WorldWideScience

Sample records for academic hospital medicine

  1. Historical evidence for the origin of teaching hospital, medical school and the rise of academic medicine.

    Science.gov (United States)

    Modanlou, H D

    2011-04-01

    Historical progression and the development of current teaching hospitals, medical schools and biomedical research originated from the people of many civilizations and cultures. Greeks, Indians, Syriacs, Persians and Jews, assembled first in Gondi-Shapur during the Sasanian empire in Persia, and later in Baghdad during the Golden Age of Islam, ushering the birth of current academic medicine.

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

    Science.gov (United States)

    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

  3. Women in Academic Medicine.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Malentacchi, Francesca; Mancini, Irene; Brandslund, Ivan; Vermeersch, Pieter; Schwab, Matthias; Marc, Janja; van Schaik, Ron H N; Siest, Gerard; Theodorsson, Elvar; Pazzagli, Mario; Di Resta, Chiara

    2015-06-01

    Developments in "-omics" are creating a paradigm shift in laboratory medicine leading to personalized medicine. This allows the increase in diagnostics and therapeutics focused on individuals rather than populations. In order to investigate whether laboratory medicine is ready to play a key role in the integration of personalized medicine in routine health care and set the state-of-the-art knowledge about personalized medicine and laboratory medicine in Europe, a questionnaire was constructed under the auspices of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and 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 supporting the implementation of personalized medicine in the clinical setting. Participants think that the current organization of laboratory medicine needs additional/relevant implementations such as (i) new technological facilities in -omics; (ii) additional training for the current personnel focused on the new methodologies; (iii) incorporation in the laboratory of new competencies in data interpretation and counseling; and (iv) cooperation and collaboration among professionals of different disciplines to integrate information according to a personalized medicine approach.

  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

    DEFF Research Database (Denmark)

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

    2015-01-01

    the implementation of personalized medicine in the clinical setting. Participants think that the current organization of laboratory medicine needs additional/relevant implementations such as (i) new technological facilities in -omics; (ii) additional training for the current personnel focused on the new...... methodologies; (iii) incorporation in the laboratory of new competencies in data interpretation and counseling; and (iv) cooperation and collaboration among professionals of different disciplines to integrate information according to a personalized medicine approach....

  6. Faculty Satisfaction in Academic Medicine.

    Science.gov (United States)

    Nyquist, Julie G.; Hitchcock, Maurice A.; Teherani, Arianne

    2000-01-01

    Describes the challenges and elements of satisfaction in academic medicine. Proposes a model of academic faculty satisfaction which postulates that organizational, job-related, and personal factors combine to develop self-knowledge, social knowledge, and satisfaction with outcomes of productivity, retention, and learner-patient satisfaction. (DB)

  7. The Undermining of Academic Medicine.

    Science.gov (United States)

    Andreoli, Thomas E.

    1999-01-01

    Discussion of trends in academic medicine focuses on declining support for research, pressures on medical schools to increase clinical revenues, public demands for cheaper care, and rising health-care costs in light of an aging population. Urges establishment of a system of universal health care equivalent to Medicare for all citizens. (DB)

  8. Moral imperatives for academic medicine.

    Science.gov (United States)

    Thompson, J N

    1997-12-01

    As the health care system becomes dominated by managed care, academic medicine must do more than simply learn how to continue to offer the same level of care with ever-tightening resources and in new practice environments. Three moral imperatives must guide how medicine is practiced and taught: (1) patients' health and well-being must always be foremost, centered in quality of care and respect for life; (2) the emotional and spiritual needs of patients must be considered, not just the physical needs; (3) academic medicine must instill in its trainees discipline, passion, and skills to meet their obligation to be lifelong learners. These imperatives make it more important than ever for medical educators to tackle two crucial questions: What kind of person makes the best possible physician? And what constitutes the best possible training for that person? Taking these questions seriously in the new era of health care may mean that medical educators need to rethink the teaching of medicine. One example of how this might be done is the Curriculum for 2002 Committee recently formed at the Wake Forest University School of Medicine. It is becoming clear that medical educators can do a better and more comprehensive job of helping future physicians uncover and strengthen their own morality and, in the face of managed care's pressures, renew their loyalty to medicine as a service rather than a business. Morally sensitized physicians can better deal with the hard issues of medicine, such as euthanasia and abortion, and can help their students examine these issues. Most important, they can show their students that physicians are members of a moral community dedicated to something other than its own self-interest.

  9. Pre-hospital emergency medicine.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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 fault lines of academic medicine.

    Science.gov (United States)

    Schafer, Andrew I

    2002-01-01

    Unprecedented advances in biomedical research and the upheaval in health care economics have converged to cause seismic changes in the traditional organization of medical schools and academic health centers. This process is particularly evident in departments of internal medicine. The activities and functions of academic medicine are in the midst of separation and realignment along lines that do not honor historical departmental and divisional boundaries. The organization of a successful medical school or department must be dynamic, constantly serving its constituents to accommodate progress and change and to promote optimal structure for academic productivity.

  12. The Market for Hospital Medicine in Denmark

    DEFF Research Database (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...... 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...

  13. 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.

    Science.gov (United States)

    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

    2015-06-01

    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 practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice.

  14. Effective organizational control: implications for academic medicine.

    Science.gov (United States)

    Wilkes, Michael S; Srinivasan, Malathi; Flamholtz, Eric

    2005-11-01

    This article provides a framework for understanding the nature, role, functioning, design, and effects of organizational oversight systems. Using a case study with elements recognizable to an academic audience, the authors explore how a dean of a fictitious School of Medicine might use organizational control structures to develop effective solutions to global disarray within the academic medical center. Organizational control systems are intended to help influence the behavior of people as members of a formal organization. They are necessary to motivate people toward organizational goals, to coordinate diverse efforts, and to provide feedback about problems. The authors present a model of control to make this process more visible within organizations. They explore the overlap among academic medical centers and large businesses-for instance, each is a billion-dollar enterprise with complex internal and external demands and multiple audiences. The authors identify and describe how to use the key components of an organization's control system: environment, culture, structure, and core control system. Elements of the core control system are identified, described, and explored. These closely articulating elements include planning, operations, measurement, evaluation, and feedback systems. Use of control portfolios is explored to achieve goal-outcome congruence. Additionally, the authors describe how the components of the control system can be used synergistically by academic leadership to create organizational change, congruent with larger organizational goals. The enterprise of medicine is quickly learning from the enterprise of business. Achieving goal-action congruence will better position academic medicine to meet its multiple missions.

  15. Academic Medicine's Changing Covenant with Society.

    Science.gov (United States)

    Colloton, John W.

    1989-01-01

    A creditable response to society's needs and expectations can be best undertaken by establishing a national agenda in academic medicine that places a high priority on health services research and the scientific analysis of the entire health care system. The expansion of the cadre of health service researchers is needed. (Author/MLW)

  16. Increasing Women's Leadership in Academic Medicine.

    Science.gov (United States)

    Academic Medicine, 1996

    1996-01-01

    This position paper of the Association of American Medical Colleges gives an overview of the current situation regarding women's careers in academic medicine; looks at some reasons for disparities between men and women; and makes recommendations concerning development and mentoring of women faculty, administrators, residents, and students as well…

  17. Preventing the Decline of Academic Medicine.

    Science.gov (United States)

    Thier, Samuel O.

    1992-01-01

    This discussion of traditional academic medicine's resistance to changes in practice, technology, and finances looks at three current problems in medical education and two in biomedical research. Solutions are proposed, based on redefinition of the relationship between universities and medical schools and expansion of the conventional narrow focus…

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

    Science.gov (United States)

    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.

  19. The market for hospital medicine in Denmark

    Directory of Open Access Journals (Sweden)

    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.

  20. Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

    Science.gov (United States)

    Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

    2009-02-01

    The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

  1. The Priority of Intersectionality in Academic Medicine.

    Science.gov (United States)

    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.

  2. ACADEMIC TRAINING Physics Technologies in Medicine

    CERN Multimedia

    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...

  3. ACADEMIC TRAINING: Physics Technologies in Medicine

    CERN Multimedia

    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...

  4. Predictors of job satisfaction among academic family medicine faculty

    Science.gov (United States)

    Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola; Kim, Florence

    2017-01-01

    Abstract Objective To identify predictors of job satisfaction among academic family medicine faculty members. Design A comprehensive Web-based survey of all faculty members in an academic department of family medicine. Bivariate and multivariable analyses (logistic regression) were used to identify variables associated with job satisfaction. Setting The Department of Family and Community Medicine at the University of Toronto in Ontario and its 15 affiliated community teaching hospitals and community-based teaching practices. Participants All 1029 faculty members in the Department of Family and Community Medicine were invited to complete the survey. Main outcome measures Faculty members’ demographic and practice information; teaching, clinical, administration, and research activities; leadership roles; training needs and preferences; mentorship experiences; health status; stress levels; burnout levels; and job satisfaction. Faculty members’ perceptions about supports provided, recognition, communication, retention, workload, teamwork, respect, resource distribution, remuneration, and infrastructure support. Faculty members’ job satisfaction, which was the main outcome variable, was obtained from the question, “Overall, how satisfied are you with your job?” Results Of the 1029 faculty members, 687 (66.8%) responded to the survey. Bivariate analyses revealed 26 predictors as being statistically significantly associated with job satisfaction, including faculty members’ ratings of their local department and main practice setting, their ratings of leadership and mentorship experiences, health status variables, and demographic variables. The multivariable analyses identified the following 5 predictors of job satisfaction: the Maslach Burnout Inventory subscales of emotional exhaustion and personal accomplishment; being born in Canada; the overall quality of mentorship that was received being rated as very good or excellent; and teamwork being rated as very

  5. Facilitating scholarly writing in academic medicine.

    Science.gov (United States)

    Pololi, Linda; Knight, Sharon; Dunn, Kathleen

    2004-01-01

    Scholarly writing is a critical skill for faculty in academic medicine; however, few faculty receive instruction in the process. We describe the experience of 18 assistant professors who participated in a writing and faculty development program which consisted of 7 monthly 75-minute sessions embedded in a Collaborative Mentoring Program (CMP). Participants identified barriers to writing, developed personal writing strategies, had time to write, and completed monthly writing contracts. Participants provided written responses to open-ended questions about the learning experience, and at the end of the program, participants identified manuscripts submitted for publication, and completed an audiotaped interview. Analysis of qualitative data using data reduction, data display, and conclusion drawing/verification showed that this writing program facilitated the knowledge, skills, and support needed to foster writing productivity. All participants completed at least 1 scholarly manuscript by the end of the CMP. The impact on participants' future academic productivity requires long-term follow-up.

  6. Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

    Science.gov (United States)

    Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J

    2008-08-01

    The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.

  7. Implementing Personalized Medicine in the Academic Health Center

    OpenAIRE

    Weiss, Scott T

    2016-01-01

    Recently we at Partners Health Care had a series of articles in the Journal of Personalized Medicine describing how we are going about implementing Personalized Medicine in an academic health care system [1–10].[...

  8. Academic Medicine's Choices in an Era of Reform.

    Science.gov (United States)

    Thier, Samuel O.

    1994-01-01

    The economic, social, and educational forces that have led to current health care reform proposals are outlined, the main proposals made to respond to these forces are noted, and ways in which academic medicine can change effectively to meet the reforms are examined. Risks to academic medicine are also considered. (Author/MSE)

  9. A second career in academic medicine.

    Science.gov (United States)

    Saunders, D E

    1984-03-01

    Career changes in all vocations are relatively common in the forties age group due to a variety of factors which include a crisis period caused by polarities of Generativity versus Stagnation as conceptualized by Erik H. Erikson. Generativity is served not only by procreativity but also by guiding the next generation through teaching. The result can be the strength of Care. Stagnation can result in unhappiness, irrational and destructive behavior, or withdrawal. Concepts of young, old and mortality also come into focus. A successful career change from private practice to academic medicine depends upon a combination of power, opportunity, and character. To be successful, the change should be made for positive reasons and be based upon youthful concepts in the cold reality of the financial and intellectual challenges of a new and competitive career. If properly done, both the personal rewards and the contribution to future medical care can be quite positive.

  10. Academic Training: Physics technologies in medicine

    CERN Multimedia

    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...

  11. Academic Training: Physics technologies in medicine

    CERN Multimedia

    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...

  12. Forum on the future of academic medicine: final session--implications of the information revolution for academic medicine.

    Science.gov (United States)

    Iglehart, J

    2000-03-01

    The seventh and final meeting of the Association of American Medical Colleges' (AAMC's) Forum on the Future of Academic Medicine began December 4, 1998, with a talk by William W. Stead, MD, associate vice-chancellor for health affairs at Vanderbilt University Medical Center and director of its informatics center. Dr. Stead envisions a future in which informatics and information technology will place the consumer squarely in the center of the system, empowered with greater knowledge of health care; he gave three short scenarios to illustrate future typical interactions of consumers with the system. He then discussed the implications for academic medicine. For example, academic medical centers (AMCs) could become the information providers and quality assurance hubs of their regions. Various participants questioned some of the speaker's claims (one asserting that there would be serious complications if clinical information were made available to patients). The second speaker, Valerie Florance, PhD, director of the AAMC's better-health@here.now program, discussed her program, whose purpose is to explore the ways medical schools and teaching hospitals can best use information technology and the Internet in the coming decade to improve individual and community health. Nothing in the ensuing discussion indicated that the participants believed that academic medical centers would be spared painful dislocations if they were to embark on a road of institutional reform to respond to the pressures of the new and more competitive global economy. Greater awareness of this not-necessarily-welcomed message may be one of the lasting legacies of the forum.

  13. Does stereotype threat affect women in academic medicine?

    Science.gov (United States)

    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.

  14. The business of pediatric hospital medicine.

    Science.gov (United States)

    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.

  15. Establishment of research-oriented hospital: an important way for translational medicine development in China

    Directory of Open Access Journals (Sweden)

    MEINA LI

    2015-06-01

    Full Text Available Globally, one of the major trends is the development of translational medicine. The traditional hospital structure could not meet the demands of translational medicine development any longer and to explore a novel hospital structure is imperative. Following the times, China proposed and implemented a development strategy for a first-class modern research-oriented hospital. To establish a research-oriented hospital has become an important strategy to guide the scientific development of high-quality medical institutions and to advance translational medicine development. To facilitate translational medicine by developing research-oriented hospital, the Chinese Research Hospital Association (CRHA has been established, which provides service of medicine, talents cultivation, scientific research and clinical teaching and covers areas of theoretical research, academic exchange, translational medicine, talents training and practice guiding. On the whole, research-oriented hospital facilitated translational medicine by developing interdisciplinary platform, training core competencies in clinical and translational research, providing financial support of translational research, and hosting journals on translational medicine, etc.

  16. Development of cell therapy medicinal products by academic institutes.

    Science.gov (United States)

    de Wilde, Sofieke; Guchelaar, Henk-Jan; Herberts, Carla; Lowdell, Mark; Hildebrandt, Martin; Zandvliet, Maarten; Meij, Pauline

    2016-08-01

    In the rapidly evolving fields of cellular immunotherapy, gene therapy and regenerative medicine, a wide range of promising cell therapy medicinal products are in clinical development. Most products originate from academic research and are explored in early exploratory clinical trials. However, the success rate toward approval for regular patient care is disappointingly low. In this paper, we define strengths and hurdles applying to the development of cell therapy medicinal products in academic institutes, and analyze why only a few promising cell therapies have reached late-stage clinical development. Subsequently, we provide recommendations to stakeholders involved in development of cell therapies to exploit their potential clinical benefit.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Training Future Leaders of Academic Medicine: Internal Programs at Three Academic Health Centers.

    Science.gov (United States)

    Morahan, Page S.; Kasperbauer, Dwight; McDade, Sharon A.; Aschenbrener, Carol A.; Triolo, Pamela K.; Monteleone, Patricia L.; Counte, Michael; Meyer, Michael J.

    1998-01-01

    Reviews need for internal leadership training programs at academic health centers and describes three programs. Elements common to the programs include small classes, participants from many areas of academic medicine and health care, building on prior experience and training, training conducted away from the institution, short sessions, faculty…

  19. Academic Medicine Meets Traditional African Healing

    Science.gov (United States)

    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…

  20. The Changing Fiscal Environment for Academic Veterinary Medicine.

    Science.gov (United States)

    Zimmel, Dana N; Lloyd, James W

    2015-01-01

    The fiscal environment for academic veterinary medicine has changed substantially over the past 50 years. Understanding the flux of state and federal government support and the implications for student debt, academic programs, and scholarly work is critical for planning for the future. The recent precipitous decline in public funding highlights the urgent need to develop and maintain an economically sustainable model that can adapt to the changing landscape and serve societal needs.

  1. Student stress and academic performance: home hospital program.

    Science.gov (United States)

    Yucha, Carolyn B; Kowalski, Susan; Cross, Chad

    2009-11-01

    The purpose of this study was to evaluate whether nursing students assigned to a home hospital experience less stress and improved academic performance. Students were assigned to a home hospital clinical placement (n = 78) or a control clinical placement (n = 79). Stress was measured using the Student Nurse Stress Index (SNSI) and Spielberger's State Anxiety Inventory. Academic performance included score on the RN CAT, a standardized mock NCLEX-RN(®)-type test; nursing grade point average; and first attempt pass-fail on the NCLEX-RN. There were no statistically significant differences between the two groups for age, gender, marital status, ethnicity, or score on the nurse entrance examination. There were significant changes in SNSI over time but not between groups. Academic load and state anxiety showed an interaction of time by group, with the home hospital group showing reductions over time, compared with the control group.

  2. Academic Medicine's Season of Accountability and Social Responsibility.

    Science.gov (United States)

    Butler, William T.

    1992-01-01

    This article reviews societal demands for increased accountability and social responsibility by academic medicine. The Association of American Medical Colleges is urged to prepare more generalist physicians and assure better access to health care services. A "National System of Regional Medical Care" is proposed. (Author/DB)

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  5. Importance of international networking in academic family medicine

    Directory of Open Access Journals (Sweden)

    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.

  6. Stress factors affecting academic physicians at a university hospital.

    Science.gov (United States)

    Lindfors, Sara; Eintrei, Christina; Alexanderson, Kristina

    2009-01-01

    Research is limited regarding occupational stress in academic physicians; professionals whose work situation includes the three areas of clinical practice, research, and teaching. The aim of this study was to gain knowledge of factors experienced as stressful by academic physicians employed by a university hospital. A questionnaire assessing the frequency and intensity of 36 potentially stressful factors was sent to all 157 academic physicians who were employed at the Linköping University Hospital, Sweden. The response rate was 77%. Both a high frequency and intensity of stress was experienced by 66% of the academic physicians in relation to "time pressure" and by almost 50% in connection with both "find time for research" and having "conflict of interest between different work assignments". Moreover, physicians in the higher age group and those who had attained a higher academic position experienced less stress. The female participants experienced more stress than the males due to gender-related problems and to variables associated with relationships at work. More knowledge is needed to determine the consequences of this finding and to identify coping strategies used for handling such stress.

  7. Academic Education in Complementary Medicine: A Tuscan Methodological Perspective

    Directory of Open Access Journals (Sweden)

    Gian Franco Gensini

    2007-01-01

    Full Text Available The implementation of complementary medicine (CM involves a large number of persons in Italy, and in the nineties, the percentage of Italian citizens adopting the most frequent and relevant practices of CM almost doubled. Appropriate academic education in CM is an important and fascinating challenge for current didactic systems in the Italian University. Already in 2004, the Joint Italian Conference of the Deans of the Faculties of Medicine and of the Presidents of Medical Degree Courses released an official statement regarding the relationship between CM and health area degree courses. The main teaching objectives embedded in the institutional framework proposed by the Joint Italian Conference are now finding specific implementation modalities in the University of Florence. For many years, the Florence Medical School has had strong and fruitful contacts with institutional bodies in Tuscany and, together with these institutions, has established a continuous dialogue with the world of CM. This exchange has given rise to various teaching activities within the academic setting. With specific reference to the undergraduate curriculum in Medicine and Surgery, a methodological course regarding CM has been designed and conducted, with selective attention being given to the CM practices having an enhanced rate of supportive scientific evidence, such as herbal medicine and acupuncture. With regard to the postgraduate curriculum, a Master degree in Acupuncture and Traditional Chinese Medicine and a Master in Clinical Phytotherapy are already active in the University of Florence and are having a remarkable success among the attending health professionals. This high degree of satisfaction well documents the importance, need and feasibility of structured academic education in CM and, in particular, of a methodological didactics such as those currently implemented in the Florence Medical School.

  8. Academic general internal medicine: a mission for the future.

    Science.gov (United States)

    Armstrong, Katrina; Keating, Nancy L; Landry, Michael; Crotty, Bradley H; Phillips, Russell S; Selker, Harry P

    2013-06-01

    After five decades of growth that has included advances in medical education and health care delivery, value cohesion, and integration of diversity, we propose an overarching mission for academic general internal medicine to lead excellence, change, and innovation in clinical care, education, and research. General internal medicine aims to achieve health care delivery that is comprehensive, technologically advanced and individualized; instills trust within a culture of respect; is efficient in the use of time, people, and resources; is organized and financed to achieve optimal health outcomes; maximizes equity; and continually learns and adapts. This mission of health care transformation has implications for the clinical, educational, and research activities of divisions of general internal medicine over the next several decades.

  9. Universal isolation precautions for patients at an academic hospital

    OpenAIRE

    Maziero,Vanessa Gomes; Vannuchi,Marli Terezinha Oliveira; Vituri,Dagmar Willamourius; Haddad, Maria do Carmo Lourenço; Tada,Cristiane Nakaya

    2012-01-01

    OBJECTIVE: To apply universal isolation precautions for patients at an academic hospital by a nursing team. METHODS: This descriptive and prospective study used data from advice service of quality control and nursing care that were gathered in observational reports of universal isolation precautions for patients admitted in two surgical inpatient units during 2008 and 2010. RESULTS: The mean general classification for both units was between desirable and adequate in the observational analysis...

  10. Key considerations for conducting Chinese medicine clinical trials in hospitals

    OpenAIRE

    Shergis Johannah L; Parker Shefton; Coyle Meaghan E; Zhang Anthony L; Xue Charlie C

    2013-01-01

    Abstract Conducting clinical trials of Chinese medicines (CM) in hospitals presents challenges for researchers. The success of hospital-based CM clinical trials may be influenced by the protocol design, including the maintenance of CM theory in compliance with scientific rigour and hospital guidelines and justified treatment approaches with results that can translate into clinical practice. Other influences include personnel and resources such as a dedicated team open to CM with an establishe...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

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

    LENUS (Irish Health Repository)

    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.

  14. Education in geriatric medicine for community hospital staff.

    LENUS (Irish Health Repository)

    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.

  15. Key considerations for conducting Chinese medicine clinical trials in hospitals

    Directory of Open Access Journals (Sweden)

    Shergis Johannah L

    2013-02-01

    Full Text Available Abstract Conducting clinical trials of Chinese medicines (CM in hospitals presents challenges for researchers. The success of hospital-based CM clinical trials may be influenced by the protocol design, including the maintenance of CM theory in compliance with scientific rigour and hospital guidelines and justified treatment approaches with results that can translate into clinical practice. Other influences include personnel and resources such as a dedicated team open to CM with an established research culture and the ability to maximise participant recruitment. This article identifies the key challenges and limitations of conducting CM clinical trials in Australian hospitals.

  16. Medicines availability at a Swaziland hospital and impact on patients

    Directory of Open Access Journals (Sweden)

    Kholiwe Shabangu

    2015-02-01

    Full Text Available Background: The burden of non-communicable diseases (NCDs in low- and middle-income countries is increasing. Where patients are expected to make increased out-of-pocket payments this can lead to treatment interruptions or non-adherence. Swaziland is no exception in this regard.Aim: The aim of the study was to investigate the availability of medicines for NCDs in a hospital and the impact of out-of-pocket spending by patients for medicines not available at the hospital.Setting: The study was conducted at Raleigh Fitkin Memorial Hospital in Manzini, Swaziland.Methods: Exit interviews to assess availability of a selected basket of medicines were conducted with 300 patients diagnosed with diabetes, hypertension or asthma. The stock status record of a basket of medicines for these conditions in 2012 was assessed at the Central Medical Stores. Results were analysed using the Statistical Package for Social Sciences version 20.0.Results: Most of the patients (n = 213; 71% confirmed not receiving all of their prescribed medicines at each visit to the hospital in the past six months. On average patients spent 10–50 times more on their medicines at private pharmacies compared to user fees in the health facility. Stock-outs at the Central Medical Stores ranging from 30 days to over 180 days were recorded during the course of the assessment period (12 months, and were found to contribute to inconsistent availability of medicines in the health facility.Conclusion: Out-of-pocket expenditure is common for patients with chronic conditions using this health facility, which suggests the possibility of patients defaulting on treatment due to lack of affordability.

  17. "Having the Right Chemistry": A Qualitative Study of Mentoring in Academic Medicine.

    Science.gov (United States)

    Jackson, Vicki A.; Palepu, Anita; Szalacha, Laura; Caswell, Cheryl; Carr, Phyllis L.; Inui, Thomas

    2003-01-01

    Sought to develop a deeper understanding of mentoring by exploring lived experiences of academic medicine faculty members. Almost 98 percent of participants identified lack of mentoring as the first or second most important factor hindering career progress in academic medicine. Prized mentors have "clout," knowledge, and interest in the…

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

    Science.gov (United States)

    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.

  19. Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations.

    Science.gov (United States)

    Eisenberg, David M; Kaptchuk, Ted J; Post, Diana E; Hrbek, Andrea L; O'Connor, Bonnie B; Osypiuk, Kamila; Wayne, Peter M; Buring, Julie E; Levy, Donald B

    2016-09-01

    Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way.Current models of IM across existing clinical centers vary tremendously in their organizational settings, principal clinical focus, and services provided; practitioner team composition and training; incorporation of research activities and educational programs; and administrative organization (e.g., reporting structure, use of medical records, scope of clinical practice) and financial strategies (i.e., specific business plans and models for sustainability).In this article, the authors address these important strategic issues by sharing lessons learned from the design and implementation of an IM facility within an academic teaching hospital, the Brigham and Women's Hospital at Harvard Medical School; and review alternative options based on information about IM centers across the United States.The authors conclude that there is currently no consensus as to how integrative care models should be optimally organized, implemented, replicated, assessed, and funded. The time may be right for prospective research in "best practices" across emerging models of IM care nationally in an effort to standardize, refine, and replicate them in preparation for rigorous cost-effectiveness evaluations.

  20. Delirium in elderly patients hospitalized in internal medicine wards.

    Science.gov (United States)

    Fortini, Alberto; Morettini, Alessandro; Tavernese, Giuseppe; Facchini, Sofia; Tofani, Lorenzo; Pazzi, Maddalena

    2014-06-01

    A prospective observational study was conducted to evaluate the impact of delirium on geriatric inpatients in internal medical wards and to identify predisposing factors for the development of delirium. The study included all patients aged 65 years and older, who were consecutively admitted to the internal medicine wards of two public hospitals in Florence, Italy. On admission, 29 baseline risk factors were examined, cognitive impairment was evaluated by Short Portable Mental Status Questionnaire, and prevalent delirium cases were diagnosed by Confusion Assessment Method (CAM). Enrolled patients were evaluated daily with CAM to detect incident delirium cases. Among the 560 included patients, 19 (3 %) had delirium on admission (prevalent) and 44 (8 %) developed delirium during hospitalization (incident). Prevalent delirium cases were excluded from the statistical analysis. Incident delirium was associated with increased length of hospital stay (p delirium during hospitalization. Results show that delirium impact is relevant to older patients hospitalized in internal medicine wards. The present study confirms cognitive impairment as a risk factor for incident delirium. The cognitive evaluation proved to be an important instrument to improve identification of patients at high risk for delirium. In this context, our study may contribute to improve application of preventive strategies.

  1. [Status of pediatric hospital medicine in Spain: a report by the Spanish Pediatric Hospital Medicine Society (SEPHO)].

