncology Center of the Hospital Universitario San Ignacio in Bogotá. The prevalence of patient CAM use was 57%, out of which 76% was based on plants like anamú, aloe, red fruits and soursop. Sixty-five percent of the patients had a positive perception of using medicinal plants and 57% used them simultaneously with the oncologist recommended allopathic treatment. We concluded that the frequency of CAM use in breast cancer patients at the Javeriana Oncology Center is within the prevalence range reported worldwide, despite differences in CAM types and frequencies. The high rates of plant-based CAM use without physician consent, brings about the lack of assessment of the synergic or antagonistic effects of CAM therapies on the allopathic treatment of breast cancer and evaluation of the antitumor and immunomodulatory potential of the traditionally used plants.

  16. Utilization of and Attitudes towards Traditional Chinese Medicine Therapies in a Chinese Cancer Hospital: A Survey of Patients and Physicians

    Jennifer L. McQuade

    2012-01-01

    Full Text Available Background. In China, the use of traditional Chinese medicine (TCM is very popular, but little is known about how it is integrated with conventional cancer care. We conducted parallel surveys of patients and physicians on TCM utilization. Methods. Two hundred forty-five patients and 72 allopathic physicians at the Fudan University Shanghai Cancer Center completed questions on their use of and attitude towards TCM. Results. Patient mean age was 51, with 60% female. Eighty-three percent of patients had used TCM. Use was greatest for Chinese herbal medicine (CHM; 55.8%. Only 1.3% of patients used acupuncture and 6.8% Qi Gong or Tai Qi. Sixty-three percent of patients notified their oncologist about TCM use. The most common reason for use was to improve immune function. CHM was often used with a goal of treating cancer (66.4%, a use that 57% of physicians agreed with. Physicians were most concerned with interference with treatment, lack of evidence, and safety. Ninety percent of physicians have prescribed herbs and 87.5% have used TCM themselves. Conclusion. The use of TCM by Chinese cancer patients is exceptionally high, and physicians are generally well informed and supportive of patients’ use. Botanical agents are much more commonly used than acupuncture or movement-based therapies.

  17. Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year

    Peppas Theodoros A

    2001-10-01

    Full Text Available Abstract Background Out of 1705 patients hospitalised for various reasons in the 3rd Internal Medicine Department of the Regional General Hospital of Nikaea, in Piraeus, 146(8,5% persons were admitted for drug intoxication between November 1999 and November 2000. Methods On average, these persons [male 50(34,2% – female 96(65,8%] were admitted to the hospital within 3.7 hours after taking the drug. Results The drugs that were more frequently taken, alone or in combination with other drugs, were sedatives (67.1%, aspirins and analgesics (mainly paracetamol (43.5%. 38.3% of patients had a mental illness history, 31.5% were in need of psychiatric help and 45.2% had made a previous suicide attempt. No death occurred during the above period and the outcome of the patients' health was normal. After mental state examination, the mental illnesses diagnosed were depression (20.96%, psychosis (15.32%, dysthymic disorder (16,2%, anxiety disorder (22.58% and personality disorder (8.87%. Conclusions Self-poisoning remains a crucial problem. The use of paracetamol and sedatives are particularly important in the population studied. Interpersonal psychiatric therapy may be a valuable treatment after people tried to poison themselves.

  18. EVALUATION OF ANXIETY & DEPRESSIVE SYMPTOMS IN PATIENTS WITH 1 ST EPISODE OF CHEST PAIN ATTENDING MEDICINE OUT PATIENT DEPARTMENT OF TERTIARY CARE TEACHING HOSPITAL

    Bhavik S.

    2015-06-01

    Full Text Available INTRODUCTION: As chest pain is an important symptom of coronary artery disease (CAD and other non - cardiac diseases , the presentation of the symptom often prompts referral to physicians for further investigation. Previous studies h ad shown significant as sociation between chest pain and D e pr e ssive and anxiety symptoms. AIMS AND OBJECTIVES: Evaluate and screen depressive symptoms , anxiety symptoms and somatic symptoms in patients with 1 st episode of chest pain attending medicine out - patient department of tertiary care teaching hospital. METHODOLGY : Cross - sectional observational study. Prior permission from institutional ethics committee of ‘SUMANDEEP VIDYAPEETH’ had been taken. 100 patients having first episosde of chest pain coming to M edicine opd of DHIRAJ HOSPITAL are recruited randomly after 1st December 2014. Each patient is given case r eport form containing sociodemographic data , patients medical history , depression and somatic symptoms scale and Hamilton’s anxiety scale (HAM - A. All data are entered in spss 16 and analysed with different ( S tatistical tests. Differences on categorical m easures will be reported as P value. The result is significant if P <0.05. RESULT: 38% & 49% patients have clinically significant depression and anxiety respectively. DSSS score is positively correlated with duration of chest pain. CONCLUSION : significant level of depression and anxiety found in 1 st episode of chest pain patients.

  19. Clinical Holistic Medicine: Factors Influencing The Therapeutic Decision-Making. From Academic Knowledge to Emotional Intelligence and Spiritual “Crazy” Wisdom

    Søren Ventegodt

    2007-01-01

    Full Text Available Scientific holistic medicine is built on holistic medical theory, on therapeutic and ethical principles. The rationale is that the therapist can take the patient into a state of salutogenesis, or existential healing, using his skills and knowledge. But how ever much we want to make therapy a science it remains partly an art, and the more developed the therapist becomes, the more of his/her decisions will be based on intuition, feeling and even inspiration that is more based on love and human concern and other spiritual motivations than on mental reason and rationality in a simple sense of the word. The provocative and paradoxal medieval western concept of the “truth telling clown”, or the eastern concepts of “crazy wisdom” and “holy madness” seems highly relevant here. The problem is how we can ethically justify this kind of highly “irrational” therapeutic behavior in the rational setting of a medical institution. We argue here that holistic therapy has a very high success rate and is doing no harm to the patient, and encourage therapists, psychiatrists, psychologist and other academically trained “helpers” to constantly measure their own success-rate. This paper discusses many of the important factors that influence clinical holistic decision-making. Sexuality could, as many psychoanalysts from Freud to Reich and Searles have believed, be the most healing power that exists and also the most difficult for the mind to comprehend, and thus the most “crazy-wise” tool of therapy.

  20. PATTERN OF NON - COMMUNICABLE DISEASES IN PATIENTS ATTENDING MEDICINE OPD AT A TERTIARY CARE HOSPITAL OF RANCHI, JHARKHAND

    Manisha

    2015-04-01

    Full Text Available BACKGROUND: Globally, non - communicable diseases (NCDs are increasingly recognized as a major cause of morbidity and mortality. These diseases have reached epidemic proportions, yet they could be significantly reduced, with millions of lives saved and untold suffering avoided, through reduction of their risk factors, early detection and timely treatments. Objective: To study the risk factors responsible for the development of non - communicable diseases in the patients attending Medicine OPD at RIMS, Ranchi. MATERIALS AN D METHODS : It was a cross - sectional observational study. The sample sizes of 207 patients were selected by Consecutive Sampling Method from OPD of Medicine department of Rajendra Institute of Medical Sciences, Ranchi, Jharkhand. Patients above 30 years of age irrespective of sex were selected in our study and road traffic accident cases & cases of blindness were excluded. Statistical Analysis was done in Proportions. RESULTS: Out of 207 cases 56 . 52% cases were NCD s . The most common age group was 50 - 59yrs. 3 9 . 31% followed by more than 60 yrs 29 . 05 %. The most common disease was cardiovascular 30 . 76 % followed by diabetes 24 . 78 %, respiratory diseases 18 . 80 % and obesity 16 . 23 %. The majorities of the sample belong to urban area 61 . 54 % and have sedentary life style 70 . 08 %, smoking habits 53 . 84 % and non - vegetarian eating habits 78 . 63 %. The disease is prevalent in business class 45 . 29 % followed by service holder 31 . 62 %. CONCLUSION: The studies revealed that majority of the subjects were physically inactive, non - vegetarian. They were consuming tobacco & alcohol, which are the risk factors of various non - communicable diseases like obesity, hypertension, diabetes, cardiovascular diseases.

  1. Multi-View Interaction Modelling of human collaboration processes: a business process study of head and neck cancer care in a Dutch academic hospital.

    Stuit, Marco; Wortmann, Hans; Szirbik, Nick; Roodenburg, Jan

    2011-12-01

    In the healthcare domain, human collaboration processes (HCPs), which consist of interactions between healthcare workers from different (para)medical disciplines and departments, are of growing importance as healthcare delivery becomes increasingly integrated. Existing workflow-based process modelling tools for healthcare process management, which are the most commonly applied, are not suited for healthcare HCPs mainly due to their focus on the definition of task sequences instead of the graphical description of human interactions. This paper uses a case study of a healthcare HCP at a Dutch academic hospital to evaluate a novel interaction-centric process modelling method. The HCP under study is the care pathway performed by the head and neck oncology team. The evaluation results show that the method brings innovative, effective, and useful features. First, it collects and formalizes the tacit domain knowledge of the interviewed healthcare workers in individual interaction diagrams. Second, the method automatically integrates these local diagrams into a single global interaction diagram that reflects the consolidated domain knowledge. Third, the case study illustrates how the method utilizes a graphical modelling language for effective tree-based description of interactions, their composition and routing relations, and their roles. A process analysis of the global interaction diagram is shown to identify HCP improvement opportunities. The proposed interaction-centric method has wider applicability since interactions are the core of most multidisciplinary patient-care processes. A discussion argues that, although (multidisciplinary) collaboration is in many cases not optimal in the healthcare domain, it is increasingly considered a necessity to improve integration, continuity, and quality of care. The proposed method is helpful to describe, analyze, and improve the functioning of healthcare collaboration. PMID:21867775

  2. 武汉市第五医院基本药物配备使用现状研究%Research on Equipment and Application Actualities of Essential Medicines in the Fifth Hospital of Wuhan

    徐洪

    2015-01-01

    Objectives To analyze the equipment and application actualities of Essential Medicines in the fifth hospital of Wuhan. Methods Data was collected from the Hospital Information System; the main indicators include the equipment rate, the equipment proportion and the sales proportion of Essential Medicines. Results The equipment rate, the equipment pro-portion and the sales proportion of Essential Medicines of the fifth hospital of Wuhan in 2012 is 57.64%, 28.10%, 19.54%, respectively. Conclusion The equipment and application proportion of Essential Medicines in The fifth hospital of Wuhan comply with the regulations of The Health Administrative Department, but the current strategies of the fifth hospital of Wuhan are not favorable to promote the Essential Medicines.%目的:分析武汉市第五医院基本药物配备使用现状。方法资料来源于HIS系统,主要指标包括基本药物配备率、基本药物配备比例、基本药物销售金额比例。结果2012年武汉市第五医院基本药物品种配备率、基本药物品种配备比率、基本药物销售金额比例分为57.64%、28.10%、19.54%。结论武汉市第五医院基本药物配备使用比例均符合卫生行政部门的规定,但医院现有策略不利于促进基本药物推广。

  3. Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records

    Hee Seung Choi

    2014-01-01

    Full Text Available Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patients, 62% were male and the average age was 50.20 years. Ninety percent of patients presented with LBP and 67% with sciatica. Eighty-four percent were diagnosed with herniated nucleus pulposus at time of surgery. Of these patients, 70% had pain recurrence 6 months or later, but 19% experienced no relief or immediate aggravation of pain after surgery. Many patients selected traditional Korean medicine treatment as primary means of postsurgery care (47%. When time to pain recurrence was short or pain persisted after surgery, return of symptoms at the same disc level and side was frequent. Conclusion. An integrative treatment model focusing on Korean medicine and used in conjunction with radiological diagnostics and conventional medicine is currently used as a treatment option for patients with pain after lumbar spine surgery.

  4. Recommendations on pre-hospital & early hospital management of acute heart failure : a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine

    Mebazaa, Alexandre; Yilmaz, M. Birhan; Levy, Phillip; Ponikowski, Piotr; Peacock, W. Frank; Laribi, Said; Ristic, Arsen D.; Lambrinou, Ekaterini; Masip, Josep; Riley, Jillian P.; McDonagh, Theresa; Mueller, Christian; deFilippi, Christopher; Harjola, Veli-Pekka; Thiele, Holger; Piepoli, Massimo F.; Metra, Marco; Maggioni, Aldo; McMurray, John; Dickstein, Kenneth; Damman, Kevin; Seferovic, Petar M.; Ruschitzka, Frank; Leite-Moreira, Adelino F.; Bellou, Abdelouahab; Anker, Stefan D.; Filippatos, Gerasimos

    2015-01-01

    Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to

  5. Hypoglycemia in the hospital

    Shomali, Mansur

    2011-01-01

    Hypoglycemia is a common adverse event affecting hospitalized patients with diabetes. This paper reviews the data regarding optimization of glucose in hospitalized patients, discusses the scope and significance of hypoglycemia in the hospital, and makes recommendations on how to reduce the risk of this serious adverse event. Keywords: hypoglycemia; hospital; diabetes; insulin(Published: 18 July 2011)Citation: Journal of Community Hospital Internal Medicine Perspectives 2011, 1: 7217 - DOI: 10...

  6. Comparison between the results of academic staff self assessment and those made by the students, Faculty of Medicine, Mazandaran University of Medical Sciences, 2006.

    H.M.Jafari; K.Vahidshahi; M. Kosaryan; Mahmoodi, M

    2007-01-01

    Abstract Background and purpose: Educational evaluation is a structured process for determination of quality and effectivness of an educational program. Of the most common and studied methods used for evaluation of academic staff is evaluation by students, however, "self-assessment" of the academic staff has not been videly used and there are few studies about it. So the purpose of this study was to assess the correlation between the results of the academic staff "self assessment" and assessm...

  7. Sleep medicine in Taiwan

    Chen, Ning-Hung; Hang, Liang-Wen; Lin, Chia-Mo

    2015-01-01

    The sleep medicine is a young medical science in Taiwan. It began from less than 10 sleep beds 20 years ago in four hospitals all over Taiwan. By the organization of sleep team in Chang Gung Memorial Hospital and the initiation of Taiwan Society of Sleep Medicine, sleep medicine becomes a popular medicine in the past decades. The setting of Sleep Society in 2002 is the milestone to promote the sleep medicine, educate the public and professionals, and control of the quality of clinical practic...

  8. Radiological safety analysis of the nuclear medicine service at the 'Hospital Nacional Dos de Mayo'/Peru

    For the purpose of applying for installation licenses for nuclear medicine, as it is required by the peruvian Law, it is necessary to make an analysis of safety and protection of the installation and its procedures, so that the technical criteria can be satisfied. Previous information includes a description of activities that employs I131 and Tc99m in the diagnosis and treatment. A description of the installations, surrounding areas and construction details is performed, especially in hot zones. The safety analysis takes into account the normal operation risk in terms of doses for each process or operation that is executed (for example: division, fraction, extraction, dilution, etc),the operation time and the frequency. The annual doses are not more than 5,88 mSv for diagnostics and 5 mSv in therapy. In accidental situations, events of individual contamination, spills, fire and explosion, which are the most likely to happen, have been taken into account. Due to these events, the doses are between 5.5 mSv and 0.53 mSv under reasonable assumptions. In view of the possibility of these normal and potential doses, it is necessary the implementation of procedures and specifications to complete the protection in the practice. The documents were evaluated and the installation license was granted. (authors). 7 refs., 1 fig

  9. Uso de hierbas medicinales en mujeres gestantes y en lactancia en un hospital universitario de Bogotá (Colombia The use of herbal medicine among pregnant and lactating women attending a university hospital in Bogota, Colombia

    Gloria Paulina Pulido Acuña

    2012-12-01

    Full Text Available Las mujeres durante la gestación y lactancia utilizan diferentes hierbas y es escasa la información en el ámbito clínico en Colombia. Objetivo: Describir las prácticas relacionadas con el uso de hierbas en mujeres gestantes y en lactancia del Hospital de San José, Bogotá (Colombia. Metodología: Estudio de corte transversal. Con un cuestionario estructurado se indagó el uso, la frecuencia, el modo y razones de uso, de las hierbas medicinales y de quién se aprendió la práctica. Resultados: El uso de hierbas en mujeres gestantes y en lactancia fue de 33.6% (IC95%: 29.2% - 38% y 36.6% (IC95%: 30.8% - 42.3%, respectivamente. En el grupo de gestantes la hierba más usada fue la manzanilla (36.7% y en las mujeres en lactancia fue el hinojo (65%. Conclusión: Las mujeres gestantes y en lactancia, utilizan hierbas para las molestias del embarazo, acelerar el parto, disminuir el frío y promover la producción de leche.The use of herbal supplements is a common practice about pregnant and lactating women, however in Colombia there is limited data regarding the extent of women's use of herbal medicines during pregnancy and breastfeeding. The aim of this study was to describe the patterns of herbal medication use among pregnant and lactating women at the Hospital San Jose in Bogota, Colombia. Methods: Cross-sectional study. A questionnaire was designed to measure the frequency of herbal supplementation, why women took the herbal medicine, form of supplements, and who recommended the supplements or how did they learn about the herbal supplements. Results: The use of herbal supplements among pregnant and lactating women is 33.6% (CI 95%: 29.2%-38% and 36.6 (CI 95%: 30.8%-42.3%, respectively. The most common supplement used by pregnant women is Chamomile (36,7%, and among lactating women is Fennel (Foeniculum vulgare (65%. Conclusion: Pregnant and breastfeeding women use herbal supplements for specific pregnancy-related problems, to induce labor, to

  10. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    Zhou, Quan

    2015-01-01

    Hua-fen Wang,1 Jing-fen Jin,1 Xiu-qin Feng,1 Xin Huang,1 Ling-ling Zhu,2 Xiao-ying Zhao,3 Quan Zhou4 1Division of Nursing, 2Geriatric VIP Ward, Division of Nursing, 3Office of Quality Administration, 4Department of Pharmacy, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, ...

  11. Radiation exposure to nuclear medicine staffs during 18F-FDG PET/CT procedures at Ramathibodi Hospital

    Donmoon, T.; Chamroonrat, W.; Tuntawiroon, M.

    2016-03-01

    The aim of this study is to estimate the whole body and finger radiation doses per study received by nuclear medicine staff involved in dispensing, administration of 18F-FDG and interacting with radioactive patients during PET/CT imaging procedures in a PET/CT facility. The whole-body doses received by radiopharmacists, technologists and nurses were measured by electronic dosimeter and the finger doses by ring dosimeter during a period of 4 months. In 70 PET/CT studies, the mean whole-body dose per study to radiopharmacist, technologist, and nurse were 1.07±0.09, 1.77±0.46, μSv, and not detectable respectively. The mean finger doses per study received by radiopharmacist, technologist, and nurse were 265.65±107.55, 4.84±1.08 and 19.22±2.59 μSv, respectively. The average time in contact with 18F-FDG was 5.88±0.03, 39.06±1.89 and 1.21±0.02 minutes per study for radiopharmacist, technologist and nurse respectively. Technologists received highest mean effective whole- body dose per study and radiopharmacist received the highest finger dose per study. When compared with the ICRP dose limit, each individual worker can work with many more 18F- FDG PET/CT studies for a whole year without exceeding the occupational dose limits. This study confirmed that low levels of radiation does are received by our medical personnel involved in 18F-FDG PET/CT procedures.

  12. Usage Pattern and Serum Level Measurement of Amikacin in the Internal Medicine Ward of the Largest Referral Hospital in the South of Iran: A Pharmacoepidemiological Study

    Namazi, Soha; Sagheb, Mohammad Mahdi; Hashempour, Mohammad Mahdi; Sadatsharifi, Arman

    2016-01-01

    Background: The inappropriate use of aminoglycosides has harmful effects such as the development of resistant pathogens and the incidence of nephrotoxicity and ototoxicity. Therefore, drug utilization evaluation of these drugs may improve their usage remarkably. The aim of this study was to assess the usage pattern of amikacin in an internal medicine ward. Methods: This cross-sectional study was conducted in the Internal Medicine Ward of Nemazee Teaching Hospital, Shiraz, Iran, in 2011. The guideline for amikacin use was approved by the institutional Pharmacy and Therapeutics Committee, and the study criteria were developed to assess several parameters involved in amikacin therapy such as appropriateness of drug use, dosage, duration of therapy, toxicity monitoring, and serum concentration assay. Serum concentration was assayed using a Cobas Mira AutoAnalyzer. Clinical and paraclinical parameters such as glomerular filtration rate, culture, microbial sensitivity, white blood cell count, and fever were collected. Results: Sixty-three patients were evaluated. Fifty-seven percent of the patients needed dose readjustment; however, it was not performed for 89% of them. Culture between 48 and 72 hours after amikacin administration was not controlled for 79% of the patients. In 19% of the patients, optimum therapeutic effect was not achieved. The mean±SD of the trough and peak concentrations was 7.63±5.4 μg/mL and 15.67±7.79 μg/mL, respectively. Forty-five percent of the trough and 38% of the peak levels were within the therapeutic range. The overall adherence of amikacin usage to the guideline was only 48%. Conclusion: To achieve appropriate treatment and prevent toxic effects, we recommend that pharmacokinetic dosing methods, amikacin guideline, and serum monitoring be considered. PMID:27217603

  13. A Cross-sectional Study Assessing Predictors of Essential Medicines Prescribing Behavior Based on Information-motivation-behavioral Skills Model among County Hospitals in Anhui, China

    Yun-Wu Zhao; Jing-Ya Wu; Heng Wang; Nian-Nian Li; Cheng Bian; Shu-Man Xu; Peng Li

    2015-01-01

    Background:The self-consciousness and practicality of preferentially prescribed essential medicines (EMs) are not high enough in county hospitals.The purposes of this study were to use the information-motivation-behavioral skills (IMB) model to identify the predictors of essential medicines prescribing behavior (EMPB) among doctors and to examine the association between demographic variables,IMB,and EMPB.Methods:A cross-sectional study was carried out to assess predictive relationships among demographic variables and IMB model variables using an anonymous questionnaire administered in nine county hospitals of Anhui province.A structural equation model was constructed for the IMB model to test the instruments using analysis of moment structures 17.0.Results:A total of 732 participants completed the survey.The average age of the participants was 37.7 ± 8.9 years old (range:22-67 years old).The correct rate of information was 90.64%.The average scores of the motivation and behavioral skills were 45.46 ± 7.34 (hundred mark system:75.77) and 19.92 ± 3.44 (hundred mark system:79.68),respectively.Approximately half(50.8%) of respondents reported that the proportion of EM prescription was below 60%.The final revised model indicated a good fit to the data (x2/df=4.146,goodness of fit index =0.948,comparative fit index =0.938,root mean square error of approximation =0.066).More work experience (β =0.153,P < 0.001) and behavioral skills (β =0.449,P < 0.001) predicted more EMPB.Higher income predicted less information (β =-0.197,P < 0.001) and motivation (β =-0.204,P < 0.001).Behavioral skills were positively predicted by information (β =0.135,P < 0.001) and motivation (β =0.742,P < 0.001).Conclusion:The present study predicted some factors of EMPB,and specified the relationships among the model variables.The utilization rate of EM was not high enough.Motivation and behavior skills were crucial factors affecting EMPB.The influence of demographic

  14. A study evaluating knowledge, attitude and practices of practitioners in the medicine department of tertiary care teaching rural hospital with respect to antihypertensives