    Science.gov (United States)

    Ramos Fernández, J M; Montiano Jorge, J I; Hernández Marco, R; García García, J J

    2014-11-01

    Few reports are available on the status of pediatric hospital medicine in Spain. This has prompted the Spanish Society of Hospital Pediatrics (SEPHO) to conduct a study to determine the status of pediatric hospital care received. Data released by the Ministry of Health, the National Institute of Statistics have been used in the study, and an analysis was made of the results of a computerized survey designed and developed by SEPHO and available on the Internet for completion from November 2011 to December 2012 among Spanish hospitals. The results of this survey are part of the beginning of our journey as an association, and the current status of child and family welfare during hospitalization needs to be determined in order to consider and, where appropriate, make recommendations for improvement and standardization of care. The study, still unpublished, is to determine the state of pediatric hospital care as seen and analyzed from the perspective of the professionals directly involved in pediatric general hospital care. We included hospitals of different size and complexity of care. The aim of this report is to present the results of the survey and relate it to demographic and health care data from official sources.

  2. Using lean methodology to teach quality improvement to internal medicine residents at a safety net hospital.

    Science.gov (United States)

    Weigel, Charlene; Suen, Winnie; Gupte, Gouri

    2013-01-01

    The overall objective of this initiative was to develop a quality improvement (QI) curriculum using Lean methodology for internal medicine residents at Boston Medical Center, a safety net academic hospital. A total of 90 residents and 8 School of Public Health students participated in a series of four, 60- to 90-minute interactive and hands-on QI sessions. Seventeen QI project plans were created and conducted over a 4-month period. The curriculum facilitated internal medicine residents' learning about QI and development of positive attitudes toward QI (assessed using pre- and post-attitude surveys) and exposed them to an interprofessional team structure that duplicates future working relationships. This QI curriculum can be an educational model of how health care trainees can work collaboratively to improve health care quality.

  3. Code R: Redesigning Hospital-wide Peer Review for Academic Hospitals.

    Science.gov (United States)

    Kim, Daniel I; Au, Huy; Fargo, Ramiz; Garrison, Roger C; Thompson, Gary; Yu, Minho; Loo, Lawrence K

    2016-09-01

    In most health care institutions, physician peer review is the primary method for maintaining and measuring physician competency and quality of care issues. However, many teaching hospitals do not have a method of tracking resident trainees' involvement in adverse cases. At the study institution, Code R was introduced as a measure to capture resident trainee involvement in the hospital-wide peer review process. The authors conducted a retrospective review of all peer review cases from January 2008 to December 2011 in an academic medical center and determined the quantity and type of resident errors that occurred compared to attending faculty. The Accreditation Council for Graduate Medical Education's core competencies served as a framework to categorize quality of care errors. The addition of Code R to the peer review process can be readily adopted by other institutions to help improve resident education, facilitate faculty supervision, and potentially improve patient safety.

  4. [Academization of naturopathy and complementary medicine in the German language area].

    Science.gov (United States)

    Stange, Rainer

    2013-01-01

    Nowadays, it seems evident that natural and complementary medicine is represented amongst medical faculties. This was not always the case. Especially in the German speaking countries, more than 100 years of history were necessary. A short history of those academic developments that explicitly led to present day activities in naturopathy and complementary medicine is given by descriptions of persons and institutions. At present, 8 professorships dedicated to either naturopathy or complementary medicine or both could be identified in German speaking countries, thus representing academic medicine at its highest levels. Naturopathy and complementary medicine had received a strong reception in academic medicine. However, the vast majority of present day activities is financed by non-profit organizations and thus depends on their economic development.

  5. Cyclotron Production of Radionuclides for Nuclear Medicine at Academic Centers

    Science.gov (United States)

    Lapi, Suzanne

    2016-09-01

    The increase in use of radioisotopes for medical imaging has led to the development of new accelerator targetry and separation techniques for isotope production. For example, the development of longer-lived position emitting radionuclides has been explored to allow for nuclear imaging agents based on peptides, antibodies and nanoparticles. These isotopes (64Cu, 89Zr, 86Y) are typically produced via irradiation of solid targets on smaller cyclotrons (10-25 MeV) at academic or hospital based facilities. Recent research has further expanded the toolbox of PET tracers to include additional isotopes such as 52Mn, 55Co, 76Br and others. The smaller scale of these types of facilities can enable the straightforward involvement of students, thus adding to the next generation of nuclear science leaders. Research pertaining to development of robust and larger scale production technologies including solid target systems and remote systems for transport and purification of these isotopes has enabled both preclinical and clinical imaging research for many diseases. In particular, our group has focused on the use of radiolabeled antibodies for imaging of receptor expression in preclinical models and in a clinical trial of metastatic breast cancer patients.

  6. Academic retainer medicine: an innovative business model for cross-subsidizing primary care.

    Science.gov (United States)

    Lucier, David J; Frisch, Nicholas B; Cohen, Brian J; Wagner, Michael; Salem, Deeb; Fairchild, David G

    2010-06-01

    Retainer-medicine primary care practices, commonly referred to as "luxury" or "concierge" practices, provide enhanced services to patients beyond those available in traditional practices for a yearly retainer fee. Adoption of retainer practices has been largely absent in academic health centers (AHCs). Reasons for this trend stem primarily from ethical concerns, such as the potential for patient abandonment when physicians downsize from larger, traditional practices to smaller, retainer-medicine practices.In 2004, the Department of Medicine at Tufts Medical Center developed an academic retainer-medicine primary care practice within the Division of General Medicine that not only generates financial support for the division but also incorporates a clinical and business model that is aligned with the mission and ethics of an academic institution.In contrast to private retainer-medicine practices, this unique business model addresses several of the ethical issues associated with traditional retainer practices-it does not restrict net access to care and it neutralizes concerns about patient abandonment. Addressing the growing primary care shortage, the model also presents the opportunity for a retainer practice to cross-subsidize the expansion of general medicine in an academic medical setting. The authors elucidate the benefits, as well as the inherent challenges, of embedding an academic retainer-medicine practice within an AHC.

  7. Academic medicine must deal with the clash of business and professional values.

    Science.gov (United States)

    Swick, H M

    1998-07-01

    Academic medicine faces unprecedented challenges, especially the impact of the changing and more business-oriented health care system on medical education. There is an inherent clash of values between business and medicine: among key business values are profit and competition, while among the traditional values of the medical profession are service, advocacy, and altruism. Business interests have already gained a central place in medicine, so the challenge has become how to utilize the positive elements of the entrepreneurial spirit to enhance professional values and advance academic medicine's central enterprise. The author maintains that to achieve that synthesis, the leaders of academic medicine must continue to engage in a dialogue with the broader academic community, the government, the public, and the health care industry. The dialogue must emphasize (1) managing change rather than resisting it (such as focusing on the positive aspects of change, keeping sight of the fundamental professional values of medicine and medical education, and maintaining cool, rational judgment in the face of challenges); (2) making academic medicine's case with many constituencies, such as the health care industry, government, and the public; and (3) fostering professionalism by increasing medical schools' emphasis on this task, by ensuring that schools keep an appropriate balance between the science and the art of medicine, and by having faculty model appropriate professional values for their students. The author concludes that while change inevitably brings challenge and a sense of loss, it also brings the opportunity to help reshape medical education to meet the needs of society.

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

    LENUS (Irish Health Repository)

    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.

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

    Science.gov (United States)

    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.

  10. Impact of teaching intensity and academic status on medical resource utilization by teaching hospitals in Japan.

    Science.gov (United States)

    Sato, Daisuke; Fushimi, Kiyohide

    2012-11-01

    Teaching hospitals require excess medical resources to maintain high-quality care and medical education. To evaluate the appropriateness of such surplus costs, we examined the impact of teaching intensity defined as activities for postgraduate training, and academic status as functions of medical research and undergraduate teaching on medical resource utilization. Administrative data for 47,397 discharges from 40 academic and 12 non-academic teaching hospitals in Japan were collected. Hospitals were classified into three groups according to intern/resident-to-bed (IRB) ratio. Resource utilization of medical services was estimated using fee-for-service charge schedules and normalized with case mix grouping. 15-24% more resource utilization for laboratory examinations, radiological imaging, and medications were observed in hospitals with higher IRB ratios. With multivariate adjustment for case mix and academic status, higher IRB ratios were associated with 10-15% more use of radiological imaging, injections, and medications; up to 5% shorter hospital stays; and not with total resource utilization. Conversely, academic status was associated with 21-33% more laboratory examinations, radiological imaging, and medications; 13% longer hospital stays; and 10% more total resource utilization. While differences in medical resource utilization by teaching intensity may not be associated with indirect educational costs, those by academic status may be. Therefore, academic hospitals may need efficiency improvement and financial compensation.

  11. Case study: the Stanford University School of Medicine and its teaching hospitals.

    Science.gov (United States)

    Pizzo, Philip A

    2008-09-01

    There is wide variation in the governance and organization of academic health centers (AHCs), often prompted by or associated with changes in leadership. Changes at AHCs are influenced by institutional priorities, economic factors, competing needs, and the personality and performance of leaders. No organizational model has uniform applicability, and it is important for each AHC to learn what works or does not on the basis of its experiences. This case study of the Stanford University School of Medicine and its teaching hospitals--which constitute Stanford's AHC, the Stanford University Medical Center--reflects responses to the consequences of a failed merger of the teaching hospitals and related clinical enterprises with those of the University of California-San Francisco School of Medicine that required a new definition of institutional priorities and directions. These were shaped by a strategic plan that helped define goals and objectives in education, research, patient care, and the necessary financial and administrative underpinnings needed. A governance model was created that made the medical school and its two major affiliated teaching hospitals partners; this arrangement requires collaboration and coordination that is highly dependent on the shared objectives of the institutional leaders involved. The case study provides the background factors and issues that led to these changes, how they were envisioned and implemented, the current status and challenges, and some lessons learned. Although the current model is working, future changes may be needed to respond to internal and external forces and changes in leadership.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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…

  15. What is the value and role of academic medicine in the life of its university?

    Science.gov (United States)

    Azziz, Ricardo

    2014-02-01

    National and global events are rapidly and irrevocably driving transformation in both academia and health care. One result is an increase in the pace of institutional restructuring, consolidations, and mergers, including the melding of academic medical centers (AMCs; i.e., medical schools and their clinical enterprises) with nonmedical universities. Georgia Regents University (GRU) resulted from one such recent consolidation, and the experience at the institution has highlighted the need to answer the question "What is the value and role of academic medicine and an AMC in the life and transformation of its university?" In attempting to answer this question, the author first contrasts the cultural features of academic medicine and nonmedical faculty and leaders, as observed from the GRU experience, which might be useful for leaders of other institutions of higher education. His analysis suggests that academic medicine is currently significantly insulated from the larger university, and that this segregation or siloing represents a lost opportunity for both the AMC and the university at large. The author's experience suggests that fostering greater synergy between the university and its AMC adds significant value, and that such synergy better ensures the ability of those universities with an AMC to undertake and meet future transformative challenges. Strategies should be proactively developed both to enhance academic medicine leaders' engagement with, exposure to, and education regarding the operations and challenges of higher education and the broader university, and, likewise, to increase nonmedical faculty's understanding of and experience with the value and unique challenges of academic medicine.

  16. Defining "faculty" in academic medicine: responding to the challenges of a changing environment.

    Science.gov (United States)

    Block, Steven M; Sonnino, Roberta E; Bellini, Lisa

    2015-03-01

    Academic medicine in the United States is at a crossroads. There are many drivers behind this, including health care reform, decreased federal research funding, a refined understanding of adult learning, and the emergence of disruptive innovations in medicine, science, and education. As faculty members are at the core of all academic activities, the definition of "faculty" in academic medicine must align with the expectations of institutions engaged in patient care, research, and education. Faculty members' activities have changed and continue to evolve. Academic health centers must therefore define new rules of engagement that reflect the interplay of institutional priorities with the need to attract, retain, and reward faculty members. In this Commentary, the authors describe and explore the potential effects of the changing landscape for institutions and their clinical faculty members. The authors make a case for institutions to adapt faculty appointment, evaluation, and promotion processes, and they propose a framework for a standardized definition of "faculty" that allows for individual variability. This framework also provides a means to evaluate and reward faculty members' contributions in education, research, and clinical care. The authors propose a deliberate national conversation to ensure that careers in academic medicine remain attractive and sustainable and that the future of academic medicine is secure.

  17. An Expanded Model of Faculty Vitality in Academic Medicine

    Science.gov (United States)

    Dankoski, Mary E.; Palmer, Megan M.; Laird, Thomas F. Nelson; Ribera, Amy K.; Bogdewic, Stephen P.

    2012-01-01

    Many faculty in today's academic medical centers face high levels of stress and low career satisfaction. Understanding faculty vitality is critically important for the health of our academic medical centers, yet the concept is ill-defined and lacking a comprehensive model. Expanding on previous research that examines vital faculty in higher…

  18. Generational influences in academic emergency medicine: structure, function, and culture (Part II).

    Science.gov (United States)

    Mohr, Nicholas M; Smith-Coggins, Rebecca; Larrabee, Hollynn; Dyne, Pamela L; Promes, Susan B

    2011-02-01

    Strategies for approaching generational issues that affect teaching and learning, mentoring, and technology in emergency medicine (EM) have been reported. Tactics to address generational influences involving the structure and function of the academic emergency department (ED), organizational culture, and EM schedule have not been published. Through a review of the literature and consensus by modified Delphi methodology of the Society for Academic Emergency Medicine Aging and Generational Issues Task Force, the authors have developed this two-part series to address generational issues present in academic EM. Understanding generational characteristics and mitigating strategies can address some common issues encountered in academic EM. By understanding the differences and strengths of each of the cohorts in academic EM departments and considering simple mitigating strategies, faculty leaders can maximize their cooperative effectiveness and face the challenges of a new millennium.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  2. Sponsorship: a path to the academic medicine C-suite for women faculty?

    Science.gov (United States)

    Travis, Elizabeth L; Doty, Leilani; Helitzer, Deborah L

    2013-10-01

    Despite increases in the percentages of women medical school graduates and faculty over the past decade, women physicians and scientists remain underrepresented in academic medicine's highest-level executive positions, known as the "C-suite." The challenges of today and the future require novel approaches and solutions that depend on having diverse leaders. Such diversity has been widely shown to be critical to creating initiatives and solving complex problems such as those facing academic medicine and science. However, neither formal mentoring programs focused on individual career development nor executive coaching programs focused on individual job performance have led to substantial increases in the proportion of women in academic medicine's top leadership positions.Faced with a similar dilemma, the corporate world has initiated sponsorship programs designed to accelerate the careers of women as leaders. Sponsors differ from mentors and coaches in one key area: They have the position and power to advocate publicly for the advancement of nascent talent, including women, in the organization. Although academic medicine differs from the corporate world, the strong sponsorship programs that have advanced women into corporations' upper levels of leadership can serve as models for sponsorship programs to launch new leaders in academic medicine.

  3. The business of academic medicine is a business like no other: a perspective.

    Science.gov (United States)

    Mooradian, Arshag D; Meenrajan, Senthil

    2009-01-01

    The financial challenges facing the academic medical centers and in particular the departments of medicine continue to escalate. In response, many centers have been increasing their expectations of clinical productivity while holding the physician compensation down. This model of capitalization of such centers intuitively makes little sense from a business perspective but has potential advantages in the short run and may be surprisingly sustainable for a variable period, depending on a number of factors; in some instances, it may last long enough to be considered a long-term success. The reason for this counterintuitive notion is that the business of academic medicine is quite different from traditional business. The comparative profiles of the academic medicine business and the other for-profit businesses are discussed. The willingness of many talented faculty members to forgo financial remuneration in exchange for opportunity to pursue scholarly activities can be misinterpreted by business planners as a prospect to muster a physician workforce with modest investments that are below market value. This mind-set fails to acknowledge the costs of creating the academic environment that will be attractive enough to faculty to practice medicine. Perhaps the most important feature that distinguishes academic medicine from the other businesses is that its workforce is medical professionals who have a fiduciary relationship with their customers.

  4. A case for change: disruption in academic medicine.

    Science.gov (United States)

    Kahn, Marc J; Maurer, Ralph; Wartman, Steven A; Sachs, Benjamin P

    2014-09-01

    Disruptive technologies allow less expensive and more efficient processes to eventually dominate a market sector. The academic health center's tripartite mission of education, clinical care, and research is threatened by decreasing revenues and increasing expenses and is, as a result, ripe for disruption. The authors describe current disruptive technologies that threaten traditional operations at academic health centers and provide a prescription not only to survive, but also to prosper, in the face of disruptive forces.

  5. Are There Jobs in Academic Pulmonary Medicine in Canada? A Resident’s View of the Future

    Directory of Open Access Journals (Sweden)

    Jae Yang

    1995-01-01

    Full Text Available A survey of all Canadian academic institutions with an adult pulmonary training program was undertaken in 1992 to investigate the number of positions in pulmonary medicine that would be available up to 1997. The positions were divided into clinician scientist (75% research and clinician teacher (75% clinical categories. Inquiry into specific areas of interests and prerequisite training requirements were made. Ten of 14 centres responded; 35 to 44 positions were identified, 22 to 27 for clinician scientists with at least two to four years’ research training after completion of a clinical pulmonary fellowship. For the remaining 13 to 17 clinician teacher positions, the requirement was for two to three years of additional clinical training beyond the clinical pulmonary fellowship. Some centres did not specify whether available positions were in the clinician scientist or in the clinician teacher group. The results of the survey suggest that there are jobs available in academic pulmonary medicine but that they are mainly in the basic research area, requiring at least an MSc, and preferably a PhD or equivalent research training. A questionnaire is included in an attempt to obtain information about other opportunities in both academic and community hospitals.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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

    Science.gov (United States)

    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…

  10. Academic Medicine Becomes a Target for Labor Organizing.

    Science.gov (United States)

    Mangan, Katherine S.

    1999-01-01

    Frustrated by the ways in which large managed-care companies are controlling physicians' lives and professional practice, the American Medical Association has voted to form a union to represent physicians and medical residents. Academic physicians have shown less interest than others. (MSE)

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

    OpenAIRE

    2015-01-01

    Background: (1) To assess pattern of antibiotic use among in-patients of medicine unit in a tertiary care hospital, (2) to determine the frequency of adverse drug reactions (ADR) among the inpatients receiving antibiotics in medicine unit. Methods: The study was prospective and based on the daily review of patient records for 2 months (June, July) of study period, including all the inpatients of medicine unit 1 receiving antimicrobials. The general information of the patients, infection, a...

  12. Process mapping evaluation of medication reconciliation in academic teaching hospitals: a critical step in quality improvement

    Science.gov (United States)

    Holbrook, Anne; Bowen, James M; Patel, Harsit; O'Brien, Chris; You, John J; Tahavori, Roshan; Doleweerd, Jeff; Berezny, Tim; Perri, Dan; Nieuwstraten, Carmine; Troyan, Sue; Patel, Ameen

    2016-01-01

    Background Medication reconciliation (MedRec) has been a mandated or recommended activity in Canada, the USA and the UK for nearly 10 years. Accreditation bodies in North America will soon require MedRec for every admission, transfer and discharge of every patient. Studies of MedRec have revealed unintentional discrepancies in prescriptions but no clear evidence that clinically important outcomes are improved, leading to widely variable practices. Our objective was to apply process mapping methodology to MedRec to clarify current processes and resource usage, identify potential efficiencies and gaps in care, and make recommendations for improvement in the light of current literature evidence of effectiveness. Methods Process engineers observed and recorded all MedRec activities at 3 academic teaching hospitals, from initial emergency department triage to patient discharge, for general internal medicine patients. Process maps were validated with frontline staff, then with the study team, managers and patient safety leads to summarise current problems and discuss solutions. Results Across all of the 3 hospitals, 5 general problem themes were identified: lack of use of all available medication sources, duplication of effort creating inefficiency, lack of timeliness of completion of the Best Possible Medication History, lack of standardisation of the MedRec process, and suboptimal communication of MedRec issues between physicians, pharmacists and nurses. Discussion MedRec as practised in this environment requires improvements in quality, timeliness, consistency and dissemination. Further research exploring efficient use of resources, in terms of personnel and costs, is required. PMID:28039294

  13. [Hospital based internal medicine: the year 2009 in review (I). The perspective of chief residents].

    Science.gov (United States)

    Tâche, Frédéric; Pantet, Olivier; Joly, Céleste; Pasquier, Mathieu; Maillard-Dewarrat, Géraldine; Méan, Marie; Cosma-Rochat, Monica; Deriaz, Sandra; Donzé, Jacques; Pasche, Antoine; Burnier, Coralie; Stadelmann, Raphaël

    2010-02-03

    Internists must regularly adjust their patients care according to recent relevant publications. The chief residents from the Department of Internal Medicine of a university hospital present some major themes of internal medicine treated during the year 2009. Emphasis will be placed primarily on changes in the daily hospital practice induced by these recent studies. This variety of topics illustrates both the broad spectrum of the current internal medicine, and the many uncertainties associated with modern medical practice based on evidence.

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

    Science.gov (United States)

    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…

  15. Technology as an Instrument to Improve Quality, Accountability, and Reflection in Academic Medicine

    Science.gov (United States)

    Wilkes, Michael S.; Howell, Lydia

    2006-01-01

    Objective: This article describes two complementary technology systems used in academic medicine to 1) improve the quality of learning and teaching, and 2) describe the barriers and obstacles encountered in implementing these systems. Method: The literature was integrated with in-depth, case-based experience with technology related to student…

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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…

  18. Status of Tenure Among Black and Latino Faculty in Academic Medicine.

    Science.gov (United States)

    Campbell, Kendall M; Rodríguez, José E; Brownstein, Naomi C; Fisher, Zedeena E

    2017-04-01

    Tenure has been used for years to recruit, promote, and retain faculty in higher education and has been associated with job security and academic freedom. Absence of tenure and not being in tenure-earning tracks is grouped with the challenges faced by underrepresented minorities in academic medicine. Those challenges include being found at the assistant professor rank more often, having more clinical responsibilities, and not being in leadership positions as often as compared to non-minority faculty. The role of tenure and tenure tracks is unclear as it relates to the presence of minority faculty. This article presents a look at the status of tenure among black and Latino faculty in academic medicine at US medical schools.

  19. Generational influences in academic emergency medicine: teaching and learning, mentoring, and technology (part I).

    Science.gov (United States)

    Mohr, Nicholas M; Moreno-Walton, Lisa; Mills, Angela M; Brunett, Patrick H; Promes, Susan B

    2011-02-01

    For the first time in history, four generations are working together-traditionalists, baby boomers, generation Xers (Gen Xers), and millennials. Members of each generation carry with them a unique perspective of the world and interact differently with those around them. Through a review of the literature and consensus by modified Delphi methodology of the Society for Academic Emergency Medicine Aging and Generational Issues Task Force, the authors have developed this two-part series to address generational issues present in academic emergency medicine (EM). Understanding generational characteristics and mitigating strategies can help address some common issues encountered in academic EM. Through recognition of the unique characteristics of each of the generations with respect to teaching and learning, mentoring, and technology, academicians have the opportunity to strategically optimize interactions with one another.

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

    Science.gov (United States)

    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. A Transformative Approach to Academic Medicine: The Partnership Between the University of Arizona and Banner Health.

    Science.gov (United States)

    Cairns, Charles B; Bollinger, Kathy; Garcia, Joe G N

    2017-01-01

    The University of Arizona Health Network (UAHN) was a modestly successful health care delivery organization with a vibrant academic portfolio and stable finances. By 2013, however, market forces, health care financing changes, and the burden of technology and informatics upgrades led to a compromised financial position at UAHN, a situation experienced by many academic medical centers. Concurrently, Banner Health had been interested in forming an academic partnership to enhance innovation, including the incorporation of new approaches into health care delivery, and to recruit high-quality providers to the organization. In 2015, the University of Arizona (UA) and Banner Health entered into a unique partnership known as Banner - University Medicine. The objective was to create a statewide system that provides reliable, compassionate, high-quality health care across all of its providers and facilities and to make a 30-year commitment to UA's College of Medicine in Tucson and the College of Medicine in Phoenix to support the State of Arizona's position as a first-tier research and training destination with world-class physicians. The goal of the Banner - University Medicine partnership is to create a nationally leading organization that transforms health care by delivering better care, enhanced service, and lower costs through new approaches focused on wellness. Key elements of this partnership are highlighted in this Commentary, including the unique governance structure of the Academic Management Council, the creation of the Academic Enhancement Fund to support the UA Colleges of Medicine in Tucson and Phoenix, and novel approaches to medical education, research, innovation, and care.

  2. Changing from paper to paperless hospitals in busy academic centers.

    Science.gov (United States)

    Shelman, Keith

    2008-01-01

    To decide to change from paper to a paperless hospital, one decides to go on a journey. This chapter will outline the destination, the reasons to make the journey and describe the best route to the destination. Becoming paperless is the route taken to the destination.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

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

    2016-04-12

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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…

  10. Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence.

    Science.gov (United States)

    Edmunds, Laurel D; Ovseiko, Pavel V; Shepperd, Sasha; Greenhalgh, Trisha; Frith, Peggy; Roberts, Nia W; Pololi, Linda H; Buchan, Alastair M

    2016-12-10

    Women are under-represented in academic medicine. We reviewed the empirical evidence focusing on the reasons for women's choice or rejection of careers in academic medicine. Using a systematic search, we identified 52 studies published between 1985, and 2015. More than half had methodological limitations and most were from North America. Eight main themes were explored in these studies. There was consistent evidence for four of these themes: women are interested in teaching more than in research; participation in research can encourage women into academic medicine; women lack adequate mentors and role models; and women experience gender discrimination and bias. The evidence was conflicting on four themes: women are less interested in research than men; women lose commitment to research as their education and training progress; women are deterred from academic careers by financial considerations; and women are deterred by concerns about work-life balance. Inconsistency of findings across studies suggests significant opportunities to overcome barriers by providing a more enabling environment. We identified substantial gaps in the scientific literature that could form the focus of future research, including shifting the focus from individuals' career choices to the societal and organisational contexts and cultures within which those choices are made; extending the evidence base to include a wider range of countries and settings; and testing the efficacy of interventions.

  11. Driving Success over the Past 50 Years-The Faculty in Academic Veterinary Medicine.

    Science.gov (United States)

    Buss, Daryl D

    2015-01-01

    The faculty at member schools and colleges of the Association of American Veterinary Medical Colleges (AAVMC) are critical for continued progress in veterinary medicine. The success of those faculty members over the past 50 years has positioned veterinary medicine to engage an ever-widening array of opportunities, responsibilities, and societal needs. Yet the array of skills and accomplishments of faculty in academic veterinary medicine are not always visible to the public, or even within our profession. The quality and the wide range of their scholarship are reflected, in part, through the according of national and international awards and honors from organizations relevant to their particular areas of expertise. The goal of this study was to illustrate the breadth of expertise and the quality of the faculty at 34 schools/colleges of veterinary medicine by examining the diversity of organizations that have recognized excellence in faculty achievements through a variety of awards.

  12. New roles: professional staff sharing between a hospital and an academic library.

    Science.gov (United States)

    Just, Melissa L

    2003-01-01

    Childrens Hospital Los Angeles is a pediatric hospital and research institute affiliated with the Keck School of Medicine of the University of Southern California (USC). Historically, the library at Childrens Hospital was staffed by a hospital-employed librarian. In 1999, the library position was outsourced to USC's Norris Medical Library. The new position is staffed by a librarian who divides her time equally between two locations: the Childrens Hospital Library and the Norris Medical Library. This staff sharing arrangement has three primary goals: increase the collaboration between the libraries; improve access to resources and library staff expertise; and provide faster document delivery service to the Childrens Hospital library. This paper presents the details of the position, and addresses the pros and cons for both libraries and the librarian.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Drug related hospital admissions in subspecialities of internal medicine.

    Science.gov (United States)

    Hallas, J

    1996-04-01

    It is well established in the literature that adverse drug reactions (ADRs) and drug non-compliance contribute substantially to the admissions at medical wards. Some important questions, however, remain unanswered. The purpose of this thesis was to characterise the drug-related hospital admissions (DRH) and to assess the magnitude of the problem seen in relation to the demographic parameters and drug use of the background population. In addition, an attempt was made to reduce the DRH incidence by an intervention program. The scope of the study program was adverse drug reactions, intended self-poisoning, non-compliance, underdosing and interactions. The material included 1999 admissions to six departments of internal medicine at Odense University Hospital. The patients were reviewed prospectively, while they were still in the wards, but use of standardised criteria fOR assessment of drug-ADR causality. With inclusion of a definite, probable and possible causal relationship, ADRs and toxic reactions were found as an important factor in 8.4% of all admissions. The incidense of ADR related admissions was 400 per 100,000 per year for the background population as a whole, but showing a strong increase with age. The drug-specific ADR incidences were generally small compared to the drug sales figures. Non-compliance contributed to 2.0% of admissions with diuretics and anti-asthmatics as the drugs most frequently involved. Two departments were re-investigated after an intervention program, primarily targetting general practitioners. The over-all incidence of DRHs was unaffected by the intervention, but the subset classified as avoidable DRHs showed a significant decline. The case material was subject to a blinded evaluation by an external peer group using the same criteria as the investigators. There was no indication that the observed decline in avoidable DRHs should be explained by a shift in the investigators' assessment of cases. It was concluded that the intervention

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

    OpenAIRE

    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...

  16. Usage report of pharmacopuncture in musculoskeletal patients visiting Korean medicine hospitals and clinics in Korea

    OpenAIRE

    Lee, Yoon Jae; Shin, Joon-Shik; Lee, Jinho; Kim, Me-Riong; Park, Ki Byung; Lee, Hwa Dong; Lee, Yoonmi; Hong, Jungwan; Ha, In-Hyuk

    2016-01-01

    Background Pharmacopuncture is a relatively new acupuncture therapy combining acupuncture with herbal medicine. While pharmacopuncture is applied extensively in Korean medicine treatment, there are no clinical reports regarding what types of pharmacopuncture are used for which diseases. Methods Data was extracted retrospectively from the electronic medical records of all inpatients and outpatients at 12 Korean medicine hospitals and clinics during the period of December 17, 2010 to October 2,...

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

    Science.gov (United States)

    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.

  18. Evaluation of Association Between Gynecologic Oncology Fellowship Length and a Career in Academic Medicine.

    Science.gov (United States)

    Kesterson, Joshua P; Szender, J Brian; Schaefer, Eric; Fanning, James; Lele, Shashikant; Frederick, Peter

    2016-04-28

    The purpose of this study is to determine the association between gynecologic oncology fellowship training factors, including fellowship length, and a career in academic medicine. A survey was sent to all 980 gynecologic oncologists identified via the SGO membership directory. The survey questions focused on demographics, fellowship training, practice- type, and research involvement. Demographics of the study population and survey responses were reported using frequencies and percentages. Chi-squared tests were used to test for associations between selected survey responses and length of fellowship. The authors received 410 (42 %) responses. Most respondents (60 %) graduated from a 3-year fellowship, while 27 and 13 % attended 2- and 4-year fellowships, respectively. Practice descriptions included academic/university (52 %), community/private practice (21 %), private practice with academic appointment (20 %), and other (7 %). A majority (64 %) reported current involvement in research as a principal investigator (PI); however, 54 % reported spending 10 % or less of their time in research-related activities. Approximately half reported that their fellowship research experience contributed to their current practice. Graduates of 3- and 4-year fellowships had similar rates of employment in academic/university settings (58 and 52 %, respectively). Graduates of 4-year fellowships were more likely to hold an advanced degree and 11 or more publications at completion of fellowship. A majority of graduates of a gynecologic oncology fellowship practice in an academic/university setting and are involved in research. Fellowship length does not correlate with a current academic medicine appointment. Graduates of 4-year fellowships are more likely to hold additional advanced degrees and more publications.

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

    DEFF Research Database (Denmark)

    Salomonsen, Laila; Skovgaard, Lasse; la Cour, Søren;

    2011-01-01

    Several studies have found that a high proportion of the population in western countries use complementary and alternative medicine (CAM). A one-page questionnaire was sent to all included hospitals in both countries. CAM is presently offered in about 50% of Norwegian hospitals and one...

  20. [Highlights of hospital-based internal medicine in 2010: chief residents' perspective].

    Science.gov (United States)

    Uhlmann, Marc; Burnard, Jérôme; Cosma Rochat, Monica; Gabus, Vincent; Micheloud, Valérie Geiser; Gobin, Niels; Laurent, Jean-Christophe; Marino, Laura; Méan, Marie; Merz, Laurent; Regamey, Julien; Stadelmann, Raphaël

    2011-02-02

    Applying knowledge acquired from recent medical studies to patient care poses a daily challenge to physicians. Chief residents from the Department of Internal Medicine at the University Hospital of Lausanne carried out a review of some of the issues they considered important. The conclusions of these various publications may have a significant impact on the daily practice of hospital-based internal medicine. Modern medicine based on scientific studies is a reminder that in spite of the essential importance of clinical experience, it is crucial to confront it with the results of relevant publications from the medical literature.

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

    Science.gov (United States)

    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.

  2. [Research on our hospital inventory management status quo of traditional Chinese medicine drugs and treatment method].

    Science.gov (United States)

    Zhang, Ying-Nan; Xu, Wen

    2014-03-01

    Under the background of the new medical reform, a large variety of traditional Chinese medicine from complicated sources, Chinese traditional medicine of actor of true and false of the quality directly affect the drug safety and clinical efficacy, but also relate to the social and economic benefits of hospital. Along with the development of the modern management of medical institutions and drug circulation circulation system reform in our country, the hospital drug inventory, supply and management work is an important topic for the pharmaceutical trading. However, there is always contradiction, dispensary need to supple pharmacy, in order to satisfy the demands of hospital patients with normal diagnosis and treatment work. However, if the drug inventory is too much, not only increases the drug monitoring problem, at the same time, but also causes storage costs rise. Therefore, completing scientific and reasonable storage and management becomes urgent problems at present. Wherefore, our country administration of traditional Chinese medicine in 2007 promulgated the "Chinese traditional medicine yinpian management norms in hospital", aims to standardize management of Chinese traditional medicine quality and improve the safety of drugs. The author through looking up information and visiting survey, to understand the currently existing problems, and summarizes the literature inland and abroad in recent years Chinese medicine drug inventory management work experience, in view of status quo of Chinese medicine inventory management in China, put forward the solution. To guarantee TCM pharmacy management more standardized, more standard, to adapt to the new reform of Chinese traditional medicine industry, improve the management level of hospital, defend the hospital's reputation and the patient's interests.

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

    Directory of Open Access Journals (Sweden)

    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

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

    DEFF Research Database (Denmark)

    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......’ incentives to consider the price of alternative treatment options paired with a more active formulary management may increase price competition between therapeutic substitutes in the Danish hospital sector in the future....

  5. Academic Medicine's Critical Role in the "Third Curve" of Health Care.

    Science.gov (United States)

    Paz, Harold L

    2016-05-01

    Over the last several years, the health care landscape has changed at an unprecedented rate due to new economic and regulatory forces ushered in by the Affordable Care Act and the introduction of innovative technologies, such as personalized medicine, that are poised to open the door to consumer-driven health care. Tremendous pressure exists on academic health centers to rapidly evolve clinically while not abandoning their unique academic mission. The convergence of personalized medicine, new digital technologies, and changes in health professionals' scope of practice alongside new payment structures will accelerate the move to a patient-centered health system. In this Commentary, the author argues that these new tools and resources must be embraced to improve the health of patients. With the traditional, fee-for-service model of care as "Curve I" and the post-Flexner era of population-based medicine as "Curve II," the author identifies the emergence of "Curve III," which is characterized by patient-centered, consumer-directed models of care. As the old models of health care undergo transition and the impact of technology and analytics grow, future practitioners must be trained to embrace this change and function effectively in the "third curve" of consumer-driven health care.

  6. Board certification in psychology: insights from medicine and hospital psychology.

    Science.gov (United States)

    Robiner, William N; Dixon, Kim E; Miner, Jacob L; Hong, Barry A

    2012-03-01

    For physicians board certification is an accepted tradition that research suggests improves services and outcomes. In contrast, relatively few psychologists pursue board certification suggesting ambivalence or limited contingencies reinforcing it. The authors report on medical school and hospital-based psychologists' attitudes toward board certification and current certification status. About one-fifth (21.7%) of the sample were certified by the American Board of Professional Psychology, a greater proportion than psychologists generally: Highest rates were seen in neuropsychology (7.5%), clinical psychology (6.4%), clinical child and adolescent psychology (3.2%) and clinical health psychology (2.8%). Few (certification. Half recognized benefits to the profession for psychologists pursuing board certification, yet 70% opposed requiring it for their hospital-based practice. Forces seeking to promote healthcare quality ultimately may increase expectations for board certification. If consumers, employers, hospitals and managed care organizations demand board certification for health professionals, greater numbers of psychologists would likely seek it.

  7. A conceptual model for faculty development in academic medicine: the underrepresented minority faculty experience.

    Science.gov (United States)

    Daley, Sandra P; Broyles, Shelia L; Rivera, Lourdes M; Brennan, Jesse J; Lu, Ethel Regis; Reznik, Vivian

    2011-01-01

    In May 2010, the Association of American Medical Colleges reported that nonwhite professors have a lower promotion rate than white professors. A cohort of 30 underrepresented minority (URM) junior faculty who participated in a structured faculty development program at a public, research-intensive, academic medical center were followed in a 10-year longitudinal study. This paper reports on the career status of 12 of the 30 URM faculty who were eligible for promotion during this period. Ninety-two percent (11/12) of URM faculty eligible for promotion were promoted to associate professor. When asked what factors contributed to their success, these URM faculty identified access and support of senior faculty mentors, peer networking, professional skill development, and knowledge of institutional culture. A faculty development program that addresses these components can promote the success of URM faculty in academic medicine.

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

    Science.gov (United States)

    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.

  9. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    Science.gov (United States)

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2017-01-01

    Background: This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Methods: Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results: In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion: By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. PMID:28005539

  10. Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

    Directory of Open Access Journals (Sweden)

    Elad Asher

    Full Text Available OBJECTIVE: To describe the daily work practice under the threat of defensive medicine among obstetricians and gynecologists. STUDY DESIGN: A prospective cross-sectional survey of obstetricians and gynecologists working at tertiary medical centers in Israel. RESULTS: Among the 117 obstetricians and gynecologists who participated in the survey, representing 10% of the obstetricians and gynecologists registered by the Israel Medical Association, 113 (97% felt that their daily work practice is influenced by concern about being sued for medical negligence and not only by genuine medical considerations. As a result, 102 (87% physicians are more likely to offer the cesarean section option, even in the absence of a clear medical indication, 70 (60% follow court rulings concerning medical practices, and 85 (73% physicians mentioned that discussions about medical negligence court rulings are included in their departments' meetings. CONCLUSIONS: Defensive medicine is a well-embedded phenomenon affecting the medical decision process of obstetricians and gynecologists.

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

    CERN Document Server

    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...

  12. Getting published in an academic-community hospital: the success of writing groups.

    Science.gov (United States)

    Salas-Lopez, Debbie; Deitrick, Lynn; Mahady, Erica T; Moser, Kathleen; Gertner, Eric J; Sabino, Judith N

    2012-01-01

    Expressed barriers to writing for publication include lack of time, competing demands, anxiety about writing and a lack of knowledge about the submission process. These limitations can be magnified for practitioners in non-university environments in which there are fewer incentives or expectations regarding academic publication productivity. However, as members of professional disciplines, practitioners have both the responsibility and, oftentimes, the insights to make valuable contributions to the professional literature. Collaborative writing groups can be a useful intervention to overcome barriers, provide the necessary skills and encouragement as well as produce publications and conference presentations that make worthy additions to the professional body of knowledge. This article discusses the evolution and outcomes of writing groups at Lehigh Valley Health Network and describes how this strategy can be adopted by other academic community hospitals to promote professional development and publication.

  13. [Study of clinical character and medicinal therapy of viral hepatitis in hospital based on real world].

    Science.gov (United States)

    Li, Yun-ru; Wang, Lian-xin; Xie, Yan-ming; Yang, Wei; Wang, Zhuo-yue; Yi, Dan-hui; Wang, Yong-yan

    2014-09-01

    Viral hepatitis was the most common infectious disease in china. But the diagnosis and treatment were varied because the viral hepatitis patients were hospitalized in different kinds of hospital such as infectious disease hospital, general hospital and Chinese medical hospital. It was necessary to know clinical characters and information of viral hepatitis patients in different hospitals. The general information, subtype distribution, prognosis, complication, medication and relations of onset with solar term from 41 180 viral hepatitis patients based on HIS data were analyzed. It was found that the age of patients between 18 to 59 years old was most; most patients were males. The national basic medical insurance was the most type of payment. The outcome of viral hepatitis in the youth and female were better than that in the old and male. Acute hepatitis was easer to restore than chronic hepatitis. Liver cirrhosis and hepatocellular carcinoma were the two most complications. The peak of onset was during summer solstice, slight heat and great heat. The most common Chinese medicine was Diammonium glycyrrhizinate and the most common western medicine was reduced glutathione. The combination of D. glycyrrhizinate with reduced glutathione, polyene phosphatidylcholine and thymosin was the main pattern. But It was not knew if the combination of western and Chinese medicine was the most effective therapy to protect liver function. It was necessary to take deeply research of the relationship between the combination therapy and their effectiveness.

  14. Understanding wider environmental influences on mentoring: Towards an ecological model of mentoring in academic medicine

    Directory of Open Access Journals (Sweden)

    Dario Sambunjak

    2015-05-01

    Full Text Available Mentoring is a complex developmental relationship that contributes to individual growth and career advancement in different areas of human activity, including academic medicine. This article describes a broader environmental milieux in which mentoring occurs and considers the ways in which the environmental factors may affect the process and outcomes of mentoring. An ecological model of mentoring is proposed that takes into account various factors broadly operating at three contextual levels. The first is societal or “macro” level, which implies cultural, economic, and political factors. The second is institutional or “meso” level, consisting of a system-related factors such as field and discipline characteristics, and government policies, and b organization-related factors such as mentoring climate, reward structure, and work design. The third contextual level relates to intrapersonal and interpersonal characteristics of mentor-mentee dyads. If mentoring dyad is viewed as the focal point, societal and institutional levels may be labeled as “external”, and personal level as “internal”. The conceptual diversity and methodological challenges in the study of mentoring need to be acknowledged, but should not be an excuse to leave the external contextual elements out of the researchers’ horizon, as they inevitably shape and modify the mentoring relationships. Conclusion. Model presented in this article offers a holistic view of mentoring in academic medicine that may help one comprehend and appreciate the complexity of influences on mentoring, and inform the future research agenda on this important topic.

  15. Fostering innovation in medicine and health care: what must academic health centers do?

    Science.gov (United States)

    Dzau, Victor J; Yoediono, Ziggy; Ellaissi, William F; Cho, Alex H

    2013-10-01

    There is a real need for innovation in health care delivery, as well as in medicine, to address related challenges of access, quality, and affordability through new and creative approaches. Health care environments must foster innovation, not just allowing it but actively encouraging it to happen anywhere and at every level in health care and medicine-from the laboratory, to the operating room, bedside, and clinics. This paper reviews the essential elements and environmental factors important for health-related innovation to flourish in academic health systems.The authors maintain that innovation must be actively cultivated by teaching it, creating "space" for and supporting it, and providing opportunities for its implementation. The authors seek to show the importance of these three fundamental principles and how they can be implemented, highlighting examples from across the country and their own institution.Health innovation cannot be relegated to a second-class status by the urgency of day-to-day operations, patient care, and the requirements of traditional research. Innovation needs to be elevated to a committed endeavor and become a part of an organization's culture, particularly in academic health centers.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    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.

  18. [The Health Technology Assessment Engine of the Academic Hospital of Udine: first appraisal].

    Science.gov (United States)

    Vidale, Claudia

    2014-01-01

    The Health Technology Assessment Engine (HTAE) of the Academic Hospital of Udine aggregates about one hundred of health technology assessment websites. It was born thanks to Google technology in 2008 and after about four years of testing it became public for everybody from the Homepage of the Italian Society of Health Technology Assessment (SIHTA). In this paper the first results obtained with this resource are reported. The role of the scientific librarian is examined not only as a support specialist in bibliographic search but also as a creative expert in managing new technologies for the community.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Pharmaceutical policies and access to medicines : a hospital-pharmacy perspective from Ghana

    NARCIS (Netherlands)

    Ankrah, D.

    2017-01-01

    Access to quality medicines is a universal human right which featured prominently on the agenda of the World Health Organisation (WHO) over the past decades. Hospital pharmacists play a pivotal role in ensuring that treatment outcomes are optimal. This thesis studied pharmaceutical policies and acce

  1. Hyperbaric medicine for the hospital-based physician.

    Science.gov (United States)

    Weaver, Lindell K

    2012-08-01

    associated with wound care centers and may be hospital based or nonhospital based. We review some of the disorders treated with HBO2 that hospital-based clinicians may be asked to evaluate.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2015-01-01

    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 (MD) in Emergency Medicine (EM) 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 (in PEM) after completion of MD/Diplomate of National Board (DNB) Pediatrics or MD/DNB in EM. The National Board of Examinations (NBE) 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.

  4. 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.

    Science.gov (United States)

    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.

  5. Academic hospital staff compliance with a fecal immunochemical test-based colorectal cancer screening program

    Institute of Scientific and Technical Information of China (English)

    Georgia Vlachonikolou; Paraskevas Gkolfakis; Athanasios D Sioulas; Ioannis S Papanikolaou; Anastasia Melissaratou; Giannis-Aimant Moustafa; Eleni Xanthopoulou; Gerasimos Tsilimidos; Ioanna Tsironi; Paraskevas Filippidis; Chrysoula Malli; George D Dimitriadis; Konstantinos Triantafyllou

    2016-01-01

    AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer(CRC) screening program using fecal immunochemical test(FIT).METHODS: All employees of "Attikon" University General Hospital aged over 50 years were thoroughly informed by a team of physicians and medical students about the study aims and they were invited to undergo CRC screening using two rounds of FIT(DyoniFOB~ Combo H, DyonMed SA, Athens, Greece). The tests were provided for free and subjects tested positive were subsequently referred for colonoscopy. One year after completing the two rounds, participants were asked to be re-screened by means of the same test.RESULTS: Among our target population consisted of 211 employees, 59(27.9%) consented to participate, but only 41(19.4%) and 24(11.4%) completed the first and the second FIT round, respectively. Female gender was significantly associated with higher initial participation(P = 0.005) and test completion- first and second round-(P = 0.004 and P = 0.05) rates, respectively. Phy sician’s(13.5% vs 70.2%, P < 0.0001) participation and test completion rates(7.5% vs 57.6%, P < 0.0001 for the first and 2.3% vs 34%, P < 0.0001 for the second round) were significantly lower compared to those of the administrative/technical staff. Similarly, nurses participated(25.8% vs 70.2%, P = 0.0002) and completed the first test round(19.3% vs 57.6%, P = 0.004) in a significant lower rate than the administrative/technical staff. One test proved false positive. No participant repeated the test one year later.CONCLUSION: Despite the well-organized, guided and supervised provision of the service, the compliance of the Academic Hospital personnel with a FIT-based CRC screening program was suboptimal, especially among physicians.

  6. [Medicines reconciliation at hospital admission into an electronic prescribing program].

    Science.gov (United States)

    Villamayor-Blanco, Lucía; Herrero-Poch, Leticia; De-Miguel-Bouzas, Jose Carlos; Freire Vazquez, M Carmen

    2016-09-01

    Objetivo: Describir y analizar los resultados obtenidos durante un año con un nuevo procedimiento de conciliación de la medicación al ingreso hospitalario basado en un programa de prescripción electrónica asistida. Método: Estudio observacional, prospectivo, no aleatorizado y no controlado de 12 meses de duración, en el que se incluyeron todos los pacientes que ingresaron, durante ese año, en un hospital general concertado de 450 camas. Para la conciliación de la medicación se utilizó el programa de prescripción electrónica como medio para el abordaje multidisciplinar (enfermería, médicos y farmacéuticos). La conciliación se realizó al ingreso hospitalario y se midieron los errores de conciliación. Resultados: Se incluyeron 23.701 pacientes, conciliándose 53.920 medicamentos, de los cuales no tenían discrepancias 48.744 (90,4%) y 5.176 (9,6%) presentaban discrepancias: 4.731 (8,8 % de los fármacos) justificadas y 445 (0,8% de los fármacos) no justificadas. La mayor parte de las discrepancias no justificadas, (n = 310; 69,7%) se debieron a errores en el registro de la medicación domiciliaria al ingreso: medicación no registrada o errores de medicamentos, dosis, frecuencia o vía de administración, omisiones de prescripción, 23,6% (n = 105) y duplicidades, 6,7% (n = 30). En ningún caso el error de conciliación llegó al paciente. Conclusiones: Mediante las ayudas informáticas incluidas en el programa de prescripción electrónica asistida y el abordaje multidisciplinar del proceso de conciliación se consigue realizar la conciliación de la medicación al ingreso en el 98% de los pacientes en el momento del ingreso, evidenciando errores de conciliación solo en el 1,3% de los pacientes.

  7. [Use of medicinal plants among people attending two reference hospitals in Cuzco, Peru].

    Science.gov (United States)

    Oblitas, Gladys; Hernández-Córdova, Gustavo; Chiclla, Analí; Antich-Barrientos, María; Ccorihuamán-Cusitito, Lucero; Romaní, Franco

    2013-03-01

    In order to determine the frequency and characteristics of the use of medicinal plants in patients from two third-level hospitals in the city of Cusco, a cross-sectional study was conducted between August and September 2011. For data collection, an instrument was built and validated through experts' judgment. The sample included 250 people selected in a non-probabilistic way. 83.2 and 75.3% informed having had used medicinal plants sometime during their lives and in the last month, respectively; additionally, 85.7 indicated that they wished their doctor would have prescribed them medicinal plants. Their most frequent uses include digestive problems (62.4%) as well as urinary (42.4%) and respiratory problems (40.4%). We conclude that the use of medicinal plants is widely spread among users of two hospitals in the city of Cusco. Utilization patterns show that patients wished the physicians of the health system prescribed medicinal plants in their consults.

  8. Building the National University of Colombia Hospital: Reconciling social and academic aspects

    Directory of Open Access Journals (Sweden)

    Raúl Esteban Sastre-Cifuentes

    2014-10-01

    Full Text Available In the process of building the National University Hospital, an analysis of the changing epidemiological profile of the population of Bogotá was undertaken, which examined the health care needs of the city, the academic needs of the university and institutional possibilities. It was made an analysis of the demographic and epidemiological profile of the population of Bogotá. It was concluded that there were factors associated with the epidemiological transition of aging, such as a low availability of health services for the elderly and diseases related to that care. Just as in the university, the hospital needs to develop all aspects of patient care to be able to adequately respond to the needs of this demographic from an interdisciplinary perspective, ensuring quality care based on the criteria of timeliness, accessibility, relevance, sufficiency, and continuity. A proposal is outlined concluding that the first phase of the portfolio of services that the University Hospital offers must be geared towards geriatric care and chronic illnesses, due to the aging of the general population as a result of a decline in fertility and mortality. This care would cater towards so-called permanent conditions that result in disability, or not easily reversible physiopathological conditions that require long-term care, as well as special training in secondary prevention and rehabilitation for the patient and the family.

  9. An Innovative Educational and Mentorship Program for Emergency Medicine Women Residents to Enhance Academic Development and Retention.

    Science.gov (United States)

    Bhatia, Kriti; Takayesu, James Kimo; Arbelaez, Christian; Peak, David; Nadel, Eric S

    2015-11-01

    Given the discrepancy between men and women's equal rates of medical school matriculation and their rates of academic promotion and leadership role acquisition, the need to provide mentorship and education to women in academic medicine is becoming increasingly recognized. Numerous large-scale programs have been developed to provide support and resources for women's enrichment and retention in academic medicine. Analyses of contributory factors to the aforementioned discrepancy commonly cite insufficient mentoring and role modeling as well as challenges with organizational navigation. Since residency training has been shown to be a critical juncture for making the decision to pursue an academic career, there is a need for innovative and tailored educational and mentorship programs targeting residents. Acknowledging residents' competing demands, we designed a program to provide easily accessible mentorship and contact with role models for our trainees at the departmental and institutional levels. We believe that this is an important step towards encouraging women's pursuit of academic careers. Our model may be useful to other emergency medicine residencies looking to provide such opportunities for their women residents.

  10. Implementing PDA technology in a medical library: experiences in a hospital library and an academic medical center library.

    Science.gov (United States)

    Morgen, Evelyn Breck

    2003-01-01

    Personal digital assistants (PDAs) have grown from being a novelty in the late 1990s to an essential tool for healthcare professionals in the 2000s. This paper describes the experiences of a librarian who implemented PDA technology first in a hospital library, and then at an academic medical center library. It focuses on the role of the library in supporting PDA technology and resources. Included are programmatic issues such as training for library staff and clinicians, and technical issues such as Palm and Windows operating systems. This model could be used in either a hospital or academic health sciences library.

  11. Forum on the Future of Academic Medicine: Session IV--The Realities of the Health Care Environment.

    Science.gov (United States)

    Iglehart, John

    1998-01-01

    Describes proceedings of a meeting of the Association of American Medical Schools' Forum on the Future of Academic Medicine, focusing on ways in which medical schools can and are responding to changing, more competitive marketplaces for health services while sustaining their missions; the health care industry perspective; and characteristics of…

  12. Perspective: A grand challenge to academic medicine: speak out on gay rights.

    Science.gov (United States)

    Dohrenwend, Anne

    2009-06-01

    Social responsibility, a dearly held value in the medical community, requires that medicine use its influence to end discrimination and to reduce barriers that affect access to care. Although the gay, lesbian, bisexual, and transgender (GLBT) population has been identified as suffering from health care disparities and oppression, the medical community and its affiliated organizations have done little to lobby in defense of the GLBT population. And with regard to the specific issue of gay marriage, medicine has yet to raise its voice in that debate, even if only to correct unscientific, capricious, and slanderous depictions of GLBT relationships. Closer to home, in medical schools and residencies, GLBT faculty and students are not provided with a safe and equal environment in which to work and learn. No credentialing provisions require residencies and their affiliate hospitals to include GLBT status in their nondiscrimination policies or to offer GLBT faculty and residents equal benefits. There is no assurance that those in power at peer-reviewed journals will use reviewers who are familiar with the research on sexual minorities to review manuscripts on GLBT topics, a situation that likely contributes to the community's status as an understudied population. Medicine cannot fulfill its obligation to GLBT patients, students, and faculty without a considerable and determined commitment to change. Some of the suggested remedies would require amending policy at the level of the Accreditation Council for Graduate Medical Education and the Association of American Medical Colleges.

  13. Diversity in academic medicine no. 2 history of battles lost and won.

    Science.gov (United States)

    Strelnick, A Hal; Lee-Rey, Elizabeth; Nivet, Marc; Soto-Greene, Maria L

    2008-12-01

    Spurred by its rapidly changing demographics, the United States is striving to reduce and eliminate racial and ethnic health disparities. To do so, it must overcome the legacy of individual, institutional, and structural racism and resolve conflicts in related political and social ideologies. This has moved the struggle over diversity in the health professions outside the laboratories and ivy-covered walls of academic medicine into the halls of Congress and chambers of the US Supreme Court. Although equal employment opportunity and affirmative action programs began as legal remedies for distinct histories of legally sanctioned racial and gender discrimination, they also became effective means for increasing the representation of underrepresented minorities in higher education and the health professions. Beginning in the 1970s and continuing today, legal challenges to measures for realizing equal opportunity and leveling the playing field have reached the US Supreme Court and state-wide ballot initiatives. These historical challenges and successes are the subject of this article. Although the history is not exhaustive, it aims to provide an important context for the struggles of advocates to improve the representation of underrepresented minorities in medicine and reduce racial and ethnic health disparities.