    Jatin Patel

    2015-06-01

    Full Text Available Background: The aim of this study was to evaluate knowledge, attitude and practices of practitioners in the medicine department of tertiary care teaching rural hospital with respect to antihypertensives and find out the disparity between the recommended and actual practices for pharmacological management. Methods: It was survey type of study, carried out using feedback questionnaire related to use of antihypertensives. Total 25 consultants were included in the study. Results: It was found that in mild hypertension single drug and two drugs in combination were preferred by 15 and 10 practitioners respectively. In moderate hypertension single drug, two drugs in combination, and greater than two drugs were preferred by 3, 13, and 7 practitioners respectively. In severe hypertension two drugs in combination and greater than two drugs were preferred by 16 and 9 practitioners respectively; none preferred single drug. Angiotensin converting enzyme inhibitors /angiotensin receptor blockers, beta blockers, Calcium channel blockers, diuretics were preferred as first line drug by 7, 4, 8, and 16 practitioners respectively. Most commonly preferred combination was Losartan and amlodipine by 16 practitioners. In pregnancy nifedipine was preferred as the first line drug while in elderly diuretics were preferred. In hypertensive patients with age less than 40 years all practitioners preferred ACEIs/ARBs. In diabetics ACEIs/ARBs was preferred by all practitioners. Each practitioner claimed to follow Joint National Committee (JNC 7 criteria. Cost of drug was an important consideration in all their prescribing patterns. Conclusion: The knowledge, attitudes and practices followed by the practitioners of Dhiraj hospital were satisfactory and guidelines oriented. [Int J Res Med Sci 2015; 3(3.000: 715-717

  15. Medicina de Família no Brasil e excelência acadêmica Brazilian Family Medicine and academic excellence Medicina familiar en Brasil y excelencia académica

    Domhnall MacAuley

    2012-02-01

    .Is research really necessary? Most of us are general practitioners because we are interested in people and their illnesses. Spending time in libraries and in laboratories and writing papers were not a priority. But, ask any family doctor if he/she is interested in finding out how illness affects his/her patients, how he/she might best treat them in the community, and how to provide the best healthcare, and he/she would undoubtedly agree. Research asks these very questions. If the discipline of General Practice is to flourish, research is not an option, it is a necessity. Asking how we can improve the healthcare for our patients is part of our discipline.Who should be involved in research? Others are already researching community healthcare in Brazil. A quick literature search shows that a lot of this is undertaken by hospital specialists. Therefore, it is important that general practitioners be part of this work. It is not enough to let others lead the way. It perpetuates the belief that General Practice is a second-class academic discipline and it will delay our acceptance as equals among the medical specialties. If General Practice is to be valued by peers in other branches of medicine, we must compete in the areas that they value. And, although we may not like it, the key criteria against which every academic discipline is measured, are academic endeavour, research publications, and higher degrees. For us to take our place as an academic discipline, there must be a vibrant General Practice research culture, which means that general practitioners will need to undertake university based Master’s and Doctoral level degrees and publish research. Not someone else – that means you.Will it be difficult to create a research culture? Yes, but you have huge advantages. You already have a university academic department of General Practice. Most of the other countries leading General Practice research had to fight this battle before you. You have a superb General Practice

  16. Managing end-of-life decision making in intensive care medicine--a perspective from Charite Hospital, Germany.

    Jan A Graw

    Full Text Available INTRODUCTION: End-of-life-decisions (EOLD have become an important part of modern intensive care medicine. With increasing therapeutic possibilities on the one hand and many ICU-patients lacking decision making capacity or an advance directive on the other the decision making process is a major challenge on the intensive care unit (ICU. Currently, data are poor on factors associated with EOLD in Germany. In 2009, a new law on advance directives binding physicians and the patient's surrogate decision makers was enacted in Germany. So far it is unknown if this law influenced proceedings of EOLD making on the ICU. METHODS: A retrospective analysis was conducted on all deceased patients (n = 224 in a 22-bed surgical ICU of a German university medical center from 08/2008 to 09/2010. Patient characteristics were compared between patients with an EOLD and those without an EOLD. Patients with an EOLD admitted before and after change of legislation were compared with respect to frequencies of EOLD performance as well as advance directive rates. RESULTS: In total, 166 (74.1% of deaths occurred after an EOLD. Compared to patients without an EOLD, comorbidities, ICU severity scores, and organ replacement technology did not differ significantly. EOLDs were shared within the caregiverteam and with the patient's surrogate decision makers. After law enacting, no differences in EOLD performance or frequency of advance directives (8.9% vs. 9.9%; p = 0.807 were observed except an increase of documentation efforts associated with EOLDs (18.7% vs. 43.6%; p<0.001. CONCLUSIONS: In our ICU EOLD proceedings were performed patient-individually. But EOLDs follow a standard of shared decision making within the caregiverteam and the patient's surrogate decision makers. Enacting a law on advance directives has not affected the decision making-process in EOLDs nor has it affected population's advance care planning habits. However, it has led to increased EOLD

  17. Nuclear medicine

    The task of the Expert Committee was to review the technical development and efficacy of nuclear medicine methods and to recommend the best possible means of establishing nuclear medicine services at various levels of medical care in different countries. After reviewing the contributions which nuclear medicine can make, the various types of medical institutions and hospitals in existence, the requirements, organization and funding of nuclear medicine services, and the cost/effectiveness of nuclear medicine, a number of recommendations were made. IAEA and WHO should make information on existing methods of cost/effectiveness analysis widely available; invite governments to include a description of such analysis methods in training programmes of their health officers; assist in the acquisition of the necessary data; and encourage and eventually support actual applications of such analyses to carefully selected nuclear medicine procedures in varying medicosocial environments. They were further recommended to study possible ways of improving reliability and ease of servicing nuclear medicine equipment, and extent of possible local construction; the possibility of making available supplies of matched characterized reagents for radioimmunoassay and related techniques; and to study the advantages of establishing a network of collaborating centres on an international basis

  18. Essential Medicines in a High Income Country: Essential to Whom?

    2015-01-01

    Objective To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an “essential” medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. Methods In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Findings Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. Conclusions This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach

  19. Clinical characteristics of very old patients hospitalized in internal medicine wards for heart failure: a sub-analysis of the FADOI-CONFINE Study Group

    Paolo Biagi

    2014-03-01

    Full Text Available The incidence and prevalence of chronic heart failure are increasing worldwide, as is the number of very old patients (>85 years affected by this disease. The aim of this sub-analysis of the multicenter, observational CONFINE study was to detect clinical and therapeutic peculiarities in patients with chronic heart failure aged >85 years. We recruited patients admitted with a diagnosis of chronic heart failure and present in the hospital in five index days, in 91 Units of Internal Medicine. The patients’ clinical characteristics, functional and cognitive status, and the management of the heart failure were analyzed. A total of 1444 subjects were evaluated, of whom 329 (23.1% were over 85 years old. Signs and symptoms of chronic heart failure were more common in very old patients, as were severe renal insufficiency, anemia, disability and cognitive impairment. The present survey found important age-related differences (concomitant diseases, cognitive status among patients with chronic heart failure, as well as different therapeutic strategies and clinical outcome for patients over 85 years old. Since these patients are usually excluded from clinical trials and their management remains empirical, specific studies focused on the treatment of very old patients with chronic heart failure are needed.

  20. [The role of the Faculty of Medicine in the process of academic modernization and professionalization at the University of Buenos Aires, 1955-1958: issues in debate and points of convergence].

    Romero, Lucía

    2010-01-01

    The article analyzes the relations between the process of academic modernization at the University of Buenos Aires in the mid-1950s and the individuals who led this process, influenced by innovative views, transformations, and people from the Faculty of Medicine. This reconstruction of the debates, proposals, and actual changes at the Faculty focuses especially on Alfredo Lanari, who, at the First Congress on Medical Education, held by the Argentinean Medical Association in 1957, put forward ideas on clinical research, teaching, and health care that showed how complicated full-time work would be for someone with the professional profile of a clinical researcher. PMID:21461533

  1. Emergency medicine in Nepal: present practice and direction for future.

    Pandey, Nishant Raj

    2016-12-01

    Emergency medicine is one of the youngest recognized specialties in Nepal, and its growth in clinical practice and academic development has been challenging. In this paper, we reviewed the current state of emergency medicine in Nepal based on review of the literature, personal observations and experience, and interviews with many Nepali and foreign emergency physicians. Most hospitals in Nepal have adopted a multi-specialist approach, where emergency room physicians are primarily general practitioners/family physicians or house officers. As physicians are receiving their training via various pathways, national standards in training and certification have not been developed. As a result, the scope of practice for emergency physicians and the quality of care vary greatly among hospitals. Difficult working conditions, physician recruitment, compensation, and academic enrichment remain major challenges in the development of emergency medicine. For the sustainable development of this specialty, more international guidance and local leadership is needed to standardize the training curriculum, to provide adequate funding opportunities for academic development and to promote the overall development of the emergency care system. PMID:27416937

  2. [PUBLIC MEDICINE AND RESEARCH-- IMPORTANT AND CHALLENGING].

    Pillar, Giora; Shapira, Chen

    2015-06-01

    Fellows who travel to the US are familiar with the American concept of combining clinical medicine and research. Research activity enforces reading, being updated, thinking creatively initiating, opening horizons, and being in contact with researchers all over the world. Thus, performing research is advantageous not only for research itself, the public, the patients and the knowledge, but also for the development of the researcher, the hospital, and the academic institute with which the hospital is affiliated. However, given the huge clinical workload and obligations, along with the shortage of physicians, the time consuming nature of research activity and the difficulties in obtaining research funds, it is certainly not obvious that clinicians can manage to conduct research and publish it. Decision makers, policy determinants and the individual drive to academic progress, encourage research activity by physicians, albeit the external support is commonly theoretical and moral, and is not commonly combined with time or appropriate resource allocation. In the current issue of "Harefuah", physicians from the Lady Davis Carmel Medical Center publish their own research and review articles. The hospital is the second largest in the Haifa region, providing services to a population of over a million people. The manuscripts reflect only a small sample of the research and clinical activities of the hospital. PMID:26281075

  3. Commentary: The battle of Louisville: money, power, politics, and publicity at an academic medical center.

    Halperin, Edward C

    2011-10-01

    In 2009, the entire clinical faculty of the Department of Neurosurgery of the University of Louisville School of Medicine elected to become employees of a nearby community hospital. This took place in the context of the financial burden of caring for the indigent, declining reimbursement, clinical demands for neurosurgical coverage of a level 1 trauma center, rising salaries for neurosurgeons, and competitive pressure on hospitals. The author, who was dean of the school of medicine at the time, would not accept the abrupt withdrawal of these clinicians from the faculty practice plan, single-point contracting, and academic governance of clinical work assignments. Politicians, the press, and accreditation bodies quickly weighed in as the university, the school, and the public good were placed in jeopardy. The motivations for this event-the community hospital defending its market share and physician recruitment and retention pipeline, the dean defending principles of academic governance and the faculty practice plan-and the responses of the participants offer an instructive case study for academic medical management. The author concludes that one might view the protagonists of this episode not as defenders of principles but, rather, as pawns in a larger drama playing out related to a perfect storm of economic and social pressures in American medicine. PMID:21955714

  4. Evaluate outcomes in treating brain tumors and intracranial diseases patients with Rotating Gamma Knife (RGK) at The Nuclear Medicine and Oncology Center, Bach Mai Hospital

    The paper presents results of evaluating the rotating gamma knife (RGK) radiosurgery at The Nuclear Medicine and Oncology Center, Bach Mai Hospital from July 2007 to May 2015.Patients: 3224 patients diagnosed with brain tumors and intracranial diseases were prescribed radiosurgery by RGK. Results: Average age was 46.8 years old. Age at the time of radiosurgery ranged from 2.5 (youngest) to 91 (oldest). The male=51.1/female=48.9. The median tumor size was 2.3 ± 1.2 cm (range 0.2 - 6.4 cm). The median prescribed dose was: pituitary tumor (14.4±2.1 Gy), meningioma (22.5±2.7 Gy), AVM (20.4±1.8 Gy), acoustic neuroma (14.1±1.9 Gy), brain metastases (20.2±2.4 Gy), craniopharyngeal tumor (12.8±1.4 Gy), pineal tumor (16.3±1.8 Gy), cavernoma (24.2±2.1 Gy), glioma (16.6±2.5 Gy), medulloblastoma (16.1±2 Gy), ependymoma (17.3±2.6 Gy), lymphoma (15.3±2.7 Gy), others (15.1±2.6 Gy). Conclusions: In comparison with pretreatment, clinical symptoms have been improved in the patients after one month and been more remarkable after six months. Complete clinical response at 1 year: 73.4%; 2 years: 82.6%; 3 years: 84.1%; 4 years: 86.8%; 5 years: 90.3%; 6 years: 94.6%. Average sizes of the tumors were reduced remarkably, started from the 3rd month to 1 year after treatment: 2±0.8 cm; after 2 years: 1.9±1.2 cm; 3 years: 1.4±0.8 cm; 4 years: 0.8±1.1 cm; 5 years: 0.4±0.6 cm; 6 years: 0.3±0.5 cm. Major complications were reported after RGK 3 to 6 months, such as: fatigue (28.4%), insomnia (22.3%), anorexia (12.7%), head ache (13.9%) and. others were less common. These complications had been controlled with medicine. (author)

  5. 近代山西第一种中医药学术期刊——《医学杂志》%The first TCM academic journal of traditional Chinese medicine in Shanxi province-Medical Magazine

    杨继红

    2008-01-01

    山西作为民国以来山西第一种中医药学术期刊,在16年刊行过程中,汇集近代诸多名医,登载了大量有较高学术水平的中医药论著及相关文献,涉及中医药临床、中西医汇通、中医药教育等方面,为传播中医知识,维护民国时期中医药事业繁荣,促进学术交流,做出了积极贡献,是研究民国中医药发展的宝贵文献资料.%As the first academic journal of traditional Chinese medicine(TCM) in Shanxi province in the Republic of China,Medical Magazine published a large number of high quality TCM original articles and relevant literature written by numerous famous modern physicians during its development of 16 years,including TCM practice,the fusion of Chinese and western medicine,and TCM education,etc.It makes a positive contribution to the spreading of TCM knowledge,maintaining the flourish of TCM,and promoting the academic exchanges at that time,and is the precious materials for the research of TCM development in the Republic of China.

  6. Historical perspectives on health. Early Arabic medicine.

    Brewer, Harry

    2004-07-01

    The Arabian conquests during and after the 7th century led to a spread of Islam as well as the consequential influence of theology on health through the teachings of the Qur'an (Koran). Although traditional medicine was widely accepted and used, the character of early aggrandisement of Arabic medicine involved a facility for adapting and absorbing Graeco-Roman knowledge. The translation schools and libraries, famous in both the East and West, preserved and expanded the knowledge acquired. European academic learning owed much to the Arabs. Information came through Spain to Italy, France and, later on, England. The founding of hospitals, whilst not an Arab initiative, received a fillip from the religious prescriptions for care of the sick. The Military Orders developed specialist institutions for the sick, probably as a result of what they saw during their sojourn in the Middle East. The legacy of Arabic medical care is still with us today and deserves understanding and greater appreciation. PMID:15301318

  7. Evaluation The Result Of Treating 1200 Patients Brain Tumor And Some Intracranial Diseases By Rotating GAMMA Knife (RGK) At The Nuclear Medicine And Oncology Center, Bach Mai Hospital

    The paper is evaluating results of treating brain tumor and some intracranial diseases by rotating gamma knife (RGK) at The Nuclear Medicine and Oncology Center, Bach Mai Hospital, from July 2007 to August 2010, for 1200 patients treated with RGK. In 1200 patients - average age: 42.6 years old, Male/Female ratio:1/1.08 - pituitary tumors accounted for 19.8%, meningioma 18.3%, arteriovenous malformations (AVM) (16.7%), acoustic neuroma (8.7%), brain metastases (7.5%), craniopharyngeal tumor (5.0%), pineal tumor (3.5%), cavernoma (6%), astrocytoma (5.2%), meduloblastoma (2.9%), ependymoma (2.6%), others (3.8%). Average target volume: minimum 0.6cm3, maximum 27.6cm3, median 6.2 ± 4.6 cm3. Average radiosurgery dose changed depend on nature of the tumor: pituitary tumor (12.4 Gy), meningioma (18.8 Gy), AVM (18 Gy), acoustic neuroma (14.6 Gy), brain metastases (18.2 Gy), craniopharyngeal tumor (12.8 Gy), pineal tumor (16.3 Gy), cavernoma (17.5 Gy), astrocytoma (14.6 Gy), medulloblastoma (16.1 Gy), ependymoma (16.3 Gy), others (15 Gy). Conclusions: Almost case have improved clinical symptoms significantly: 80.2% after 1 month (complete response 20.2%), 100% at 36th month (complete response: 94%). Size of the tumor were reduced remarkably. Treatment were safe, no death or severe complications were observed within and after radiosurgery. (author)

  8. Pattern of antidiabetic drugs use in type-2 diabetic patients in a medicine outpatient clinic of a tertiary care teaching hospital

    Bela Patel

    2013-08-01

    Full Text Available Background: Diabetes mellitus (DM is an important public health problem in developing countries. Drug utilisation study of antidiabetic agents is of paramount importance to promote rational drug use in diabetics and make available valuable information for the healthcare team. The aim of study was to investigate the drug utilization pattern in type-2 diabetic patients. Methods: A prospective, cross-sectional study was carried out in medicine outpatient clinic of tertiary care hospital, Ahmedabad for eight weeks. Patients with type-2 diabetes and on drug therapy for at least one month were included. Patients’ socio-demographic and clinical data were noted in a pre-designed proforma. Data was analysed by using SPSS version 20 and Excel 2007. Results: Total 114 patients were enrolled with mean (± standard deviation age and duration of diabetes of 56.8 ± 10.5 and 8.3 ± 9.4 years respectively. Male: Female ratio was 0.72:1. Mean fasting and postprandial blood glucose levels were 147.5 ± 73.1 and 215.6 ± 97.3 mg/dl respectively. Most common symptom was weakness/fatigue (77.2%. Hypertension (70.2% was most common co-morbid illness. Mean number of drugs prescribed were 7.8 ± 2.5. Total numbers of patients receiving more than five drugs were 89.5%. Most commonly used drug group was biguanides (87.7% followed by sulphonylureas (68.4%. Conclusion: Metformin (biguanide was the most utilized (87.7% antidiabetic drug for type-2 diabetes. This study revealed that the pattern of antidiabetic prescription was rational and largely compliant with NICE (National Institute for Health and Clinical Excellence guidelines. [Int J Basic Clin Pharmacol 2013; 2(4.000: 485-491

  9. 我院实施高危药品风险管理的实践和体会%Practice and Experience of the Implementation of High-risk Medicines Risk Management in Our Hospital

    张华锋; 彭桂清; 李丽; 许静; 陈绪龙

    2012-01-01

    OBJECTIVE: To provide reference for reasonable application and management of high-risk medicines. METHODS: Based on the actual situation of our hospital and the potential risks of high-risk medicines, management pattern of high-risk medicines in our hospital was developed and the experience of clinical application of the pattern was summarized. RESULTS & CONCLUSIONS : We should formulate management pattern which includes the management of high-risk medicines control, improvement of drug storage and ward drug management and computer software for management enhancement, etc. We should also strengthen the understanding of clinical physician on high-risk medicines, management and use of high-risk medicines among nurses in order to improve drug safety management and ability of risk prevention.%目的:为高危药品的管理与临床合理应用提供参考.方法:结合我院实际情况,根据高危药品的潜在风险因素,制订我院高危药品的管理模式并总结其应用后的体会.结果与结论:我院建立的管理模式包括控制高危药品的使用管理、完善药房和病区药品管理和运用计算机软件系统加强管理等;还有加强临床医师对高危药品的相关认识、加强护理人员对高危药品的使用管理等,以提高药物安全管理水平和风险防范能力.

  10. Application of Oracle and Java for the development of medicine information search software in Wangjing Hospital%利用Oracle、Java开发我院药品信息查询软件

    宗志勇; 贾鹰珏; 刘小鹏; 张瑞丽; 苏爽; 刘权

    2015-01-01

    目的:开发药品信息查询软件,解决纸质说明书药品信息更新速度慢、查阅不方便等实际问题,为临床提供快捷的药学信息服务。方法根据临床和医院药学实际需求,通过药品说明书收集、整理、扫描、图像处理、信息提取等步骤,利用Oracle 10G构建医院药品信息库,使用Java开发药品信息查询软件。结果本软件共收录药品1201种,占我院药品目录品种数的98.85%。使用者可通过4种查询方式(通用名查询、商品名查询、模糊查询和关键词查询)获取药品说明书文字版信息和影印版信息。结论利用Oracle 、Java开发的药品信息查询软件可为临床提供实用快捷的药学信息服务。%Objective Since it is a common problem for medical practice that paper instructions for medicine information are difficult to update and inconvenient to search ,this article is to provide convenient service of pharmacy information for clini-cal practice by developing medicine information search software in our hospital .Methods According to the practical needs of clinical study and pharmacy research ,we took appropriate measures to collect data ,categorize contents ,scan pictures ,polish images and extract information for the medicine instructions .Based on the above work ,we applied Oracle 10G to establish medicine information database for our hospital and utilized Java to design medicine information search software .Results Our search software includes 1 201 kinds of medicines ,taking up 98 .85% of the medicines in our catalogue .The users can use four different search methods (including common name search ,commodity name search ,fuzzy search and key word search) to gain the written material and photographic information of medicine instructions .Conclusion With the help of the software of Oracle and Java ,the newly designed software for medicine information search can provide convenient pharmacy information service for

  11. Implementing a pilot leadership course for internal medicine residents: design considerations, participant impressions, and lessons learned

    Blumenthal, Daniel M; Bernard, Ken; Fraser, Traci N.; Bohnen, Jordan; Zeidman, Jessica; Stone, Valerie E

    2014-01-01

    Background Effective clinical leadership is associated with better patient care. We implemented and evaluated a pilot clinical leadership course for second year internal medicine residents at a large United States Academic Medical Center that is part of a multi-hospital health system. Methods The course met weekly for two to three hours during July, 2013. Sessions included large group discussions and small group reflection meetings. Topics included leadership styles, emotional intelligence, a...

  12. Implementing a pilot leadership course for internal medicine residents: design considerations, participant impressions, and lessons learned

    Blumenthal, Daniel M; Bernard, Ken; Fraser, Traci N.; Bohnen, Jordan; Zeidman, Jessica; Stone, Valerie E

    2014-01-01

    Background: Effective clinical leadership is associated with better patient care. We implemented and evaluated a pilot clinical leadership course for second year internal medicine residents at a large United States Academic Medical Center that is part of a multi-hospital health system. Methods: The course met weekly for two to three hours during July, 2013. Sessions included large group discussions and small group reflection meetings. Topics included leadership styles, emotional intelligence,...

  13. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    Wang HF; Jin JF; Feng XQ; Huang X.; Zhu LL; Zhao XY; Zhou Q

    2015-01-01

    Hua-fen Wang,1 Jing-fen Jin,1 Xiu-qin Feng,1 Xin Huang,1 Ling-ling Zhu,2 Xiao-ying Zhao,3 Quan Zhou4 1Division of Nursing, 2Geriatric VIP Ward, Division of Nursing, 3Office of Quality Administration, 4Department of Pharmacy, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, disp...

  14. The Phenomenon of Collaboration: A Phenomenologic Study of Collaboration between Family Medicine and Obstetrics and Gynecology Departments at an Academic Medical Center

    Brown, David R.; Brewster, Cheryl D.; Karides, Marina; Lukas, Lou A.

    2011-01-01

    Collaboration is essential to manage complex real world problems. We used phenomenologic methods to elaborate a description of collaboration between two departments at an academic medical center who considered their relationship to represent a model of effective collaboration. Key collaborative structures included a shared vision and commitment by…

  15. Structure and Activities of Nuclear Medicine in Kuwait.

    Elgazzar, Abdelhamid H; Owunwanne, Azuwuike; Alenezi, Saud

    2016-07-01

    The practice of nuclear medicine in Kuwait began in 1965 as a clinic for treating thyroid diseases. The practice developed gradually and until 1981 when the Faculty of Medicine established the Division of Nuclear Medicine in the Department of Radiology, which later became a separate department responsible for establishing and managing the practice in all hospitals of Kuwait. In 1987, a nuclear medicine residency program was begun and it is administered by Kuwait Institute for Medical Specializations originally as a 4-year but currently as a 5-year program. Currently there are 11 departments in the ministry of health hospitals staffed by 49 qualified attending physicians, mostly the diplomats of the Kuwait Institute for Medical Specializations nuclear medicine residency program, 4 academic physicians, 2 radiopharmacists, 2 physicists, and 130 technologists. These departments are equipped with 33 dual-head gamma cameras, 10 SPET/CT, 5 PET/CT, 2 cyclotrons, 1 breast-specific gamma imaging, 1 positron-emitting mammography, 10 thyroid uptake units, 8 technegas machines, 7 PET infusion systems, and 8 treadmills. Activities of nuclear medicine in Kuwait include education and training, clinical service, and research. Education includes nuclear medicine technology program in the Faculty of Allied Health Sciences, the 5-year residency program, medical school teaching distributed among different modules of the integrated curriculum with 14 didactic lecture, and other teaching sessions in nuclear medicine MSc program, which run concurrently with the first part of the residency program. The team of Nuclear Medicine in Kuwait has been active in research and has published more than 300 paper, 11 review articles, 12 book chapters, and 17 books in addition to 36 grants and 2 patents. A PhD program approved by Kuwait University Council would begin in 2016. PMID:27237444

  16. PROMOTE THE DEVELOPMENT OF ACUPUNCTURE MEDICINE AND ENHANCE LEVEL OF GLOBAL ACUPUNCTURE RESEARCHThe Fifth General Assembly of WFAS and the Fifth Academic Conference was rounded off in Seoul

    范玲玲

    2001-01-01

    The Fifth General Assembly of WFAS was held in Seoul, Republic of Korea, on November 12, 2 000. She Jing, Vice Health Minister and concurrent Director-General of State Administration of Traditional Chinese Medicine from the People's Republic of China and Hong-Bin Kang, Vice Mayor of Seoul, Republic of Korea, attended the opening ceremony and adressed at the assembly. They spoke highly of the contributions that WFAS has made to the development and application of acupuncture medicine. They pointed out that in the past 13 years since the establishement of WFAS, fruitful efforts have been made for the dissemination and development of acupuncture medicine in the world. The organizational structure of WFAS is becoming more mature in the process of promoting the development of acupuncture science and accelerating the mutual understanding and cooperation among acupuncture groups in the world. The development of WFAS has entered a new stage since WFA$ was admitted into official relations with WHO.

  17. Haptic medicine.

    Mason, Cindy; Mason, Earl

    2009-01-01

    The paper introduces haptic medicine--healthcare based on loving touch for healing and preventing disease. We describe the effects of loving touch (a square inch of our skin has over 1000 nerves) on the body, brain and mind. We describe two web-based health education and media projects. The first, HYPERLINK "http://www.21stcenturymed.org" www.21stcenturymed.org is a place for health practitioners to start learning about touch and resources. The second project, Humans Without Borders, is a multi-lingual self help education website for everyday people. Teaching materials for these projects are based on our previous work with a form of haptic medicine known as psychophysiophilosophy with patients at Stanford Hospital, Kaiser Permanente and Lucille Packard Children's Hospital. We describe psychophysiophilosophy, relate motherly love to recent discoveries in neurosciences and give hints on ways to increase motherly love in each of us. We present a plan for moving into the future by re-introducing haptic medicine into our daily lives through self-help and as an adjunct for current physician practice. There is an exercise in self-help for the reader and an appendix of recent clinical research with profound benefits on the use of human touch for over 40 conditions. PMID:19745495

  18. Evaluation of radiation dose to patients from Tc-99m during bone scan in nuclear medicine at Korle-Bu Teaching Hospital

    Internal dosimetry deals with the measurement of the radiation dose absorbed internally by an organ after the administration of isotopes for diagnosis and treatment. In the present study radiation absorbed dose has been calculated for technetium-99m methylene diphosphonate (Tc-99m MDP) which is used frequently for bone scan in Korle-Bu teaching hospital nuclear medicine department. In these cases a small amount of isotopes are accumulated in kidney, urinary bladder etc. Study on sixty-five patients undergoing bone scans has been performed quantitatively using e.soft software. The Tc-99m MDP doses were administered to the patients with activity ranging from 377.4 to 932.4 MBq depending on their weights, and were then scanned with an installed e.Cam SPECT system. A 256 × 1024 matrix size was used in acquiring the bone scans. Also the scans of five volunteer patients at three different times (1 hour, 2 hour and 3 hour after injection) were used to determine the residence time in the bladder and kidney. To determine the amount of activity in patient kidney and urinary bladder, conjugate view method was applied on images information. MIRD equation and OLINDA/EXM software were then used to estimate absorbed dose in different organs of patients. The absorbed value obtained from the two methods were compared. The activity in patient’s left kidney, right kidney and urinary bladder undergoing bone scan three hours after injection of Tc-99m were 1.52±0.48 MBq, 1.52±0.44 MBq 4.88±3.11MBq respectively. The residence time for the kidney and urinary bladder were 0.128±0.043 hour and 1.099±0.330 hour respectively. The absorbed dose per unit of injected activity (mGy/MBq) for bladder, kidneys, liver, lungs, red marrow, ovaries, pancreas, skin and spleen were calculated for the male and the female patients using the two methods. The absorbed dose values obtained from the two methods were compared. In the study for absorbed dose calculation, MIRD equation is in agreement with

  19. Prevalence of common canine digestive problems compared with other health problems in teaching veterinary hospital, Faculty of Veterinary Medicine, Cairo University, Egypt

    Gamal M. H. Rakha

    2015-03-01

    Full Text Available Aim: The present study was conducted to ascertain the prevalence of common digestive problems compared to other health problems among dogs that were admitted to the teaching veterinary hospital, faculty of veterinary medicine, Cairo University, Egypt during 1 year period from January to December 2013. Also, study the effect of age, sex, breeds, and season on the distribution of digestive problems in dogs. Materials and Methods: A total of 3864 dogs included 1488 apparently healthy (included 816 males and 672 females and 2376 diseased dogs (included 1542 males and 834 females were registered for age, sex, breed, and the main complaint from their owners. A complete history and detailed clinical examination of each case were applied to the aids of radiographic, ultrasonographic, and endoscopic examination tools. Fecal examination was applied for each admitted case. Rapid tests for parvovirus and canine distemper virus detection were also performed. Results: A five digestive problems were commonly recorded including vomiting, diarrhea, concurrent vomiting with diarrhea, anorexia, and constipation with a prevalence (% of 13.6, 19.1, 10.1, 13.1, and 0.5 respectively while that of dermatological, respiratory, urinary, neurological, cardiovascular, auditory, and ocular problems was 27.9, 10.5, 3.3, 0.84, 0.4, 0.25, and 0.17 (% respectively. This prevalence was obtained on the basis of the diseased cases. Age and breed had a significant effect on the distribution of digestive problems in dogs (p0.05 on the distribution of such problems. Conclusion: Digestive problems were the highest recorded problems among dogs, and this was the first records for such problems among dogs in Egypt. Age, gender, and breeds had a significant effect on the distribution of the digestive problems in dogs while season had a non-significant effect on the distribution of such problems. The present data enable veterinarians in Egypt to ascertain their needs for diagnostic tools

  20. Principle and Innovation of Performance Evaluation in Hospital of Traditional Chinese Medicine in Municipal City%地市级中医院绩效管理的原则和创新

    王进臣

    2011-01-01

    With the deepening of health care reform, it is the problem urgently to be solved in achieve performance appraisal system through the utilization of traditional Chinese medicine and the quickening of comprehensive reform of it. New problems and situation of city-level traditional Chinese hospitals is thought. Principles, which are following the development regulation of traditional Chinese medicine, grasping the functional orientation in regional health planning of hospitals, adhering to people oriented principle, stressing quality, making overall plans and taking all factors into consideration, and promoting and integrated development, should be paid attention to in performance reform. So the new thought of performance reform is achieved to provide references for perfecting hospital performance reform.%文章就地市级中医院在绩效改革中面临的新情况新问题,进行思考,提出绩效改革中应着重把握的原则:认真遵循中医药发展规律;把握医院在区域卫生规划中的职能定位;坚持以人为本;注重质量;"六位一体"统筹兼顾、全面发展.并在此基础上构想绩效改革的新思路,为完善医院绩效改革工作提供参考.

  1. University Medicine in Italy: an exemplary “case report” of several unresolved criticities

    Roberto Manfredi

    2010-12-01

    Full Text Available The present role, space, task, mission, function, and outcome of University Medicine in Italy are briefly examined, taking as a pure and trivial pretext the actual professional activity of single, representative physician who changed his role at the same specialistic Department of the same University Hospital, by covering an University role in the past five years, after working at the same facility as an Hospital-affiliated specialist in charge of the same Medical Division during the previous 14 years. The lights and shadows of assistential and academic medicine organisation and integration in Italy are the starting point of our preliminary observations, which may be potentially extended to the University Medicine as a whole, from an organisative, functional, and especially ergonomic point of view.

  2. Post-Academic Masters Course in Management of Transfusion Medicine : Why the Difference in Access to the eLearning Between Countries?

    Smit Sibinga, Cornelis; Greener, S; Rospigliosi, A

    2011-01-01

    Health care includes supportive services such as laboratory, radiology and blood transfusion. Blood safety and sustainability of the blood supply is increasingly organized on a WHO advocated nationally supported principle where regional blood procurement centres supply hospitals. To manage such regi

  3. Post-Academic Masters in Management of Transfusion Medicine (MMTM); an Evaluation of the eLearning Part of the Course

    Smit Sibinga, Cornelis; Escudeiro, P

    2010-01-01

    Health care includes supportive services such as laboratory, radiology and blood transfusion. Blood safety and sustainability of the blood supply is increasingly organized on a WHO advocated nationally supported principle where regional blood procurement centres supply hospitals. To manage such regi

  4. Social contract of academic medical centres to the community: Dr Howard Atwood Kelly (1858-1943), a historical perspective.

    Allen, Paul

    2016-05-01

    Academic medical centres have traditionally been bastions of teaching and research. Outreach to the community at large and involvement in community affairs have sometimes been lacking in the overall mission and activities of academic medical centres. This paper provides an historical perspective first on the numerous achievements of a physician and surgeon and then on the topic of involvement in community affairs by reviewing the many contributions of America's pioneer gynaecological surgeon and one of the four physician founders of the Johns Hopkins Hospital and School of Medicine in 1889 - Dr Howard Atwood Kelly. PMID:24906403

  5. Chair of a department of medicine: now a different job.

    Kastor, John A

    2013-07-01

    The job of chair of a department of medicine, once seen as the apex in the career of an academic internist, has lost much of its allure, in part because of increasing administrative and financial obligations that require more of the time and effort of chairs than formerly. This is the impression the author gathered from interviewing 44 current and former chairs, deans, division chiefs, and hospital directors.He was told that chairs have lost some of their independence as departments have become increasingly dependent on the support of the executives at their university hospitals who, as the source of funds and facilities, can even specify which clinical services the chairs may develop. Conflict over the assignment of resources between dean and hospital CEO, which one interviewee stated can produce "incredible tensions," can complicate efforts of chairs to build clinical and research strength within their departments according to their own preferences. The growing administrative and financial duties of the job have forced some chairs to decrease their dedication to the classic responsibilities of teaching medical students and house officers.Recruiting outstanding leaders for departments of medicine challenges search committees and deans more than in the past because many suitable candidates do not choose to be considered and prefer to lead institutes, centers, or specialty divisions. The author suggests, however, that schools-by providing chairs with adequate administrative support and authority-can structure the job to improve its attractiveness and allow chairs more time to engage in traditional academic pursuits. PMID:23799437

  6. The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors

    Dijkgraaf Marcel G

    2011-05-01

    Full Text Available Abstract Background The potential of clinical interventions, aiming at reduction of preventable Adverse Drug Events (preventable ADEs during hospital stay, have been studied extensively. Clinical Pharmacy is a well-established and effective service, usually consisting of full-time on-ward participation of clinical pharmacists in medical teams. Within the current Hospital Pharmacy organisation in the Netherlands, such on-ward service is less feasible and therefore not yet established. However, given the substantial incidence of preventable ADEs in Dutch hospitals found in recent studies, appears warranted. Therefore, "Ward-Oriented Pharmacy", an on-ward service tailored to the Dutch hospital setting, will be developed. This service will consist of multifaceted interventions implemented in the Internal Medicine wards by hospital pharmacists. The effect of this service on preventable ADEs in elderly inpatients will be measured. Elderly patients are at high risk for ADEs due to multi-morbidity, concomitant disabilities and polypharmacy. Most studies on the incidence and preventability of ADEs in elderly patients have been conducted in the outpatient setting or on admission to a hospital, and fewer in the inpatient setting. Moreover, recognition of ADEs by the treating physicians is challenging in elderly patients because their disease presentation is often atypical and complex. Detailed information about the performance of the treating physicians in ADE recognition is scarce. Methods/Design The design is a multi-centre, interrupted time series study. Patients of 65 years or older, consecutively admitted to Internal Medicine wards will be included. After a pre-measurement, a Ward-Oriented Pharmacy service will be introduced and the effect of this service will be assessed during a post-measurement. The primary outcome measures are the ADE prevalence on admission and ADE incidence during hospital stay. These outcomes will be assessed using structured

  7. The Discussion about Control Measures for the Risk of Using Medicines Which Coming from Hospital Operating Room%医院手术室的用药风险来源及控制对策探讨

    刘彦雪; 邓伟生

    2011-01-01

    Taking some measures, such as strengthen the management of drug quality, setting up a strict medication verification system and Training Nurses some drug knowledge, is good to control the risk of using medicines in hospital operating room.%通过实施加强药品质量管理、严格用药核实制度、对相关工作人员进行药物知识培训等控制措施,有利于防止手术室用药风险的发生.

  8. Automated system of control of radioactive liquid effluents of patients submitted to therapy in hospitals of nuclear medicine (SACEL); Sistema automatizado de control de efluentes liquidos radiactivos de pacientes sometidos a terapia en hospitales de medicina nuclear (SACEL)

    Ruiz C, M.A.; Rivero G, T.; Celis del Angel, L.; Sainz M, E.; Molina, G. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)]. e-mail: marc@nuclear.inin.mx

    2006-07-01

    Different hospitals of nuclear medicine require of the technical attendance for the design, construction and instrumentation of an effluents retention system coming from the room dedicated to the medical application of iodine 131, with the one object of giving execution to the normative requirements of radiological protection, settled down in the General Regulation of Radiological Safety (RGSR) emitted by the CNSNS in November, 1988 and in the corresponding official standards. An automatic system of flow measurement, the activity concentration of the effluents to the drainage, the discharges control and the automated report it will allow the execution of the national regulations, also the elimination of unhealthy activities as the taking of samples, analysis of those same and the corresponding paperwork, its will allow that the SACEL is capable of to carry out registrations that are to consult in an automated way. The changes in the demands of the National Commission of Nuclear Safety and Safeguards in relation to the liberation of radioactive material in hospitals by medical treatments, it has created the necessity to develop a system that quantifies and dose the liquid effluents of people under thyroid treatment with iodine-131 to the drainage. The Automated System of Control of radioactive liquids effluents generated in Hospitals of Nuclear Medicine (SACEL) developed in the National Institute of Nuclear Research, it fulfills this regulation, besides improving the work conditions for the medical and technical personnel of the hospital in that are installed, since this system has the advantage of to be totally automated and to require of a minimum of attendance. The SACEL is an electro-hydraulic system of effluents control, based in the alternate operation of two decay deposits of the activity of the material contaminated with iodine-131. The system allows to take a registration of those volumes and liberated dose, besides being able to be monitoring in remote

  9. PACS in nuclear medicine

    PACS (Picture Archiving and Communication System) is being rapidly spread and installed in many hospitals, but most of the system do not include nuclear medicine field. Although additional costs of hardware for nuclear medicine PACS is low, the complexity in developing viewing software and little market have made the nuclear medicine PACS not popular. Most PACS utilize DICOM 3.0 as standard format, but standard format in nuclear medicine has been Interfile. Interfile should be converted into DICOM format if nuclear images are to be stored and visualized in most PACS. Nowadays, many vendors supply the DICOM option in gamma camera and PET. Several hospitals in Korea have already installed nucler PACS with DICOM, but only the screen captured images are supplied. Software for visualizing pseudo-color with color lookup tables and expressing with volume view should be developed to fulfill the demand of referring physicians and nuclear medicine physicians. PACS is going to integrate not only radiologic images but also endoscopic and pathologic images. Web and PC based PACS is now a trend and is much compatible with nuclear medicine PACS. Most important barrier for nuclear medicine PACS that we encounter is not a technical problem, but indifference of investor such as administrator of hospital or PACS. Now it is time to support and invest for the development of nuclear medicine PACS

  10. Columbia-Presbyterian Medical Center Integrated Academic Information Management System (IAIMS) Outpatient Clinical Information System Implemented in a Faculty General Medicine Practice

    Shea, Steven; Clark, Anthony S.; Clayton, Paul D.

    1990-01-01

    We describe a clinical information system for hospital-based ambulatory care implemented in the context of the institution's IAIMS Phase III effort. Key features of this application are physician data entry to maintain summary clinical profiles that include medication lists, problem lists, and preventive care, and integration with other components of the Clinical Information System at the levels of the database, the user interface, and data sharing. A goal of this application is to provide co...

  11. Nuclear Medicine

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  12. Abasto, surtimiento y gasto de bolsillo en medicamentos en hospitales públicos de México en 2009 Supply prescription filling and out-of-pocket expenditures on medicines in public hospitals in Mexico in 2009

    Sergio Sesma-Vázquez

    2011-01-01

    Full Text Available OBJETIVO. Analizar la disponibilidad de medicamentos en las farmacias hospitalarias, el surtimiento de prescripciones a pacientes egresados y el gasto de bolsillo en medicamentos de pacientes hospitalizados. MATERIAL Y MÉTODOS. Análisis descriptivo de la Encuesta Nacional de Satisfacción y Trato Adecuado (ENSATA de 2009 con una muestra representativa de hospitales públicos sobre disponibilidad de una lista de 83 medicamentos en el momento de la visita a la farmacia, la proporción del surtimiento de recetas a pacientes en el momento de su alta y su gasto de bolsillo durante su estancia hospitalaria. RESULTADOS. En total se entrevistó a 26 271 pacientes egresados de los 160 hospitales públicos visitados. La disponibilidad de medicamentos en el ámbito nacional fue de 82%. Los hospitales de los Servicios Estatales de Salud (SESA mostraron una disponibilidad de 77% (variación de 30 a 96%. El surtimiento completo de recetas fue de 97% en las instituciones de seguridad social, cifra que contrasta con 56.2% de los hospitales de los SESA, que además presentaron una gran varianza entre estados (13 a 94% La mediana del gasto de pacientes hospitalizados fue de 150 pesos moneda nacional (1% gastó más de 10 000 pesos. CONCLUSIONES. La falta de los medicamentos en los hospitales tiene un impacto económico en el gasto de los hogares, particularmente en aquellos que cuentan con pocos recursos, y puede aumentar la morbilidad o mortalidad de los pacientes hospitalizados en las instituciones públicas.OBJECTIVE. To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. MATERIAL AND METHODS. Using the National Satisfaction and Responsiveness Survey (ENSATA 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the

  13. New Jersey hospitals renew their identities; part of Meridian Health. Raising awareness of the advantages of a healthcare system.

    Botvin, Judith D

    2005-01-01

    Meridian Health, Wall, N.J., is a three-hospital system that also includes a network of partner companies. The objectives of this branding campaign were to create a better awareness of the benefits of academic medicine, to close the physician referral loop and to improve internal morale. The objectives were realized by emphasizing the teamwork of the system's doctors and showing their actual faces and voices. PMID:15739860

  14. The Top 100 Cited Articles in Clinical Orthopedic Sports Medicine.

    Nayar, Suresh K; Dein, Eric J; Spiker, Andrea M; Bernard, Johnathan A; Zikria, Bashir A

    2015-08-01

    Orthopedic sports medicine continues to evolve, owing much of its clinical management and practice to rigorous academic research. In this review, we identify and describe the top 100 cited articles in clinical sports medicine and recognize the authors and institutions driving the research. We collected articles (excluding basic science, animal, and cadaveric studies) from the 25 highest-impact sports medicine journals and analyzed them by number of citations, journal, publication date, institution, country, topic, and author. Mean number of citations was 408 (range, 229-1629). The articles were published in 7 journals, most in the 1980s to 2000s, and represented 15 countries. Thirty topics were addressed, with a heavy emphasis on anterior cruciate ligament injury and reconstruction, knee rating systems, rotator cuff reconstruction, and chondrocyte transplantation. The 3 most cited articles, by Insall and colleagues, Constant and Murley, and Tegner and Lysholm, addressed a knee, a shoulder, and another knee rating system, respectively. Several authors contributed multiple articles. The Hospital for Special Surgery and the University of Bern contributed the most articles (5 each). This study provides a comprehensive list of the past century's major academic contributions to sports medicine. Residents and fellows may use this list to guide their scholarly investigations. PMID:26251939

  15. 文化建设在中医医院发展中的探索%Role of Cultural Construction in the Development of Chinese Medicine Hospital

    汪劲

    2015-01-01

    Hospital culture reflects the long-term construction and management of hospitals in the spiritual wealth created has hospital characteristics, and in creating a good atmosphere, pool staf strength, such as baking and establish a good social image plays an important role in the implementation of brand strategy and enhance the core competitiveness of the hospital an important way.%医院文化体现了医院在长期建设和管理中所创造的具有医院特色的精神财富,在创造良好氛围,凝聚员工力量,树立良好社会形象等发面发挥着重要作用,是实施品牌战略,增强医院核心竞争力的重要途径。

  16. Latex allergies - for hospital patients

    ... latex to be removed from your room The pharmacy and dietary staff to be told about your latex allergy so they do not use latex when they prepare your medicines and food Alternative Names Latex products - hospital; Latex allergy - hospital; Latex sensitivity - hospital; Contact dermatitis - ...