  14. Studies about Management and Management of Medicines at the Regional Public Hospital of Kwaingga Keerom Regency Province of Papua

    Directory of Open Access Journals (Sweden)

    Herlina Pabuntang

    2017-02-01

    Full Text Available Hospital has a strategic role in providing quality services in accordance with the standards established and can reach all layers of society. Medicines management in hospitals need to have a good management. Purpose of this research to describe the planning of medicines, medicines acceptance, storage, procurement and distribution of medicines and know and understand the factors supporting and restricting and countermeasure strategy stock out of the medicines conducted by the management of the Kwaingga Hospital Regency of Keerom in 2016. Research methodology was qualitative descriptive study with the kind of approach to the case studies. Population and sample examined was the officer on duty in hospital health Kwaingga as many as 9 people. Data collection is done by observation, in-depth interviews and documentation. Data analysis technique used is descriptive qualitative. Research results obtained that the medicines planning in Kwaingga Hospital is done based on the amount of the budget is provided by the regional Government of the Regency of Keerom and funds dropping from Papua Province, and the selection of the remedy is done based on national formularium (FORNAS. Procurement of medicines in Kwaingga Hospital done by a third party so that it takes a relatively long time. Acceptance of medication in Kwaingga Hospital running slow. this is because the process of procurement of medicines carried out by third parties. Storage of medicines stored in the warehouse of medicines with the State of the storage areas are qualified by BPOM. Medicines distribution is done by installation of pharmaceuticals for room each performed four times each month with the format LPLPO by request of each room.

  15. Perspective: Prospective health care and the role of academic medicine: lead, follow, or get out of the way.

    Science.gov (United States)

    Snyderman, Ralph; Yoediono, Ziggy

    2008-08-01

    The authors contend that the crisis facing the U.S. health care system is in large part a consequence of that system's disease-oriented, reactive, and sporadic approach to care, and they suggest that a prospective approach to health care, which emphasizes personalized medicine and strategic health planning, would be a more rational way to prevent disease and maximize health. During recent years, personalized, predictive, preventive, and participatory medicine--that is, prospective care--has been receiving increasing attention as a solution to the U.S. health care crisis. Advocacy has been mainly from industry, government, large employers, and private insurers. However, academic medicine, as a whole, has not played a leading role in this movement. The authors believe that academic medicine has the opportunity and responsibility to play a far greater role in the conception and development of better models to deliver health care. In doing so, it could lead the transformation of today's dysfunctional system of medical care to that of a prospective approach that emphasizes personalization, prediction, prevention, and patient participation. Absent contributing to improving how care is delivered, academic medicine's leadership in our nation's health will be bypassed.

  16. [Induction of hospital indebtedness due to medicine purchases under monopoly conditions: the case of imatinib mesylate].

    Science.gov (United States)

    Scopel, Carolinne Thays; Chaves, Gabriela Costa

    2015-03-01

    Medicine expenditures consume a large share of the health budget, so knowledge on the use of these funds is essential for decision-making in public health and improvement of pharmaceutical care. This study analyzed the indebtedness of a high-complexity university hospital due to increased spending on imatinib mesylate. The descriptive study was based on analysis of documents and records in the Hospital Information System (SIH) from 2002 to 2010. Starting with inclusion of the medicine in the budget, the study mapped strategies by the pharmaceutical industry and government, as well as government responses to reduce the product's price. The systematization and publication of information stored in files and electronic databases can help monitor the results of programs funded by the Brazilian Ministry of Health.

  17. Appropriateness of gastrointestinal consultations for hospitalized patients in an academic medical center

    Directory of Open Access Journals (Sweden)

    Cohen M

    2010-01-01

    Full Text Available Background: Consultation of experts in the internal medicine or surgery subspecialties is needed in the hospitalized population according to decisions of the house staff. Sometimes the referrals are not justified, consuming time and money without a significant change in the patient outcome. Objectives: The aim of our retrospective study was to evaluate justification of consecutive referrals of hospitalized patients for gastroenterology consultation. Materials and Methods: Request for consultation was deemed not justified when at least one of the following parameters was found: No contribution to case management, discharge before consultation, cancellation at the last minute, and a recommendation for ambulatory management or surgery. Results: In August-September 2006, there were 232 requests for gastroenterology consultations. Of them 127 (54.7% were men. The average age was 64.13±20.33 years. Ninety-four (40.2% of the cases had been hospitalized because of other reasons than the consultation issue. Consultation was not justified in 60 patients (25.9%. Ambulatory management was a possibility in 151 cases (65.0%. Request for colonoscopy and gastrointestinal background disease were the only significant predictive factors for justification of consultation, P < 0.0001 for both. Conclusions: In one fourth of the cases, gastroenterology consultation was not justified according to our strict criteria.

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

    Science.gov (United States)

    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

  19. Part-time careers in academic internal medicine: a report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine.

    Science.gov (United States)

    Linzer, Mark; Warde, Carole; Alexander, R Wayne; Demarco, Deborah M; Haupt, Allison; Hicks, Leroi; Kutner, Jean; Mangione, Carol M; Mechaber, Hilit; Rentz, Meridith; Riley, Joanne; Schuster, Barbara; Solomon, Glen D; Volberding, Paul; Ibrahim, Tod

    2009-10-01

    To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhance workforce flexibility, and provide high-quality research, patient care, and education in a cost-effective manner. The task force provided a series of detailed steps for operationalizing part-time practice; to do so, key issues were addressed, such as fixed costs, malpractice insurance, space, cross-coverage, mentoring, career development, productivity targets, and flexible scheduling. Recommendations included (1) increasing respect for work-family balance, (2) allowing flexible time as well as part-time employment, (3) directly addressing negative perceptions about part-time faculty, (4) developing policies to allow flexibility in academic advancement, (5) considering part-time faculty as candidates for leadership positions, (6) encouraging granting agencies, including the National Institutes of Health and Veterans Administration, to consider part-time faculty as eligible for research career development awards, and (7) supporting future research in "best practices" for incorporating part-time faculty into academic departments of medicine.

  20. [A model of occupational, environmental and community medicine. History and evolution of the Hospital Unit of Occupational Medicine (UOOML) in Lombardia].

    Science.gov (United States)

    Cirla, A M; Feltrin, G

    1998-01-01

    The authors describe the historical evolution of the prevention in Lombardia, and the role of the Hospital Units for Occupational Medicine, not only on the clinical oriented fields, but also on the areas of formation and training. Hospital Units for Occupational Medicine are today the best synthesis of "occupational-environmental-community health". There development is based on adequate standards of human and instrumental resources, as so as a real financial budget. At last, it's important that these Units are allocated in a so-called "bipolar department", open to the hospital and also open to the territorial structures for prevention and safety (department of occupational health).

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

    Science.gov (United States)

    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.

  2. [Academic cell therapy facilities are challenged by European regulation on advanced therapy medicinal products].

    Science.gov (United States)

    Chabannon, Christian; Sabatier, Florence; Rial-Sebbag, Emmanuelle; Calmels, Boris; Veran, Julie; Magalon, Guy; Lemarie, Claude; Mahalatchimy, Aurélie

    2014-05-01

    Regulation (EC) n° 1394/2007 from the European Parliament and the Council describes a new category of health products termed « Advanced Therapy Medicinal Products » (ATMPs). ATMPs derive from cell engineering, tissue engineering or genetic manipulations, and can in some instances be combined with medical devices. ATMPs are distributed and administered to patients, after biotechnology or pharmaceutical companies have obtained a marketing authorization that is granted by the European Commission on the basis of the European Medicines Agency (EMA) assessment. Seven years after the publication of the regulation, few of these therapies have received a marketing authorization, and even fewer have met commercial success, suggesting that a number of medical and economic issues still need to be sorted out in order to achieve sustainability in this field. The coexistence of three sets of rules for three categories of health products that are biologically and medically related - ATMPs, ATMPs produced under the hospital exemption rule, and cell therapy products (CTPs) (a specific legal category in France) that have long been used in hematopoietic cell transplantation - constitutes a complex regulatory framework. This situation raises significant issues for historical as well as emerging operators in this moving field that are discussed thereafter.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 中西医学术分野的焦点和分野点%Academic Focus and Dividing Line of Traditional Chinese Medicine and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    祝世讷

    2016-01-01

    中医与西医的学术差异有微观和宏观两个层次,宏观差异是学术视野的分异,是整体性和根本性的差异.以欧氏几何与非欧几何为例,论证了中西医学术的分野是两圆相交式,即局部相交,主体相异,核心并立,方向相悖.指出了中西医学术分野的一个焦点——是否以人为本;剖析了中西医学术的四个分野点——人与人体之分、还原与非还原之分、生态与理化之分、临床研究与实验研究之分. 总结了中西医学术分野的两个基本特征——中医视野宽广但深细不足,西医视野缩减而深细.%The acadimic differences of traditional Chinese medicine and western medicine can be divided into micro and macro levels. The macro difference is the differentiation of academic views and it is an in-tegrity and fundamental difference. Based on Euclidean geometry and non-Euclidean geometry,the author demonstrates that the division of the research fields of the two medical systems is like two intersecting cir-cles. They belong to different subjects and partly intersect. Their cores exist side by side and their direc-tions are contrary to each other. Whether based on human being is the focus of the academic division of traditional Chinese medicine and western medicine. The paper analyzes the four division points of the two medical systems:the differences between body and human being,the differences between reduction and non-reduction,the differences between bionomics and physiclhemical and the differences between clinical re-search and experimental research. The two basic academic characteristics of traditional Chinese medicine and western medicine are summarized:the research field of traditional Chinese medicine is broad but not deep and the research field of western medicine is deep but not broad.

  5. Impact of Professional Student Mentored-Research Fellowship on Medical Education and Academic Medicine Career Path

    Science.gov (United States)

    Stratton, Terry; Kelly, Thomas H.; Starnes, Catherine P.; Sawaya, B. Peter

    2015-01-01

    Context This study explores the long-term impact of the Professional Student Mentored Research Fellowship (PSMRF) program at the University of Kentucky College of Medicine (UKCOM) on medical students’ research productivity and career paths. Methods Demographic characteristics, academic profiles, number of publications and residency placements from 2007-2012 were used to assess 119 PSMRF graduates against a comparison cohort of 898 UKCOM (non-PSMRF) students. Results PSMRF students had higher MCAT scores at admission (31.5 ± 0.6 vs. 30.6 ± 0.2, p = 0.007) and achieved higher USMLE Step 1 scores (228 ± 4.2 vs. 223 ± 1.5, p = 0.03) than comparison group. PSMRF students were more likely to publish Pubmed-indexed papers (36.7% vs. 17.9%, p < 0.0001), achieve AOA status (19.3% vs. 8.5%, p = 0.0002) and match to top 25 U.S. News and World Report residency programs (23.4% vs. 12.1%, p = 0.008). A greater proportion of PSMRF fellows matched to top tier competitive specialties (23% vs. 14.2%, p= 0.07), however this difference was not statistically significant. Conclusions The PSMRF program shows a significant increase in enrollment, as well as positive associations with indicators of success in medical school and subsequent quality of residency program. PMID:25996460

  6. Evidence-based medicine and hospital reform: tracing origins back to Florence Nightingale.

    Science.gov (United States)

    Aravind, Maya; Chung, Kevin C

    2010-01-01

    The use of reliable evidence to evaluate health care interventions has gained strong support within the medical community and in the field of plastic surgery in particular. Evidence-based medicine aims to improve health care and reduce costs through the use of sound clinical evidence in evaluating treatments, procedures, and outcomes. The field is hardly new, however, and most trace its origins back to the work of Cochrane in the 1970s and Sackett in the 1990s. Though she wouldn't know it, Florence Nightingale was applying the concepts of evidence-based reform to the medical profession more than a century before. She used medical statistics to reveal the nature of infection in hospitals and on the battlefield. Moreover, Nightingale marshaled data and evidence to establish guidelines for health care reform. Tracing the origins of evidence-based medicine back to Nightingale underscores how critical this movement is to improving the quality and effectiveness of patient care today.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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. Clinically significant anaerobic bacteria isolated from patients in a South African academic hospital: antimicrobial susceptibility testing.

    Science.gov (United States)

    Naidoo, S; Perovic, O; Richards, G A; Duse, A G

    2011-09-27

    BACKGROUND. Increasing resistance to some antimicrobial agents among anaerobic bacteria has made susceptibility patterns less predictable. METHOD. This was a prospective study of the susceptibility data of anaerobic organisms isolated from clinical specimens from patients with suspected anaerobic infections from June 2005 until February 2007. Specimens were submitted to the microbiology laboratory at Charlotte Maxeke Johannesburg Academic Hospital, where microscopy, culture and susceptibility testing were performed the using E test® strip minimum inhibitory concentration method. Results were interpreted with reference to Clinical and Laboratory Standards Institute guidelines for amoxicillin-clavulanate, clindamycin, metronidazole, penicillin, ertapenem, cefoxitin, ceftriaxone, chloramphenicol and piperacillin-tazobactam. RESULTS. One hundred and eighty anaerobic isolates were submitted from 165 patients. The most active antimicrobial agents were chloramphenicol (100% susceptible), ertapenem (97.2%), piperacillin-tazobactam (99.4%) and amoxicillin-clavulanic acid (96.7%). Less active were metronidazole (89.4%), cefoxitin (85%), clindamycin (81.7%), ceftriaxone (68.3%) and penicillin (33.3%). CONCLUSION. Susceptibility testing should be performed periodically to identify emerging trends in resistance and to modify empirical treatment of anaerobic infections.

  10. Evaluation of rational use of medicines (RUM in four government hospitals in UAE

    Directory of Open Access Journals (Sweden)

    Amal Mahmood

    2016-03-01

    Full Text Available Rational: Studies conducted showed that there were gaps regarding the rational use of medicines (RUM. Aims and objectives: Evaluate RUM in main government hospitals in four emirates in UAE, using WHO prescribing indicators. Method: Multicenter prospective cross-sectional comparative study was conducted in 4 hospitals in 4 different Emirates in UAE. Using consecutive random sampling method, a total of 1100 prescriptions (2741 prescribed drugs were collected and analyzed from surveyed hospitals from April to October 2012. Index of Rational Drug Prescribing (IRDP was used as an indicator of RUM. Results: The main finding of this study was that, the mean values of prescribing indicators of RUM in the surveyed hospitals were estimated to be within the WHO optimal values for generics (100.0 vs. 100.0, antibiotics (9.8 ± 4.8 vs. ⩽30, injections (3.14 ± 1.7 vs. ⩽10 and formulary (EML prescribing (100.0 vs. 100.0. However, the only discrepancy was reported regarding the number of drugs per prescription which was found to be more than the WHO optimal value (2.49 ± 0.9 vs. ⩽2; respectively. The mean IRDP was 4.55 which was less than the WHO optimal value of 5. Conclusions: Strategies and interventions are desirable to promote RUM and minimize the consequences of poly-pharmacy.

  11. A division of medical communications in an academic medical center's department of medicine.

    Science.gov (United States)

    Drazen, Jeffrey M; Shields, Helen M; Loscalzo, Joseph

    2014-12-01

    Excellent physician communication skills (physician-to-patient and patient-to-physician) have been found to have a positive impact on patient satisfaction and may positively affect patient health behaviors and health outcomes. Such skills are also essential for accurate, succinct, and clear peer-to-peer (physician-to-physician), physician-to-lay-public, and physician-to-media communications. These skills are not innate, however; they must be learned and practiced repeatedly. The Division of Medical Communications (DMC) was created within the Department of Medicine at Brigham and Women's Hospital as an intellectual home for physicians who desire to learn and teach the wide variety of skills needed for effective communication.In this Perspective, the authors provide an overview of the key types of medical communications and share the DMC model as an innovative approach to providing expert guidance to physicians and physicians-in-training as they develop, practice, and refine their communication skills. Current DMC projects and programs include a Volunteer Patient Teaching Corps, which provides feedback to medical students, residents, and faculty on communication skills; a controlled trial of a modified team-based learning method for attending rounds; expert coaching in preparation for presentations of all types (e.g., grand rounds; oral presentations or poster presentations on basic science, clinical, or medical education research); sessions on speaking to the media and running a meeting well; and courses on writing for publication. Objective assessment of the impact of each of these interventions is planned.

  12. Hand hygiene technique quality evaluation in nursing and medicine students of two academic courses

    Directory of Open Access Journals (Sweden)

    Manuela Škodová

    2015-08-01

    Full Text Available AbstractObjective: because they are health professionals, nursing and medical students' hands during internships can function as a transmission vehicle for hospital-acquired infections.Method: a descriptive study with nursing and medical degree students on the quality of the hand hygiene technique, which was assessed via a visual test using a hydroalcoholic solution marked with fluorescence and an ultraviolet lamp.Results: 546 students were assessed, 73.8% from medicine and 26.2% from nursing. The area of the hand with a proper antiseptic distribution was the palm (92.9%; areas not properly scrubbed were the thumbs (55.1%. 24.7% was very good in both hands, 29.8% was good, 25.1% was fair, and 20.3% was poor. The worst assessed were the male, nursing and first year students. There were no significant differences in the age groups.Conclusions: hand hygiene technique is not applied efficiently. Education plays a key role in setting a good practice base in hand hygiene, theoretical knowledge, and in skill development, as well as good practice reinforcement.

  13. Developing and understanding a hospital-based proton facility: bringing physics into medicine.

    Science.gov (United States)

    Slater, James M

    2007-08-01

    From October 18 to 20, 2006, a symposium, Developing and Understanding a Hospital-based Proton Facility: Bringing Physics Into Medicine, was held at the Renaissance Esmeralda Resort and Spa, Indian Wells, California. The event was offered by the Department of Radiation Medicine at Loma Linda University (LLU), supported by the Telemedicine and Advanced Technology Research Center (TATRC) and the United States Army Medical Research and Materiel Command (USAMRMC). The meeting was intended to discuss factors involved in planning, developing, and operating a hospital-based proton treatment center. It brought together some of the most distinguished physicists, radiation biologists, and radiation oncologists in the world, and more than 100 individuals participated in the three-day educational offering. This overview reports on the event and introduces several papers written by many of the speakers from their presentations, for publication in this issue of Technology in Cancer Research and Treatment. Both the symposium and the papers are appropriate for this journal: exploitation of technology was one of the underlying themes of the symposium.

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

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    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.

  15. Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals

    Science.gov (United States)

    Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

    2014-01-01

    Abstract Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1–5 years and served 90–100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40–45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals

  16. Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals.

    Science.gov (United States)

    Rodriguez, Annabelle; Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

    2014-08-01

    Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1-5 years and served 90-100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40-45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals and specific

  17. [The department budget, in the context of the hospital global budget. Initial results in general medicine].

    Science.gov (United States)

    Besançon, F

    1984-02-23

    In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

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

    Science.gov (United States)

    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…

  19. DRUG UTILIZATION STUDY OF URINARY TRACT INFECTIONS IN MEDICINE DEPARTMENT IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Rajat

    2014-11-01

    Full Text Available : BACKGROUND: The WHO in 1977 provided the proper definition of Drug Utilization. It has been defined as the marketing, distribution, prescription and use of drugs in society with special emphasis on the resulting medical and social consequences. Urinary tract infection (UTI is caused by pathogenic invasion of the urinary tract which leads to an inflammatory response of the urothelium. Urinary tract infections are common burden in patients with diabetes mellitus. Cystitis, ascending infection leading to pyelonephritis, impaired leucocyte function, recurrent vaginitis, emphysematous complications and renal/perinephric abscesses are well recognized in this group of patients if glycemic control is poor. The present study was undertaken to identify the common pathogens and drug sensitivity pattern of the isolate among patients who attended the medicine outpatients department so as to guide empirical treatment. OBJECTIVES: To evaluate prescription pattern of antibiotics in UTI in medicine department in a tertiary care hospital. Study of type of patients along with type of UTI major symptoms, precipitating factors, evaluation of uropathogens. To analyze rationality among the prescriptions. METHODS AND MATERIALS: This prospective, observational and analytical study was done to assess the antibiotics prescribed in UTI in medicine department in a tertiary care hospital. Gender distribution, age wise distribution, type of patients (outpatients, inpatients, type of UTI (complicated, uncomplicated, presenting symptoms, lab investigations related to UTI, microorganisms isolated from urine culture, antibiotics prescribed for UTI, precipitating factors for UTI, route of drug administration, adjuvant drugs along with antibiotics for UTI and outcome of the treatment were evaluated. Patients receiving antibiotic therapy in UTI of either gender of age >18 years, visiting medicine department were included. Approval from the institutional ethics committee was

  20. The ambivalent chaplain: negotiating structural and ideological difference on the margins of modern-day hospital medicine.

    Science.gov (United States)

    Norwood, Frances

    2006-01-01

    The chaplain experience in modern-day hospital medicine is largely one of marginalization. It is not, however, an experience without agency. Working within the constraints of difference, chaplains learn how to negotiate on the margins of medicine. This starts with learning the language of hospital medicine, learning to skillfully see, speak, and move in ways that minimize difference. Successes in socialization and acclimation do not, however, guarantee the chaplain a place in the hospital, where chaplains encounter both structural marginalization (resulting from inequalities in power and hierarchy) and ideological marginalization (resulting from inequalities in accepted forms of knowledge and practice). Using the theories of Michel Foucault (1973) and Byron Good (1994), I examine how chaplains negotiate structural and ideological marginality, at times embracing their connection to medicine (downplaying their connection to the institution of religion) and at other times embracing their connection to religion and religious practices. The result is an ambivalent chaplain who strategically embraces one or the other paradigm in order to survive. Using data gathered during a 12-month ethnography of chaplain interns at a university teaching hospital, this article examines the structural and ideological differences between science and religion through the modern-day practice of hospital chaplains. It both introduces readers to the modern-day chaplain, a healer largely absent in ethnography, and adds a renewed perspective to a long-standing body of literature on the relationship between structure and agency, and science and religion.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Residents values in a rational decision-making model: an interest in academics in emergency medicine.

    Science.gov (United States)

    Burkhardt, John Christian; Smith-Coggins, Rebecca; Santen, Sally

    2016-10-01

    Academic physicians train the next generation of doctors. It is important to understand the factors that lead residents to choose an academic career to continue to effectively recruit residents who will join the national medical faculty. A decision-making theory-driven, large scale assessment of this process has not been previously undertaken. To examine the factors that predict an Emergency resident's interest in pursuing an academic career at the conclusion of training. This study employs the ABEM Longitudinal Survey (n = 365). A logistic regression model was estimated using an interest in an academic career in residency as the dependent variable. Independent variables include gender, under-represented minority status, survey cohort, number of dependent children, possession of an advanced degree, ongoing research, publications, and the appeal of science, independence, and clinical work in choosing EM. Logistic regression resulted in a statistically significant model (p < 0.001). Residents who chose EM due to the appeal of science, had peer-reviewed publications and ongoing research were more likely to be interested in an academic career at the end of residency (p < 0.05). An increased number of children (p < 0.05) was negatively associated with an interest in academics. Individual resident career interests, research productivity, and lifestyle can help predict an interest in pursuing an academic career. Recruitment and enrichment of residents who have similar values and behaviors should be considered in programs interested in generating more graduates who enter an academic career.

  3. What is a hospital? Future roles and prospects for success: the business of medicine: a course for physician leaders.

    Science.gov (United States)

    Shalowitz, Joel

    2013-09-01

    As hospitals consolidate and take on more financial and clinical risk, they face numerous obstacles. While the past can provide answers to solving many of the challenges, some issues are new and require innovative approaches. This article, from a speech delivered to The Business of Medicine: A Course for Physician Leaders symposium presented by Yale-New Haven Hospital and the Medical Directors Leadership Council at Yale University in November 2012, discusses the models for these hospital organizations and the pitfalls they will face in coordinating care. The insights will help these systems overcome potential problems and enhance their chances of success.

  4. Analysis on Western Medicine Hospital Library of Medicine Management Method%关于医院西药库药品管理的方法分析

    Institute of Scientific and Technical Information of China (English)

    郭荭

    2016-01-01

    Objective To study and to explore the hospital medicine management methods of western medicine library, in order to improve the management quality of hospital library western medicine drugs to provide reference basis. Methods From January 2014 to December, the period from the western medicine library using ABC classification management in the process of drug administration management;In January 2015, our hospital library medicine western medicine management of ABC classification management is optimized and improved, the introduction of the CVA classification management, take CVA classification management to manage library medicine, western medicine to collect data from January 2015 to Decem-ber. Contrast two phases in purchasing drug types, safety inventory cycle, year purchase amount, purchase, purchase cycle, inventory, inventory turnover, inventory average workload, rate of out of stock. Results Compared with from January 2014 to December, from January 2015 to December of the year purchasing drug species increased significantly (P< 0.05), the safety stock cycle, purchasing cycle were significantly reduced(P< 0.05), the annual purchase amount, in the mean number of pro-curement, inventory, inventory workload were significantly reduced(P<0.05), obviously improve the inventory turnover ratio, out of stock rate significantly decreased(P< 0.05). Conclusion Western medicine library of medicine management in hospi-tal, can manage to take CVA classification management, to improve hospital medicine library inventory turns, decrease the rate of out of stock, enhances the working efficiency of the western medicine library in an all-round way.%目的:研究并探讨医院西药库药品管理的方法,为提高医院西药库药品管理质量提供借鉴依据。方法于2014年1—12月,该阶段内该院西药库药品管理过程中采用ABC分类管理法进行管理;2015年1月起,该院西药库药品管理方面对ABC分类管理法进行了优化和改进,引

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

    Directory of Open Access Journals (Sweden)

    Akshaya Srikanth Bhagavathula

    2014-05-01

    Conclusion: We have recorded a high rate of prevalence of potential DDI in the internal 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.

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

    DEFF Research Database (Denmark)

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Perspective: the negativity bias, medical education, and the culture of academic medicine: why culture change is hard.

    Science.gov (United States)

    Haizlip, Julie; May, Natalie; Schorling, John; Williams, Anne; Plews-Ogan, Margaret

    2012-09-01

    Despite ongoing efforts to improve working conditions, address well-being of faculty and students, and promote professionalism, many still feel the culture of academic medicine is problematic. Depression and burnout persist among physicians and trainees. The authors propose that culture change is so challenging in part because of an evolutionary construct known as the negativity bias that is reinforced serially in medical education. The negativity bias drives people to attend to and be more greatly affected by the negative aspects of experience. Some common teaching methods such as simulations, pimping, and instruction in clinical reasoning inadvertently reinforce the negativity bias and thereby enhance physicians' focus on the negative. Here, the authors examine the concept of negativity bias in the context of academic medicine, arguing that culture is affected by serially emphasizing the inherent bias to recognize and remember the negative. They explore the potential role of practices rooted in positive psychology as powerful tools to counteract the negativity bias and aid in achieving desired culture change.

  9. Internal medicine and emergency admissions: from a national hospital discharge records (SDO study to a regional analysis

    Directory of Open Access Journals (Sweden)

    Filomena Pietrantonio

    2016-02-01

    Full Text Available In Italy, the number of internists has grown by 10% since 1990 reaching 11,435 units, they manage 39,000 beds in 1060 Internal Medicine (IM wards. The Internists are expected to ensure a cost-effective management of poly-pathological and complex patients. A collaborative study between the Federation of Associations of Hospital Doctors on Internal Medicine (FADOI and the Consortium for Applied Health Economics Research (C.R.E.A. Sanità based on data from hospital discharge records has been conducted starting from November 2014. In this article the preliminary results are shown with focus on emergency admissions characteristics to contribute to define the role of hospital IM. Evaluation is performed comparing emergency and planned admissions, IM impact on hospital admissions, availability of community-based healthcare services, diagnosis-related groups (DRGs weight in IM and regional differences in managing hospital admissions with focus on IM department. In 2013 IM wards discharged 1,073,526 patients (16.18% of the total discharged by hospitals with a total economic value of 3,426,279.88 € (average DRG 3882.80 €, from 3682.19 to 4083.42. The average length of stay (LOS in IM was 9.3 days. IM covers 27% of admissions from Emergency Room. Determinants significantly affecting the emergency admissions are old age and comorbidities of the patients that also have a role in increasing LOS. 55% of Italian hospital admissions are emergency admissions. Hospitalization rates in emergency are systematically higher than those in election and the greatest differences are in the regions with inefficiently organized regional network. The role of the hospital IM appears central in the offer of beds to the emergency room by accepting 27% of urgent admissions. The increasing impact of IM on hospital management will put the internists as authoritative stakeholders in health policy.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study.

    Science.gov (United States)

    Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

    2014-01-01

    Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning.