  17. Professors to go. Emigration of the academic staff of the Faculty of medicine of the German University in Prague before and after the Nazi Occupation, 1938–39

    Šimůnek, Michal V.; Hermann, Tomáš

    Prague : Ústav pro soudobé dějiny AV ČR, 2011 - (Stella, M.; Štrbáňová, S.; Kostlán, A.), s. 337-361 ISBN 978-80-7285-146-1. [Scholars in Exile and Dictatorships of the 20th Century. Prague (CZ), 24.05.2011-26.05.2011] R&D Projects: GA AV ČR IAAX00630801 Institutional research plan: CEZ:AV0Z80630520 Keywords : scientific exile * German University in Prague * history of medicine Subject RIV: AB - History http://www.science.usd.cas.cz/Scholars_in_Exile_2011_Proceedings.pdf

  18. 2010-2013年某院门诊中成药应用分析%Utilization of Chinese Patient Medicine in Outpatient of One Hospital during 2010-2013

    王锦芳

    2014-01-01

    OBJECTIVE:To analyze the utilization of Chinese patent medicine in one hospital in order to provide reference for rational use Chinese patent medicine. METHODS: Retrospective, the 48 000 prescription of Chinese medicine prescription during 2010⁃2013 were counted and analysed with DDD, DDDs and trend analysis method. RESULTS:The hospital of Chinese patent medicine directory structure was not reasonable,and the number of drugs was too much;the amount of sales accounted of Chinese patent medicine for a higher proportion of the total amount of drug sales,the annual growth rate too fast,it was higher than the amount of the upward trend over the same period the hospital drug sales and other income;DDDs annual growth rate was higher than the annual growth rate of hospital drug sales amount;the average DDC was 6�36 yuan,and slightly higher;In the 4 years of B/A were 2�2, 2�3, 2�3, 2�4;the use of drugs were concentrated in stasis agent, fuzheng agent , and so on. CONCLUSIONS:Excessive use of Chinese patent medicines should be vigilant,strengthen the drug monitoring and to promote rational clinical use of drugs.%目的:探讨某院门诊中成药的使用情况,为合理用药提供参考。方法:采用回顾性分析,利用限定日剂量( DDD)分析、用药频度( DDDs)分析、趋势分析法,对2010—2013年某院门诊48000张中成药处方的用药情况进行统计、分析。结果:该院中成药目录结构不合理,品规数过多;中成药销售金额占药品销售总金额比例较高,且年度上升趋势过快,高于该院同期药品销售金额和其他收入的上升趋势;DDDs的年增长幅度高于该院药品销售金额的年增长幅度;平均DDC略高,为6�36元;4年来,其B/A平均分别为2�2、2�3、2�3、2�4;药品使用集中于祛瘀剂、扶正剂类等。结论:应警惕中成药的过度使用,加强监控,以促进临床合理用药。

  19. Extracts from IAEA's Resources Manual in Nuclear Medicine. Part-3: Establishing Nuclear Medicine Services

    In the past, consideration was given to the categories of nuclear medicine ranging from simple imaging or in-vitro laboratories, to more complex departments performing a full range of in-vitro and in-vivo procedures that are also involved in advanced clinical services, training programmes, research and development. In developing countries, nuclear medicine historically has often been an offshoot of pathology, radiology or radiotherapy services. These origins are currently changing as less radioimmunoassay is performed and fully-fledged, independent departments of nuclear medicine are being set up. The trend appears to be that all assays (radioassay or ELISA) are done in a biochemistry laboratory whereas nuclear medicine departments are involved largely in diagnostic procedures, radionuclide therapy and non-imaging in-vitro tests. The level of nuclear medicine services is categorized according to three levels of need: Level 1: Only one gamma camera is needed for imaging purposes. The radiopharmaceutical supply, physics and radiation protection services are contracted outside the centre. Other requirements include a receptionist and general secretarial assistance. A single imaging room connected to a shared reporting room should be sufficient, with a staff of one nuclear medicine physician and one technologist, with back-up. This level is appropriate for a small private practice. Level 2: This is suitable for a general hospital where there are multiple imaging rooms where in-vitro and other non-imaging studies would generally be performed as well as radionuclide therapy. Level 3: his is appropriate for an academic institution where there is a need for a comprehensive clinical nuclear medicine service, human resource development and research programmes. Radionuclide therapy for in-patients and outpatients is provided

  20. Development of a medical academic degree system in China

    Lijuan Wu

    2014-01-01

    Full Text Available Context: The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose: We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content: Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP. The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. Conclusion: The future education reforms might include: 1 a domestic system of ‘credits’ that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2 International – a mutual professional and academic recognition between China and other countries by reference to

  1. Finn Bøe--war, medicine, music.

    Hem, Erlend; Natvig, Jacob B; Børdahl, Per E

    2016-03-15

    In January 1944 the Norwegian Resistance Movement placed a radio transmitter in the attic of the Department of Obstetrics and Gynaecology, the National Hospital (Rikshospitalet), Oslo. Knut Haugland (1917-2009) used this to send messages to the Norwegian government-in-exile in London. The transmitter was discovered by the Gestapo, and German troops surrounded the building on 1 April 1944. Haugland survived a dramatic escape. While the transmitter was in operation, Haugland lived with senior registrar Finn Bøe (1906-70) and his family in a hospital apartment. Bøe risked his own life and that of his family to assist during a dramatic phase of the resistance struggle. Bøe had completed a focused and purposeful clinical and academic training when he was appointed senior registrar at the Department of Obstetrics and Gynaecology, the National Hospital, in 1943. He was professionally ambitious. His thesis from 1938 was disqualified, but four years later he submitted a new, experimental thesis which he successfully defended in 1945. In 1955, Bøe became the first senior consultant at the Department of Obstetrics and Gynaecology at Aker hospital. Under his leadership, it became the largest in the Oslo area, and one of the most active in Norway with regard to science. Several of Bøe's own academic works on placental morphology and blood circulation have become classics. Outside of medicine, his great interest was music, and not only as a piano player. He also wrote a book about his fellow townsman Edvard Grieg. PMID:26983150

  2. Academics respond

    Hazel, Spencer

    2015-01-01

    Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK......Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK...

  3. A Strategic Vision for NSF Investments in Antarctic and Southern Ocean Research: Recommendations of a New Study from the National Academes of Sciences, Engineering, and Medicine.

    Weller, R. A.; Bell, R. E.; Geller, L.

    2015-12-01

    A Committee convened by the National Academies of Sciences, Engineering, and Medicine carried out a study (at the request of NSF's Division of Polar Programs) to develop a strategic vision for the coming decade of NSF's investments in Antarctic and Southern Ocean research. The study was informed by extensive efforts to gather ideas from researchers across the United States. This presentation will provide an overview of the Committee's recommendations—regarding an overall strategic framework for a robust U.S. Antarctic program, regarding the specific areas of research recommended as highest priority for NSF support, and regarding the types of infrastructure, logistical support, data management, and other critical foundations for enabling and adding lasting value to the proposed research .

  4. State of emergency medicine in Azerbaijan

    Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

    2008-01-01

    Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the “specialty” model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...

  5. 高等院校开展院前急救技能培训必要性与可行性的探讨%The approach of feasibility and necessity of pre-hospital emergency medicine education in colleges

    吴向辉; 周树生

    2009-01-01

    院前急救的及时性、院前急救的水平和质量对挽救生命和降低致残率至关重要,而急救知识、急救技能的推广和普及是院前急救成功与否的基础.高校大学生在时间、精力、学习能力等方面都优于其他人群,因此,对他们进行急救知识和急救技能的培训,可以带动全民急救水平的提高.%"People-orientated" is the Chinese Communist Party's philosophy. "life comes before everything else" can be demonstrated obviously in some situations including various natural disasters, pub- lie health emergencies and accidents. The pre-hospital emergency care in good time plays an important role in rescuing lives and reducing disabled rate. Public education of emergency first-aid knowledge and skills is the comer-stone of the successful pre-hospital aid. Compared to other groups in the society, undergraduates have enough time and energy as well as the ability to acquire new information and skills. So, it may im- prove the level of first-aid in public to perform the education program on pre-hospital emergency medicine a- mong college students.

  6. Academic writing

    Eremina, Svetlana V.

    2003-10-01

    The series of workshops on academic writing have been developed by academic writing instructors from Language Teaching Centre, Central European University and presented at the Samara Academic Writing Workshops in November 2001. This paper presents only the part dealing with strucutre of an argumentative essay.

  7. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph

    2010-11-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application. PMID:20844424

  8. 基层医院2011年至2012年中药注射剂使用分析%Use Situation of Chinese Medicine Injections in Our Hospital from 2011 to 2012

    杨作英

    2014-01-01

    Objective To understand the status quo of the use of Chinese medicine injections in our hospital for promoting their clinical rational use and management. Methods The amount of sales,medication frequency,average daily cost of traditional Chinese medicine injections from 2011 to 2012 were statistically analyzed. Results The use of Chinese medicine injections involved in 5 major categories of 13 varieties,which was dominated by the blood - regulating agents,followed by tonic and clearing heat agents;Xuesaitong Injection was in the top 2 of the amount of sales and DDDs. Conclusion The rational use and management of Chinese medicine injections should be strengthened.%目的:了解医院中药注射剂的使用现状,促进临床合理使用及管理。方法对2011年至2012年中药注射剂的销售金额、用药频度(DDDs)、日均费用等进行统计。结果中药注射剂使用涉及5大类13个品种,以理血剂为主,其次是补益剂和清热剂;销售金额和DDDs排序前2位的均有注射用血塞通。结论临床应加强中药注射剂的合理使用及管理。

  9. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training

    Nawaz, Haq; Via, Christina M.; Ali, Ather; Rosenberger, Lisa D.

    2015-01-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, i...

  10. Risco de hospitalizações repetidas em idosos usuários de um centro de saúde escola Risk of repeated hospitalizations in elderly users of an academic health center

    Isabel Casale Guerra

    2007-03-01

    Full Text Available O objetivo deste trabalho foi estratificar 305 idosos com 65 anos ou mais, atendidos em um Centro de Saúde Escola (Botucatu, São Paulo, Brasil, quanto à probabilidade de admissão hospitalar repetida. Os dados foram coletados por meio de um instrumento de avaliação do risco de admissão hospitalar repetida, constituído por oito indicadores de saúde: autopercepção da saúde, hospitalização, consultas médicas, diabetes, doença cardiovascular, sexo, apoio social e idade. Verificou-se que 56,4% dos entrevistados apresentaram baixa probabilidade de admissão hospitalar repetida; 26,9%, média; 10,5%, média-alta; e 6,2%, alta. Na associação dos indicadores de saúde com a probabilidade de admissão hospitalar repetida, observou-se que, para idosos classificados como sendo de riscos médio, médio-alto e alto, em relação àqueles com baixo, os riscos relativos foram significativos: saúde média ou ruim (2,31; hospitalização (2,38; mais de três consultas médicas (1,75; diabetes (2,10; doença cardiovascular (2,76; homens (1,68; e 75 anos ou mais (1,62. Constatou-se que o instrumento utilizado possibilitou a estratificação dos idosos quanto ao risco de serem hospitalizados repetidas vezes, o que pode contribuir para propostas de reorganização dos serviços de saúde.The aim of this study was to stratify 305 elderly (> 65 years treated at an academic health center (Botucatu, São Paulo, Brazil according to risk of repeated hospitalization. Data collection used an instrument to evaluate risk of repeated hospital admissions, including eight health indicators: self-rated health, hospitalizations, doctor visits, diabetes, cardiovascular disease, gender, social support, and age. 56.4% of interviewees presented low probability of repeated hospitalization, as compared to 26.9% medium, 10.5% medium-high, and 6.2% high probability. Combining health indicators with the probability of repeated hospitalization, for elderly classified as

  11. The Chinese Association of the Integration of Traditional and Western Medicine (CAIM) 2002 National Congresses (Call for Papers)

    2001-01-01

    @@September Beijing The Year Working Meeting of CAIM, 2002 Information: No call for paperSeptember Beijing The 2nd World Integrative Medicine Congress (WIMCO 2002) Information: The Academic Department of CAIM, 18 Beixincang,Dongzhimennei, Beijing (100700), Email: secretary@wimco-2002.com Deadline: April 1, 2002March Beijing The National Conference of Integration Medical for Young and Mid-aged Doctors Information: Dr. Songjun, Xiyuan Hospital,1 Caochang, Haidian District, Beijing (100091), Email: junsong-tcm@sina.com.cn Deadline: December 31, 2001 March Suzhou, Jiangsu Province The National Conference of ITWM Dermatology and Venereology Information: Dr. Zhu Lifen, Department of Dermatology, Zhongshan Hospital,

  12. Situation of Integrative Medicine in China:Results from a National Survey in 2004

    CHEN Ke-ji; LU Ai-ping

    2006-01-01

    Integrative medicine (IM) usually called integrated traditional and Western medicine in China, which came into being in the 1950s as a new form of medicine, although is now developing quickly, little is known about its status and existing problems. So a national survey in China was conducted through questionnaire in 2004 by Chinese Association of Integrative Medicine with the support of State Administration of Traditional Chinese Medicine (SATCM). The results show that, of all the medical professionals investigated in this survey, 91.21% and 93.52% respondents respectively favored IM as the best diagnostic and therapeutic method. Of all the patients who once went through TCM, Western medicine (WM) and IM therapies,68.85%, 65.45% and 71.2% respondents respectively most appreciated IM, IM hospitals and IM therapeutic treatments. Most of the 6 595 respondents held that the optimal scientific research strategy in TCM should be integrating modern medical research method (n = 2 380) or modern scientific method (n = 2 920). However, many hospitals exposed the problems in the aspects of governmental supports and funding supports, human resources, and domestic or international academic activities. These results indicated that IM is the patients' social needs and doctors' aspiration in China. For further development of IM, the enhancement of scientific research construction and assistance by policies and finance from the government and other institutions are urgently needed in China.

  13. Performance evaluation of the activity meters of nuclear medicine services of the hospitals Rafael Angel Calderon, San Juan de Dios and Mexico during the period from July 1, 2008 to December 31, 2008

    Nuclear medicine has used radioisotopes associated to drugs in order to get them to an organ of interest. The radioisotope has the quality to emit radiation, which passes through the body, after being admitted to it, and this is perceived by equipment such as a gamma camera to study the behavior of the organ under study. The radiation is a energy emission able to boot electrons from atoms and produce ions, thus the chemical composition may be altered, resulting in alterations in the cells. Conditions such as: a onreproductive of the cells, causing a tumor; or alterations in geminal cells, causing genetic alterations, which may occur in the offspring of an individual. For the above reason is that the use of radiopharmaceuticals should be as careful as possible, doing as little radiation exposure, without compromising the quality of the study, these should be applied with more important in more radiosensitive population such as children and older adults. The doses used in nuclear medicine are quantified using a device called activity meters and the proper functioning of the overexposures shall impose or low-quality studies doses outside the range of usefulness. The operation of these machines based on the quality control logs have been studied to discover if there are alterations in dosages of nuclear medicine departments of hospitals Calderon Guardia, San Juan de Dios and Mexico. Tests of zero settings, display, physical monitoring, high voltage, linearity test, stability, background radiation, precision, accuracy and consistency have been performed as quality control. This research is classified as non-experimental longitudinal quantitative. The study population was the record set and the realization of quality control tests made to the hospital activity meters above. The collection of data was performed by two steps, the first taking records concerning quality control of the different hospitals, completed tabulation, gratification and analysis of the same. The

  14. Emergency preparedness of Research Center for Radiation medicine and its hospital to admit and treat the patients with signs of acute radiation sickness

    After the Chernobyl accident, the Research Center for Radiation Medicine (RCRM) was established in Kiev (Ukraine). Its main task was to maintain a high level of emergency preparedness and be ready to examine and treat patients who suffer as a result of hypothetical radiation accident. Based on the previous experience, this institution's specialists worked out new diagnostic criteria and drug treatment schemata for acute radiation sickness, created a database on 75 patients with this diagnosis and improved educational programmes for medical students and physicians working in the field of radiation medicine. RCRM collaborates fruitfully with western partners through the joint research projects and connects with the World Health Organisation's Radiation Emergency Medical Preparedness and Assistance Network centre. Collaboration with Kiev Center for Bone Marrow Transplantation allows RCRM to use aseptic wards having highly filtered air for the treatment of most severely irradiated patients. (authors)

  15. On the development and strategy of translational medicine at hospitals%医院转化医学发展方向与策略的思考

    刘亮; 吴晓松; 刘广东; 孔越

    2014-01-01

    Translational medicine has been on the rise for 20 years as a new model of biomedical research,which plays a positive role in narrowing the gap between basic research and clinical medicine and in development of medical sciences.This paper traced back the milestones of translational medicine,and analyzed the hurdles for China to develop translational medicine,namely the organization system,management model and benefit sharing.On such basis,the authors recommended on the development and strategy,especially in clinical medical institutions in China.%转化医学作为近20年来在世界范围内兴起的生物医学研究新模式,在推进基础医学与临床医学结合,促进医学科技发展方面发挥了重要作用.本研究通过回溯转化医学发展的历史,分析我国转化医学在具体组织与实施中面临的关于组织体制、管理模式、效益分享等诸多难题,并在此基础上提出未来转化医学发展,特别是在临床医疗机构中的发展的一些方向和策略方面的建议和参考.

  16. Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.

    Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

    2015-05-01

    The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. PMID:25903144

  17. Implementation of radioactive wastes management system in nuclear medicine service of Hospital das Clinicas of Universidade de Campinas - UNICAMP, in Sao Paulo State, Brazil

    This work reports the experience acquired at the Servico de Medicina Nuclear of the Hospital de Clinicas/UNICAMP (SMN/HC) in planning and implementing the management system of radioactive waste. This system respects the Comissao Nacional de Energia Nuclear' (CNEN) standards and has been of relatively easy and simple performance, without disturbing the SMN/HC's routine. It has also proof to keep its quality along the time. (author)

  18. Exploration of the articulation of African traditional medicine and Western biomedicine in hospital spaces in the town of Barberton, South Africa

    Andreadis, Petros Isidoros

    2015-01-01

    Whilst hospitals are the dominant institutions through which Western biomedical treatment is delivered, it is also argued that these institutions do not reproduce a distinct notion of a biomedical model, but instead assume different configurations, reflecting and replicating wider socio-cultural processes. In South Africa, this includes a reflection and replication of challenges arising from an eclectic therapeutic landscape in which biomedicine is but one avenue. The challe...

  19. FacilitiesHospitals_HOSPITAL

    Vermont Center for Geographic Information — This datalayer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  20. 医院药品管理与成本核算存在问题及对策%The Problems and Strategies for Hospital Medicine Management and Cost Accounting

    韦健

    2013-01-01

      新的《医院财务制度》和《医院会计制度》对于药品的核算进行了改革,要求药品由按零售价核算改为按进价核算,明确规定应当根据实际情况采用个别计价法、先进先出法或者加权平均法来确定发出物资的实际成本,文章结合我院药品管理与核算存在的问题进行深入分析与探讨,提出切实可行的解决方案,加强药品的规范化管理和药品的成本核算。%The new current versions of Hospital Finance System and Hospital Accounting System promote the reform of medicine accounting. It requires the method of the drugs cost accounting to change the retailing price accounting to the purchasing price accounting. It clearly defines individual valuation method, “first-in, first-out” method or weighted average method should be used to determine the actual cost of the materials based on the actual situation. It analyzes the problems of medical management and cost accounting, and proposes the practical solutions to strengthen the standard management of medicine and the medical cost accounting.

  1. The evaluation of the distribution and antimicrobal susceptibility of the strains isolated from war wound specimens of the Libyan patients at Izmir University School of Medicine Medicalpark Hospital in Turkey

    Mürşide Tunçel Başoğlu

    2013-12-01

    Full Text Available OBJECTIVE[|]Skin and soft tissue infections are important due to the clinical picture they create and the varying microorganisms that cause infection.Wound culture helps by reducing treatment cost and monitorizing resistant strains and their spread. The aim of our study is to evaluate the distribution and antimicrobial susceptibility of strains isolated from wound specimens of the patients after the Libya conflict and compare to Turkish patients at Izmir University School of Medicine Medicalpark Hospital. [¤]METHODS[|]Fourty wound specimens of Libyan patients admitted to Izmir University School of Medicine Medicalpark Hospital between October 2011 - April 2012 after the Libya conflict and 154 wound specimens of Turkish patients treated during the same interval were retrospectively evaluated. The strains were isolated by conventional methods and automatized Vitek 2.0 (Biomerieux, France system. The antibiotic susceptibility was studied by automatized Vitek 2.0 system.[¤]RESULTS[|]Seventeen (42.5% of the fourty specimens were culture positive. Ten (58.8% of them were Gram negative, and seven (41.2% were Gram positive. The mostly isolated strains were Enterobacter cloacae (23.5%, coagulase negative Staphylococci (CoNS (23.5%, Stapylococcus aureus (17.6% and Proteus mirabilis (11.7%. Enterobacter cloacae was susceptible to meropenem and amikacin.[¤]CONCLUSION[|]We evaluated the distribution and antimicrobial susceptibility of wound specimens after the Libya conflict. The mostly isolated strains were E. cloacae and CoNS. Meanwhile Turkish patients had P. mirabilis as Gram negative bacteria and methicillin susceptible S. aureus as Gram positive bacteria isolated in wound specimens. We could not compare this data to our country due to a lack of similar studies. Further studies with a greater number of patients are necessary to obtain reasonable data. [¤

  2. From the High Energy Physics Laboratory to the hospital -some experiences of the application of MWPC [multiwire proportional counter] technology to medicine

    In this talk I wish to briefly review the experience we have obtained at the Rutherford Appleton Laboratory over the past decade in the adaptation of MWPC (multiwire proportional counter) technology to diagnostic imaging applications in medicine. A cursory glance at the history of science and technology quickly shows the often intimate and mutually beneficial relationship between ''pure'' science (and scientists) and practical applications. The following talk traces some of the principal features of the situation which have been brought to my attention in the course of the last decade. (author)

  3. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    Wang HF

    2015-03-01

    Full Text Available Hua-fen Wang,1 Jing-fen Jin,1 Xiu-qin Feng,1 Xin Huang,1 Ling-ling Zhu,2 Xiao-ying Zhao,3 Quan Zhou4 1Division of Nursing, 2Geriatric VIP Ward, Division of Nursing, 3Office of Quality Administration, 4Department of Pharmacy, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. Methods: An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People’s Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014. Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. Results: The number of MAEs continuously decreased from 143 (first half-year of 2012 to 64 (first half-year of 2014, with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, P<0.05. The number of MAEs related to high-alert medications decreased from 32 (the second half-year of 2011 to 16 (the first half-year of 2014, with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, P<0.05. Omission was the top type of MAE during the first half-year of 2011 to the first half-year of 2014, with a decrease by 50% (40 cases versus 20 cases. Intravenous administration error was the

  4. Reflection on medical ethics and professionalism training of the hospital postgraduates in the medicine-education collaboration situation%医教协同医院研究生医德和职业素养培养的思考

    龙丽; 顾兴智

    2015-01-01

    医教协同深化临床医学人才培养改革形势下,医院需要重新审视思考研究生医德和职业素养培养的必要性,采取灵活多样的教育方式,重点培养研究生的医德医风、临床实践、人文沟通和团队合作精神,使研究生成长为德才兼备的医学人才。%In the Medicine-education collaboration situation of deepening the reform of clinical medicine talents, the necessity of medical ethics and professionalism training of the hospital postgraduates needs to be reexamined. Medical ethics, clinical practice, humanity communication and team-work spirit can be focused on through various of channels. Thus, postgraduates can be brought up clinical talents with political integrity and ability.

  5. The application of hospitality elements in hospitals.

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority. PMID:23424818

  6. Severe sepsis and septic shock in pre-hospital emergency medicine: survey results of medical directors of emergency medical services concerning antibiotics, blood cultures and algorithms.

    Casu, Sebastian; Häske, David

    2016-06-01

    Delayed antibiotic treatment for patients in severe sepsis and septic shock decreases the probability of survival. In this survey, medical directors of different emergency medical services (EMS) in Germany were asked if they are prepared for pre-hospital sepsis therapy with antibiotics or special algorithms to evaluate the individual preparations of the different rescue areas for the treatment of patients with this infectious disease. The objective of the survey was to obtain a general picture of the current status of the EMS with respect to rapid antibiotic treatment for sepsis. A total of 166 medical directors were invited to complete a short survey on behalf of the different rescue service districts in Germany via an electronic cover letter. Of the rescue districts, 25.6 % (n = 20) stated that they keep antibiotics on EMS vehicles. In addition, 2.6 % carry blood cultures on the vehicles. The most common antibiotic is ceftriaxone (third generation cephalosporin). In total, 8 (10.3 %) rescue districts use an algorithm for patients with sepsis, severe sepsis or septic shock. Although the German EMS is an emergency physician-based rescue system, special opportunities in the form of antibiotics on emergency physician vehicles are missing. Simultaneously, only 10.3 % of the rescue districts use a special algorithm for sepsis therapy. Sepsis, severe sepsis and septic shock do not appear to be prioritized as highly as these deadly diseases should be in the pre-hospital setting. PMID:26719078

  7. The Effect of Medicinal Education on Adherence Taking Warfarin in Acute Coronary Syndrome (ACS and Atrial Fibrilation (AF Patients at PKU Muhammadiyah Yogyakarta Hospital

    Jastria Pusmarani

    2015-12-01

    Full Text Available In order to improve warfarin medication adherence in patient with Acute Coronary Syndrome (ACS and Atrial Fibrillation (AF, giving education with leaflet administration is one of the solutions. This study was aim to know the impact of pharmacist education with using prepared leaflet on the adherence to warfarin in ACS and AF patients. This study used pre test and post test with control group design. Data were collected prospectively during 8 weeks in June–July 2014 at the ambulatory ACS and AF patients at PKU Muhammadiyah Yogyakarta hospital, Indonesia. Data were collected by medical record and the questionnaire using Morisky Medication Adherence Scale (MMAS. Wilcoxon test was used for statistical analysis. The results shows pre test and post test value in the control group was p=0.194 and pre and post test value in the test group was p=0.058. There was no significant difference (p>0.05 after giving education with leaflet. The education with leaflet had no effect to adherence in warfarin in ACS and AF patients at PKU Muhammadiyah Yogyakarta hospital.

  8. For a dialogue among medicines

    Morin, Edgar

    2011-01-01

    Western medicine, as taught in universities and practiced in hospitals, has circulated all over the world, largely ignoring the plurality of other medicines linked to traditional practices and knowledge, or labelling them as “superstitions”. These other medicines - Western and imported from other cultures - continue to exist and increasingly coexist in Western medical systems themselves, taking profit of their very limits and deficiencies. This paradox is due largely to the hyper-specializa...

  9. Academic Words and Academic Capitalism

    Billig, Michael

    2013-01-01

    This paper suggests that it is the best and worst of times for academic work. It is the best of times because there are more academics publishing than ever before. It is the worst of times because there is much unnecessary publication. Working in the competitive conditions of academic capitalism, academics feel impelled to keep publishing, whether or not they have anything to say. The pressures to publish continually and to promote one’s own approach are reflected in the way that social scien...

  10. Utilization of Compounded Medications in an Oral Medicine Practice.

    Stock, Shannon; Rubino, Katie; Woo, Sook-Bin; Margolis, Arthur; Thomas, Irena; Aboalela, Ali; thomas Ali; Treister, Nathaniel

    2016-01-01

    For many oral medicine conditions, the use of compounded topical therapies that are locally absorbed and act directly at the affected site can provide greater efficacy compared with systemically delivered medications while minimizing systemic side effects. The objective of this study was to characterize the utilization and costs associated with the use of compounded medications in an academic, hospital-based oral medicine practice. This was a retrospective analysis of outpatients treated at the Center for Oral Disease at Brigham and Women's Hospital (Boston, Massachusetts) during the five-year period from November 2006 through November 2011. Patient prescription and payment information were obtained from the pharmacy's patient database. Variables included prescription compound, number of prescriptions refilled, prescription cost, and payment contributions from insurance and patients. An electronic medical record review was conducted to obtain patient demographics and diagnoses. There were 510 unique perscriptions corresponding to 423 patients filled during the study period. Four distinct medications comprised the majority (479/510; 94%) of prescriptions filled. The vast majority (94%) of prescriptions filled were at least partially paid for by insurance, with median patient co-pays ranging from $21 (clonazepam solution) to $34 (ketoprofen cream). Compound medications provide an affordable, flexible therapeutic option for patients being treated for a variety of oral medicine conditions. PMID:27323426

  11. Study of regenerative medicine in China: demands and clinical translation

    Xiao-bing FU

    2012-03-01

    Full Text Available The repair and regeneration of tissue is a well-discussed topic. Over the past 20 years, with the development of genetics, auxology, stem cell biology, and tissue engineering, tissue repair and regeneration have rapidly developed as emerging "Regenerative Medicine". Regenerative medicine has significant market demand in China. Based on national statistics, injury and poisoning patients rank third in afflictions in city hospitals (accounting for 9.13% and rank second in afflictions in county hospitals (accounting for 14.07%. Totally, approximately one hundred million patients suffered from traumatic, genetic and metabolic diseases in China and demand reparative and regenerative medical treatment each year. The Chinese government and its related departments have always attached great importance and support to the development of regenerative medicine, and the Chinese academic circle is involved in a very wide range of diseases and injuries including regenerative medical theory and technology. Stem cell biology, organ engineering and duplication, tissue engineering research and production have developed rapidly, and great portion of these studies have started to appear in applications, which have aroused extensive concerns in international professional circle. In the next 10 years, the Chinese regenerative medical system will be further improved, in both statute and rules, clinical translation will be further accelerated. Breakthroughs are expected in induced differentiation of stem cells and synchronous repair and regeneration of multiple organs, construction of major organs by tissue engineering, large-scale applications of tissue engineering products, and other aspects.

  12. Risks of Academic Underachievement in Epilepsy

    J Gordon Millichap

    2004-01-01

    The relation between neuropsychological functioning and academic achievement and the role of family environment, seizures, and psychosocial variables were examined in 173 children with chronic epilepsy, ages 8 to 15 years, at Purdue School of Science; Indiana University School of Medicine, Indianapolis; and University of Wisconsin-Madison School of Medicine, WI.

  13. Expatriate academics

    Selmer, Jan; Lauring, Jakob

    2011-01-01

    Purpose – The literature on business expatriates has been increasing rapidly, but research on expatriate academics has remained scant, despite the apparent increasing globalisation of the academic world. Therefore, more research is needed on the latter group of expatriates. This paper aims to fil...

  14. The Laboratory Medicine and the care of patients infected by the Ebola virus. Experience in a reference hospital of Madrid, Spain.

    Fernandez-Puntero, Belen; Gomez-Rioja, Ruben; Alcaide, Maria Jose; Oliver, Paloma; Fernandez-Calle, Pilar; Iturzaeta, Jose Manuel; Buno, Antonio

    2015-11-01

    The ongoing Ebola virus outbreak in several countries in West Africa was considered by the World Health Organisation (WHO) as a public health emergency of international concern. Healthcare providers must be prepared by organising specific procedures in our hospitals based on recommendations from national and international healthcare organisations. Two aims should be considered: appropriate medical care for patients with suspected or confirmed disease must be ensured, as must measures to prevent transmission to healthcare workers. The clinical laboratory plays an important role and must define and establish its own procedures in accordance with clinicians and integrated into those of the institution, starting with the definition of the organisation model in the laboratory to achieve those goals. In this review we present our experience based on the care of three patients with confirmed cases. We hope it will help other colleagues to plan for Ebola. PMID:26053009

  15. Nuclear Medicine.

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  16. Aerospace Medicine

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  17. FacilitiesHospitals_HOSPITAL

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  18. Hospitals; hospitals13

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  19. [Opening medicine containers].

    Glerup, E; Dengsø, H

    1990-07-01

    In connection with self-administration of medicine for patients with rheumatoid arthritis, patients with weak hands and elderly patients in general, the design of many medicine containers makes them awkward to handle for the patients. In this investigation 12 different medicine containers were tested. The 12 containers represent the antirheumatic medicine containers available on the market in Denmark in 1988. Sixty patients participated in the investigation. Thirty had rheumatoid arthritis and 30 had normal hand function. The age range was 40-85 years The patients had the choice between five possible answers concerning each container. In all patients, grip strength was measured. The patients with rheumatoid arthritis were classified in four functional classes, and pulpa-vola distance end thumb--5th MCP point distance were measured. The opening mechanisms of 29% of the antirheumatic medicine containers are unacceptable; these are plastic containers with a "push-off" top and suppository packs. 46%--(containers with screw cap or pressure dispensing) are considered acceptable. For 25% (tablet and capsule blister packs) the patients' estimate varied. It is important that medicine containers can be opened by the patients without difficulty, so that they do not present a hindrance to a correct intake of medicine or result in an unnecessary admission to hospital. The results of this investigation show that it is of continuous importance to encourage the production of medicine containers that comply with the requirements of the patients. PMID:2142351

  20. ANTIBACTERIAL ACTIVITY OF THREE PLANT EXTRACTS USED IN NIGERIA FOLKLORIC MEDICINE AGAINST HOSPITAL ISOLATES OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA AND METHICILLIN-SENSITIVE STAPHYLOCOCCUS AUREUS (MSSA

    Daniyan SY

    2011-03-01

    Full Text Available Staphylococcus aureus is a species of bacterium commonly found on the skin and/or in the noses of healthy people. Although it is usually harmless at these sites, it may occasionally get into the body (eg through breaks in the skin such as abrasions, cuts, wounds, surgical incisions or indwelling catheters and cause infections. These infections may be mild (eg pimples or boils or serious (eg infection of the bloodstream, bones or joints. It is one of the important bacteria as a potential pathogen specifically for nosocomial infections. Interest in plants with antimicrobial properties has revived as a result of current problems associated with the use of antibiotics.Hexane, ethylacetate, methanol and water extracts from 3 different plant species, Jatropha curcas, Piliostigma thonningii and Hyptis suaveolens used in Nigeria as popular medicine for the treatment of several ailments of microbial and non-microbial origin were evaluated for potential antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA and methicillin-sensitive Staphylococcus aureus (MSSA using agar dilution method. Results revealed that there were no significant differences in the % susceptibility to MRSA and MSSA between the standard drugs and the different plant extracts using different extracting solvents (P>0.05. All the extracts of the 3 plants were effective on MRSA except water extract of Jatropha curcas and Piliostigma thonningii. Hexane extract from P. thonningii was inhibitory to 100% of both MRSA and MSSA isolates followed by ethyl acetate extract of J. curcas 61% of MSSA, ethyl acetate extract of P. thonningii on 38% of MRSA, methanol extract of J. curcas on 33% of both MSSA and MRSA and the least activity was with water extract of H. suaveolens on 17% of both MSSA and MRSA; no activity was observed with water extract of J. curcas. Hexane extract of P.thonningii was the only extract found in this study to inhibit the growth of both MRSA and MSSA

  1. Survey on the use of essential medicines at all levels of hospitals in Huizhou in 2013%2013年惠州市各级医院基本药物品种使用情况调查

    陈浩; 黄雷; 郭林

    2016-01-01

    Objective Investigation and analysis of 2013,Huizhou tertiary hospitals,secondary hospitals and grassroots medical and health institutions essential medicines procurement of equipment,and use of,as national, provincial and formulate implementation system of essential drugs policy and adjust the varieties of essential drugs to provide a basis.Methods Using random sampling method,extraction of Huizhou two tertiary hospitals,secondary hospitals and 27 grassroots medical and health institutions and the basic situation of drug use,the basic drugs with the variety,sales amount and the number of beds,outpatient,inpatient volume,common diseases for statistical analysis on national and provincial essential drugs and supplementary medicines Varieties Screening and selection.Results In Huizhou,tertiary hospital basic drugs can gain of around 35%;basic medical and health institutions is not 100%implementation of essential drug system and equipped with basic drugs;current national essential drugs,and added to the species,about 1/3 is not included in al levels of hospital drug list,mainly is proprietary Chinese medicines.About 50% secondary hospitals and basic medical and health institutions in the presence of but for 3 consecutive months is more than 50 kinds of basic drug varieties.In addition,78% of the basic medical and health institutions needs to supplement the needs of drug varieties.Conclusion By "zero slip sales,providing Medicare reimbursement,including in the performance appraisal,etc,to further promote the national system for basic drugs expanding the scope of implementation.National essential drugs and the addition of species which can not fuly meets the after the reform of basic medical and health institutions and the need for medication needs to formulate rational drug selection and update mechanism and guarantee the production,procurement and supply of basic drugs and the addition of the species.%目的:调查分析2013年,惠州市三级医院、二级医

  2. Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014

    Records of 100 patients were revised with diagnosis of ischemic cerebrovascular event in the neurology and internal medicine at the Hospital Mexico since March 2013 to March 2014. A total of 46 patients were men and 54 were women. The overall mean age was 69 years, for men have been 66 years and for women from 71. Patients of all provinces were entered main of San Jose with 56% followed by 19% Alajuela. The hospital management by specialty was distributed 60% to internal medicine and 40% neurology. The risk factors most frequently found were: hypertension 85%, diabetes mellitus 40%, smoking 35%, and dyslipidemia 35%. Overweight was observed in 23% of patients and 22% obese. As for the initial clinical manifestations documented in the first physical examination, the 6 most frequently found have been: faciobrachiocrural hemiparesis 60%, delirium 22%, dysarthria 22%, headache 20%, nausea and/or vomiting 17% and aphasia 15%. A total of 13% of patients have altered the consciousness and 5% have required ventilatory support for first 24 hours of evolution. 27% of patients have arrived within the first 3 hours of onset of symptoms, 11% between 3 to 4.5 hours and the remaining 62% beyond 4.5 hours of duration. 70% of patients have had 1 or more comorbidities prior to the event, the top 5 have been: ischemic heart disease 31%, 29% atrial fibrillation, cerebrovascular disease 19%, 16% chronic kidney disease and congestive heart failure by 12%. Regarding the topographic classification of stokes, 16% were TACI, PACI 46%, 27% LACI and POCI only 11%. The average NIHSS scale has been 9 points to admission, 10 to 48 hours and 6 points at the time of discharge. Regarding brain scan on admission to 98% of the patients were performed while that between 48-72 hours alone to 74%. The most common initial tomographic CT findings have been: 49% lucency of more than 1/3 of middle cerebral artery territory, without alteration 46%, 8% cerebral edema data and 8% midline deviation. Hemorrhagic

  3. C235-V3 cyclotron for a proton therapy center to be installed in the hospital complex of radiation medicine (Dimitrovgrad)

    Galkin, R. V.; Gurskii, S. V.; Jongen, Y.; Karamysheva, G. A.; Kazarinov, M. Yu.; Korovkin, S. A.; Kostromin, S. A.; Calderan, J.-M.; Cahay, P.; Mokrenko, S. P.; Morozov, N. A.; Nkongolo, H.; Ol'shevskii, A. G.; Paradis, Y.; Petrov, D. S.; Romanov, V. M.; Samsonov, E. V.; Syresin, E. M.; Shakun, A. N.; Shakun, N. G.; Shirkov, G. D.; Shirkov, S. G.

    2014-06-01

    Proton therapy is an effective method of treating oncologic diseases. In Russia, construction of several centers for proton and ion therapy is slated for the years to come. A proton therapy center in Dimitrovgrad will be the first. The Joint Institute for Nuclear Research (Russia) in collaboration with Ion Beam Application (IBA) (Belgium) has designed an C235-V3 medical proton cyclotron for this center. It outperforms previous versions of commercial IBA cyclotrons, which have already been installed in 11 oncologic hospital centers in different countries. Experimental and calculation data for the beam dynamics in the C235-V3 medical cyclotron are presented. Reasons for beam losses during acceleration are considered, the influence of the magnetic field radial component in the midplane of the accelerator and main resonances is studied, and a beam extraction system is designed. In 2011-2012 in Dubna, the cyclotron was mounted, its magnetic field was properly configured, acceleration conditions were optimized, and beam extraction tests were carried out after which it was supplied to Dimitrovgrad. In the C235-V3 cyclotron, an acceleration efficiency of 72% and an extraction efficiency of 62% have been achieved without diaphragming to form a vertical profile of the beam.

  4. Heart failure - medicines

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  5. Emergency medicine in Dubai, UAE.

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice. PMID:20157462

  6. Emergency medicine in Dubai, UAE

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  7. Evaluation of an academic service partnership using a strategic alliance framework.

    Murray, Teri A; James, Dorothy C

    2012-01-01

    Strategic alliances involve the sharing of resources to achieve mutually relevant benefits and they are flexible ways to access resources outside of one's own institution. The recent landmark report from the Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health, called for academic and health care organizations to strategically align around the future registered nurse workforce to improve the quality and safety of patient care. The dedicated education unit (DEU) is one practical way for 2 entities to align so that students can learn to administer safe, quality care. Because DEUs have great potential, it is critical to evaluate the alignment between the academic and service partner for appropriate fit, mutual benefit, and long-term success. In this article, we analyze the effectiveness of the Saint Louis University School of Nursing (SLUSON) and Mercy Hospital, St. Louis (MHSL) DEU project, an alliance between a medical center and school of nursing, using the Single Alliance Key Success Model. PMID:22177471

  8. Nuclear medicine

    Several growth areas for nuclear medicine were defined. Among them were: cardiac nuclear medicine, neuro-psychiatric nuclear medicine, and cancer diagnosis through direct tumor imaging. A powerful new tool, Positron Emission Tomography (PET) was lauded as the impetus for new developments in nuclear medicine. The political environment (funding, degree of autonomy) was discussed, as were the economic and scientific environments

  9. Nuclear medicine in China

    Since China first applied isotopes to medical research in 1956, over 800 hospitals and research institutions with 4000 staff have taken up nuclear technology. So far, over 120 important biologically active materials have been measured by radioimmunoassay in China, and 44 types of RIA kit have been supplied commercially. More than 50,000 cases of hyperthyroidism have been treated satisfactorily with 131I. Radionuclide imaging of practically all organs and systems of the human body has been performed, and adrenal imaging and nuclear cardiology have become routine clinical practice in several large hospitals. The thyroid iodine uptake test, renogram tracing and cardiac function studies with a cardiac probe are also commonly used in most Chinese hospitals. The active principles of more than 60 medicinal herbs have been labelled with isotopes in order to study the drug metabolism and mechanism of action. Through the use of labelled neurotransmitters or deoxyglucose, RIA, radioreceptor assay and autoradiography, Chinese researchers have made remarkable achievements in the study of the scientific basis of acupuncture analgesia. In 1980 the Chinese Society of Nuclear Medicine was founded, and since 1981 the Chinese Journal of Nuclear Medicine has been published. Although nuclear medicine in China has already made some progress, when compared with advanced countries, much progress is still to be made. It is hoped that international scientific exchange will be strengthened in the future. (author)

  10. Engineering in translational medicine

    2014-01-01

    This book covers a broad area of engineering research in translational medicine. Leaders in academic institutions around the world contributed focused chapters on a broad array of topics such as: cell and tissue engineering (6 chapters), genetic and protein engineering (10 chapters), nanoengineering (10 chapters), biomedical instrumentation (4 chapters), and theranostics and other novel approaches (4 chapters). Each chapter is a stand-alone review that summarizes the state-of-the-art of the specific research area. Engineering in Translational Medicine gives readers a comprehensive and in-depth overview of a broad array of related research areas, making this an excellent reference book for scientists and students both new to engineering/translational medicine and currently working in this area.

  11. Survey on Awareness and Knowledge about the Effect of Diabetes Mellitus on Systemic and Oral Health in Patients Visiting General Medicine Outpatient Department in Dental Hospital

    Shantala Arunkumar

    2015-04-01

    Full Text Available Objective: This survey was conducted on known diabetic patients to appraise the awareness and knowledge about the effect of diabetes mellitus (DM on systemic and oral health and to evaluate the source of the information. Aim: The aim of this study was to gather baseline information on awareness and knowledge of diabetic patients regarding their systemic and oral health with the view of enhancing their oral health education. Which will help in updating their knowledge regarding strong association of DM on oral diseases, also about importance of maintaining glycemic levels and good oral health. Methodology: This experimental study was conducted on known diabetic patients visiting general medicine outpatient department for fitness to undergo dental treatments. Patients were evaluated by using a self developed questionnaire by interview method. The questions were about awareness regarding effect of DM on systemic and oral health, sources of information patients have received and elicit the symptoms of DM in those diabetics and educate them regarding importance of glycemic control and maintenance of oral health. Results: All the participants had Type 2 DM. The knowledge about DM disease was poor and most of them attended camps related to DM and their systemic consequences, but none of them attended DM associated oral health camps. Many patients(47.5% were educated about the effect of DM on systemic organs and their prevention, by their treating physician, but none of the physicians informed about effect of DM on oral tissues (0%. Surprisingly, only some dentists (24% told regarding oral complications of DM, large number of patients gathered information by other sources mainly from relatives and friends, who are diabetics (61.9%. So awareness of diabetic patients of their increased risk for oral diseases is low compared to their awareness of systemic diseases. Conclusion: It is of paramount importance for dental specialist to raise the attentiveness

  12. Hospital Compare

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  13. HCAHPS - Hospital

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  14. Nuclear medicine

    This article presents a brief history of nuclear medicine in France and describes the recent developments and equipment of the 3 techniques most used in hospital nuclear departments: 1) gamma-camera, 2) single photon emission computed tomography (SPECT), and 3) positron emission computed tomography (PECT). Concerning gamma-camera, a new design is being studied in a collaboration between the Saint-Gobain company and the LETI (a laboratory of Cea). In this innovative design the scintillator and the photomultiplier are replaced by a matrix of semi-conductor detectors based on CdZnTe crystal combined with an adequate electronic equipment. Concerning SPECT, many different techniques and equipment are used. Most improvements handle with the reduction of the survey time for the patient by using several detectors set on a ring around the patient. Concerning PECT, the developments follow 2 parallel ways: first the use of better scintillating materials for detecting 511 KeV photons (BGO: bismuth germanate, BaF2, LSO: lutetium orthosilicate, or GSO: gadolinium orthosilicate), and secondly the use of beta+ decay radionuclides that are more easily integrated in molecules similar to those present in the humane metabolism (18F through the fluorodeoxyglucose molecule). (A.C.)