  12. Are Australasian academic physicians an endangered species?

    Science.gov (United States)

    Wilson, A

    2007-11-01

    It has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient-based services as well as a corporate health-care ethos or does it relate to innate problems in the training process and career structure for academic clinicians? A better understanding of the barriers to involvement in academic practice, including the effect of gender, the role and effect of overseas training, expectation of further research degrees and issues pertaining to the Australian academic workplace will facilitate recruitment and retention of the next generation of academic clinicians. Physician-scientists remain highly relevant as medical practice and education evolves in the 21st century. Hospital-based academics carry out a critical role in the ongoing mentoring of trainees and junior colleagues, whose training is still largely hospital based in most specialty programmes. Academic clinicians are uniquely placed to translate the rapid advances in medical biology into the clinical sphere, by guiding and carrying out translational research as well as leading clinical studies. Academic physicians also play key leadership in relations with government and industry, in professional groups and medical colleges. Thus, there is a strong case to assess the problems facing recruitment and retention of physician-scientists in academic practice and to develop workable solutions.

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

    Directory of Open Access Journals (Sweden)

    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

  14. 我院中成药应用分析%Application analysis of Chinese patent medicine in our hospital

    Institute of Scientific and Technical Information of China (English)

    庞国丽

    2015-01-01

    目的:评价本院中成药应用的现状和发展中存在的问题。方法对本院门诊所使用的中成药的金额、数量、种类进行统计分析。结果本院门诊应用的中成药占药品使用的比例很大,以清热类药居多(48.9%),其次为活血化瘀类(24.5%)和止血类(11.0%)。总体使用规范,但仍存在一些不合理现象。结论提高中成药疗效,规范合理使用中成药需全院全社会共同努力。%Objective To evaluate the problems in current condition and development of Chinese patent medicine application in our hospital.Methods The statistical analysis was made on the consumption sum, quantity, and category of Chinese patent medicine in outpatient service of our hospital.Results Chinese patent medicine accounted for a large proportion in outpatient drug use in our hospital, with a majority of heat-clearing drugs (48.9%) following by promoting circulation and removing stasis drugs (24.5%) and hemostasis drugs (11.0%). The application was basically standard with a few of irrational phenomena.Conclusion Improving the curative effect of Chinese patent medicine and standardizing the rational use of Chinese patent medicine require the concerted efforts in the hospital and society.

  15. Plastic surgeons’ self-reported operative infection rates at a Canadian academic hospital

    OpenAIRE

    Ng, Wendy KY; Kaur, Manraj Nirmal; Thoma, Achilleas

    2014-01-01

    The significant morbidity associated with surgical site infections, in addition to increased hospital stays and health care resource utilization, has garnered much attention, especially in the era of cost-conscious health care systems and third-party payers. Although previous studies have investigated hospital-acquired infection rates across all surgical subspecialities, none have focused specifically on plastic surgery procedures. This retrospective study examined surgical site infection dat...

  16. Malpractice liability, patient safety, and the personification of medical injury: opportunities for academic medicine.

    Science.gov (United States)

    Sage, William M

    2006-09-01

    The political battle over trial lawyers and "tort reform" centers on whether or not to reduce incentives to sue for medical malpractice by capping damages in malpractice suits and limiting legal fees. But the current struggle mis-states the case for innovation in medical malpractice policy. Rather than focus exclusively on the financial consequences of legal claims, malpractice reform should move closer to the bedside, emphasizing error prevention, open communication, rapid compensation, and efficient insurance of the costs of injury. Academic health centers are well positioned to lead this effort in each of their three recognized missions: patient care, teaching, and research. Academic health centers enjoy greater institutional cohesiveness and research capacity than most other medical practice settings. Perhaps most important, their high visibility ensures that patients who suffer avoidable harm within their walls become salient to the public as individuals, not merely as dollar entries in a litigation ledger.

  17. A Third-Year Family Medicine Clerkship Based in an Academic Family Practice Center.

    Science.gov (United States)

    Taylor, Robert B; And Others

    1984-01-01

    A 5-week family medicine clerkship is described that uses several innovative techniques: problem-based learning focusing on patient management tutorials; consultation with specialists; supervised patient care and a nursing home inpatient teaching service; and workshops on topics such as office-surgical techniques, practice management, and…

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

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

    Institute of Scientific and Technical Information of China (English)

    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.

  1. Scientometric study of academic publications on antioxidative herbal medicines in type 2 diabetes mellitus

    OpenAIRE

    Tabatabaei-Malazy, Ozra; Ramezani, Amir; Atlasi, Rasha; Larijani, Bagher; Abdollahi, Mohammad

    2016-01-01

    Background Scientometric analysis is increasingly used for research assessment. We aimed to perform a scientometric analysis of research productivity in field of antioxidative hypoglycemic herbal medicine and diabetes. Methods Some of search terms were “type 2 diabetes”, “antioxidant”, “herb”, “phytotherapy”, “ethnopharmacology”, “Chinese medicine”, “traditional medicine”, in Scopus web databases until January 2015, and limited to human. The collected data were used to generate the specific f...

  2. The house of gastrointestinal medicine: how academic medical centers can build a sustainable economic clinical model.

    Science.gov (United States)

    Rustgi, Anil K; Allen, John I

    2013-11-01

    Academic Medical Centers (AMCs) have been given unique responsibilities to care for patients, educate future clinicians, and bring innovative research to the bedside. Over the last few decades, this tripartite mission has served the United States well, and payers (Federal, State, and commercial) have been willing to underwrite these missions with overt and covert financial subsidies. As cost containment efforts have escalated, the traditional business model of AMCs has been challenged. In this issue, Dr Anil Rustgi and I offer some insights into how AMCs must alter their business model to be sustainable in our new world of accountable care, cost containment, and clinical integration.

  3. [Intensive and palliative care medicine. From academic distance to caring affection].

    Science.gov (United States)

    Burchardi, H

    2014-02-01

    Intensive care medicine has made great contributions to the immense success of modern curative medicine. However, emotional care and empathy for the patient and his family seem to be sparse. There is an assumed constraint to objectivity and efficiency, as well as a massive economic pressure which transfers the physician into an agent of the disease instead of a trustee of the ill human being. The physician struggles against the disease and feels the death of his patient as his personal defeat. However, in futile situations the intensivist must learn to let go. He is responsible for futile overtreatment as well as for successful treatment. Today, in futile situations in the intensive care unit (ICU), it is possible to change the goal from curative treatment to palliative care. This is a consequent further development from critical care medicine. In end-of-life situations in the intensive care unit, emotional care and empathy are mandatory using intensive dialogues with the family. Despite great workload stress enough time for such conversation should be taken, because the physician will generously be repaid by the way he sees his medical activity. The maintenance of a culture of empathy within the intensive care team is a major task for the leader. In this manner, the ICU will become and remain a place for living humanity.

  4. Factors associated with nonattendance at clinical medicine scheduled outpatient appointments in a university general hospital

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    Giunta D

    2013-11-01

    Full Text Available Diego Giunta,1,2 Agustina Briatore,3 Analía Baum,3 Daniel Luna,3 Gabriel Waisman,2 Fernán Gonzalez Bernaldo de Quiros1–31Internal Medicine Research Unit, 2Internal Medicine Department, 3Health Informatics Department, Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaIntroduction: Nonattendance at scheduled outpatient appointments for primary care is a major health care problem worldwide. Our aim was to estimate the prevalence of nonattendance at scheduled appointments for outpatients seeking primary care, to identify associated factors and build a model that predicts nonattendance at scheduled appointments.Methods: A cohort study of adult patients, who had a scheduled outpatient appointment for primary care, was conducted between January 2010 and July 2011, at the Italian Hospital of Buenos Aires. We evaluated the history and characteristics of these patients, and their scheduling and attendance at appointments. Patients were divided into two groups: those who attended their scheduled appointments, and those who did not. We estimated the odds ratios (OR and corresponding 95% confidence intervals (95% CI, and generated a predictive model for nonattendance, with logistic regression, using factors associated with lack of attendance, and those considered clinically relevant. Alternative models were compared using Akaike's Information Criterion. A generation cohort and a validation cohort were assigned randomly.Results: Of 113,716 appointments included in the study, 25,687 were missed (22.7%; 95% CI: 22.34%–22.83%. We found a statistically significant association between nonattendance and age (OR: 0.99; 95% CI: 0.99–0.99, number of issues in the personal health record (OR: 0.98; 95% CI: 0.98–0.99, time between the request for and date of appointment (OR: 1; 95% CI: 1–1, history of nonattendance (OR: 1.07; 95% CI: 1.07–1.07, appointment scheduled later than 4 pm (OR: 1.30; 95% CI: 1.24–1.35, and specific days of the week (OR: 1

  5. Traditional medicine for HIV infected patients in antiretroviral therapy in a tertiary hospital in Kano, Northwest Nigeria

    Institute of Scientific and Technical Information of China (English)

    Igbiks Tamuno

    2011-01-01

    Objective:To investigate the prevalence of use of traditional medicines amongst patients with HIV infection receiving therapies of antiretroviral(ARV) drugs at the Aminu Kano Teaching Hospital(AKTH), Kano, Northwest Nigeria, and to assess the attitude of these patients to theirARV therapy.Methods: A cross sectional prospective study using pretested structured questionnaires administered on430 patients with antiretroviral therapy attending the AKTH between April and June2009. Data was collected on socio-demographic characteristics, use of traditional medicine and attitude to antiretroviral therapy.Results: A mean age of(33.6±8.4)years old was found with67.2% females and32.8% males. A total of29% had no formal education while 10.5% had postgraduate education;12% earned above 35 000 naira (230 USD) per month;63.8% were married;39.8% had at least2 sexual partners; 27.5% used traditional medicine before commencement of antiretroviral therapy (ART), but only4.25% of patients used ARV and traditional medicine concurrently. There was no significant difference in most of the socio-demographic indices between the concurrent users and other patients (P>0.05). A total of 28.8% HIV patients,14.6% patients used traditional medicine beforeART and29.4% concurrent users had missed at least a dose of theirARVs since commencement of therapy. 148 (37%) of the patients had their drug regimen changed at least once while23 (20.90%) patients receiving traditional medicine beforeARTand5 (29.41%) patients having two treatments had their drug regimen changed.Conclusions: A total of4.25% patients used ARV and traditional medicine concurrently. In conclusion, the widespread use of traditional medicine by patients living with HIV/AIDSshould be of concern to clinicians and policy makers.

  6. Assigning a team-based pager for on-call physicians reduces paging errors in a large academic hospital.

    Science.gov (United States)

    Shieh, Lisa; Chi, Jeffrey; Kulik, Carol; Momeni, Arash; Shelton, Andrew; DePorte, Cynthia; Hopkins, Joseph

    2014-02-01

    As complexity of care of hospitalized patients has increased, the need for communication and collaboration among members of the team caring for the patient has become increasingly important. This often takes the form of a nurse's need to contact a patient's physician to discuss some aspect of care and modify treatment plans. Errors in communication delay care and can pose risk to patients. This report describes the successful implementation of a standardized team-based paging system at an academic center. Results showed a substantial improvement in nurses' perceptions of knowing how to contact the correct physician when discussion of the patient's care is needed. This improvement was found across multiple medical and surgical specialties and was particularly effective for services with the greatest communication problems.

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

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    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.

  8. Academic Primer Series: Five Key Papers about Team Collaboration Relevant to Emergency Medicine

    Science.gov (United States)

    Gottlieb, Michael; Grossman, Catherine; Rose, Emily; Sanderson, William; Ankel, Felix; Swaminathan, Anand; Chan, Teresa M.

    2017-01-01

    Introduction Team collaboration is an essential for success both within academics and the clinical environment. Often, team collaboration is not explicitly taught during medical school or even residency, and must be learned during one’s early career. In this article, we aim to summarize five key papers about team collaboration for early career clinician educators. Methods We conducted a consensus-building process among the writing team to generate a list of key papers that describe the importance or significance of team collaboration, seeking input from social media sources. The authors then used a three-round voting methodology akin to a Delphi study to determine the most important papers from the initially generated list. Results The five most important papers on the topic of team collaboration, as determined by this mixed group of junior faculty members and faculty developers, are presented in this paper. For each included publication, a summary was provided along with its relevance to junior faculty members and faculty developers. Conclusion Five key papers about team collaboration are presented in this publication. These papers provide a foundational background to help junior faculty members with collaborating in teams both clinically and academically. This list may also inform senior faculty and faculty developers about the needs of junior faculty members. PMID:28210368

  9. [Psychological characteristics of obese patients hospitalized at the obesity unit of the 4th Internal Medicine Clinic of the Medical School Hospital in Prague].

    Science.gov (United States)

    Slabá, S; Cepická, B

    1998-01-01

    This study presents the results of a psychological survey carried out in 1995 and 1996 in the Obesity Unit of IVth Department of Internal Medicine, General Faculty Hospital in Prague. There were 86 patients examined. The patients underwent a series of tests and questionnaires--Raven's Progressive Matrices, STAI, Miniscripts, Body Image. No significant differences were found between men and women. On the basis of this screening the general characteristics of obese patients hospitalized in this Unit can be described as follows: average to above average level of mental capacity for the general population, a need to "be strong and have everything under control", a need for recognition from other people, slightly increased level of anxiety. In their perception of their bodies they see themselves as overweight, unattractive and in a poor state of health.

  10. Medicine of senescence or managing a hospital system: the resistible rise of geriatric medicine in the State of Victoria.

    Science.gov (United States)

    Hunter, Cecily

    2006-04-01

    This paper investigates the conditions in which geriatric medicine emerged in the state of Victoria between the late 1950s and the late 1970s. It shows how, in transforming a charity model of care into a medical model of service, nascent geriatricians were caught up in the shifting balance of responsibilities between state and Commonwealth governments in funding health services and care for the aged, and in the efforts of a small segment of the Australian medical profession to establish an organisational setting and professional context for social medicine. In Victoria, the potential for doctors to circumvent bureaucratic and professional limitations on their work lay in their relationship with their institutional committees of management whose members were drawn from the general community. The paper argues that pioneer 'geriatricians' failed to establish a field of practice that met all the needs they discerned in their patient group because they could not change community ideas about appropriate responses to old age infirmity.

  11. Assessing research impact in academic clinical medicine: a study using Research Excellence Framework pilot impact indicators

    Directory of Open Access Journals (Sweden)

    Ovseiko Pavel V

    2012-12-01

    Full Text Available Abstract Background Funders of medical research the world over are increasingly seeking, in research assessment, to complement traditional output measures of scientific publications with more outcome-based indicators of societal and economic impact. In the United Kingdom, the Higher Education Funding Council for England (HEFCE developed proposals for the Research Excellence Framework (REF to allocate public research funding to higher education institutions, inter alia, on the basis of the social and economic impact of their research. In 2010, it conducted a pilot exercise to test these proposals and refine impact indicators and criteria. Methods The impact indicators proposed in the 2010 REF impact pilot exercise are critically reviewed and appraised using insights from the relevant literature and empirical data collected for the University of Oxford’s REF pilot submission in clinical medicine. The empirical data were gathered from existing administrative sources and an online administrative survey carried out by the university’s Medical Sciences Division among 289 clinical medicine faculty members (48.1% response rate. Results The feasibility and scope of measuring research impact in clinical medicine in a given university are assessed. Twenty impact indicators from seven categories proposed by HEFCE are presented; their strengths and limitations are discussed using insights from the relevant biomedical and research policy literature. Conclusions While the 2010 pilot exercise has confirmed that the majority of the proposed indicators have some validity, there are significant challenges in operationalising and measuring these indicators reliably, as well as in comparing evidence of research impact across different cases in a standardised manner. It is suggested that the public funding agencies, medical research charities, universities, and the wider medical research community work together to develop more robust methodologies for capturing

  12. Hospitals

    Data.gov (United States)

    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...

  13. Use of potentially inappropriate medicines in elderly: A prospective study in medicine out-patient department of a tertiary care teaching hospital

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    Zaveri H

    2010-01-01

    Full Text Available Objective: The present study was undertaken with the aim to detect extent of drug use in elderly at medicine outpatient department at tertiary care hospital and to evaluate inappropriate prescribing with the help of Beers′ criteria 2002. Materials and Methods: The study was carried out at medicine out patient department of our hospital. 407 geriatric patients were included during the study period of three and half months. The data was collected in a proforma which included the patients′ details and the prescriptions. Results: The results reveal that 7.42% of total drugs were prescribed in an inappropriate manner and 23.59% of total patients received at least one inappropriate drug prescription. Administration of a drug which is avoided in elderly forms a common category of inappropriate drug use. Antihistamines, anticholinergic, sedatives and hypnotics and cardiac glycosides are the most common drug groups prescribed in inappropriate manner. Conclusion: To conclude, this study shows high prevalence of inappropriate use of drugs in geriatric practice suggesting urgent need for sincere efforts to improve the situation.

  14. Does Academic Blogging Enhance Promotion and Tenure? A Survey of US and Canadian Medicine and Pediatric Department Chairs

    Science.gov (United States)

    Varma, Manu; Adams, Martha; Jhaveri, Kenar D

    2016-01-01

    Background Electronic educational (e-learning) technology usage continues to grow. Many medical journals operate companion blogs (an application of e-learning technology) that enable rapid dissemination of scientific knowledge and discourse. Faculty members participating in promotion and tenure academic tracks spend valuable time and effort contributing, editing, and directing these medical journal blogs. Objective We sought to understand whether chairs of medicine and pediatric departments acknowledge blog authorship as academic achievement. Methods The authors surveyed 267 chairs of US and Canadian medicine and pediatric departments regarding their attitudes toward the role of faculty participation in e-learning and blogging in the promotion and tenure process. The survey completion rate was 22.8% (61/267). Results A majority of respondents (87%, 53/61) viewed educational scholarship as either important or very important for promotion. However, only 23% (14/61) perceived importance to faculty effort in producing content for journal-based blogs. If faculty were to participate in blog authorship, 72% (44/61) of surveyed chairs favored involvement in a journal-based versus a society-based or a personal (nonaffiliated) blog. We identified a “favorable group” of chairs (19/59, 32%), who rated leadership roles in e-learning tools as important or very important, and an “unfavorable group” of chairs (40/59, 68%), who rated leadership roles in e-learning tools as somewhat important or not important. The favorable group were more likely to be aware of faculty bloggers within their departments (58%, 11/19 vs 25%, 10/40), viewed serving on editorial boards of e-learning tools more favorably (79%, 15/19 vs 31%, 12/39), and were more likely to value effort spent contributing to journal-based blogs (53%, 10/19 vs 10%, 4/40). Conclusions Our findings demonstrate that although the majority of department chairs value educational scholarship, only a minority perceive value

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

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    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  17. Oral and maxillofacial malignancies: An analysis of 77 cases seen at an academic medical hospital

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    Adebayo Aremu Ibikunle

    2016-01-01

    Full Text Available Introduction: Oral and maxillofacial malignancies (OMMs consist of a wide range of lesions, which constitute varying proportions of the total incidence of malignancies in the human population. Available epidemiological data vary across racial, geographical, gender, and occupational divides. They are often associated with significant impairment of patients' quality of life. Materials and Methods: A review of hospital records of patients with histologically diagnosed primary OMM, who presented to the Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, over a 5-year period, was done. Data including age, gender, site, and type of tumor, and histological grade of tumor were retrieved and analyzed with the SPSS version 20.0. Results: A total of 77 cases of OMMs were identified with a male/female ratio of 1:1.03. The mean (±standard deviation age was 50.1 (17.8 years. Squamous cell carcinoma was the most frequently seen epithelial malignancy constituting 35.1% of all malignancies, with most patients in advanced stages of the disease. Osteosarcoma was the most frequently diagnosed sarcoma, constituting 11.7% of all malignancies seen. Salivary gland malignancies constituted 29 (37.7%. Other malignancies seen include, malignant peripheral nerve sheath tumor, leiomyosarcoma, and malignant melanoma. Conclusion: OMMs constitute a significant health burden in our region. Thus, adequate resources should be allocated toward improving awareness among the populace. Policy shifts and regular dental visits which may increase the likelihood of early intervention should be instituted.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Fang X

    2016-04-01

    Full Text Available 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. 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 <0.05. Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine

  20. Perspective: adopting an asset bundles model to support and advance minority students' careers in academic medicine and the scientific pipeline.

    Science.gov (United States)

    Johnson, Japera; Bozeman, Barry

    2012-11-01

    The authors contend that increasing diversity in academic medicine, science, technology, engineering, and mathematics requires the adoption of a systematic approach to retain minority high school and college students as they navigate the scientific pipeline. Such an approach should focus on the interrelated and multilayered challenges that these students face. The authors fuse an alternative conceptualization of the scientific and technical human capital theoretical framework and the theory of social identity contingencies to offer a conceptual model for targeting the critical areas in which minority students may need additional support to continue toward careers in science. Their proposed asset bundles model is grounded in the central premise that making greater progress in recruiting and retaining minorities likely requires institutions to respond simultaneously to various social cues that signal devaluation of certain identities (e.g., gender, race, socioeconomic status). The authors define "asset bundles" as the specific sets of abilities and resources individuals develop that help them succeed in educational and professional tasks, including but not limited to science and research. The model consists of five asset bundles, each of which is supported in the research literature as a factor relevant to educational achievement and, the authors contend, may lead to improved and sustained diversity: educational endowments, science socialization, network development, family expectations, and material resources. Using this framework, they suggest possible ways of thinking about the task of achieving diversity as well as guideposts for next steps. Finally, they discuss the feasibility of implementing such an approach.

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

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    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.

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

    Science.gov (United States)

    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 public finance from local 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.

  3. Mapping of nursing records into the NIC and the ICNP in a Korean oriental-medicine hospital.

    Science.gov (United States)

    Lee, Eunjoo; Lee, Mikyoung; Jung, Ok Bun

    2006-01-01

    This study uses mapping methodology to examine the applicability of the Nursing Interventions Classification and the International Classification of Nursing Practice to nursing practice in a Korean Oriental-medicine hospital. Data were collected from the nursing records of 56 stroke patients in one unit, and intervention statements were mapped into NIC and ICNP. Of 147 unique nursing intervention statements extracted, 136 (92.52%) could be mapped into NIC and 99 (67.35%) statements could be completely mapped into ICNP. Using mapping methodology, this study validates that both NIC and ICNP would be useful for documenting nursing care in a Korean hospital, but it also identifies additional concepts that need to be represented in both of these standardized nursing languages. It is recommended that nurses be more careful in documenting their interventions and also that SNLs be developed further to more completely represent nursing practice.

  4. An exploratory study of complementary and alternative medicine in hospital midwifery: models of care and professional struggle.

    Science.gov (United States)

    Adams, Jon

    2006-02-01

    Complementary and alternative medicine (CAM) is increasingly popular amongst midwives in Australia. A growing number of hospital midwives are personally integrating one or a range of CAM within their midwifery practice. Despite this trend we still know little about CAM in midwifery, particularly at a grass-roots level. This paper reports findings from one section of a larger exploratory study examining grass-root practitioners' understandings and experiences of complementary therapies in nursing and midwifery. Thirteen in-depth interviews were conducted with midwives working in New South Wales public hospitals and currently integrating CAM within their general midwifery practice. Analysis illustrates how midwives' explanations of, and affinity claims regarding, CAM feed into wider ongoing issues relating to professional autonomy and the relationship between midwifery and obstetrics.

  5. Comparative analysis of acute toxic poisoning in 2003 and 2011: analysis of 3 academic hospitals.

    Science.gov (United States)

    Jang, Hak-Soo; Kim, Jung-Youn; Choi, Sung-Hyuk; Yoon, Young-Hoon; Moon, Sung-Woo; Hong, Yun-Sik; Lee, Sung-Woo

    2013-10-01

    Social factors may affect the available sources of toxic substances and causes of poisoning; and these factors may change over time. Additionally, understanding the characteristics of patients with acute toxic poisoning is important for treating such patients. Therefore, this study investigated the characteristics of patients with toxic poisoning. Patients visiting one of 3 hospitals in 2003 and 2011 were included in this study. Data on all patients who were admitted to the emergency departments with acute toxic poisoning were retrospectively obtained from medical records. Total 939 patients were analyzed. The average age of patients was 40.0 ± 20 yr, and 335 (36.9%) patients were men. Among the elements that did not change over time were the facts that suicide was the most common cause, that alcohol consumption was involved in roughly 1 of 4 cases, and that there were more women than men. Furthermore, acetaminophen and doxylamine remained the most common poisoning agents. In conclusion, the average patient age and psychotic drug poisoning has increased over time, and the use of lavage treatment has decreased.

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

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    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.

  7. The health of irregular and illegal immigrants: analysis of day-hospital admissions in a department of migration medicine.

    Science.gov (United States)

    Affronti, Mario; Affronti, Andrea; Pagano, Salvatore; Soresi, Maurizio; Giannitrapani, Lydia; Valenti, Miriam; La Spada, Emanuele; Montalto, Giuseppe

    2013-10-01

    It is difficult to trace full details of the path which irregular or illegal immigrants follow when seeking assistance in the network of the various hospital departments and health structures. The aim of this work was to analyze the health needs of immigrant people by reviewing the types of treatment given to them in the day-hospital of our Department of Migration Medicine. Our study analyzed day-hospital admissions between 2003 and 2009. The patient charts used for managing day-hospital activity were adopted in 2002 in conformity with the "OSI project". From these it is possible to draw up a scale picture of the distribution of each pathology in the immigrant population. The sample population consisted of 1,758 subjects, representing 7.4% of potential users. More than half came from Africa, followed by Asia, and then Europe. Gastroenterological diseases ranked first, with dyspeptic syndromes most frequently diagnosed. Infections and parasitic diseases ranked second, and the most frequent diagnoses were sexually transmitted diseases. Third were diseases of the genitourinary system. Metabolic disorders ranked fourth, among them, more than half of the cases were of diabetes mellitus, in patients from south-east Asia. Diseases of the circulatory system were sixth, with hypertension the most frequent pathology. Our data confirm a marked persistence of the phenomenon known as the "healthy immigrant effect" in these types of patients, as well as the prominent role played by "social determinants" in conditioning the health of immigrants, particularly in the case of some infectious diseases.

  8. Reasons for inpatients not to seek clarity at Dr George Mukhari Academic Hospital, Pretoria

    Directory of Open Access Journals (Sweden)

    Langalibalele H. Mabuza

    2014-01-01

    Full Text Available Background: Healthcare practitioners should provide patients with information regarding their clinical conditions. Patients should also feel free to seek clarity on information provided. However, not all patients seek this clarity.Objectives: To explore the reasons inpatients gave for not seeking clarity on information that was received but not understood.Methods: This was a qualitative arm of a larger study, titled ‘Are inpatients aware of the admission reasons and management plans of their clinical conditions? A survey at a tertiary hospital in South Africa’, conducted in 2010. Of the 264 inpatients who participated in the larger study, we extracted the unstructured responses from those participants (n = 152 who had indicated in the questionnaire that there was information they had not understood during their encounter with healthcare practitioners, but that they had nonetheless not sought clarity.Data were analysed thematically.Results: Themes that emerged were that inpatients did not ask for clarity as they perceived healthcare practitioners to be ‘too busy’, aloof, non-communicators and sometimes uncertain about patients’ conditions. Some inpatients had unquestioning trust in healthcare practitioners,whilst others had experiences of bad treatment. Inpatients had poor self-esteem, incapacitating clinical conditions, fear of bad news and prior knowledge of their clinical conditions. Some inpatients stated that they had no reason for not seeking clarity.Conclusion: The reasons for not seeking clarity were based on patients’ experiences with the healthcare practitioners and their perceptions of the latter and of themselves. A programme should be developed in order to educate inpatients on effective communication with their healthcare practitioners.

  9. Clinical Profile, Predictors of Mortality, and Treatment of Patients after Myocardial Infarction, in an Academic Medical Center Hospital

    Directory of Open Access Journals (Sweden)

    Zornoff Leonardo A. M.