  15. Academic Freedom in a Changing Academic World

    Aarrevaara, Timo

    2010-01-01

    This article considers the academic profession and academic freedom in light of the results of the Changing Academic Profession (CAP) survey in Finland and four other European countries. Academic freedom is examined as a phenomenon that provides a setting for goal determination by members of the academic profession. It has a bearing on both institutional autonomy and individual academic freedom, i.e. the freedom of research and teaching. Academic freedom can be examined on t...

  16. Norovirus - hospital

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  17. Nuclear Medicine week in Colombia

    During the week of 6-12 October 2003 the IAEA organized a Research Coordination Meeting on 'Relationship between lower Respiratory Tract Infection, Gastroesophageal reflux and bronchial Asthma in children' at Hospital San Ignacio in Bogota. Besides there were four workshops in Bogota; workshops on Bone infection and Bone scan in Pediatric ortopaedics at Hospital Militar and Fundacion CardioInfantil, a workshop for Nuclear Medicine Technologists and a workshop on Sentinel Lymph Node mapping and Surgical Gamma Probe Application at Institute of Oncology. A nuclear cardiology workshop was organized in Medellin, and finally crowning them all was the 9th Congress of the Colombian Association of Nuclear Medicine at Cali from 10-12 October, 2003; probably the largest and best Colombian nuclear medicine congress every held in the country. A workshop was also organized in Cali for nuclear medicine technologists in conjunction with the Annual Convention. It was a mix of IAEA's Technical Cooperation and Regular Budget activities along with the activities of Colombian Association of Nuclear Medicine, bringing in absolute synergy to galvanize the entire nuclear medicine community of the country. The week saw nuclear medicine scientists from more than 20 IAEA Member States converging on Colombia to spread the message of nuclear medicine, share knowledge and to foster International understanding and friendship among the nuclear medicine people of the world

  18. Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital

    Fabiana Rossi Varallo; Helaine Carneiro Capucho; Cleópatra da Silva Planeta; Patrícia de Carvalho Mastroianni

    2014-01-01

    OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to Decemb...

  19. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients...

  20. Ancient medicine--a review.

    Zuskin, Eugenija; Lipozencić, Jasna; Pucarin-Cvetković, Jasna; Mustajbegović, Jadranka; Schachter, Neil; Mucić-Pucić, Branka; Neralić-Meniga, Inja

    2008-01-01

    Different aspects of medicine and/or healing in several societies are presented. In the ancient times as well as today medicine has been closely related to magic, science and religion. Various ancient societies and cultures had developed different views of medicine. It was believed that a human being has two bodies: a visible body that belongs to the earth and an invisible body of heaven. In the earliest prehistoric days, a different kind of medicine was practiced in countries such as Egypt, Greece, Rome, Mesopotamia, India, Tibet, China, and others. In those countries, "medicine people" practiced medicine from the magic to modern physical practices. Medicine was magical and mythological, and diseases were attributed mostly to the supernatural forces. The foundation of modern medicine can be traced back to ancient Greeks. Tibetan culture, for instance, even today, combines spiritual and practical medicine. Chinese medicine developed as a concept of yin and yang, acupuncture and acupressure, and it has even been used in the modern medicine. During medieval Europe, major universities and medical schools were established. In the ancient time, before hospitals had developed, patients were treated mostly in temples. PMID:18812066

  1. Scaling up Family Medicine in Uganda

    Innocent K. Besigye; Jane F. Namatovu

    2014-01-01

    It is evident that politicians, health managers and academics are realising the potential contribution of Family Medicine to health systems in sub-Saharan Africa. The challenge is in training institutions to recruit and train enough Family Physicians in order to meet expectations. The 3rd Family Medicine Conference in Uganda, held in October 2013, explored innovative ways of scaling up Family Medicine training and practice in Uganda.

  2. Diabetes Medicines

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  3. Herbal Medicine

    ... for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are ... and fresh or dried plants. People use herbal medicines to try to maintain or improve their health. ...

  4. Summary of the 2008 Evidence-based Chinese Medicine(EBCM) Workshop

    吴大嵘; 赖世隆; 杨显荣

    2009-01-01

    The 2008 Evidence-based Chinese Medicine (EBCM) Workshop,jointly organized by the International Society for Chinese Medicine/Editorial Board of Chinese Medicine(Macao) and the Guangdong Provincial Hospital of Chinese Medicine/ Second Affiliated Hospital of Guangzhou University of

  5. Analysis of Anesthetic Drugs Application in the Internal Medicine Pharmacy of Our Hospital during 2008-2009%我院2008年和2009年内科药房麻醉药品应用分析

    韩毅音; 裴保香; 马培琴

    2011-01-01

    Objective To investigate the anesthetic drugs application in the inpatients in the Internal Medicine Pharmacy of our hospital to offer reference for rational drug use. Methods To retrieve the related data from January to November, 2008-2009 from HIS of our hospital for statistically analyzing the drug name, specification, usage and dosage. Results There were totally 13 kinds of anesthetic drugs including 5 dosage forms. The top 5 places in total consumptions from January to November, 2008 were Romifentanil Hydrochloride for Injection, Sufantanil Citrate Injection, Fantanil Citrate Injection, Morphine Hydrochloride Injection and Pethidine Hydrochloride Injection. The top 5 places in total consumptions used from January to November, 2009 were Remifentanil Hydrochloride for Injection, Fentanyl Transdermal Patches, Fentanyl Citrate Injection, Sufentanil Citrate Injection and Oxycodone Hydrocloride Controlled Release Tablets. Conclusion Remifentanil Hydrochloride Injection is a new member in fentanyl category with quick action and efficacy quickly disappearing, which is widely used in the operative patients in our hospital. The application of anesthetic drugs in our hospital is basically rational but some problems exist. The medication supervision should be enhanced and the medication should be strictly abided the cancer pain three-ladder analgesic therapeutic principles.%目的 了解中国人民解放军总医院内科药房麻醉药品的应用情况,为合理用药提供参考.方法 调取该院2008年和2009年两年1月至11月医院信息系统中相关数据,统计药品名称、规格、用法用量等.结果 该院内科药房两年供应的麻醉药品有13个品种、5种剂型,2008年1月至11月DDDs排前5位的是注射用盐酸瑞芬太尼、枸橼酸舒芬太尼注射液、枸橼酸芬太尼注射液、盐酸吗啡注射液和盐酸哌替啶注射液,2009年1月至11月DDDs排前5位的是注射用盐酸瑞芬太尼、芬太尼透皮贴、枸橼酸芬

  6. Nuclear medicine therapy

    Eary, Janet F

    2013-01-01

    One in three of the 30 million Americans who are hospitalized are diagnosed or treated with nuclear medicine techniques. This text provides a succinct overview and detailed set of procedures and considerations for patient therapy with unsealed radioactivity sources.  Serving as a complete literature reference for therapy with radiopharmaceuticals currently utilized in practice, this source covers the role of the physician in radionuclide therapy, and essential procedures and protocols required by health care personnel.

  7. Wittgenstein, medicine and neuropsychiatry

    Hélio A.G. Teive

    2011-08-01

    Full Text Available A historical review is presented of the link between Ludwig Wittgenstein, considered the most important philosopher of the 20th century, and medicine, particularly neurology and psychiatry. Wittgenstein worked as a porter at Guy's Hospital in London, and then as a technician at the Royal Victoria Infirmary in Newcastle. He wrote about his important insights into language, and neuroscience. It has been suggested that he had Asperger syndrome and a possible movement disorder (mannerisms.

  8. History and Perspectives of Nuclear Medicine in Thailand

    Sombut Boonyaprapa

    2014-01-01

    In 1955, the first nuclear medicine division was established in Thailand by Professor Romsai Suwannik in the Department of Radiology, Siriraj Hospil, Mahidol University in Bangkok. In 1959 four years later, the second nuclear medicine division was established in the Department of Radiology, Chulalongkorn Hospital in Bangkok. The third nuclear medicine division was started in Rajvithi Hospital in Bangkok in 1961. The fourth nuclear medicine division was installed in Chiang Mai University which...

  9. Academic Practice

    Nielsen, Sandro; Heine, Carmen

    Vejledning i at undgå plagiering ved at følge de normer, der gælder for good academic practice. Dette indebærer at man angiver kilder korrekt, og når det er nødvendigt, og at man har en korrekt udformet fortegnelse over referencer. Vejledningen indeholder konkrete eksempler på korrekt kildeangive...

  10. Academic Prophecies.

    Nielsen, Robert M.; Polishook, Irwin H.

    1985-01-01

    Academic prophecies are characterized by their innocence, detachment from the realities of politics and economics, and deference to a limited cohort of administrative representatives. Careless forecasting of the untested future contributes to public misunderstanding of higher education's role in society. (MLW)

  11. ACADEMIC TRAINING

    Françoise Benz

    2002-01-01

    12, 13, 14, March LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 POSTPONED! - Modern Project Management Methods - POSTPONED! By G. Vallet / Ed. Highware, Paris, F. Academic Training Françoise Benz Secretariat Tel. 73127 francoise.benz@cern.ch

  12. Academic Cloning.

    Sikula, John P.; Sikula, Andrew F.

    1980-01-01

    The authors define "cloning" as an integral feature of all educational systems, citing teaching practices which reward students for closely reproducing the teacher's thoughts and/or behaviors and administrative systems which tend to promote like-minded subordinates. They insist, however, that "academic cloning" is not a totally negative practice.…

  13. Academic Words and Academic Capitalism Academic Words and Academic Capitalism

    Michael Billig

    2013-03-01

    Full Text Available

    Este artículo sugiere que esta época es la mejor y peor para la labor académica. La mejor en cuanto hay más publicaciones académicas que nunca. Y la peor porque sobra mucho de estas publicaciones. Trabajando en las condiciones competitivas del capitalismo académico, los académicos se sienten en la necesidad de continuar publicando, independientemente de que tengan algo que decir. Las presiones de publicar continuamente y promover la propia perspectiva se reflejan en la manera en la que los científicos sociales están escribiendo. Y es que los académicos utilizan un lenguaje técnico basado en sustantivos, con una precisión menor a la del lenguaje ordinario. Los estudiantes de postgrado han sido educados en esta manera de escribir como una condición previa a iniciarse en las ciencias sociales. Así, la naturaleza misma del capitalismo académico no sólo determina las condiciones en las que los académicos trabajan, sino que también afecta su manera de escribir.


    This paper suggests that it is the best and worst of times for academic work. It is the best of times because there are more academics publishing than ever before. It is the worst of times because there is much unnecessary publication. Working in the competitive conditions of academic capitalism, academics feel impelled to keep publishing, whether or not they have anything to say. The pressures to publish continually and to promote one’s own approach are reflected in the way that social scientists are writing. Academics use a noun-based technical language, which is less precise than ordinary language. Postgraduates are taught this way of writing as a precondition for entering the social sciences. In this way, the nature of academic capitalism not only determines the conditions under which academics are working but it affects the way that they are writing.

  14. Check-up and follow-up of papillary and follicular thyroid carcinoma in the department of nuclear medicine at Ibn Sina hospital Rabat; Bilan et surveillance des carcinomes papillaire et vesiculaire de la thyroide dans le service de medecine nucleaire de l'hopital Ibn Sina de Rabat

    Ben Rais Aouad, N.; Ghfir, I.; Guerrouj, H.; Fellah, S.; Rahali, J.; Ksyar, R.; Missoum, F.; Bssis, A.; Azrak, S. [CHU Ibn Sina, Service de Medecine Nucleaire, Rabat (Morocco)

    2009-10-15

    In the department of nuclear medicine at Ibn Sina university hospital. Thyroid carcinoma follow-up strategy has been modified and includes cervical ultrasonography and thyroglobulin measurement. The role of radio-iodine scanning in the management of differentiated thyroid carcinoma is decreasing. Papillary and follicular carcinoma have good prognosis but late metastases exist and can lead to death. A lifelong follow-up is therefore mandatory. The main goal of follow-up is to detect earlier persistent or recurrent disease. (authors)

  15. Hospitable radiopharmaceuticals

    Two types of hospitalary radiopharmaceutical was given in Nuclear Medicine: the centralized and hospitalary radiopharmaceuticals. The good practice in the use, instrumentation and quality control of radiopharmaceuticals are used in nuclear medicine for diagnostic and therapy diseases

  16. Veterinary Teaching Hospital introduces radioactive iodine therapy for feline hyperthyroidism

    Douglas, Jeffrey S.

    2008-01-01

    The Virginia-Maryland Regional College of Veterinary Medicine's Veterinary Teaching Hospital has introduced a new radioactive iodine therapy for an endocrine disorder that commonly affects older cats.

  17. Challenges Facing Early Career Academic Cardiologists

    Tong, Carl W.; Ahmad, Tariq; Brittain, Evan L.; Bunch, T. Jared; Damp, Julie B.; Dardas, Todd; Hijar, Amalea; Hill, Joseph A.; Hilliard, Anthony A.; Houser, Steven R.; Jahangir, Eiman; Kates, Andrew M.; Kim, Darlene; Lindman, Brian R.; Ryan, John J.

    2014-01-01

    Early-career academic cardiologists currently face unprecedented challenges that threaten a highly valued career path. A team consisting of early career professionals and senior leadership members of American College of Cardiology (ACC) completed this white paper to inform the cardiovascular medicine profession regarding the plight of early career cardiologists and to suggest possible solutions. This paper includes: (1) definition of categories of early career academic cardiologists, (2) gene...

  18. Musings on genome medicine: the Obama effect redux

    Nathan, David G.; Orkin, Stuart H.

    2009-01-01

    From the point of view of genome medicine, Barack Obama has made two vital policy decisions: he has chosen a new director of the National Institutes of Health, and his proposed change in United States healthcare policy will have profound effects on genome medicine and, indeed, all of academic medicine.

  19. Future directions for academic practice plans: thoughts on organization and management from Johns Hopkins University and the University of Pennsylvania.

    Longnecker, David E; Henson, Douglas E; Wilczek, Kenneth; Wray, Janet L; Miller, Edward D

    2003-11-01

    Academic practice plans have been challenged in recent years by increasing pressures for productivity and financial performance. Most practice plans began as relatively loose affiliations among the clinical departments associated with their respective medical schools, and such approaches were adequate in an earlier era. However, this model is not well suited to deal with the current and future challenges that face the practice plans, hospitals, and medical schools that comprise our academic medical centers. The current clinical, financial, and regulatory environment requires highly effective business management, a shared commitment to common goals, and meticulous attention to regulatory compliance. In turn, the organizational structures, daily management, and overall governance of academic practice plans must be revised to address these new expectations. The business, clinical, and academic performance of the individual practices must be aligned to meet the diverse, and sometimes conflicting, needs of the academic health center. Both Johns Hopkins Medicine and the University of Pennsylvania (Penn Medicine) have been addressing these issues independently, but their approaches share many common principles. Among others, these principles include (a) organizational alignment, (b) strong practice plan business management, (c) shared resources and strategies, (d) accountability for performance in each practice based on credible data generated by the practice plan, (e) uniform audit and compliance standards, and (f) application of market strategy principles to assure the right mix of primary and specialist physicians, and appropriate incentive-based compensation for physicians. The application of these approaches at two academic health centers, and the rationale for these approaches, are discussed in detail. PMID:14604872

  20. 中医医院护士组织公民行为与组织公平感相关性研究%The relationship between organizational citizenship behavior and organizational justice among nurses in traditional Chinese medicine hospitals

    曹秋茹; 郭玲玉; 刘根莉

    2011-01-01

    Objective: To explore the relationship between organizational justice and organizational citizenship behavior among clinical nurses. Methods: A total of 316 nurses from 4 large traditional Chinese medicine hospitals were investigated by Organizational Justice Questionnaire and Chinese Organizational Citizenship Behavior Scale. Results:There was a positive relationship between organizational justice and organizational citizenship behaviors among clinical nurse after controlling their demographic variables. Conclusion:This study confirms that organizational justice can significantly predict organizational citizenship behaviors. Nursing managers must attach more importance to organizational justice to eliminate nurse's unfair feeling which could negatively impact the nurses' working enthusiasm.%目的:通过实证研究验证中医医院临床护士的组织公平感与组织公民行为的关系.方法:采用横断面问卷调查法对来自4 家大型中医医院的316 名护士进行组织公平感和组织公民行为的测量.结果:在控制了人口统计学变量后,组织公平感与中医护士的组织公民行为显著相关.结论:中医医院护士的组织公平感会对其组织公民行为具有积极的正向影响,所以护理管理者必须给予高度重视,尽力消除不公平感对护士工作积极性的消极影响.

  1. 结合JCI标准加强我院病区科室药品管理%Enhancement of Ward Departments Management of Medicines in Our Hospital Based on JCI Standard

    刘世林; 杨晓蓉; 黄亮; 张伶俐

    2012-01-01

    目的:加强病区药品管理,保证患者用药安全.方法:结合《美国医疗机构评审国际联合委员会医院评审标准》(下简称JCI标准)药品管理原则,从普通药品基数管理、药品贮存与养护、高危药品管理、麻醉药品和一类精神药品以及急救药品管理进行行政和技术干预,制订持续改进的方法和流程.12个月后评价干预效果,并与干预前进行比较.结果:12个月后,普通药品未按要求贮存(8 vs.19)、未规范放置(11 vs.78)和药品基数不符(0vs.1)等均较干预前减少,差异有统计学意义(P<0.05);各病区高危药品、麻醉和一类精神药品、急救药品管理合格率达到100%.结论:结合JCI标准后,加强了我院病区药品管理的制度化、规范化及多部门协作,促进了药品管理和用药安全的持续改进与提高.%OBJECTIVE: To enhance ward management of medicines, and to gurantee the safety of drag use. METHODS: Based on American Joint Commission on the Accreditation of Healthcare Organizations International Accreditation Standards for Hospitals (called JCI for short), the standard, system and work flow of ward management of medicines were established, and index for performance check were all determined, such as base of drug management, drag storage and conservation, the management of high-risk drugs, narcotics and class I psychotropic substances and emergency drugs. 12 months later, the effects of JCI standard were compared before and after the implementation. RESULTS: 12 months later, the number of drags which were not stored in accordance with standard (8 vs. 19), not placed in right place (11 vs. 78) or drug base not imcompatible (0 vs. 1) were decreased, there was statistical significance (P<0.05); the qualified rate of the management of high-risk drugs, narcotics and class I psycho-tropic substances and emergency drugs all reached 100%. CONCLUSION: The use of JCI standard enhances the systemization and standardization

  2. Academic entrepreneurship

    Sass, Enrico

    2013-01-01

    Research on entrepreneurial motivation of university scientists is often determined by quantitative methods without taking into account context-related influences. According to different studies, entrepreneurial scientists found a spin-off company due to motives like independency, market opportunity, money or risk of unemployment (short-term contracts). To give a comprehensive explanation, it is important to use a qualitative research view that considers academic rank, norms and values of uni...

  3. Institutionalizing the academic health department within the context of the 3-fold academic mission.

    Livingood, William C; Goldhagen, Jeffrey; Bryant, Thomas; Harmon, Robert G; Wood, David L

    2014-01-01

    A mature model of an academic health department (AHD) that has been institutionalized over 2 decades is described within the context of the 3-fold traditional mission of academics (teaching, research, and service/practice). This adaptive model for AHDs, based on mutual benefits that can be viewed through the lenses of both the academic health center mission and the public health functions and services, has important implications for AHD sustainability. Continued collaboration in any academic-public health partnership will depend in part on the commitments of the changing leadership. However, institutionalizing support for the academic mission enables this collaboration to transcend changing leadership styles and priorities. The collaboration of Duval County Health Department and University of Florida College of Medicine-Jacksonville is an example of a model of AHD that has endured major changes in leadership within both the academic center and the Duval County Health Department. PMID:24667196

  4. Improving patient safety in transfusion medicine: contemporary challenges and the roles for bedside and laboratory biovigilance in addressing them

    Andrzejewski Jr C

    2014-07-01

    Full Text Available Chester Andrzejewski Jr,1 Darlene Cloutier,1 David Unold,2 Richard C Friedberg1 1Transfusion Medicine Services, Department of Pathology, Baystate Medical Center, Baystate Health, Springfield, MA, 2Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA Abstract: Throughout the history of hemotherapy (HT, various challenges and concerns have been encountered in its practical application. When viewed using a prismatic lens of history, recurrent themes regarding adverse HT sequelae separate and become apparent. These can be broadly classified into three categories: infectious, noninfectious, and administrative/logistical. Using the HT care map as a frame of reference along with its associated rites, we examine the contemporary spectrum of HT adverse events and concerns, and some approaches as to how these may be addressed from bedside and laboratory medicine biovigilance perspectives enhancing patient care and blood transfusion safety. Although our vantage point is from an academic community hospital venue, the issues and concerns identified are germane to many if not all transfusion-medicine practice environments. Included among the subjects we explore are patient/specimen identification issues, blood-management initiatives, unrecognized and/or unreported suspected transfusion reactions, transfusion-associated adverse pulmonary sequelae (including transfusion-related acute lung injury and transfusion-associated circulatory overload, expanded applications of electronic health records and issues regarding their “meaningful use” and interinstitutional “digital compatibilities”, biovigilance integration of electronic data networks within and between health care entities, and anticipated workforce contractions secondary to projected declines in the availability of qualified laboratory professionals. Cooperative initiatives between accreditation and regulatory entities, blood collectors and suppliers, hospital

  5. Relation between academic yield and stress in medical students

    María del Mar Durán Ortiz; Camila Escobar Alvira; Adriana Morales Acosta; Samuel Arturo Monroy Castaño; Alexander Ramírez Álvarez; Juliana Ramírez Hoyos; José Luis Trejos Valdés; José Jaime Castaño Castrillón; Sandra Patricia González Peña

    2006-01-01

    Objective. To study risk factors that where found as influence in the academic yield (stress, alcohol, friendships, depression and family relations) in the students of the Medicine Faculty of the Universidad de Manizales. Materials and methods: Descriptive study integrated by random selected sample, who were attending of II to XI semester of the Medicine faculty. An anonymous survey was conduced about sociodemographic, cultural, academic and motivational characteristics,including stress, depr...

  6. O brinquedo no hospital: uma análise da produção acadêmica dos enfermeiros brasileiros El juguete en el hospital: un análisis de la producción Académica de los Enfermeros Brasileños The toy in the hospital: an analysis of the Brazilian Nurses' academic production

    Tânia Maria Coelho Leite

    2007-06-01

    Full Text Available Este estudo teve como objetivo analisar o conteúdo das teses e dissertações de enfermeiros brasileiros sobre a utilização do brinquedo no hospital. O levantamento dos dados foi realizado por meio de uma busca no Portal Capes, Cepen, Ibict e consulta às referências dos trabalhos, que foram analisados qualitativamente. Os objetivos mais freqüentemente encontrados referem-se à vivência da criança durante a hospitalização, ao significado e importância do brinquedo e dificuldades para sua implantação. O brinquedo foi utilizado com maior freqüência no pré e pós-operatório. A análise dos resultados obtidos nos trabalhos pautou-se nos efeitos do brinquedo sobre as crianças. Ficou evidente que, para os enfermeiros, o brinquedo é ferramenta indispensável no cuidado à criança. Portanto, recomenda-se que a prática do brinquedo / brinquedo terapêutico seja utilizada no plano de assistência de enfermagem pediátrica.Este estudio tuvo como objetivo analizar el contenido de las tesis y disertaciones de enfermeros brasileños sobre la utilización del juguete en el hospital. Los datos fueron levantados a traves de una búsqueda en el Portal Capes, Cepen, Ibict, consultando las referencias de los trabajos y analizándolos de manera cualitativa. Los objetivos encontrados con más frecuencia se refieren a la vivencia del niño durante la hospitalización, al significado y a la importancia del juguete y a las dificultades para implantar su presencia en el ámbito hospitalar. El juguete fue usado con más frecuencia en el pré y en el post-operatorio. El análisis de los resultados obtenidos en los trabajos fué pautado en el efecto que los juguetes tienen sobre los niños. Quedó evidente que para los enfermeros, el juguete es una herramienta indispensable en el cuidado de los niños. Por lo tanto, recomiendase que la práctica del juguete / juguete terapéutico sea usado en el plano de asistencia de enfermería pediátrica.The purpose

  7. Nuclear medicine

    The article deals with the growth of nuclear medicine in India. Radiopharmaceuticals both in elemental form and radiolabelled compounds became commercially available in India in 1961. Objectives and educational efforts of the Radiation Medicine Centre setup in Bombay are mentioned. In vivo tests of nuclear medicine such as imaging procedures, dynamic studies, dilution studies, thyroid function studies, renal function studies, linear function studies, blood flow, and absorption studies are reported. Techniques of radioimmunoassay are also mentioned. (S.K.K.)

  8. Hospital Variation in Survival After In‐hospital Cardiac Arrest

    Merchant, Raina M.; Berg, Robert A.; Yang, Lin; Becker, Lance B.; Groeneveld, Peter W.; Chan, Paul S.

    2014-01-01

    Background In‐hospital cardiac arrest (IHCA) is common and often fatal. However, the extent to which hospitals vary in survival outcomes and the degree to which this variation is explained by patient and hospital factors is unknown. Methods and Results Within Get with the Guidelines‐Resuscitation, we identified 135 896 index IHCA events at 468 hospitals. Using hierarchical models, we adjusted for demographics comorbidities and arrest characteristics (eg, initial rhythm, etiology, arrest location) to generate risk‐adjusted rates of in‐hospital survival. To quantify the extent of hospital‐level variation in risk‐adjusted rates, we calculated the median odds ratio (OR). Among study hospitals, there was significant variation in unadjusted survival rates. The median unadjusted rate for the bottom decile was 8.3% (range: 0% to 10.7%) and for the top decile was 31.4% (28.6% to 51.7%). After adjusting for 36 predictors of in‐hospital survival, there remained substantial variation in rates of in‐hospital survival across sites: bottom decile (median rate, 12.4% [0% to 15.6%]) versus top decile (median rate, 22.7% [21.0% to 36.2%]). The median OR for risk‐adjusted survival was 1.42 (95% CI: 1.37 to 1.46), which suggests a substantial 42% difference in the odds of survival for patients with similar case‐mix at similar hospitals. Further, significant variation persisted within hospital subgroups (eg, bed size, academic). Conclusion Significant variability in IHCA survival exists across hospitals, and this variation persists despite adjustment for measured patient factors and within hospital subgroups. These findings suggest that other hospital factors may account for the observed site‐level variations in IHCA survival. PMID:24487717

  9. COPD Medicine

    ... AerobiKa® Cardiology Medications Anticoagulant Medicine Anticoagulants and Drug-Food Interactions COPD Medications Bronchodilators Anti-Inflammatories Antibiotics Managing Your Medications Devices ...

  10. Tratamento de hidrocefalia com derivação ventrículo-peritoneal: análise de 150 casos consecutivos no Hospital das Clínicas de Ribeirão Preto Treatment of hydrocephalus by ventriculoperitoneal shunt: analysis of 150 consecutive cases in the Hospital of the Faculty of Medicine of Ribeirão Preto

    Carlos Eduardo Barros Jucá

    2002-01-01

    Full Text Available INTRODUÇÃO: O presente trabalho analisou 150 casos consecutivos de tratamento da hidrocefalia com DVP no Hospital das Clínicas de Ribeirão Preto entre março de 1997 e julho de 2000. OBJETIVO: Traçar as principais características dos pacientes e dos procedimentos, com ênfase nas etiologias, diagnóstico, complicações, seqüelas e fatores associados. MÉTODOS: Prontuários médicos como fonte para quantificar as variáveis selecionadas. RESULTADOS: As etiologias congênitas e adquiridas tiveram a mesma incidência, destacando-se a mielomeningocele no primeiro grupo e a prematuridade e a meningite no segundo. As principais complicações foram o mal funcionamento da válvula (33% e a infecção (15%. Incluídas as cirurgias devido às complicações, houve 2,5 procedimentos por paciente em média. No último retorno, 40% dos pacientes apresentavam algum grau de retardo do desenvolvimento neuro-psico-motor (RDNPM. As principais etiologias relacionadas a RDNPM foram prematuridade, meningite e malformações complexas. Discussão: O trabalho serviu como ferramenta para ajudar a caracterizar a história natural da hidrocefalia e de seu tratamento em nosso meio, fornecendo base para uma melhor compreensão da mesma e para comparação com a literatura e com outros serviços. A taxa de RDNPM está condizente com a literatura. A taxa de infecção está mais elevada, podendo haver relação com o fato de ser este um hospital-escola. Maior tempo de seguimento seria necessário para comparação da incidência de complicações mecânicas.INTRODUCTION/OBJECTIVES: This study has analyzed 150 consecutive cases of treatment of hydrocephalus by ventriculoperitoneal shunt in the Faculty of Medicine of Ribeirão Preto's Hospital between May 1997 and July 2000, in order to stablish the main characteristics of the patients and proceedings , in particular the etiologies, diagnosis, complications, final outcome and associated factors. METHODS: Medica

  11. Abstracts From the Proceedings of the 2015 Annual Meeting of the Clerkship Directors of Internal Medicine (CDIM).

    Nixon, L James; Ryder, Hilary F; Alexandraki, Irene; Lyons, Maureen D; McEwen, Kelsey Angell; DeWaay, Deborah J; Warrier, Sarita; Lang, Valerie J; LaRochelle, Jeffrey

    2016-01-01

    Since its inception in 1989, Clerkship Directors in Internal Medicine (CDIM) has promoted excellence in medical student education. CDIM members move medical education forward by sharing innovations in curriculum and assessment and discoveries related to educating our students and administering our programs. The Alliance for Academic Internal Medicine, of which CDIM is a founding member, broadens the umbrella beyond student education to include five academically focused specialty organizations representing departments of medicine, teaching hospitals, and medical schools working together to advance learning, discovery, and caring. CDIM held its 2015 annual meeting at Academic Internal Medicine Week in Atlanta, Georgia. This year 36 innovation and research submissions were selected for either oral abstract or poster presentation. The quality of the presentations was outstanding this year and included many of the most important issues in medical education. The CDIM research committee selected the following seven abstracts as being of the highest quality, the most generalizable, and relevant to the readership of Teaching and Learning in Medicine. Two abstracts include information from the CDIM annual survey, which remains a rich source for answering questions about student education on a national level. Looking at trends in medical education, three of the seven selected abstracts mention entrustable professional activities. Three of the abstracts address how we assess student skill and provide them with appropriate feedback. These include two schools' approach to bringing milestones into the medical student realm, use of objective structured clinical exam for assessing clinical skill in clerkship, and what students want in terms of feedback. Four articles deal with curricular innovation. These include interprofessional education, high-value care, transitions of care, and internship preparation. We are pleased to share these abstracts, which represent the breadth and

  12. Complementary and Alternative Medicine: A Survey of Its Use in Pediatric Oncology

    Rafiaa Valji

    2013-01-01

    Full Text Available Background. The use of complementary and alternative medicine (CAM is high among children and youths with chronic illnesses, including cancer. The objective of this study was to assess prevalence and patterns of CAM use among pediatric oncology outpatients in two academic clinics in Canada. Procedure. A survey was developed to ask patients (or their parents/guardians presenting to oncology clinics at the Stollery Children’s Hospital in Edmonton and the Children’s Hospital of Eastern Ontario (CHEO in Ottawa about current or previous use of CAM products and practices. Results. Of the 137 families approached, 129 completed the survey. Overall CAM use was 60.5% and was not significantly different between the two hospitals. The most commonly reported reason for not using CAM was lack of knowledge about it. The most common CAM products ever used were multivitamins (86.5%, vitamin C (43.2%, cold remedies (28.4%, teething remedies (27.5%, and calcium (23.0%. The most common CAM practices ever used were faith healing (51.0%, massage (46.8%, chiropractic (27.7%, and relaxation (25.5%. Many patients (40.8% used CAM products at the same time as prescription drugs. Conclusion. CAM use was high among patients at two academic pediatric oncology clinics. Although most respondents felt that their CAM use was helpful, many were not discussing it with their physicians.

  13. ACADEMIC TRAINING

    Françoise Benz

    2002-01-01

    6, 7 May LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 Decoding the Human Genome, Scientific basis and ethic and social aspects by S.E. Antonarakis and A. Mauron / Univ. of Geneva Decoding the Human genome is a very up-to-date topic, raising several questions besides purely scientific, in view of the two competing teams (public and private), the ethics of using the results, and the fact that the project went apparently faster and easier than expected. The lecture series will address the following chapters: Scientific basis and challenges, Ethical and social aspects of genomics. Academic Training Françoise Benz Tel. 73127

  14. How Did Social Medicine Evolve, and Where is it Heading?

    Dorothy Porter

    2007-01-01

    This essay briefl y examines some of the diverse developments of social medicine as an academic discipline and its links to political conceptualizations of the role of medicine in society. The author then analyses the possible future directions open to the discipline in the Anglo-American context. A better understanding of the evolution of social medicine could help to focus its role in responding to the health needs of a post-industrial, globalizing world. [PLoS Medicine, October 2006

  15. 中医院校护理本科生学习适应性的调查研究%Academic adjustment of undergraduate nursing students in the University of Traditional Chinese Medicine

    王惠婷; 李壮苗

    2014-01-01

    目的:调查护理本科生学习适应性,为护理教育者指导护理专业学生改善学习适应性提供依据。方法采用学习适应性量表对251名在校护理本科生进行调查。结果护理本科生学习适应性为(3.52±0.44)分,各维度得分不均衡。高年级、家庭教育类型为放任型的护理专业学生学习能力高(P<0.05)。低年级护理本科生学习态度端正(P<0.05),专业满意度为学生学习动机、教学模式、学习能力、学习态度及学习适应总分的重要影响因素(P<0.05)。结论护理本科生学习态度端正,但学习动机和环境得分较低。护理教育者应针对护理学专业学生的学习适应问题引导其寻找内在的学习动力,形成良好的学习态度,为其提供良好的学习环境。%Objective To investigate the level of academic adjustment among undergraduate nursing students,and provide a basis for nursing educators to improve students' academic adjustment. Methods Totally 251 undergraduate nursing students were investigated using Undergraduate Academic Adjustment Scale (UAAS). Results The score of academic adjustment among undergraduate nursing students was(3.52±0.44).The scores of academic ability were different among students in different family education styles(P<0.05) and grades(P<0.05);the scores of learning attitudes were different among students in different grades(P<0.05). Moreover,professional satisfaction was related to the scores of learning motivation,teaching mode,academic ability,learing attitudes and the total score of academic adjustment (P<0.05). Conclusion Undergraduate nursing students have right learning attitudes,but lower level of learning motivation and academic environment. Nursing educators should guide nursing students looking for intrinsic motivation,forming good academic attitude,and provide well academic environment for them aiming at different adjustment problems.

  16. Vacinação dos viajantes: experiência do Ambulatório dos Viajantes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Travelers' vaccinations: experience from the Travelers' Clinic of Hospital das Clínicas, University of São Paulo School of Medicine

    Simone Chinwa Lo

    2008-10-01

    Full Text Available O perfil dos indivíduos, a situação vacinal e as vacinas recomendadas aos viajantes que procuram o serviço médico de orientação pré-viagem do Ambulatório dos Viajantes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo foram analisados no presente estudo. Dos 445 viajantes estudados, 51% eram mulheres; a mediana de idade foi de 33,5 anos; 51% viajavam a trabalho e 39,5% por lazer. Destinos mais procurados: África (47%; Ásia (31,7%; América do Sul (21,4%. Trezentos e oitenta e cinco (86,5% viajantes tiveram indicação de vacinação para viagem. Principais vacinas recomendadas: febre tifóide (55,7%, difteria-tétano (54,1%, hepatite A (46,1%, hepatite B (44,2%, febre amarela (24,7%. A orientação pré-viagem mostrou-se importante não só para indicar as vacinas recomendadas para a viagem, mas também como oportunidade para atualização das vacinas de rotina.TThe profile and vaccination status of travelers seeking pre-travel medical advice at the Travelers' Clinic of Hospital das Clínicas, University of São Paulo School of Medicine, and the vaccines recommended for them, were analyzed in the present study. Among the 445 travelers who were studied, 51% were women, the median age was 33.5 years, 51% were traveling on business and 39.5% were traveling for leisure purposes. The destinations most sought were Africa (47%, Asia (31.7% and South America (21.4%. Vaccination before traveling was recommended for 385 (86.5% of the travelers. The main vaccines recommended were against typhoid fever (55.7%, diphtheria-tetanus (54.1%, hepatitis A (46.1%, hepatitis B (44.2% and yellow fever (24.7%. The pre-travel guidance was shown to be important not only for indicating the vaccines recommended for the trip, but also as an opportunity to update routine vaccinations.

  17. Programa de Triagem Neonatal do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil Neonatal Screening Program at the University Hospital of the Ribeirao Preto School of Medicine, São Paulo University, Brazil

    Patrícia Künzle Ribeiro Magalhães

    2009-02-01

    Full Text Available O Programa de Triagem Neonatal do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil, instituído em 1994 diagnosticou, até 2005, 76 crianças com hipotireoidismo congênito, 10 com fenilcetonúria e 25 com hemoglobinopatias, o que representou uma incidência de 1:2.595, 1:19.409, 1:4.120, respectivamente. Foram diagnosticadas 2.747 crianças com traço falciforme (1:37,5 nascidos vivos. A cobertura média do programa foi de 94,5%. Houve uma considerável melhora nos parâmetros de avaliação da qualidade do programa no período, porém, sem atingir os índices ideais. Campanhas visando à maior divulgação da importância da triagem neonatal são necessárias para aumentar a cobertura e a instituição do 3º dia de vida do recém-nascido como sendo o Dia do Teste do Pezinho poderia contribuir para que idades mais precoces de tratamento fossem atingidas, melhorando o prognóstico das crianças acometidas.The Neonatal Screening Program at the University Hospital of the Ribeirao Preto School of Medicine, São Paulo University, Brazil, was introduced in 1994. As of December 2005, congenital hypothyroidism had been diagnosed in 76 infants, phenylketonuria in 10, and hemoglobinopathies in 25, representing incidence rates of 1:2,595, 1:19,409, and 1:4,120, respectively. A total of 2,747 newborns had the sickle cell trait, i.e., were heterozygous for the sickle mutation (1:37.5 live births. The program's mean coverage during this period was 94.5%. There was major improvement in the parameters for evaluating the program's quality, although they were still far from ideal. Public-awareness campaigns on the importance of neonatal screening are needed to increase the program's coverage. Setting postnatal day 3 as the standard Day for the Heel Stick Test would help ensure treatment at earlier ages, thus improving prognosis for affected infants.

  18. Vulnerable Medicine

    Bochner, Arthur P.

    2009-01-01

    In "Narrative Medicine: Honoring the Stories of Illness," Rita Charon paints an original and humane portrait of what it can mean to be a doctor, to live a life immersed in sickness and dedicated to wellness. Charon drops the veil, inviting readers to look at the secret, subjective, emotional face of medicine, a zone of self-censored feelings and…

  19. Effect of Academic Education on Patient Satisfaction

    Narges Ebrahimi; M. D. Lawrence

    2013-01-01

    The study of patient satisfaction is becoming increasingly important. From the business perspective, patients represent the major customers of the hospital who receive and feel the healthcare services directly and realistically. However, despite their many efforts and successes with satisfaction measurement, evidence shows that more work in this area is still needed. This research investigates the effects and the relative importance of academic education on patient satisfaction. Eleven hospit...

  20. A family-oriented therapy program for youths with substance abuse: long-term outcomes related to relapse and academic or social status

    Wang, Liang-Jen

    2016-01-01

    Liang-Jen Wang,1 Shing-Fang Lu,1 Mian-Yoon Chong,2 Wen-Jiun Chou,1 Yu-Lian Hsieh,1 Tong-Ning Tsai,1 Ching Chen,2 Yi-Hsuan Lee11Department of Child and Adolescent Psychiatry, 2Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanObjective: The abuse of illegal substances by youths in Taiwan has become a major public health issue. This study explores the outcomes (relapse rate and academic or social status) of a family-ori...

  1. Emergency Medicine in Guyana: Lessons from Developing the Country's First Degree-conferring Residency Program

    Nicolas P Forget

    2013-09-01

    Full Text Available Introduction: Academic departments of emergency medicine are becoming increasingly involved in assisting with the development of long-term emergency medicine training programs in low and middle-income countries. This article presents our 10-year experience working with local partners to improve emergency medical care education in Guyana.Methods: The Vanderbilt Department of Emergency Medicine has collaborated with the Georgetown Public Hospital Corporation on the development of Emergency Medicine skills followed by the implementation of an emergency medicine residency training program. Residency development included a needs assessment, proposed curriculum, internal and external partnerships, University of Guyana and Ministry of Health approval, and funding.Results: In our experience, we have found that our successful program initiation was due in large part to the pre-existing interest of several local partners and followed by long-term involvement within the country. As a newer specialty without significant local expertise, resident educational needs mandated a locally present full time EM trained attending to serve as the program director. Both external and internal funding was required to achieve this goal. Local educational efforts were best supplemented by robust distance learning. The program was developed to conform to local academic standards and to train the residents to the level of consultant physicians. Despite the best preparations, future challenges remain.Conclusion: While every program has unique challenges, it is likely many of the issues we havefaced are generalizable to other settings and will be useful to other programs considering or currentlyconducting this type of collaborative project. [West J Emerg Med. 2013;14(5:477–481.

  2. Perspectives and practical applications of medical oncologists on defensive medicine (SYSIPHUS study): a study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG).

    Tanriverdi, Ozgur; Cay-Senler, Filiz; Yavuzsen, Tugba; Turhal, Serdar; Akman, Tulay; Komurcu, Seref; Cehreli, Ruksan; Ozyilkan, Ozgur

    2015-04-01

    Defensive medicine occasionally indulges unnecessary treatment requests to defend against lawsuits for medical errors and the use of unapproved medical applications. This study determines the attitudes and orientations of medical oncologists on defensive medicine. A cross-sectional survey was sent by e-mail to medical oncologists. The survey was designed to determine the participants' demographic characteristics and defensive medicine practices. The survey measured the attitudes about defensive medicine practices of the oncologists based on a five-point Likert scale (never, rarely, sometimes, often, and always). One hundred and forty-six of a total of 402 physicians serving in oncology were fully filled, and the rate of return invitation was 36 %. The majority of participants were male, with a duration of between 7 and 9 years of work as university hospital officials, and the mean age was 46 ± 9 (years). International guidelines were followed in the most common is NCCN, and the majority of respondents felt that the application of these guidelines improves their defensive medicine. All participants of defensive medicine who stand on the basis of the definition were found to be more afraid of complaints by patients' relatives. Physicians of 45 % was noted that applying defensive medicine. Among the participants were the most frequent checkups of positive defensive approach is defined as increasing or shortening the follow-up period, while avoiding high-risk patients were detected as described in the definition of negative defensive medicine. Both professional groups in both the positive and negative defensive medicine approach defensive medicine approach, academic tasks, work experience and job time, there was a significant correlation between the location. Made in single- and multi-variable analyses, positions were identified both positive and negative defensive medicine is an independent risk factor for direction. Improving the working conditions of young

  3. Assessment of preclinical students’ academic motivation before and after a three-day academic affair program

    Aung MN; Somboonwong J; Jaroonvanichkul V; Wannakrairot P

    2015-01-01

    Myo Nyein Aung,1 Juraiporn Somboonwong,2 Vorapol Jaroonvanichkul,1 Pongsak Wannakrairot3 1Medical Education Unit, 2Quality Management Division and Department of Physiology, 3Academic Affairs Division, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandBackground: Medical students’ motivation is an important driving factor for academic performance, and therefore medical teachers and educators are often highly interested in this topic. This study evaluated the impact of an ac...

  4. Brief hospitalizations of elderly patients

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...... than 24 hours, as such short admissions could indicate that the patients had not been severely ill and that it might have been possible in these cases to avoid hospitalization. METHODS: Medical records were examined to determine the number of patients aged 75 or more who passed through the emergency...... department over a period of two months, and the proportion of those patients who were discharged after less than 24 hours. The reasons for the hospitalization, the diagnoses and the treatment given were noted. RESULTS: There was a total of 595 hospitalizations of patients aged 75 or above in the emergency...

  5. ACADEMIC TRAINING

    Françoise Benz

    2002-01-01

    25, 26, 27, 28 February and 1st March from 11.00 to 12.00 hrs - Auditorium, bldg. 500 LECTURE SERIES Neutrino masses and oscillations by A. de Rujula / CERN-TH This course will not cover its subject in the customary way. The emphasis will be on the simple theoretical concepts (helicity, handedness, chirality, Majorana masses) which are obscure in most of the literature, and on the quantum mechanics of oscillations, that ALL books get wrong. Which, hopefully, will not deter me from discussing some of the most interesting results from the labs and from the cosmos. Academic Training Françoise Benz Secretariat Tel. 73127 francoise.benz@cern.ch

  6. Chinese Academic Journal(CA J- CD) International Version Starts to Be Published for Overseas

    2005-01-01

    @@ Chinese Academic Journal(CAJ-CD) is a series of integrated full text database of current electronic academic journals in China. The subject areas of CAJ-CD are included in the humanities, social science,natural. science, engineering, agriculture, medicine, technology, and so on. All these journals reflect the progresses and the most recent dynamic developing information in China's academic researches.

  7. Celebrating Leadership in Public Health and Medicine Friends of the National Library of Medicine (FNLM) | NIH ...

    ... of this page please turn Javascript on. Celebrating Leadership in Public Health and Medicine Friends of the ... Hospital Dr. Braunwald was honored for his outstanding leadership and contributions to the world of cardiology as ...

  8. Academic Engagement and Commercialisation

    Perkmann, Markus; Tartari, Valentina; McKelvey, Maureen;

    2013-01-01

    as ‘academic engagement’. Apart from extracting findings that are generalisable across studies, we ask how academic engagement differs from commercialisation, defined as intellectual property creation and academic entrepreneurship. We identify the individual, organisational and institutional...... antecedents and consequences of academic engagement, and then compare these findings with the antecedents and consequences of commercialisation. Apart from being more widely practiced, academic engagement is distinct from commercialisation in that it is closely aligned with traditional academic research...

  9. Implementing a global integrative rehabilitation medicine rotation: a physical medicine and rehabilitation residency program's experience.