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate clinical profiles, predictors of 30-day mortality, and the adherence to international recommendations for the treatment of myocardial infarction in an academic medical center hospital. METHODS: We retrospectively studied 172 patients with acute myocardial infarction, admitted in the intensive care unit from January 1992 to December 1997. RESULTS: Most patients were male (68%, white (97%, and over 60 years old (59%. The main risk factor for coronary atherosclerotic disease was systemic blood hypertension (63%. Among all the variables studied, reperfusion therapy, smoking, hypertension, cardiogenic shock, and age were the predictors of 30-day mortality. Most commonly used medications were: acetylsalicylic acid (71%, nitrates (61%, diuretics (51%, angiotensin-converting enzyme inhibitors (46%, thrombolytic therapy (39%, and beta-blockers (35%. CONCLUSION: The absence of reperfusion therapy, smoking status, hypertension, cardiogenic shock, and advanced age are predictors of 30-day mortality in patients with acute myocardial infarction. In addition, some medications that are undoubtedly beneficial have been under-used after acute myocardial infarction.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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

  14. Use and satisfaction of complementary and alternative medicine among diabetic patients in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Monica N.

    2016-12-01

    Conclusions: Doctors should enquire diabetics regarding CAM use since the voluntary disclosure is very less. Keeping lines of communication open for any discussions regarding pros and cons of CAM. Increasing patient awareness about potential drug interactions, when CAM is practised along with conventional medicine. [Int J Basic Clin Pharmacol 2016; 5(6.000: 2521-2527

  15. [Terrorists' target World Cup 2006: disaster medicine on the sidelines?! Aspects of hospital disaster planning].

    Science.gov (United States)

    Weidringer, J W; Ansorg, J; Ulrich, B C; Polonius, M-J; Domres, B D

    2004-09-01

    Focussing on possible mass casualty situations during events such as the soccer world championship in 2006, the Professional Board of Surgeons in Germany and the German Society for Surgery canvassed surgeons-in-chief in the last quarter of 2003 concerning disaster plans for hospitals. The rate of returned questionnaires amounted to 26% covering the following areas of interest: plans-ready to use, known by the employees as well as by the rescue coordination center, performance of exercises, and concepts on decontamination and detoxification. Based on past numbers of casualties during soccer disasters, an excursus into details also includes a description of an approach to reduce the danger of bottleneck effects at doors. A preliminary concept based on the upcoming system for funding hospitals in Germany and including new partnerships is outlined, succeeded by some hopefully helpful hints for a web-based hospital disaster plan.

  16. Hospital heavies. Venture capital bulks up companies that outsource medicine's newest specialty: inpatient-only care.

    Science.gov (United States)

    Huff, C

    They're the designated drivers of inpatient care, cutting hospital stays by 19 percent on average. Yet as venture capital firms infuse hospitalist startup companies, some primary care doctors complain that their sickest patients are being taken away from them.

  17. Medical students' experiences of diseases in internal medicine in university and community hospitals

    NARCIS (Netherlands)

    Raghoebar-Krieger, HMJ; Bender, W; Kreeftenberg, HG; Stewart, RE; Sleijfer, DT

    2002-01-01

    Because medical students in The Netherlands should achieve common national objectives, it is important to know whether clinical experiences in different hospitals are comparable. The research questions were: (1) Do students achieve learning experiences of the required diseases during the internship

  18. Alternative models for academic family practices

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    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.

  19. 浙江中医学术流派的启迪%The Enlightenment of Academic Schools of Zhejiang Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    范永升; 谢冠群

    2012-01-01

    [目的]研究浙江中医学术流派对当今中医的启迪意义.[方法]以浙江中医学术流派的代表医家为研究对象,分析中医学术流派形成的条件及对中医学术发展的推动作用.[结果]各派医家通过学术创新促进中医学发展,在解决临床难题时推动医学进步;强调理论与临床缺一不可,在理论的指导下,运用自己独特的招数取得理想的疗效;虚怀若谷,善于学习他人经验,不断丰富完善自己;始终把患者的利益放在首位,推行仁心仁术.[结论]浙江中医学术流派纷呈,然其形成却需具备众多条件,值得借鉴.%[Objective] To research the enlightening meaning of Zhejiang Chinese medicine academic schools to present TCM. [Methods] Take the representative doctors of Zhejiang Traditional Chinese Medicine academic schools as research objects, to analyse forming conditions of TCM academic schools and their promotion to TCM academic development. [Results] The medical scientists of various schools promoted the development of Chinese medicine through academic innovation, and advanced medical progress in solving clinical problems, stressed the theory and clinical practice were indispensable. Under the guidance of the theory, they used their unique skill to achieve the desired effect, open-inded and good at learning from the experiences of others, and constantly enriched and improved their own, and always put the interests of patients first, and carried out kind heartedness and kind technology. [Conclusion] There're many academic schools in Zhejiang TCM, however their formation needs many conditions, and that'than important thing to remember.

  20. The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan

    Directory of Open Access Journals (Sweden)

    Shimizu T

    2013-07-01

    Full Text Available Taro Shimizu,1 Yusuke Tsugawa,2,3 Yusuke Tanoue,4 Ryota Konishi,5 Yuji Nishizaki,6 Mitsumasa Kishimoto,7 Toshiaki Shiojiri,8 Yasuharu Tokuda9 1Hospitalist Division, Department of Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan; 2Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 3Center for Clinical Epidemiology, St Luke's Life Science Institute, 4Department of Vascular and Oncological Surgery, Hospital of Tokyo University, 5Department of General Internal Medicine, Kanto Rousai Hospital, 6Department of Cardiology, Juntendo University School of Medicine, 7Division of Rheumatology, St Luke's International Hospital, Tokyo, Japan; 8Asahi Chuo Hospital, Chiba, Japan; 9Department of Medicine, Tsukuba University Mito Kyodo General Hospital, Mito City, Ibaraki, Japan Background: It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven. Objective: We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals. Methods: To assess the knowledge base of medicine, we conducted the General Medicine In-Training Examination (GM-ITE for second-year residents in the last month of their residency. The items of the exam were developed based on the outcomes designated by the Japanese Ministry of Health, Labor, and Welfare. The educational environment was evaluated using the Postgraduate Hospital Educational Environment Measure (PHEEM score, which was assessed by a mailed survey 2 years prior to the exam. A mixed-effects linear regression model was employed for the analysis of variables associated with a higher score. Results: Twenty-one teaching hospitals participated in the study and a total of 206 residents (67 women participated and

  1. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    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...

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

    Science.gov (United States)

    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.

  3. Developing an academic medical library core journal collection in the (almost) post-print era: the Florida State University College of Medicine Medical Library experience.

    Science.gov (United States)

    Shearer, Barbara S; Nagy, Suzanne P

    2003-07-01

    The Florida State University (FSU) College of Medicine Medical Library is the first academic medical library to be established since the Web's dramatic appearance during the 1990s. A large customer base for electronic medical information resources is both comfortable with and eager to migrate to the electronic format completely, and vendors are designing radical pricing models that make print journal cancellations economically advantageous. In this (almost) post-print environment, the new FSU Medical Library is being created and will continue to evolve. By analyzing print journal subscription lists of eighteen academic medical libraries with similar missions to the community-based FSU College of Medicine and by entering these and selected quality indicators into a Microsoft Access database, a core list was created. This list serves as a selection guide, as a point for discussion with faculty and curriculum leaders when creating budgets, and for financial negotiations in a broader university environment. After journal titles specific to allied health sciences, veterinary medicine, dentistry, pharmacy, library science, and nursing were eliminated from the list, 4,225 unique journal titles emerged. Based on a ten-point scale including SERHOLD holdings and DOCLINE borrowing activity, a list of 449 core titles is identified. The core list has been saved in spreadsheet format for easy sorting by a number of parameters.

  4. [Communication and interpersonal skills in medicine: an educational intervention in hospital].

    Science.gov (United States)

    Ghilardi, Alberto; Pedrini, Laura; Rossini, Manuela; Tiraboschi, Andrea; Buizza, Chiara

    2014-12-01

    The present paper is aimed to describe methods and results of an educational intervention on doctor-patient communication. The intervention was addressed to 26 hospital physicians and lasted 20 hours, and it was formulated according to patient-centred model. At the end of the intervention, participants referred satisfaction for the course, and the proportion of doctors with patient-centred style was higher compared to the one of the initial assessment (Z Wilcoxon=2,236; p=.02). No associations were found between communicative-relational style and sociodemographic variables. For hospital physicians, three main topics seems require future interventions: the communication of bad news, the management of own emotions, the influence of context's factors on doctor-patient relationship.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Clinical Pathways Based on Integrative Medicine in Chinese Hospitals Improve Treatment Outcomes for Patients with Acute Myocardial Infarction: A Multicentre, Nonrandomized Historically Controlled Trial

    Directory of Open Access Journals (Sweden)

    Lei Wang

    2012-01-01

    Full Text Available Objective. To determine the impact of an integrative medicine clinical pathways (CPs on the length of in-hospital stay and on outcomes for patients with acute myocardial infarction (AMI. Methods. A multicenter nonrandomized controlled trial enrolling 197 consecutive patients with AMI at eight urban TCM hospitals was conducted between 1 January 2010 and 31 October 2010. These patients were enrolled in the interventional group after the CPs had been implemented. The control group included 405 patients with AMI from eight hospitals; these patients were treated between 1 January 2008 and 31 December 2009, before the CPs were implemented. Outcome measures were the length of hospital stay costs of medical care, and major cardiovascular events (MACEs during hospitalization. Results. Compared with the control group, the patients in intervention group had a shorter length of hospital stay (9.2±4.2 days versus 12.7±8.6 days, P<0.05, and reduced healthcare costs in hospital (46365.7±18266.9 versus 52866.0±35404.4, P<0.05. There were statistically significant differences in MACE between the two groups during the hospitalization period (2.5% versus 6.9%, P=0.03. Conclusion. These data suggest that the development and implementation of the clinical pathways based in Integrative Medicine could further improve quality of care and outcome for patients with AMI.

  7. The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan.

    Science.gov (United States)

    Mizuno, Atsushi; Tsugawa, Yusuke; Shimizu, Taro; Nishizaki, Yuji; Okubo, Tomoya; Tanoue, Yusuke; Konishi, Ryota; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2016-01-01

    Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014. We compared the ITE score and the hospital volume. Results A total of 2,015 participants (70.6% men; age, 27.3±2.9 years old) from 208 hospitals were retrospectively analyzed. Generalized estimating equations were used, and the results revealed that an increasing number of hospitalizations, decreasing staff number, decreasing age and PGY-2 were significantly associated with higher GM-ITE scores. Conclusion The hospital volume, such as the number of hospitalizations, is thus considered to have a positive impact on the GM-ITE scores.

  8. [Research on establishment of clinical safety intensive hospital monitoring net of traditional Chinese medicine injection].

    Science.gov (United States)

    Wang, Lian-Xin; Xie, Yan-Ming; Wang, Zhi-Fei

    2012-09-01

    The establishment of clinical safety monitoring net of traditional Chinese medicine (TCM) injection is the one of the key issues of the monitoring work. The monitoring net is including varieties of types of net, such as clinical monitoring net, multimedia network platform, the net of experts or talents. The paper will introduce the establishing method of clinical safety monitoring net, the establishing of clinical safety monitoring net, and the establishing of network based on the internet, the knowledge network construction of experts, the net construction of talents are all included, to assure the development for clinical safety monitoring work.

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

    Institute of Scientific and Technical Information of China (English)

    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. Survey of Nurses\\' Viewpoints on Causes of Medicinal Errors and Barriers to Reporting in Pediatric Units in Hospitals of Mashhad University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Masoomeh Seidi

    2012-12-01

    Full Text Available Background and Objective: Patient safety is the principal concern of current health care delivery systems, and several recent studies initiated by the Institute of Medicine have reported a high incidence of medicinal errors. Of the approximately 44000-98000 patient deaths reported each year because of medical errors, 7000 are attributed to medicinal errors. The purpose of this study was to determine nurses' perceptions of causes of medicinal errors and barriers to reporting them in the pediatric wards of Mashhad University of Medical Sciences. Materials and Methods: This cross-sectional descriptive study recruited156 nurses working in general pediatric units via the convenience sample method. A questionnaire containing four sections was used: the first section on demographic information; the second on the reasons for medicinal errors; the third on the estimation of the percentage of medicinal errors occurring in the units; and the final section on the reasons for failing to report the medicinal errors. Results: The most important medicinal errors from the nurses' viewpoint were failure to check medicinal orders (73.9% and errors in the medication administration (64%. The nurses estimated that only 45% of all the medicinal errors were reported, and they cited a lack of knowledge about unit policies and routines (59.8% and negligence to report (59.8% as the most important reasons for the failure to report the errors. Conclusion: We need to improve the accuracy of medicinal error reporting by nurses and to provide a hospital environment conducive to preventing errors from occurring.

  11. Inbox Messaging: an effective tool for minimizing non-urgent paging related interruptions in hospital medicine provider workflow

    Science.gov (United States)

    Ferguson, Alice; Aaronson, Barry; Anuradhika, Anuradhika

    2016-01-01

    Communication is one of the foundations on which safe, high quality care is built.1, 3, 6, 17, 20 The nature of hospital medicine requires that nurses and providers be efficient and effective in communicating with multiple disciplines.17 This need for timely communication must continually be balanced with the need to minimize interruptions in workflow.1,2 3,4,6,7,9,13,15,17,18 Interruptions not only lead to distraction, they also add inefficiency to the care process and have been shown to contribute to an increased risk of medical error.2,3,4,7,17,18 A major source of interruptions are pagers that emit an audible tone with each message received.3,9,10,17,18 This interruptive nature makes pagers a less-than-ideal tool for communicating non-urgent (address within one hour) messages received.3,9,10,17,18 In addition to increasing interruptions, pagers do not facilitate closed loop communication, another feature that has been shown to improve safety.14,17,25 Inbox Messaging is intended to provide a less disruptive closed-loop method of communication for non-urgent messages. Inbox Messaging is an interface within the electronic health record (EHR) that functions similarly to e-mail. A multi-disciplinary communication workgroup identified this interface as having potential to not only decrease interruptions, but to also facilitate closed-loop communication. Inbox is currently utilized between the hours of 0700 and 1800 for non-urgent nurse-provider communication about patients on the hospital medicine service. The number of RN non-urgent pages per day was 103 (SD=19, n=97) prior to the Inbox intervention, with a significant decrease (p<.001) during follow-up to 38 (SD=14, n=354) pages per day. At the same time, the number of messages per day increased from 0 to 80 (SD=20, n=354) messages during follow-up. As desired, the mean number of RN urgent pages was unchanged from 13 per day to 13 per day (p=.52). Cerner Inbox Messaging decreases the frequency of non-urgent pager

  12. [The Karl-Sudhoff-Institute in Leipzig and the academic discipline history of medicine in the GDR].

    Science.gov (United States)

    Kästner, Ingrid

    2014-01-01

    Developmental trends, focus of research and the methods by which work in the field of the History of Medicine was organised in the German Democratic Republic (East Germany) is presented through the example of the Karl Sudhoff Institute in Leipzig, the largest Institute for the study of the History of Medicine in the GDR. The article follows the succession of the Directors, and includes, in addition to descriptions of research and publishing activities, appendices on the work of the Society for the History of Medicine in the German Democratic Republic as well as the historical medical collections.

  13. The future of discovery chemistry: quo vadis? Academic to industrial--the maturation of medicinal chemistry to chemical biology.

    Science.gov (United States)

    Hoffmann, Torsten; Bishop, Cheryl

    2010-04-01

    At Roche, we set out to think about the future role of medicinal chemistry in drug discovery in a project involving both Roche internal stakeholders and external experts in drug discovery chemistry. To derive a coherent strategy, selected scientists were asked to take extreme positions and to derive two orthogonal strategic options: chemistry as the traditional mainstream science and chemistry as the central entrepreneurial science. We believe today's role of medicinal chemistry in industry has remained too narrow. To provide the innovation that industry requires, medicinal chemistry must play its part and diversify at pace with our increasing understanding of chemical biology and network pharmacology.

  14. Prevalence of delirium in hospitalized patients from an internal medicine service

    Directory of Open Access Journals (Sweden)

    Ana Carolina González Pezoa

    2015-12-01

    Full Text Available INTRODUCCIÓN El delirium es un síndrome neurocognitivo frecuente en pacientes hospitalizados, que se asocia en forma categórica e independiente a peores resultados globales en quienes lo presentan. A pesar de esto, suele ser subvalorado y no reconocido como un cuadro que requiere un manejo específico, independiente de la causa que lo origina. OBJETIVOS Determinar la tasa de prevalencia de delirium en los pacientes ingresados a un servicio de medicina y, secundariamente, el subdiagnóstico del cuadro por parte del médico tratante, residente o interno de medicina. MÉTODOS Estudio observacional descriptivo realizado en el Servicio de Medicina del Hospital Dr. Eduardo Pereira a los 125 pacientes ingresados entre el 12 de abril y 12 mayo de 2014. A través de la herramienta diagnóstica Confusion Assessment Method Instrument, se determinó la tasa de prevalencia del delirium y de casos subdiagnosticados. RESULTADOS Ciento dos pacientes cumplieron los criterios de inclusión. De éstos, 19 (18,6% pacientes fueron diagnosticados con delirium. En el grupo de pacientes diagnosticados, 13 (68,4% eran de sexo femenino. El subdiagnóstico se presentó en ocho pacientes (42,1%. CONCLUSIONES La prevalencia de delirium en este centro está dentro de lo esperable, según la literatura. Considerando la disponibilidad de herramientas para realizar su diagnóstico, es necesario instruir al equipo de salud para mejorar el reconocimiento y manejo de este cuadro dada su importancia pronóstica.

  15. The impact of social media on the academic performance of second year medical students at College of Medicine, University of Babylon, Iraq

    Directory of Open Access Journals (Sweden)

    Ahmed Tawfeeq Alahmar

    2016-07-01

    Full Text Available Social media applications and their use among students have witnessed dramatic increase in the last decade and data on their effect on students academic performance are inconsistent. The aim of this study was to assess the impact of social media on the academic performance and grades of second year medical students at the College of Medicine, University of Babylon, Iraq. Second year medical students (n=57 completed online questionnaire about the type of social media they use frequently, time spent on these media in hours per day, the reasons for use of these media and the effect of social media on their grades. Students were also asked to provide the cumulative grades of physiology and anatomy courses. Time spent by students on social media and facebook messenger was correlated with combined grades of physiology and anatomy courses. All students have been using facebook and 96.5% have been using facebook messenger. Other popular applications were telegram, instagram and ask.fm. Average time spent on social media was 5.07+/- 2.93 and on facebook messenger was 1.80 +/-1.45 hours per day. Forty-two percent of students reported that social media have positive effect on their academic performance. No correlation has been found between time spent on social media or facebook messenger and students combined grades of physiology and anatomy. To conclude, social media and in particular facebook and facebook messenger are very popular among second year medical students. Time spent on social media seems to have no influence on second year medical students grades and academic performance. [J Med Allied Sci 2016; 6(2.000: 77-83

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

    Science.gov (United States)

    Marin, Jennifer R; Mills, Angela M

    2015-12-01

    The 2015 Academic Emergency Medicine 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 use 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 before 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 the planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were a total of 164 individuals involved in the conference and spanned various specialties, including general emergency medicine, pediatric emergency medicine, radiology, surgery, medical physics, and the decision sciences.

  17. Universal isolation precautions for patients at an academic hospital Precauciones universales en el aislamiento de pacientes en un hospital universitario Precauções universais em isolamentos de pacientes em hospital universitário

    Directory of Open Access Journals (Sweden)

    Vanessa Gomes Maziero

    2012-01-01

    Full Text Available OBJECTIVE: To apply universal isolation precautions for patients at an academic hospital by a nursing team. METHODS: This descriptive and prospective study used data from advice service of quality control and nursing care that were gathered in observational reports of universal isolation precautions for patients admitted in two surgical inpatient units during 2008 and 2010. RESULTS: The mean general classification for both units was between desirable and adequate in the observational analysis of universal precaution. A borderline effect was observed only in November 2008 at the Men's Surgical Unit. The units assessed had compromised biosecurity, however, as time advanced data showed an improvement on their performance. CONCLUSION: The effective involvement of nurses in the unit is critical to prevent and control nosocomial infections.OBJETIVO: Utilización de las precauciones universales por el equipo de Enfermería en el aislamiento de pacientes en un Hospital Universitario. MÉTODOS: Estudio descriptivo, prospectivo. Fueron utilizados datos de la Asesoría de Control de Calidad de la Asistencia de Enfermería, correspondientes a los informes de las observaciones respecto a las precauciones universales en el aislamiento de pacientes en dos unidades de internamiento Médico - Quirúrgico, en el período comprendido entre 2008 y 2010. RESULTADOS: Las dos unidades de la institución presentaron un promedio general de clasificación, del análisis observacional de precaución universal, entre deseable y adecuada, siendo limítrofe apenas en noviembre del 2008 en la unidad Médico-Quirúrgica Masculina. Las unidades evaluadas, respecto a la adhesión a las precauciones universales, presentaron compromiso con la bioseguridad, y los datos exhibidos se mostraron mejores en cada año descrito. CONCLUSIÓN: La participación activa del enfermero responsable por la unidad es importante en la prevención y control de infecciones hospitalarias

  18. Storage and disposal of medicines by academics from health area from a public university of Paraná

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    Lenita Nunes Piveta

    2015-11-01

    Full Text Available Medicines are indispensable tools for the health establishment and care is required in their storage and disposal. This study aimed to verify the form of storage and disposal of medicines by students from the Health SciencesDepartment of a public university in Paraná. A cross-sectional study was conducted with students of Nursing, Pharmacy and Medicine courses from UniversidadeEstadual de Londrina, Paraná, Brazil, through the application of a self-report study. The data collection was performed in the University’s classrooms during the months of May to June of 2014, resulting in 564 students surveyed. It was considered proper disposal when the student referred to disposing the expired or inappropriate for use products in locations that make the collection of these products. The students interviewed had a mean age of 21.0 years (Standart Deviation: 3.3; 74.1% of the total were female. The bedroom was the main location quoted for storage of medicines (47.8% most of them keep the medicines out of reach of children (82.6%. Regarding the verification of the expiration date 60.1% of the students do this practice. Most of (64.5% keeps the remains of treatments for future use, and household waste (63.0% was the main mentioned location for the disposal of those who are expired. Only 20.7% discarded the medicines correctly. The study population stores the products correctly, however, most are largely unaware of the disposal locations. Therefore, it is necessary to promote awareness and guidance for the future professionals.

  19. Research on Data Element Standardization of Hospital Management in Traditional Chinese Medicine Hospital%中医医院综合管理信息数据元标准化研究

    Institute of Scientific and Technical Information of China (English)

    李宇明; 温明锋; 陈健超

    2014-01-01

    The compilation of medical information standard in traditional Chinese medicine is important to realize the information sharing, business collaboration, connectivity and other basic work in traditional Chinese medicine hospital, it plays a basic, guiding, strategic and global role and position. This paper mainly focuses on the development of hospital management data element standardization in traditional Chinese medicine hospital.%中医药信息数据元相关标准的编制,是实现中医药信息共享、业务协同和互联互通等的基础性工作,具有基础性、指导性、战略性和全局性的地位和作用。本文主要就我国中医医院综合管理信息数据元目录的编制及其内容进行研究和探讨。

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

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    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.

  1. Introduction of the Balanced Scorecard into an academic department of medicine: creating a road map to success.

    Science.gov (United States)

    Bouland, Daniel L; Fink, Ed; Fontanesi, John

    2011-01-01

    In this paper, we describe: 1) the environmental forces driving performance measurement and management in the University of California San Diego Department of Medicine; 2) the systematic process used by the department to implement a Balanced Scorecard; 3) the initial direct and indirect outcomes of this effort; 4) the opportunities and challenges to the Balanced Scorecard as a management directive; and 5) future directions.

  2. Academic Relationships and Teaching Resources. Fogarty International Center Series on the Teaching of Preventive Medicine, Volume 6.

    Science.gov (United States)

    Clark, Duncan W., Ed.

    The monograph is one of the Fogarty International Center Series on the Teaching of Preventive Medicine, undertaken to: (1) review and evaluate the state of the art of prevention and control of human diseases; (2) identify deficiences in knowledge requiring further research (including analysis of financial resources, preventive techniques, and…

  3. Analysis of Chinese Medicine Hospital Resource Situation from 2005 to 2009%2005-2009年我国中医医院资源情况分析

    Institute of Scientific and Technical Information of China (English)

    郑格琳; 李金芳; 孙晓东; 杨永生; 陈思; 陈珞珈

    2011-01-01

    医院资源主要包括人员、床位、医疗设备、固定资产等.通过对2005-2009年我国中医医院机构数、床位、人员、固定资产等资源情况进行分析,并与综合医院进行比较,找出存在的问题,以期为"十二五"中医医院的发展提供参考.数据均来源于2005-2009年卫生部和国家中医药管理局.%Hospital resources include personnel, beds, medical equipment and fixed assets, etc. Through the analysis of resource situation in China, including the number of institutions, beds, personnel and fixed assets, etc, comparison with general hospitals, problems are found out to provide references for the development of traditional Chinese medicine hospitals during the Twelfth Five Years. The data are all derived from Chinese Health Statistics Yearbook published by Ministry of Public Health and National Traditional Chinese Medicine Statistical Excerpting published by the state administration of traditional Chinese medicine from 2005 to 2009.

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

    Directory of Open Access Journals (Sweden)

    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

  5. Integrating the Principles of Evidence Based Medicine and Evidence Based Public Health: Impact on the Quality of Patient Care and Hospital Readmission Rates in Jordan

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    Mohammad S. Alyahya

    2016-08-01

    Full Text Available Introduction: Hospital readmissions impose not only an extra burden on health care systems but impact patient health outcomes. Identifying modifiable behavioural risk factors that are possible causes of potentially avoidable readmissions can lower readmission rates and healthcare costs. Methods: Using the core principles of evidence based medicine and public health, the purpose of this study was to develop a heuristic guide that could identify what behavioural risk factors influence hospital readmissions through adopting various methods of analysis including regression models, t-tests, data mining, and logistic regression. This study was a retrospective cohort review of internal medicine patients admitted between December 1, 2012 and December 31, 2013 at King Abdullah University Hospital, in Jordan. Results: 29% of all hospitalized patients were readmitted during the study period. Among all readmissions, 44% were identified as potentially avoidable. Behavioural factors including smoking, unclear follow-up and discharge planning, and being non-compliant with treatment regimen as well as discharge against medical advice were all associated with increased risk of avoidable readmissions. Conclusion: Implementing evidence based health programs that focus on modifiable behavioural risk factors for both patients and clinicians would yield a higher response in terms of reducing potentially avoidable readmissions, and could reduce direct medical costs.

  6. Detection of blaSHV, blaTEM and blaCTX-M antibiotic resistance genes in randomly selected bacterial pathogens from the Steve Biko Academic Hospital.

    Science.gov (United States)

    Ehlers, Marthie M; Veldsman, Chrisna; Makgotlho, Eddy P; Dove, Michael G; Hoosen, Anwar A; Kock, Marleen M

    2009-08-01

    Extended-spectrum beta-lactamases (ESBLs) are considered to be one of the most important antibiotic resistance mechanisms. This study reported the ESBL-producing genes in 53 randomly selected clinical bacterial isolates from the Steve Biko Academic Hospital. The presence of the bla(SHV), bla(TEM) and bla(CTX-M) genes was determined, and the overall prevalence of these genes detected in this study was 87% (46/53) in comparison with the literature; these results were higher when compared with 33% for Escherichia coli in Europe and 0.8% in Denmark for similar pathogens. These research findings indicated that it is crucial to routinely monitor the prevalence of these resistance genes.

  7. Academic physiatry. Balancing clinical practice and academic activities.

    Science.gov (United States)

    Grabois, M

    1992-04-01

    The need for continued and diversified growth of both scholarly and clinical activities within academic physical medicine and rehabilitation (PM&R) departments is discussed with reference to the demands placed on academic departments by the various components of their mission, such as administration, clinical service, education and research. The expansion and improvement of clinical services should include the following components: program development, resources needed, finances required and marketing. Clinical subspecialization of faculty and solid affiliation with nonacademic hospitals and rehabilitation facilities is essential for academic PM&R. The faculty should include three categories: clinical faculty, clinical-research faculty and research faculty. Adequate financial resources must comprise an appropriate balance of academic funds, clinical income and grant sources. Clinical funds will play a greater role as other sources of funds diminish. Any practice plan must recognize the equality of the differing faculty members' practices, whether their interests are clinical, educational or research-oriented. The expansion and intensification of clinical programs by academy PM&R departments could increase competition in the medical community. Sensitivity to the perceptions of other practitioners and institutions, careful planning and cooperation will help the field grow and improve levels of care for the patients we serve in light of the changing medical care environment.