    Kosasih, Judith B; Jurisic, Daniela H; Gandini, Cristiano; Sauter, Carley N; Braza, Diane W

    2013-06-01

    An innovative international rotation in integrative rehabilitation medicine was implemented as part of the physical medicine and rehabilitation residency program at the Medical College of Wisconsin. Rotation objectives were to introduce medical knowledge of integrative medicine treatments into physical medicine and rehabilitation practice and to initiate collaboration with international academic partners. Residents were approved based on their academic record, completion of prerequisites, and personal statement. During a 4-wk rotation located in Italy, residents developed an integrative treatment strategy for each patient using conventional medical care and other therapeutic options, including acupuncture, biofeedback, aquatic therapy, yoga, and others. Postrotation assessment included evaluations by Italian team and patients, residents' evidence-based presentations, and postrotation self-reflection. Participating residents reported high achievement in clinical performance, improved application of integrative medicine, broader appreciation of cultural diversity in patient care, and increased personal and professional development. This reciprocal program model serves as an example for other programs interested in implementing similar international rotations. PMID:23291603

  10. Commentary: Interim leadership of academic departments at U.S. medical schools.

    Grigsby, R Kevin; Aber, Robert C; Quillen, David A

    2009-10-01

    Medical schools and teaching hospitals are experiencing more frequent turnover of department chairs. Loss of a department chair creates instability in the department and may have a negative effect on the organization at large. Interim leadership of academic departments is common, and interim chairs are expected to immediately demonstrate skills and leadership abilities. However, little is known about how persons are prepared to assume the interim chair role. Newer competencies for effective leadership include an understanding of the business of medicine, interpersonal and communication skills, the ability to deal with conflict and solve adaptive challenges, and the ability to build and work on teams. Medical schools and teaching hospitals need assistance to meet the unique training and support needs of persons serving as interim leaders. For example, the Association of American Medical Colleges and individual chair societies can develop programs to allow current chairs to reflect on their present positions and plan for the future. Formal leadership training, mentorship opportunities, and conscientious succession planning are good first steps in preparing to meet the needs of academic departments during transitions in leadership. Also, interim leadership experience may be useful as a means for "opening the door" to underrepresented persons, including women, and increasing the diversity of the leadership team. PMID:19881413

  11. Hospital Hints

    ... and your family. They can help find homecare, rehabilitation, social services, long-term care, and support groups. Inside the Hospital Hospitals have many patient-care areas. For example, the intensive care unit (also called the ICU) has special equipment and staff to care for ...

  12. Folk Medicine

    ... CLPPP CAP Healthy Homes Assessment Tools Lead Health Literacy Initiative Refugee Tool Kit Resources Healthy Homes and ... As blood lead levels increase, so does lead’s effects on health. How to tell if herbal medicines ...

  13. [Management strategies and choice of antithrombotic treatment in patients admitted with acute coronary syndrome--executive summary for clinical practice. Consensus Document of the Regional Chapters of the Italian National Association of Hospital Cardiologists (ANMCO) and of the Italian Society of Emergency Medicine (SIMEU)].

    Uguccioni, Massimo; Pugliese, Francesco; De Luca, Leonardo; Tubaro, Marco; Ruggieri, Maria Pia; Colivicchi, Furio; Ammirati, Fabrizio; Ansalone, Gerardo; Avella, Andrea; Azzolini, Paolo; Bertazzoni, Giuliano; Brama, Paolo; Cacciatore, Giuseppe; De Luca, Massimo; De Simone, Massimo; Di Fusco, Stefania Angela; Ferraiuolo, Giuseppe; Ferranti, Fabio; Granatelli, Antonino; Loschiavo, Paolo; Mezzanotte, Roberto; Mirante, Enrico; Monti, Francesco; Pajes, Giuseppe; Pandolfo, Luciano; Proiettil, Fabrizio; Revello, Alessandra; Rigattieri, Stefano; Sabetta, Francesco; Sciahbasi, Alessandro; Scioli, Roberto; Serdoz, Roberto; Susi, Beniamino; Vincentelli, Giovanni Maria; Zuccalà, Giuseppe; Zulli, Luigi

    2013-03-01

    This document has been developed by the Lazio regional chapters of two scientific associations, the Italian National Association of Hospital Cardiologists (ANMCO) and the Italian Society of Emergency Medicine (SIMEU), whose members are actively involved in the everyday management of Acute Coronary Syndromes (ACS). The document is aimed at providing a specific, practical, evidence-based guideline for the effective management of antithrombotic treatment (antiplatelet and anticoagulant) in the complex and ever changing scenario of ACS. The document employs a synthetic approach which considers two main issues: the actual operative context of treatment delivery and the general management strategy. PMID:23923585

  14. Medicinal Moves

    2011-01-01

    Traditional Chinese medicine is becoming a new source of growth in China-Africa trade LIU Tao never expected that his traditional Chinese medicine (TCM) products would be so warmly welcomed at the annual Canton Fair last year.His surprise came after a large number of African businessmen expressed a keen interest in importing the products.That knowledge left a broad smile on his face.

  15. Surviving Hurricane Katrina: reconstructing the educational enterprise of Tulane University School of Medicine.

    Krane, N Kevin; Kahn, Marc J; Markert, Ronald J; Whelton, Paul K; Traber, Peter G; Taylor, Ian L

    2007-08-01

    Hurricane Katrina was one of the greatest natural disasters to ever strike the United States. Tulane University School of Medicine, located in downtown New Orleans, and its three major teaching hospitals were flooded in the aftermath of the storm and forced to close. Faculty, students, residents, and staff evacuated to locations throughout the country. All critical infrastructure that normally maintained the school, including information technology, network communication servers, registration systems, and e-mail, became nonoperational. However, on the basis of experiences learned when Tropical Storm Allison flooded the Texas Medical Center in 2001, Baylor College of Medicine, University of Texas-Houston, University of Texas Medical Branch in Galveston, and Texas A&M School of Medicine created the South Texas Alliance of Academic Health Centers, which allowed Tulane to move its education programs to Houston. Using Baylor's facilities, Tulane faculty rebuilt and delivered the preclinical curriculum, and clinical rotations were made available at the Alliance schools. Remarkably, the Tulane School of Medicine was able to resume all educational activities within a month after the storm. Educational reconstruction approaches, procedures employed, and lessons in institutional recovery learned are discussed so that other schools can prepare effectively for either natural or man-made disasters. Key disaster-response measures include designating an evacuation/command site in advance; backing up technology, communication, financial, registration, and credentialing systems; and establishing partnership with other institutions and leaders. PMID:17762249

  16. Florida International University: development and accreditation of Miami's Public College of Medicine.

    Rock, John A; Simpson, Joe Leigh; Dambach, George; O'Leary, J Patrick; Markham, Sanford; Bagby, Larry; Seecharan, Khaleel; Berkman, Ronald M

    2009-10-01

    Anticipating pressing health care needs in the region, Florida International University (FIU) proposed the FIU College of Medicine (COM), which was approved by the Florida Board of Governors in March 2006. The FIU COM provides a program of study enabling graduates to pursue a wide spectrum of professional careers. This includes careers in general and subspecialty private practice, academic medicine, public service, health care, and public policy leadership. Irrespective of career choice, the special emphasis of the FIU COM mission is its focus on community health in a diverse metropolitan region. Clinical facilities are met through a public partner and multiple private hospital affiliations. Educational objectives are organized into five strands reflecting the breadth of medical education and running concurrently through the four-year curriculum: (1) human biology, (2) disease, illness, and injury, (3) clinical medicine, (4) professional development, and (5) medicine and society. Founding teaching faculty with expertise in the core basic sciences will not only introduce core scientific concepts during the initial seven months but reinforce these same concepts during organ system integrated courses and clerkships. The Neighborhood Health Education Learning Program is an FIU COM innovation in which each medical student is a member of a team that throughout the four-year curriculum identifies and addresses health care needs and factors affecting health outcomes. Preliminary approval of FIU COM was conferred in February 2008, with the first cohort of 40 students matriculating in August 2009. PMID:19881442

  17. Lasers in veterinary medicine: a review

    Bartels, Kenneth E.

    1994-09-01

    As in other facets of medical science, the use of lasers in veterinary medicine is a relatively new phenomenon. Economic aspects of the profession as well as questionable returns on investment have limited laser applications primarily to the academic community, research institutions, and specialty practices. As technology improves and efficacy is proven, costs should decrease and allow further introduction of laser surgical and diagnostic devices into the mainstream of clinical veterinary medicine.

  18. Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

    Asli Gorek Dilektasli; Ezgi Demirdogen Cetinoglu; Nilufer Aylin Acet Ozturk; Funda Coskun; Guven Ozkaya; Ahmet Ursavas; Cuneyt Ozakin; Mehmet Karadag; Esra Uzaslan

    2016-01-01

    Introduction. The most common cause of acute COPD exacerbation (AECOPD) is the respiratory tract infections. We sought to determine the bacteriological etiology of hospitalized acute exacerbations of COPD requiring hospitalization in consecutive two years. Methods. We aimed to determine the bacteriological etiology underlying in patients whom admitted to Uludag University Faculty of Medicine, Department of Pulmonary Medicine and hospitalized with AECOPD in the last two years. Medical records ...

  19. Hospital restructuring and burnout.

    Greenglass, Esther R; Burke, Ronald J

    2002-01-01

    Increasingly, organizations are experiencing changes as a result of extensive downsizing, restructuring, and merging. In Canada, government-sponsored medicine has been affected as hospitals have merged or closed, reducing essential medical services and resulting in extensive job loss for hospital workers, particularly nurses. Hospital restructuring has also resulted in greater stress and job insecurity in nurses. The escalation of stressors has created burnout in nurses. This study examines predictors of burnout in nurses experiencing hospital restructuring using the MBI-General Survey which yields scores on three scales: Emotional exhaustion, Cynicism, and Professional efficacy. Multiple regressions were conducted where each burnout scale was the criterion and stressors (e.g., amount of work, use of generic workers to do nurses' work), restructuring effects, social support, and individual resources (e.g., control coping, self-efficacy, prior organizational commitment) were predictors. There were differences in the amount of variance accounted for in the burnout components by stressors and resources. Stressors contributed most to emotional exhaustion and least to professional efficacy. Individual resources were more likely to contribute to professional efficacy and least to emotional exhaustion. Stressors and resources accounted for approximately equal amounts of variance in cynicism. Three conclusions were drawn. First, present findings parallel others by showing that individual coping patterns contribute to professional efficacy. Second, emotional exhaustion was found to be the prototype of stress. Third, prior organizational commitment, self-efficacy, and control coping resulted in lower burnout. PMID:15137570

  20. Starting a new residency program: a step-by-step guide for institutions, hospitals, and program directors.

    Barajaz, Michelle; Turner, Teri

    2016-01-01

    Although our country faces a looming shortage of doctors, constraints of space, funding, and patient volume in many existing residency programs limit training opportunities for medical graduates. New residency programs need to be created for the expansion of graduate medical education training positions. Partnerships between existing academic institutions and community hospitals with a need for physicians can be a very successful means toward this end. Baylor College of Medicine and The Children's Hospital of San Antonio were affiliated in 2012, and subsequently, we developed and received accreditation for a new categorical pediatric residency program at that site in 2014. We share below a step-by-step guide through the process that includes building of the infrastructure, educational development, accreditation, marketing, and recruitment. It is our hope that the description of this process will help others to spur growth in graduate medical training positions. PMID:27507541

  1. Starting a new residency program: a step-by-step guide for institutions, hospitals, and program directors

    Michelle Barajaz

    2016-08-01

    Full Text Available Although our country faces a looming shortage of doctors, constraints of space, funding, and patient volume in many existing residency programs limit training opportunities for medical graduates. New residency programs need to be created for the expansion of graduate medical education training positions. Partnerships between existing academic institutions and community hospitals with a need for physicians can be a very successful means toward this end. Baylor College of Medicine and The Children's Hospital of San Antonio were affiliated in 2012, and subsequently, we developed and received accreditation for a new categorical pediatric residency program at that site in 2014. We share below a step-by-step guide through the process that includes building of the infrastructure, educational development, accreditation, marketing, and recruitment. It is our hope that the description of this process will help others to spur growth in graduate medical training positions.

  2. 我院中成药致不良反应158例分析%Analysis of 158 Cases of ADR Caused by Chinese Patent Medicines in Our Hospital

    何霖; 何金; 曾琼瑶; 彭杨; 杨培洪; 程模

    2015-01-01

    OBJECTIVE:To investigate the characteristics and factors of ADR caused by Chinese patent medicine(CPM)and to provide reference for rational drug use and safety evaluation in the clinic. METHODS:158 cases of ADR caused by CPM collect-ed from our hospital during Jan.2009-Dec.2014 were analyzed. RESULTS:The occurrence of ADR caused by CPM was related to patient’s age,route of administration,category of drugs,irrational drug-use and so on. The incidence of ADR in patients over the age of 60 was the highest (31.01%),the largest number of ADR were caused by intravenous injection (79.11%),ADRs were most likely caused by blood-regulating preparation and dissipate blood stasis preparation (79.75%);ADR manifested as lesion of skin and its appendents(43.01%),followed by gastro-intestinal injury(16.06%)and whole-general injury(10.36%). The severe ADR was anaphylactoid reaction;after symptomatic treatment,the prognosis is good. CONCLUSIONS:According to syndrome differentiation and individual difference,CPM should be used rationally,and great importance should be attached to drug use moni-toring to reduce the incidence of ADR.%目的:了解我院中成药致不良反应(ADR)发生的特点及诱发因素,为临床合理用药及安全性评价提供参考。方法:对我院2009年1月-2014年12月上报国家ADR监测中心的158例中成药致ADR报告进行归类、统计、分析。结果:中成药致ADR的发生与患者年龄、给药途径、药品种类、不合理用药有关。ADR发生率以60岁以上的患者比例最高(占31.01%);以静脉滴注给药为主(占79.11%);药品种类主要为理血剂和祛瘀剂(占79.75%)。ADR累及最多的器官/系统为皮肤及其附件(占43.01%),其次是胃肠系统损害(16.06%)和全身性损害(10.36%);严重的ADR为过敏性休克,经过对症处理后,ADR转归较好。结论:临床应根据中医辨证,注重患者个体差异,规范使用中成

  3. General Nuclear Medicine

    ... Resources Professions Site Index A-Z General Nuclear Medicine Nuclear medicine imaging uses small amounts of radioactive ... of General Nuclear Medicine? What is General Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  4. Children's (Pediatric) Nuclear Medicine

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  5. Children's (Pediatric) Nuclear Medicine

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  6. Children's (Pediatric) Nuclear Medicine

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  7. Hospital fundamentals.

    Althausen, Peter L; Hill, Austin D; Mead, Lisa

    2014-07-01

    Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID

  8. A RANDOMIZED CONTROLLED TRIAL ON THE EFFICACY OF MEDHYA RASAYANA TABLET ON ACADEMIC STRESS AND PERFORMANCE IN SCHOOL CHILDREN

    Abhimanyu Kumar

    2013-08-01

    Full Text Available Background:School children and academics are not exempted from stress. In Indian context, especially for high school children, the demands to be placed high, parental pressures, the future career option and time bound targets along with inherent biological variations of adolescence create paramount stress. Such stress can be detrimental if not well managed. Despite of loss of lives consequent upon stress and poor performance, academic stress is less researched. Psychotherapy is the current gold standard. Hence this trial aims to evolve the risk factors, common manifestations and adaptations with the academic stress, remedial measures with herbal medicine.Objectives: Evaluation of efficacy and safety of oral administration of Medhya Rasayana (MR on manifestations of academic stress and to improve the academic performance. Setting and design: Study was carried out in Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital (SDMCA&H, Hassan, Karnataka, South India, from December, 2010- December, 2012. Interventional, single blinded, randomized psychotherapy-placebo controlled efficacy trial.Materials and methods:164 children of either sex, studying in tenth standard with normal intelligent quotient (IQ, average and above average stress as indicated from the scores on academic anxiety scale (AASC and Sarason’s Test anxiety scale (TASC, consciously willing to participate in the trial were randomized in to three groups (GP–medhya (M and medhya with psychotherapy (MP and control – Placebo with psychotherapy (PP group. M-group received MR, MP-group with MR and psychotherapy while PP-group given placebo with psychotherapy over 3 months. Stress identified by test anxiety and academic anxiety scores, clinical manifestations and performances were evaluated before, after therapy and after exams. Children suffering from chronic systemic illnesses, developmental disorders, psychiatric illness, post traumatic stress disorder and not

  9. Links between nuclear medicine and radiopharmacy

    Radiopharmaceuticals are nowadays under the responsibility of the radio-pharmacist because of their medicinal product status. Radiopharmacy belongs to the hospital pharmacy department, nevertheless, interactions with nuclear medicine department are important: rooms are included or located near nuclear medicine departments in order to respect radiation protection rules, more over staff, a part of the material and some activities are shared between the two departments. Consequently, it seems essential to formalize links between the radiopharmacy and the nuclear medicine department, setting the goals to avoid conflicts and to ensure patients' security. Modalities chosen for this formalization will depend on the establishment's organization. (authors)

  10. 17. The Business of Integrative Medicine: Panel Discussion

    MacElhern, Lauray; Carter, Susan; Locke, Amy; Dusek, Jeffery; Conway, Nancy; Edwards, Tanya

    2013-01-01

    Focus Area: Sustainable Business Models In this session, panelist members of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) share what has been successful in the implementation of integrative healthcare across different health systems and academic health centers. Some use what may be termed a “vertical” model, or one that is a stand-alone entity that operates outside of the health system or academic health center. Others use “horizontal” business models, which rea...

  11. 27 CFR 22.105 - Hospitals, blood banks, and sanitariums.

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Hospitals, blood banks... Tax-Free Alcohol § 22.105 Hospitals, blood banks, and sanitariums. (a) Tax-free alcohol withdrawn for use by hospitals, blood banks, and sanitariums shall be used exclusively for medicinal,...

  12. Competency Modeling for Academic Leaders in Hospital An Integrated Approach%临床医学学科带头人胜任特征模型建构——量化与质化结合的方法

    王桢; 苏景宽; 罗正学; 时勘

    2011-01-01

    Research on competency model is one of the frontier issues of HRM research. This study is conducted to obtain the competency model of clinical academic leaders by ways of structured job analysis questionnaires and Behavioral Event Interview (BEI). Questionnaires of Occupational Information Network (O*NET) are administered to 494 clinical workers, on the results of which, further Behavioral Event Interviews (BEI) are carried out with 20 clinical academic leaders. Moreover, subject matter experts are invited to confirm the primary competency construct along with the process. The results of this study show that a combined method to establish the competency model of clinical academic leaders is effective. The findings also demonstrate the competency model of clinical academic leaders is composed of eighteen competencies, divided into three levels, and with seven distinctive competencies. The findings also indicate three new competencies: individual consideration, outer resource seeking and business sense.%胜任特征模型研究是人力资源管理理论和实践的前沿问题,然而目前研究多采用单一的方法.本研究首先使用0*NET问卷对494位医院工作人员进行工作分析,然后对20位学科带头人进行行为事件访谈,结合进行专家小组访谈,构建临床医学学科带头人的胜任特征模型.研究发现多方法构建模型具有较好的效果.该职位胜任特征模型包括18项特征,可以分为个性特征,认知技能,管理能力三个理论层次.此外,本研究发现了个性化关怀等三项较新的素质要求.

  13. Mesopotamian medicine.

    Retief, F P; Cilliers, L

    2007-01-01

    Although the Mesopotamian civilisation is as old as that of Egypt and might even have predated it, we know much less about Mesopotamian medicine, mainly because the cuneiform source material is less well researched. Medical healers existed from the middle of the 3rd millennium. In line with the strong theocratic state culture, healers were closely integrated with the powerful priestly fraternity, and were essentially of three main kinds: barû (seers) who were experts in divination, âshipu (exorcists), and asû (healing priests) who tended directly to the sick. All illness was accepted as sent by gods, demons and other evil spirits, either as retribution for sins or as malevolent visitations. Treatment revolved around identification of the offending supernatural power, appeasement of the angry gods, for example by offering amulets or incantations, exorcism of evil spirits, as well as a measure of empirical therapy aimed against certain recognised symptom complexes. Medical practice was rigidly codified, starting with Hammurabi's Code in the 18th century BC and persisting to the late 1st millennium BC. Works like the so-called Diagnostic Handbook, the Assyrian Herbal and Prescription Texts describe the rationale of Mesopotamian medicine, based predominantly on supernatural concepts, although rudimentary traces of empirical medicine are discernible. There is evidence that Egyptian medicine might have been influenced by Mesopotamian practices, but Greek rational medicine as it evolved in the 5th/4th centuries BC almost certainly had no significant Mesopotamian roots. PMID:17378276

  14. Travel medicine

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

  15. Hospital Inspections

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  16. Historic images in nuclear medicine

    Hess, Søren; Høilund-Carlsen, Poul Flemming; Alavi, Abass

    2014-01-01

    In 1976, 2 major molecular imaging events coincidentally took place: Clinical Nuclear Medicine was first published in June, and in August researchers at the Hospital of the University of Pennsylvania created the first images in humans with F-FDG. FDG was initially developed as part of an evolution...... set in motion by fundamental research studies with positron-emitting tracers in the 1950s by Michel Ter-Pegossian and coworkers at the Washington University. Today, Clinical Nuclear Medicine is a valued scientific contributor to the molecular imaging community, and FDG PET is considered the backbone...

  17. Effects of Hospital-Based Physical Therapy on Hospital Discharge Outcomes among Hospitalized Older Adults with Community-Acquired Pneumonia and Declining Physical Function

    Kim, Sun Jung; Lee, Joo Hun; Han, Boram; Lam, Julia; Bukowy, Elizabeth; Rao, Avinash; Vulcano, Jordan; Andreeva, Anelia; Bertelson, Heather; Shin, Hyun Phil; Yoo, Ji Won

    2015-01-01

    To examine whether hospital-based physical therapy is associated with functional changes and early hospital readmission among hospitalized older adults with community-acquired pneumonia and declining physical function. Study design was a retrospective observation study. Participants were community-dwelling older adults admitted to medicine floor for community-acquired pneumonia (n = 1,058). Their physical function using Katz activities of daily living (ADL) Index declined between hospital adm...

  18. Checklists for quality assurance and audit in nuclear medicine

    A series of checklists are given which aim to provide some guidance to staff in determining whether their working procedures in nuclear medicine are likely to produce a good service and avoid mistakes. The checklists relate to the special equipment used in nuclear medicine departments, radiopharmaceuticals, nuclear medicine staff, services to medical and other hospital staff and finally the service to patients. The checklists are relevant to an average nuclear medicine department performing less than 2000 imaging studies per year. (U.K.)

  19. Scaling up Family Medicine in Uganda

    Innocent K. Besigye

    2014-01-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 It is evident that politicians, health managers and academics are realising the potential contribution of Family Medicine to health systems in sub-Saharan Africa. The challenge is in training institutions to recruit and train enough Family Physicians in order to meet expectations. The 3rd Family Medicine Conference in Uganda, held in October 2013, explored innovative ways of scaling up Family Medicine training and practice in Uganda.

  20. The Role of Family Medicine in the Health Science Centre

    Bean, I. W.

    1981-01-01

    The evolution of training in family medicine has passed through several controversial phases to its current position within academic medicine. Many controversies still exist; this article defines them in the areas of education, service and research, gives some reasons why they exist, and offers conclusions on the benefits of having a family practice unit in a health science centre.