  8. Pervasive Observation Medicine: The Application of RFID to Improve Patient Safety in Observation Unit of Hospital Emergency Department.

    Science.gov (United States)

    Chen, Chang-I; Liu, Cheng-Yaw; Li, Yu-Chuan; Chao, Chia-Cheng; Liu, Chien-Tsai; Chen, Chieh-Feng; Kuan, Ching-Feng

    2005-01-01

    Over the past decade, observation medicine has become an important component of emergency medicine. There are several settings in which observation medicine has been useful and valuable.(1) RFID as the patient identification, not only generates the on-line laboratory data and radiology report via hand-held wireless PDA, this RFID system help physician stream-line patient admission to acute bed or ICU in the emergency department more effectively.

  9. A comparative study of content and satisfied degree of demand between inpatients with nasopharyngeal carcinoma from Traditional Chinese Medicine hospital and Western medicine hospital%中、西医院住院鼻咽癌患者对医院需求内容及满足程度的比较研究

    Institute of Scientific and Technical Information of China (English)

    郭趣; 刘丽萍; 李德琼

    2015-01-01

    目的:了解中、西医院住院鼻咽癌患者对医院的需求情况,探讨改进医院服务的努力方向。方法选择某三甲中医院住院鼻咽癌患者30名和在某三甲西医院住院鼻咽癌患者70名,调查分析患者需求内容、需求满足程度。结果中、西医院患者需求内容及需求满足程度总分比较差异均无统计学意义(P >0.05)。单项需求程度比较显示,“病房有空调设备”项,西医院评分比中医院患者高(P 0.05). The degree of demand on single item of “unit of air conditioning equipment”in patients from Western medicine hospital was higher than that in patients from TCM hospital (P <0.05).The degree of demands satisfied on“diseases brochure”“treatment effect of medical equipment”in patients from Western medicine hospital were higher than those in patients of TCM hospital (P <0.05).And the three items scores of “the methods of cop-ing with side effects”“unit of air conditioning equipment”“the medical expenses”in patients from TCM hospital were higher than those of Western medical hospital (P <0.05).Comparison of the top 10 items of high de-mands showed that patients of TCM hospital had the same 5 items as Western hospital.Comparison of demand satisfied degree item scores less than 5 showed that patients of TCM hospital and Western hospital had 12 same items. Conclusion The effects on meeting the needs of patients with nasopharyngeal carcinoma from TCM and Western hospitals were the same.There were similarities and differences in the demands between patients with nasopharyngeal carcinoma from Western and TCM hospital.Nursing work should be improved according to different needs.The integrated of traditional Chinese and Western medicine can provide better nursing serv-ice.

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

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    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.

  11. Assessment of Scientific Communication Self-Efficacy, Interest, and Outcome Expectations for Career Development in Academic Medicine.

    Science.gov (United States)

    Anderson, Cheryl B; Lee, Hwa Young; Byars-Winston, Angela; Baldwin, Constance D; Cameron, Carrie; Chang, Shine

    2016-02-01

    Competency in forms of scientific communication, both written and spoken, is essential for success in academic science. This study examined the psychometric properties of three new measures, based on social cognitive career theory, that are relevant to assessment of skill and perseverance in scientific communication. Pre- and postdoctoral trainees in biomedical science (N = 411) completed online questionnaires assessing self-efficacy in scientific communication, career outcome expectations, and interest in performing tasks in scientific writing, oral presentation, and impromptu scientific discourse. Structural equation modeling was used to evaluate factor structures and model relations. Confirmatory factor analysis supported a 22-item, 3-factor measure of self-efficacy, an 11-item, 2-factor measure of outcome expectations, and a 12-item, 3-factor measure of interest in scientific communication activities. Construct validity was further demonstrated by theory-consistent inter-factor relations and relations with typical communications performance behaviors (e.g., writing manuscripts, abstracts, presenting at national meetings).

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Internal Medicine ward of a teaching hospital in Western Nepal: a prospective study

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    Easow Joshy

    2003-07-01

    Full Text Available Abstract Background Information about antibiotic use and resistance patterns of common microorganisms are lacking in hospitals in Western Nepal. Excessive and inappropriate use of antibiotics contributes to the development of bacterial resistance. The parameter: Defined daily dose/100 bed-days, provides an estimate of consumption of drugs among hospital in-patients. This study was carried out to collect relevant demographic information, antibiotic prescribing patterns and the common organisms isolated including their antibiotic sensitivity patterns. Methods The study was carried out over a 3-month period (01.04.2002 to 30.06.2002 at the Manipal Teaching Hospital, Western Nepal. The median number of days of hospitalization and mean ± SD cost of antibiotics prescribed during hospital stay were calculated. The use of antibiotics was classified for prophylaxis, bacteriologically proven infection or non-bacteriologically proven infection. Sensitivity patterns of the common organisms were determined. Defined daily dose/100 bed-days of the ten most commonly prescribed antibiotics were calculated. Results 203 patients were prescribed antibiotics; 112 were male. Median duration of hospitalization was 5 days. 347 antibiotics were prescribed. The most common were ampicillin, amoxicillin, metronidazole, ciprofloxacin and benzylpenicillin. Mean ± SD cost of antibiotics was 16.5 ± 13.4 US$. Culture and sensitivity testing was carried out in 141 patients. The common organisms isolated were H. influenzae, E. coli, K. pneumoniae and S. aureus. Conclusions Antibiotic resistance is becoming a problem in the Internal Medicine ward. Formulation of a policy for hospital antibiotic use and an educational programme especially for junior doctors is required.

  15. Medically unexplained illness and the diagnosis of hysterical conversion reaction (HCR in women’s medicine wards of Bangladeshi hospitals: a record review and qualitative study

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    Kendall Emily A

    2012-10-01

    Full Text Available Abstract Background Frequent reporting of cases of hysterical conversion reaction (HCR among hospitalized female medical patients in Bangladesh’s public hospital system led us to explore the prevalence of “HCR” diagnoses within hospitals and the manner in which physicians identify, manage, and perceive patients whom they diagnose with HCR. Methods We reviewed admission records from women’s general medicine wards in two public hospitals to determine how often and at what point during hospitalization patients received diagnoses of HCR. We also interviewed 13 physicians about their practices and perceptions related to HCR. Results Of 2520 women admitted to the selected wards in 2008, 6% received diagnoses of HCR. HCR patients had wide-ranging symptoms including respiratory distress, headaches, chest pain, convulsions, and abdominal complaints. Most doctors diagnosed HCR in patients who had any medically-unexplained physical symptom. According to physician reports, women admitted to medical wards for HCR received brief diagnostic evaluations and initial treatment with short-acting tranquilizers or placebo agents. Some were referred to outpatient psychiatric treatment. Physicians reported that repeated admissions for HCR were common. Physicians noted various social factors associated with HCR, and they described failures of the current system to meet psychosocial needs of HCR patients. Conclusions In these hospital settings, physicians assign HCR diagnoses frequently and based on vague criteria. We recommend providing education to increase general physicians’ awareness, skill, and comfort level when encountering somatization and other common psychiatric issues. Given limited diagnostic capacity for all patients, we raise concern that when HCR is used as a "wastebasket" diagnosis for unexplained symptoms, patients with treatable medical conditions may go unrecognized. We also advocate introducing non-physician hospital personnel to address

  16. 军队医院药品物流及智能药柜监管系统的开发%Development of Medicine Logistics and Smart Medicine Cabinet Supervision System in Military Hospital

    Institute of Scientific and Technical Information of China (English)

    栾艳; 石磊

    2015-01-01

    Objective To strengthen the comprehensive management of hospital medicine, so as to pro-mote the comprehensive level of drug management in peacetime and wartime.Method Aiming at the existing problems of drug administration in our country.Combining with advanced technology from domestic and foreign.To construct the hospital medicine management information system.Results A set of drug regulatory system has been established, which realized the comprehensive management of medicine in hospital and field medical station.Con-clusion The application of system strengthened the speed of logistical support, improved the medication safety of soldiers, and promoted the digital management level of field pharmacy.%目的:加强对医院药品的全面管理,提升平时与战时药品管理的综合水平。方法针对我国药品管理现存问题,结合国内外先进技术,对医院药品管理进行信息化建设。结果开发一套功能齐全的药品监管系统,实现对医院、野战医疗所药品的全面管理。结论系统的应用加强后勤保障速度,提高官兵用药安全,提升野战药局数字化管理水平。

  17. BUILDING AN ACADEMIC PEDIATRIC HEALTH SYSTEM AS THE WORLD CONTINUES TO TURN: A CASE STUDY.

    Science.gov (United States)

    Ellen, Jonathan M

    2016-01-01

    In 2011, All Children's Hospital (ACH) joined the Johns Hopkins Health System (JHHS) and in so doing became a member of Johns Hopkins Medicine (JHM). The value proposition for the joining of ACH and JHHS/JHM was to transform ACH into an academic pediatric health system. This case study of the transformation provides evidence for the usefulness of a precision medicine framework to organize investments in programs and practices that further the tripartite mission of academic medical centers and may increase the value of the care they deliver.

  18. 基层医院中成药应用现状分析%Analysis of the Utilization of ChinesePatent Medicines in Primary Hospital

    Institute of Scientific and Technical Information of China (English)

    邓秀英; 张鹏; 杨海霞

    2014-01-01

    Objective:To investigate the utilization of Chinese patent medicines in a primary hospital , in order to promote clinical ra-tional drug use though provide reference data for clinical medicine .Methods: The utilization of the Chinese patent medicines were re-viewed and analyzed statistically with regard to its categories , proportion in total , usage and dosage , adverse reaction , use rationality etc . Results:The Chinses patent medicine usage increased year by year , Chinese patent medicines for activating blood circulation to dissipate blood stasis were mainly used , part of Chinese patent medicine were irrational used .At the same time, the adverse drug reactions caused by traditional Chinese medicine Should be taken into consideration seriously .Conclusion:Application of Chinese patent medicine should pay more attention , do the dialectical medication .standardized application of Chinese patent medicine needs the joint efforts of the whole society.%目的:通过调查某基层医院中成药使用情况,了解中成药使用现状,为临床用药提供参考数据,促进基层医院合理用药。方法:对某基层医院使用中成药的种类、用量、使用合理性及不良反应发生等情况进行统计分析。结果:基层医院中成药使用量逐年增加,主要以祛瘀类药物使用为主,部分中成药物使用欠合理,同时中成药不良反应引起临床重视。结论:规范应用中成药应引起重视,做到辩证用药,规范应用中成药需全社会共同努力。

  19. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  20. The production and reception of scientific papers in the academic-industrial complex: the clinical evaluation of a new medicine.

    Science.gov (United States)

    Abraham, J

    1995-06-01

    The production and reception of scientific papers in the academic-industrial complex have been neglected in sociology. In this article the social processes which influence the nature of the scientific paper in that complex are explored in depth by taking a number of controversial medical papers as case studies. The empirical evidence is collected and discussed in the light of sociological theories of normative ethos, paradigm development, reward-induced conformity and social interests in science. It is concluded that within the medical-industrial complex conformity to industrial interests can be a major criterion in defining the kind of reception given to a scientific paper and the professional autonomy of the authors in the paper's production, rather than an ethos of scientific scepticism or commitment to paradigmatic conventions. This is seen to have implications for the production of scientific knowledge - implications that might be in conflict with the public interest. Consequently, the desirability of current British Government proposals to intensify its policy of making science more responsive to the needs of industry may have significant drawbacks, hitherto unacknowledged in official circles, and in need of more extensive sociological investigation.

  1. Hospital outpatient perceptions of the physical environment of waiting areas: the role of patient characteristics on atmospherics in one academic medical center

    Directory of Open Access Journals (Sweden)

    Sun Pi-hung

    2007-12-01

    Full Text Available Abstract Background This study examines hospital outpatient perceptions of the physical environment of the outpatient waiting areas in one medical center. The relationship of patient characteristics and their perceptions and needs for the outpatient waiting areas are also examined. Method The examined medical center consists of five main buildings which house seventeen primary waiting areas for the outpatient clinics of nine medical specialties: 1 Internal Medicine; 2 Surgery; 3 Ophthalmology; 4 Obstetrics-Gynecology and Pediatrics; 5 Chinese Medicine; 6 Otolaryngology; 7 Orthopedics; 8 Family Medicine; and 9 Dermatology. A 15-item structured questionnaire was developed to rate patient satisfaction covering the four dimensions of the physical environments of the outpatient waiting areas: 1 visual environment; 2 hearing environment; 3 body contact environment; and 4 cleanliness. The survey was conducted between November 28, 2005 and December 8, 2005. A total of 680 outpatients responded. Descriptive, univariate, and multiple regression analyses were applied in this study. Results All of the 15 items were ranked as relatively high with a range from 3.362 to 4.010, with a neutral score of 3. Using a principal component analysis' summated scores of four constructed dimensions of patient satisfaction with the physical environments (i.e. visual environment, hearing environment, body contact environment, and cleanliness, multiple regression analyses revealed that patient satisfaction with the physical environment of outpatient waiting areas was associated with gender, age, visiting frequency, and visiting time. Conclusion Patients' socio-demographics and context backgrounds demonstrated to have effects on their satisfaction with the physical environment of outpatient waiting areas. In addition to noticing the overall rankings for less satisfactory items, what should receive further attention is the consideration of the patients' personal

  2. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  3. Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.

    Science.gov (United States)

    Musey, Paul I; Linnstaedt, Sarah D; Platts-Mills, Timothy F; Miner, James R; Bortsov, Andrey V; Safdar, Basmah; Bijur, Polly; Rosenau, Alex; Tsze, Daniel S; Chang, Andrew K; Dorai, Suprina; Engel, Kirsten G; Feldman, James A; Fusaro, Angela M; Lee, David C; Rosenberg, Mark; Keefe, Francis J; Peak, David A; Nam, Catherine S; Patel, Roma G; Fillingim, Roger B; McLean, Samuel A

    2014-12-01

    Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender

  4. Mergers involving academic health centers: a formidable challenge.

    Science.gov (United States)

    Pellegrini, V D

    2001-10-01

    Escalating economic pressures on the clinical enterprise threaten the missions of education and research in many of the most prestigious academic health centers. Following the model of industry, mergers of the healthcare delivery systems of teaching hospitals and clinics held promise for economies of scale and an improved operating margin. Failure to follow business principles in constructing the merged entity, differences in organizational governance and culture, and inability of physician leadership to prioritize, downsize, and consolidate clinical programs to optimize operational efficiencies all compromise the success of such mergers in academic medicine. Academic institutions and their respective governing boards need to exercise greater discipline in financial analysis and a willingness to make difficult decisions that show favor to one parent institution over another if mergers are to be effective in this setting. To date, an example of a vibrant and successful merger of academic health centers remains to be found.

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

    Institute of Scientific and Technical Information of China (English)

    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。

  6. [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].

    Science.gov (United States)

    Sitbon, O; Humbert, M; Simonneau, G

    2005-11-05

    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.

  7. Leveraging on information technology to enhance patient care: a doctor's perspective of implementation in a Singapore academic hospital.

    Science.gov (United States)

    Ong, B K C

    2002-11-01

    Information technology (IT) can improve the safety of patient care by minimising prescribing errors and organising patient-specific information from diverse databases. Apart from legibility, prescribing safety is enhanced as online access to databases carrying patient drug history, scientific drug information and guideline reference, and patient-specific information is available to the physician. Such specific information includes discharge summaries, surgical procedure summaries, laboratory data and investigation reports. In addition, decision support and prompts can be built in to catch errant orders. For such system implementations to work, the IT backbone must be fast, reliable and simple to use. End-user involvement and ownership of all aspects of development are key to a usable system. However, the hospital leadership must also have the will to mandate and support these development efforts. With such support, the design and implementation team can then map out a strategy where the greatest impact is achieved in both safety and enhanced information flow. The system should not be considered a finished work, but a continual work in progress. The National University Hospital's continuously updated Computerised Patient Support System (CPSS) is an example of an IT system designed to manage information and facilitate prescribing. It is a client-server based, one-point ordering and information access portal for doctors that has widespread adoption for drug prescription at outpatient and discharge medication usage areas. This system has built in safety prompts and rudimentary decision support. It has also become the choice means of accessing patient-related databases that impact on diagnoses and management.

  8. Epidemiology of Methicillin-Resistant Staphylococcus aureus Diabetic Foot Infections in a Large Academic Hospital: Implications for Antimicrobial Stewardship

    Science.gov (United States)

    Moore, Robert J.; Hand, Elizabeth O.; Howell, Crystal K.

    2016-01-01

    Introduction Diabetic foot infections (DFIs) are the leading cause of non-traumatic lower extremity amputations in the United States. Antimicrobials active against methicillin-resistant Staphylococcus aureus (MRSA) are recommended in patients with associated risk factors; however, limited data exist to support these recommendations. Due to the changing epidemiology of MRSA, and the consequences of unnecessary antibiotic therapy, guidance regarding the necessity of empirical MRSA coverage in DFIs is needed. We sought to 1) describe the prevalence of MRSA DFIs at our institution and compare to the proportion of patients who receive MRSA antibiotic coverage and 2) identify risk factors for MRSA DFI. Methods This was a retrospective cohort study of all adult, culture-positive DFI patients managed at University Hospital, San Antonio, TX between January 1, 2010 and September 1, 2014. Patient eligibility included a principal ICD-9-CM discharge diagnosis code for foot infection and a secondary diagnosis of diabetes. The primary outcome was MRSA identified in the wound culture. Independent variables assessed included patient demographics, comorbidities, prior hospitalization, DFI therapies, prior antibiotics, prior MRSA infection, and laboratory values. Multivariable logistic regression was used to identify risk factors for MRSA DFI. Results Overall, 318 patients met inclusion criteria. Patients were predominantly Hispanic (79%) and male (69%). Common comorbidities included hypertension (76%), dyslipidemia (52%), and obesity (49%). S. aureus was present in 46% of culture-positive DFIs (MRSA, 15%). A total of 273 patients (86%) received MRSA antibiotic coverage, resulting in 71% unnecessary use. Male gender (OR 3.09, 95% CI 1.37–7.99) and bone involvement (OR 1.93, 1.00–3.78) were found to be independent risk factors for MRSA DFI. Conclusions Although MRSA was the causative pathogen in a small number of DFI, antibiotic coverage targeted against MRSA was unnecessarily

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

    Directory of Open Access Journals (Sweden)

    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

  10. The Role of Family and Emergency Medicine in Undergraduate Medical Education

    OpenAIRE

    Sawchuk, Victor N.

    1980-01-01

    Clinical clerks electing emergency and family medicine rotations during the 1977 and 1978 academic years at the University of Calgary Faculty of Medicine evaluated their clerkships on the opportunities provided to learn new useful medical knowledge, learn new clinical skills and practice them. All rotations were perceived as providing excellent opportunities to learn medical knowledge. However, nearly 20% of students felt that four of the teaching hospital ward based specialty and subspecialt...

  11. Academics explore humidity's benefits.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  13. Circulation of core collection monographs in an academic medical library.

    Science.gov (United States)

    Schmidt, C M; Eckerman, N L

    2001-04-01

    Academic medical librarians responsible for monograph acquisition face a challenging task. From the plethora of medical monographs published each year, academic medical librarians must select those most useful to their patrons. Unfortunately, none of the selection tools available to medical librarians are specifically intended to assist academic librarians with medical monograph selection. The few short core collection lists that are available are intended for use in the small hospital or internal medicine department library. As these are the only selection tools available, however, many academic medical librarians spend considerable time reviewing these collection lists and place heavy emphasis on the acquisition of listed books. The study reported here was initiated to determine whether the circulation of listed books in an academic library justified the emphasis placed on the acquisition of these books. Circulation statistics for "listed" and "nonlisted" books in the hematology (WH) section of Indiana University School of Medicine's Ruth Lilly Medical Library were studied. The average circulation figures for listed books were nearly two times as high as the corresponding figures for the WH books in general. These data support the policies of those academic medical libraries that place a high priority on collection of listed books.

  14. Use of complementary and alternative medicine by patients with hematological diseases experience at a university hospital in northeast Mexico

    Science.gov (United States)

    Jaime-Pérez, José Carlos; Chapa-Rodríguez, Adrián; Rodríguez-Martínez, Marisol; Colunga-Pedraza, Perla Rocío; Marfil-Rivera, Luis Javier; Gómez-Almaguer, David

    2012-01-01

    Background Complementary and alternative medicine includes a diverse group of medical and healthcare systems, practices and products not considered part of conventional medicine. Although there is information on unconventional practices in oncological diseases, specific data regarding the use of complementary and alternative medicine by hematology patients is scarce. Objective The aim of this study is to document the prevalence of this modality of unconventional therapy in patients with malignant and benign hematological diseases, particularly children with acute lymphoblastic leukemia. Methods An observational study of adult patients and guardians of children with malignant or benign hematological diseases was carried out by applying a structured questionnaire detailing the use and results of the most prevalent complementary and alternative medicine practices. Results One hundred and twenty patients were included; 104 had malignant and 16 had benign hematological diseases. The use of complementary and alternative medicine was greater in benign diseases but the difference was not statistically significant (64.7% versus 41.7%; p-value = 0.08). Patients and guardians with high school or college educations used these alternative practices more than patients with less schooling (60.7% versus 54.7%; p-value = 0.032). The use of folk remedies was most prevalent followed by herbal preparations and spiritual healing. Sixty-four percent of patients that used these unconventional practices reported improvement in their symptoms and increased capacity to perform daily activities. Conclusion No significant difference was documented between patients with malignant or benign hematological diseases using these alternative practices. The majority of complementary and alternative medicine users reported improvement of the disease or chemotherapy-related symptoms. PMID:23049401

  15. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  16. Complete-genome sequencing elucidates outbreak dynamics of CA-MRSA USA300 (ST8-spa t008) in an academic hospital of Paramaribo, Republic of Suriname

    Science.gov (United States)

    Sabat, Artur J.; Hermelijn, Sandra M.; Akkerboom, Viktoria; Juliana, Amadu; Degener, John E.; Grundmann, Hajo; Friedrich, Alexander W.

    2017-01-01

    We report the investigation of an outbreak situation of methicillin-resistant Staphylococcus aureus (MRSA) that occurred at the Academic Hospital Paramaribo (AZP) in the Republic of Suriname from April to May 2013. We performed whole genome sequencing with complete gap closure for chromosomes and plasmids on all isolates. The outbreak involved 12 patients and 1 healthcare worker/nurse at the AZP. In total 24 isolates were investigated. spa typing, genome-wide single nucleotide polymorphism (SNP) analysis, ad hoc whole genome multilocus sequence typing (wgMLST), stable core genome MLST (cgMLST) and in silico PFGE were used to determine phylogenetic relatedness and to identify transmission. Whole-genome sequencing (WGS) showed that all isolates were members of genomic variants of the North American USA300 clone. However, WGS revealed a heterogeneous population structure of USA300 circulating at the AZP. We observed up to 8 SNPs or up to 5 alleles of difference by wgMLST when the isolates were recovered from different body sites of the same patient or if direct transmission between patients was most likely. This work describes the usefulness of complete genome sequencing of bacterial chromosomes and plasmids providing an unprecedented level of detail during outbreak investigations not being visible by using conventional typing methods. PMID:28106148

  17. Complete-genome sequencing elucidates outbreak dynamics of CA-MRSA USA300 (ST8-spa t008) in an academic hospital of Paramaribo, Republic of Suriname.

    Science.gov (United States)

    Sabat, Artur J; Hermelijn, Sandra M; Akkerboom, Viktoria; Juliana, Amadu; Degener, John E; Grundmann, Hajo; Friedrich, Alexander W

    2017-01-20

    We report the investigation of an outbreak situation of methicillin-resistant Staphylococcus aureus (MRSA) that occurred at the Academic Hospital Paramaribo (AZP) in the Republic of Suriname from April to May 2013. We performed whole genome sequencing with complete gap closure for chromosomes and plasmids on all isolates. The outbreak involved 12 patients and 1 healthcare worker/nurse at the AZP. In total 24 isolates were investigated. spa typing, genome-wide single nucleotide polymorphism (SNP) analysis, ad hoc whole genome multilocus sequence typing (wgMLST), stable core genome MLST (cgMLST) and in silico PFGE were used to determine phylogenetic relatedness and to identify transmission. Whole-genome sequencing (WGS) showed that all isolates were members of genomic variants of the North American USA300 clone. However, WGS revealed a heterogeneous population structure of USA300 circulating at the AZP. We observed up to 8 SNPs or up to 5 alleles of difference by wgMLST when the isolates were recovered from different body sites of the same patient or if direct transmission between patients was most likely. This work describes the usefulness of complete genome sequencing of bacterial chromosomes and plasmids providing an unprecedented level of detail during outbreak investigations not being visible by using conventional typing methods.

  18. Empleo de plantas medicinales en usuarios de dos hospitales referenciales del Cusco, Perú Use of medicinal plants among people attending two reference hospitals in Cusco, Peru

    Directory of Open Access Journals (Sweden)

    Gladys Oblitas

    2013-03-01

    Full Text Available Con el fin de determinar la frecuencia de empleo de plantas medicinales y describir las características de su uso en pacientes de dos hospitales referenciales de la ciudad de Cusco, se realizó un estudio transversal entre agosto y septiembre de 2011. Para el recojo de datos se construyó un instrumento, validado por juicio de expertos. El tamaño de la muestra fue de 250 personas seleccionadas no probabilísticamente. El 83,2 y 75,3% informaron haber empleado plantas medicinales alguna vez en su vida y en el último mes, respectivamente; además, el 85,7 señaló que desearía que su médico le recete plantas medicinales. Sus usos más frecuentes son para problemas digestivos (62,4%; urinarios (42,4%, y respiratorios (40,4%. Se concluye que el empleo de plantas medicinales se encuentra bastante difundido entre los usuarios de dos hospitales referenciales de la ciudad de Cusco. Los patrones de empleo revelan que los pacientes desean que los médicos del sistema de salud prescriban plantas medicinales en su acto médicoIn order to determine the frequency and characteristics of the use of medicinal plants in patients from two third-level hospitals in the city of Cusco, a cross-sectional study was conducted between August and September 2011. For data collection, an instrument was built and validated through experts’ judgment. The sample included 250 people selected in a non-probabilistic way. 83.2 and 75.3% informed having had used medicinal plants sometime during their lives and in the last month, respectively; additionally, 85.7 indicated that they wished their doctor would have prescribed them medicinal plants. Their most frequent uses include digestive problems (62.4% as well as urinary (42.4% and respiratory problems (40.4%. We conclude that the use of medicinal plants is widely spread among users of two hospitals in the city of Cusco. Utilization patterns show that patients wished the physicians of the health system prescribed medicinal

  19. Effectiveness of an educational intervention on the management of type 2 diabetic patients hospitalized in Internal Medicine: results from the FADOI-DIAMOND study.

    Science.gov (United States)

    Gulli, Giovanni; Frasson, Stefania; Borzì, Vito; Fontanella, Andrea; Grandi, Marco; Marengo, Claudio; Nicolucci, Antonio; Pastorelli, Ruggero; Solerte, Bruno; Gatti, Adriano; Raimondo, Francesco Cristiano; Bonizzoni, Erminio; Gussoni, Gualberto; Mazzone, Antonino; Ceriello, Antonio

    2014-10-01

    Appropriate management of hyperglycemia is crucial for patients with type 2 diabetes. Aim of the FADOI-DIAMOND study was to evaluate real-world management of type 2 diabetic patients hospitalized in Internal Medicine wards (IMW) and the effects of a standardized educational intervention for IMW staff. DIAMOND has been carried out in 53 Italian IMW, with two cross-sectional surveys interspersed with an educational program (PRE phase and POST phase). In PRE phase, each center reviewed the charts of the last 30 hospitalized patients with known type 2 diabetes. An educational program was conducted in each center by means of the "outreach visit," a face-to-face meeting between IMW staff and a trained external expert. Six months after, each center repeated the data collection (POST phase), specular to the PRE. A total of 3,167 patients were enrolled (1,588 PRE and 1,579 POST). From PRE phase to POST, patients with registered anthropometric data (54.1 vs. 74.9 %, p educational program, more patients received insulin during hospitalization (68.3 vs. 63.6 %, p = 0.005). A more relevant variation in glycemia during hospitalization was observed in POST phase than PRE (-22.2 vs. -15.5 mg/dL, p educational intervention led to persistent improvement in the management of hospitalized patients with type 2 diabetes and to significant better glycemic control. Further studies might evaluate the effectiveness of a more aggressive educational program, on both management and outcomes.

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

    Science.gov (United States)

    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 <0.05). Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine equivalent dose per discharged patient increased from 8.52 mg/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

  1. Research on the Management of Nursing Human Resources in the Hospital of Traditional Chinese Medicine%中医院护理人力资源管理研究

    Institute of Scientific and Technical Information of China (English)

    王丽; 张海; 郑进

    2016-01-01

    The management of nursing human resources is the first consideration in the nursing management. The difficulties of managing the nursing human resources in the Second Hospital of Traditional Chinese medicine was summarized by analyzing its status quo concisely.It was found out that the ability of nursing management needs improving,the nursing staff are not adequate,the comprehensive qualities of the nursing staff are varied,and the construction of nursing culture needs strengthening.Therefore,some countermeasures are put forward to give more enlightenments for the management of the hospital of traditional Chinese medicine,and they are promoting the training of management knowledge,making an analysis of human resources,enhancing the learning of professional knowledge,and cultivating the nursing culture in the hospital.%护理人力资源管理是护理管理的第一要素。本研究简要分析了四川省第二中医医院护理人力资源管理的现状,归纳出该院护理人力资源管理工作中的难点,包括护理管理能力亟待提升、护理人员总数严重不足、护理人员素质参差不齐和护理文化建设急需加强等方面,并提出对策:加强管理知识培训、开展人力资源分析、加强专业知识学习以及培育医院护理文化等,以期能够为广大中医院护理管理工作者带来启示。

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

    Science.gov (United States)

    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…

  3. Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine.

    Science.gov (United States)

    Carpenter, Christopher R; Bromley, Marilyn; Caterino, Jeffrey M; Chun, Audrey; Gerson, Lowell W; Greenspan, Jason; Hwang, Ula; John, David P; Lyons, William L; Platts-Mills, Timothy F; Mortensen, Betty; Ragsdale, Luna; Rosenberg, Mark; Wilber, Scott

    2014-07-01

    In the United States and around the world, effective, efficient, and reliable strategies to provide emergency care to aging adults is challenging crowded emergency departments (EDs) and strained healthcare systems. In response, geriatric emergency medicine clinicians, educators, and researchers collaborated with the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine to develop guidelines intended to improve ED geriatric care by enhancing expertise, educational, and quality improvement expectations, equipment, policies, and protocols. These Geriatric Emergency Department Guidelines represent the first formal society-led attempt to characterize the essential attributes of the geriatric ED and received formal approval from the boards of directors of each of the four societies in 2013 and 2014. This article is intended to introduce emergency medicine and geriatric healthcare providers to the guidelines while providing recommendations for continued refinement of these proposals through educational dissemination, formal effectiveness evaluations, cost-effectiveness studies, and eventually institutional credentialing.

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

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    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.

  5. A Cost Analysis of an Introduction to Clinical Medicine Course in a Non-University Teaching Hospital.

    Science.gov (United States)

    Tai, Lee W.; Tulley, John E.

    1997-01-01

    Analysis of direct costs to teach a 10-week Introduction to Clinical Medicine course to 26 students in the spring of 1995 found that attending physicians worked a total of 736.5 hours, for a cost of $37,303; residents worked 314 hours, at a cost of $4,396; and miscellaneous costs totaled $2,019. The per-student cost was $1,681. (Author/MSE)

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

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    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

  7. Development and Experience of Medicine Consultation in Our Hospital%我院药物咨询工作的开展及体会

    Institute of Scientific and Technical Information of China (English)

    徐文萍; 胡学文; 石柳柳

    2011-01-01

    目的:推动医院药学服务开展,促进药学咨询工作整体水平的提高.方法:收集我院2009年1月-2010年12月药物咨询案例4 045例,按咨询人群、咨询内容等进行归纳、分析,并总结体会.结果与结论:开通药物咨询热线、配备高素质咨询人员队伍、规范药物咨询工作流程等是药物咨询工作顺利开展的保证.咨询人群以体力劳动者为最多(1 777例,43.93%),其次为医护人员(603例,14.91%);咨询内容主要包括药物基本信息(1 930例,47.71%)、用法用量(1 093例,27.02%)、适应证与药物的相互作用(573例,14.17%)等.药物咨询工作为医、护、患三方所需,应提高药师整体业务水平和沟通技巧,针对不同患者制定不同的服务策略,从而提升药师的社会地位,提高患者和医护人员对药师的认可度.%OBJECTIVE: To promote the development of hospital pharmaceutical care, and to improve the overall level of pharmaceutical consultation. METHODS: 4 045 records of medicine consultation were collected from our hospital during Jan. 2009-Dec. 2010. Those cases were analyzed in respect of consultation patients and consultation contents. RESULTS & CONCLUSIONS: Medicine consultation hot line, high-quality consultant provider team and standard medicine consultation process are the guarantee of the development of medicine consultation. Consultation group mainly are manual workers (1 777 cases, 43.93%), followed by physicians and nurses (603 cases, 14.91%). The contents of consultation include general information of drugs (1 930 cases, 47.71%), dosage and usage (1 093 cases, 27.02%), indication and drug interaction (573 cases, 14.17%), etc. The improvement of professional and communication skills of pharmacists and individual service for different patients are significant to enhance the social position of pharmacist and improve acceptance of patient and medical staff to pharmacist.

  8. [Development of internal medicine since the establishment of the Regional Hospital in Sarajevo from 1894 until today].

    Science.gov (United States)

    Grujić, M

    1994-01-01

    The first bigger regular hospital in Sarajevo was built by the Bosnian vali Osman-pasha in the year 1866 and had only 32 beds. The construction expenses and keeping, according the Porta's approval was supported by Gazi-Husrevbeg's Vakuf, the name was The Vakuf's Hospital. In the year 1894, initiated by the Regional Government (Landesregierung) the Regional Hospital (Landesspital) came to existence, 1894, when opened had 238 beds, with modern outfits and technical facilities. There were 4 departments: Internal, Surgery, Dermatovenerology and Gynecology-Obstetrics. The Department for Internal Diseases had 50 beds. The first chief was Primarius Dr Geza Kobler, came from the Viennese Medical Faculty and had been assistant to Prof. Schretter. Simultaneously, he was director of the Hospital. His assistants were: Dr Berthold Haas to 1898 and Dr Heinrich Propper to 1900 and the interns were: Dr Bodo Koloman, Dr Alexander Dorner, Dr Erwin Horn, Dr Dragan Plentaj and Dr Risto Jeremić. Later, as chief was appointed Dr Ludomil Sas-Korcinski, professor of the Cracau University, his associates were to the year 1910: Dr Hamdija Karamehmedović, later to became chief of the Department for Infectious Diseases and the Intern, Dr Mustafa Kadić. At the eve of the World War 1, in 1914, the pavilion "K" was built, where the Department housed. At that time chief was Primarius Dr Ljubo Bilić, while his associates were Dr Gavro Bozić, Dr Vjekoslav Kusan and Dr Duro Ostojić. Later, some other doctors same, having a permanent job, Dr Bogdan Zimonjić, Dr Miron Simić, Dr David Pinto, Dr Sreten Kaluräercić and Dr David Baruh.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. [The posturological department as clinical support for occupational medicine: clinical cases and results of a hospital unit].

    Science.gov (United States)

    Centemeri, R; D'Orso, M I; Latocca, R; Pagani, W; Cesana, G C

    2007-01-01

    The posturologic visit is a not widely known medical method for the evaluation and the therapy of low back pain. We describe the clinical and instrumental method followed in our posturological clinical unit organized jointly by hospital and university and the clinical cases evaluated in two years. An individual diagnostic evaluation and a personal therapy allowed an almost generalized complete remission of the symptoms and a very low number of reactivation of low back pain after a follow up of one years.

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

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    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.

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

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    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

  12. Phychological Contract Construction of the Staff from Hospitals of Chinese Medicine%中医院员工心理契约的构建

    Institute of Scientific and Technical Information of China (English)

    韩玮; 殷虹; 高日

    2015-01-01

    中医院员工以知识型为主,他们的心理期望比较高。心理契约提供了了解和认识雇佣关系以及员工、组织相互责任的独特视角。心理契约具有主观性、内隐性、非正式的特点。中医院要构建良好的心理契约应加强以下几方面的管理:营造和谐的医院文化;结合医院战略目标进行职业生涯规划;建立健全沟通机制;维护心理契约的公平;做好员工招聘期间的告知义务;提供全面的岗前培训;搭建发挥员工所长的工作平台;鼓励先进员工,增强成就感。%The staff from hospitals of Chinese medicine are knowledge-based and they have high phychological expectations. Phychological contract is subjective, hidden and informal; it provides a unique perspective to know and understand the employment relationship between the staff and the organizations and their mutual responsibilities. To construct favorable phychological contract, the hopitals of Chinese medicine should strengthen the following management: create harmonious hospital culture, plan the career based on strategic objectives, build healthy communicative system, maintain fair phychological contract, do the informative duty well during staff recruitment, provide comprehensive pre-service training, build a working platform for the staff to bring their advantages into play, encourage advanced staff and enhance their sense of accompliments.

  13. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students, Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Directory of Open Access Journals (Sweden)

    Stanislaw Gorski

    2017-01-01

    Full Text Available Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students, targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards. Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization, received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

  14. 上海某三级医院学科带头人胜任力素质评价研究%Study on evaluation for characteristic items of the competency of academic leaders in a tertiary hospital in shanghai

    Institute of Scientific and Technical Information of China (English)

    陈玮; 费健; 杨伟国; 沈柏用; 李国红

    2015-01-01

    目的:了解上海某三级医院学科带头人的现状,为学科发展、人才梯队建设提供参考建议。方法:采用文献学习、专家访谈、行为事件访谈法、问卷调查等方式研究学科带头人胜任力的有关核心因素,形成学科带头人胜任力问卷,获得有关胜任力特征项数据。结果:学科带头人在不同胜任力特征项得分具有显著性差异(P<0.05)。与其他胜任力特征项相比,弹性与适应、培养他人、全局观念得分较高,而追求卓越、激励他人得分较低。上海某三级医院学科带头人胜任力处于中等水平,与绩优水平的学科带头人还有一定距离。结论:学科带头人往往不缺乏其专业素质,真正影响其学科发展程度、效率、效果的是处于冰山模型下深层次特质。学科带头人胜任力特征要素研究对提升学科带头人的科学性,改善其综合能力,为医院未来发展具有较强的指导意义。%Objectives: To investigate the current status of academic leaders in a tertiary hospital in shanghai area, and put forward some proposals about subject development, staff rundle construction for reference. Methods: Core elements of competency of the academic leaders were investigated by literature reviews, expert interviews, behavioral event interview, and questionnaires. The questionnaire of the competency of academic leaders was prepared and the data relevant to characteristic items of the competency were obtained. Results: The data relevant to characteristic items of the competency among the academic leaders have significant difference (P<0.05). Compared with the other items of competency, elasticity and adaptation, training others, concept of overall situation were higher, but pursue excellence, motivating others were significantly lower. Compared with the high achievement academic leaders, Academic leaders of a tertiary hospital in Shanghai area have some distance, and the

  15. Criterion-referenced evaluation of day one clinical competencies of veterinary students: VOLES-the VMTH (Veterinary Medicine Teaching Hospital) Online Evaluation System.

    Science.gov (United States)

    Zeck, Steven; Wall, Judy A; Smith, Bradford P; Wilson, W David; Walsh, Donal A

    2012-01-01

    This article describes an extensive online criterion-referenced evaluation system for the assessment of veterinary students' achievement during their final year's Doctor of Veterinary Medicine (or equivalent) clinical education. Data are reported for the 2001 to 2009 University of California at Davis veterinary graduates, for a total of more than 1,100 students. These criterion-referenced evaluations extensively document the level of clinical skills attained and demonstrated during the individual clinical rotations that comprise the fourth-year curriculum. On average, in each of the 17,500 clinical rotations undertaken during this time period, student performance was assessed in at least 11 separate areas of skills, knowledge, and professional attributes. This provided more than 200,000 criterion-referenced judgments of the individual clinical attributes of graduates over nine years. The system is based on a previously detailed and validated definition of the skills, knowledge, and professional attributes that students should have demonstrated before graduation. The extensive database that this system has provided has established that this system, termed VOLES (VMTH [Veterinary Medicine Teaching Hospital] On-Line Evaluation System), is an effective tool to assess the clinical capabilities of veterinary students and their achievement of the "Day One" skills required for entering clinical practice. These expected proficiencies are balanced according to the differing expectations that each area of veterinary clinical practice demands.

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

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    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. Pediatric integrative medicine: pediatrics' newest subspecialty?

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    Vohra Sunita

    2012-08-01

    Full Text Available Abstract Background Integrative medicine is defined as relationship-centered care that focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing, including evidence-based complementary and alternative medicine. Pediatric integrative medicine (PIM develops and promotes this approach within the field of pediatrics. We conducted a survey to identify and describe PIM programs within academic children’s hospitals across North America. Key barriers and opportunities were identified for the growth and development of academic PIM initiatives in the US and Canada. Methods Academic PIM programs were identified by email and eligible for inclusion if they had each of educational, clinical, and research activities. Program directors were interviewed by telephone regarding their clinical, research, educational, and operational aspects. Results Sixteen programs were included. Most (75% programs provided both inpatient and outpatient services. Seven programs operated with less than 1 FTE clinical personnel. Credentialing of complementary and alternative medicine (CAM providers varied substantially across the programs and between inpatient and outpatient services. Almost all (94% programs offered educational opportunities for residents in pediatrics and/or family medicine. One fifth (20% of the educational programs were mandatory for medical students. Research was conducted in a range of topics, but half of the programs reported lack of research funding and/or time. Thirty-one percent of the programs relied on fee-for-service income. Conclusions Pediatric integrative medicine is emerging as a new subspecialty to better help address 21st century patient concerns.

  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

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

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    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.

  20. Polypharmacotherapy and drug-drug interactions in patients hospitalized in an Internal Medicine department: magnitude of the problem and clinical implications

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    Luigi Lusiani

    2013-04-01

    Full Text Available BACKGROUND The use of multiple drugs is a growing problem in elderly patients: it increases the risk of drug-drug interactions and reduces the compliance to cures. The magnitude and the clinical implications of this phenomenon in patients hospitalized in Internal Medicine departments (IM remain largely unknown. AIM OF THE STUDY To evaluate how frequently polypharmacotherapy occurs in IM patients, to what extent the hospitalization affects it, and to what extent potential drug-drug interactions have to do with the treated conditions. MATERIALS AND METHODS In this observational study, the clinical records of 232 consecutive patients (median age 80 years were reviewed, and the medical prescriptions on admission to and at discharge from the hospital were analysed, with special regard to potential drugdrug interactions, using the Micromedex® Healthcare Series system (www.thomsonhc.com; the interactions were classified in terms of severity and type (clinical relevance. RESULTS The total number of prescribed drugs per-patient on admission and at discharge were 4.73 ± 2.88 vs 5.69 ± 2.78 (p < 0.01; the number of potentially harmful interactions were 0.91 ± 1.17 vs 1.39 ± 1.59 (p < 0.01; the percentage of patients at risk for any interactions (mostly moderate or severe, as a matter of fact were 53% vs 66% (p < 0.01. As for clinical relevance, most interactions were of the pharmacodymanic type (67 vs 93, p n.s., and very few patients (5 vs 5 had interactions potentially interfering with their disease status. The risk of interactions progressively increased with the number of prescribed drugs, reaching a plateau of 60% with the combination of 4 drugs. CONCLUSIONS Our data confirm that drug-drug interactions due to polypharmacotherapy are a relevant problem in patients hospitalized in IM, and that hospitalization per se adds to its magnitude. Although few patients seem to be directly threatened in their disease status, most of them are exposed to the

  1. 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

    NARCIS (Netherlands)

    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

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

    DEFF Research Database (Denmark)

    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 beta-blockers in 2004 and 27% in 1995, 39% of the variation in use of ACE inhibitors in 2004 and 3% in 1995...

  3. 医院信息化建设在转化医学发展中的作用与方向%Role and Development of Hospital Information Construction in Translational Medicine Research

    Institute of Scientific and Technical Information of China (English)

    张燕舞; 唐小利; 夏杰峰

    2012-01-01

    This paper discussed the role of hospital information construction in translational medicine research, including the construction of information supporting platform for translational medicine research, clinical and research data warehouse and information integration and sharing platform. It proposed hospital information construction mode for 3T roadmap of translational medicine. Moreover, a few problems about hospital information construction to support the standardization of information integration in the development of translational medicine, and the development of hospital information management were put forward.%分析了医院信息化建设在转化医学发展中的作用,包括搭建转化医学发展信息支撑平台、建设临床与科研数据仓库、建立信息资源整合与共享平台,提出面向转化医学3T的医院信息化建设模式,指出医院信息化建设支撑转化医学发展中信息集成标准化、医院信息管理发展问题.

  4. Construction of human resource information management system in hospital of traditional Chinese medicineZh%论中医医院人力资源信息化管理系统构建

    Institute of Scientific and Technical Information of China (English)

    张小会; 李宗友; 谢春娥; 曾俊杰

    2015-01-01

    Informatization has brought opportunities to the development of the medical industry, human resource management in hospital of traditional Chinese medicine. The management of human resources in the hospital of traditional Chinese medicine should adopt new ideas and system, and change the traditional human resource management mode. Through studying the status of human resource information management in hospital of traditional Chinese medicine, the relevant measures and suggestions for the construction of human resource information management system in hospital of traditional Chinese medicine are put forward in this paper.%我国中医医院人力资源管理在信息化进程中,应采用新理念、新体制,改变传统人力资源管理模式.本文对中医医院人力资源信息化管理的现状进行分析,提出科学构建中医医院人力资源信息管理系统的相关措施和建议.

  5. Executive summary of the CAEP 2014 Academic Symposium: How to make research succeed in your department.

    Science.gov (United States)

    Stiell, Ian G; Artz, Jennifer D; Perry, Jeffrey; Vaillancourt, Christian; Calder, Lisa

    2015-05-01

    The vision of the recently created Canadian Association of Emergency Physicians (CAEP) Academic Section is to promote high-quality emergency patient care by conducting world-leading education and research in emergency medicine. The Academic Section plans to achieve this goal by enhancing academic emergency medicine primarily at Canadian medical schools and teaching hospitals. It seeks to foster and develop education, research, and academic leadership amongst Canadian emergency physicians, residents, and students. In this light, the Academic Section began in 2013 to hold the annual Academic Symposia to highlight best practices and recommendations for the three core domains of governance and leadership, education scholarship, and research. Each year, members of three panels are asked to review the literature, survey and interview experts, achieve consensus, and present their recommendations at the Symposium (2013, Education Scholarship; 2014, Research; and 2015, Governance and Funding). Research is essential to medical advancement. As a relatively young specialty, emergency medicine is rapidly evolving to adapt to new diagnostic tools, the challenges of crowding in emergency departments, and the growing needs of emergency patients. There is significant variability in the infrastructure, support, and productivity of emergency medicine research programs across Canada. All Canadians benefit from an investigation of the means to improve research infrastructure, training programs, and funding opportunities. Such an analysis is essential to identify areas for improvement, which will support the expansion of emergency medicine research. To this end, physician-scientist leaders were gathered from across Canada to develop pragmatic recommendations on the improvement of emergency medicine research through a comprehensive analysis of current best practices, systematic literature reviews, stakeholder surveys, and expert interviews.

  6. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Science.gov (United States)

    Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina

    2017-01-01

    Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males) participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward. PMID:28164113

  7. 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

    Directory of Open Access Journals (Sweden)

    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.

  8. Device-associated infection rates and bacterial resistance in six academic teaching hospitals of Iran: Findings from the International Nocosomial Infection Control Consortium (INICC).

    Science.gov (United States)

    Jahani-Sherafat, Somayeh; Razaghi, Maryam; Rosenthal, Victor D; Tajeddin, Elahe; Seyedjavadi, Simasadat; Rashidan, Marjan; Alebouyeh, Masoud; Rostampour, Maryam; Haghi, Arezo; Sayarbayat, Masoumeh; Farazmandian, Somayeh; Yarmohammadi, Tahere; Arshadi, Fardokht K; Mansouri, Nahid; Sarbazi, Mohammad R; Vilar, Mariano; Zali, Mohammad R

    2015-01-01

    Device-associated health care-acquired infections (DA-HAIs) pose a threat to patient safety, particularly in the intensive care unit (ICU). However, few data regarding DA-HAI rates and their associated bacterial resistance in ICUs from Iran are available. A DA-HAI surveillance study was conducted in six adult and pediatric ICUs in academic teaching hospitals in Tehran using CDC/NHSN definitions. We collected prospective data regarding device use, DA-HAI rates, and lengths of stay from 2584 patients, 16,796 bed-days from one adult ICU, and bacterial profiles and bacterial resistance from six ICUs. Among the DA-HAIs, there were 5.84 central line-associated bloodstream infections (CLABs) per 1000 central line-days, 7.88 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator-days and 8.99 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. The device utilization ratios were 0.44 for central lines, 0.42 for mechanical ventilators and 1.0 for urinary catheters. The device utilization ratios of mechanical ventilators and urinary catheters were higher than those reported in the ICUs of the INICC and the CDC's NHSN reports, but central line use was lower. The DA-HAI rates in this study were higher than the CDC's NHSN report. However, compared with the INICC report, the VAP rate in our study was lower, while the CLAB rate was similar and the CAUTI rate was higher. Nearly 83% of the samples showed a mixed-type infection. The most frequent pathogens were Acinetobacter baumannii, Staphylococcus aureus and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae and Enterococcus spp. In the S. aureus isolates, 100% were resistant to oxacillin. Overall resistances of A. baumannii and K. pneumonia to imipenem were 70.5% and 76.7%, respectively. A multiple drug resistance phenotype was detected in 68.15% of the isolates. The DA-HAI rates in Iran were shown to be higher than the CDC-NHSN rates and similar to the INICC rates

  9. 转化医学在无锡市三甲医院中的SWOT分析%The SWOT analysis of translational medicine in the first-class hospitals in Wuxi

    Institute of Scientific and Technical Information of China (English)

    唐玉; 徐明; 李杨; 韩志君; 杨静宇; 鲁晓杰

    2015-01-01

    Objective To explore the sustainable development strategy.of translational medicine in hospitals, we conducted the in-depth analysis for the current status of translational medicine in the Level 3-A hospitals in Wuxi city.Methods the SWOT analysis was performed to identify the advantages, disadvantages, opportunities and threats in the translational medicine development in for those hospitals.Results Development of translational Medicine in those hospitals in Wuxi city highlights the advantages, opportunities and challenges.Conclusions the leadship of Translational Medicine should change their concepts, provide full play to the advantages of a variety of resources, conducting reform and innovation, establish a long-term system of human resource for talented researchers and reward system in order to accelerate the development of translational medicine.%目地 通过对无锡市三甲医院转化医学深入分析,探讨医院转化医学持续发展的策略.方法 运用SWOT分析方法,对无锡市三甲医院转化医学发展的优势、劣势、机遇、威胁进行全面分析.结果 转化医学在无锡市三甲医院中,优势突出,机遇与挑战并存.结论 转化医学管理者要转变观念,充分发挥多种资源优势,改革创新,建立长效人才机制及发展激励机制,加速转化医学的发展.

  10. Nutritional status influences the length of stay and clinical outcomes in patients hospitalized in internal medicine wards.

    Science.gov (United States)

    Ordoñez, Ana Manuela; Madalozzo Schieferdecker, Maria Eliana; Cestonaro, Talita; Cardoso Neto, João; Ligocki Campos, Antônio Carlos

    2013-01-01

    Objetivo: Vincular el estado nutricional (EN) con la evolución clínica y la duración de la estancia de los pacientes ingresados en las clínicas médicas de un hospital universitario. Métodos: Estudio observacional retrospectivo en el que los datos analíticos se obtuvieron de los pacientes ingresados durante el período de un año. Para la evaluación del EN se utilizaron: la valoración global subjetiva (VGS), el índice de masa corporal (IMC), el pliegue cutáneo triciptal (PCT), la circunferencia muscular del brazo (CMB) y el diagnostico del estado nutricional por la combinación de métodos (VGS, medidas de antropometría y bioquímicas). El análisis estadístico se realizó con el poder de confianza del 95% (p Ser mayor se asoció con la presencia de hipertensión arterial (p <0,001), diabetes mellitus (p = 0,003) y requerir cambios en la consistencia de la dieta (p = 0,003). Al final de la evaluación el 45,7% eran desnutridos. Presentar disminución de la ingesta de alimentos (p = 0,01), malnutrición según el SGA (p = 0,02) y la CMB (p = 0,03) se asoció con mortalidad. Estuvieron más tiempo hospitalizados los pacientes con nivel terciario de atención (p = 0,01), disminución de la ingestión de alimentos (p = 0,001), que murieron (p = 0,004), con un diagnóstico de desnutrición por VGS (p = 0,001) y por la combinación de métodos (p = 0,001). Conclusión: pacientes desnutridos según VGS y con disminución de la ingestión de alimentos al comienzo de la hospitalización se mantuvieron más tiempo en el hospital y tuvieron peores resultados clínicos (mayor número de muertes). El diagnóstico de la desnutrición por CMB también se relacionó con una mayor frecuencia de muertes.

  11. 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

    Directory of Open Access Journals (Sweden)

    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

  12. 上海三级医院临床学科带头人胜任力模型研究%Study on the competency model of academic leaders in tertiary hospitals in shanghai area

    Institute of Scientific and Technical Information of China (English)

    陈玮; 费健; 俞郁萍; 杨伟国; 李国红

    2016-01-01

    Objective This research puts the academic leader under the competency background to investigate the current status of academic leaders in tertiary hospitals in Shanghai,combines the theories a-nalysis with practice on the Correlative Research,takes evaluation of academic leaders as the target to deep into the discussion,studies the application value and special significance of the competency model on culti-vation,introduction and evaluation of academic leaders in tertiary hospitals in Shanghai area.Methods Core elements of competency of the academic leaders were investigated by literature reviews,expert inter-views,behavioral event interview,and questionnaires.The questionnaire of the competency of academic leaders was prepared and the numbers and induction relevant to characteristic items of the competency were obtained.Results The notion of six feature families is proposed by study of the competency model which composed 18 relative characteristic items.Six feature families are leadership,organization team with coordi-nation,innovation and implement of project,strategic thinking and overall outlook,self-control and self-management,pursuit excellence and development.Conclusions The academic leader not being lack of professional quality,it is the deep characteristics under the Iceberg Model that influenced the development degree,efficiency,effects of subjects.The study on the competency of the academic leader is helpful for e-valuation of academic leaders'comprehensive abilities and put forward some proposal about stuff rundle con-struction for reference in hospital.%目的:调查上海三级医院学科带头人现状,结合理论分析与实证调查,以评价学科带头人为目标进行相关研究及深入讨论,研究胜任力模型在上海三级医院的学科带头人培养、引进、评价等方面的应用价值和特殊意义。方法采用文献学习、专家咨询、行为事件访谈法、问卷调查等方式研究临床学科带头人胜

  13. Etiological study of fever of unknown origin in patients admitted to medicine ward of a teaching hospital of Eastern India

    Directory of Open Access Journals (Sweden)

    Dipanjan Bandyopadhyay

    2011-01-01

    Full Text Available Background: In a developing country, infectious disease remains the most important cause of fever, but the noncommunicable diseases, like malignancy, are fast becoming important differential diagnoses. An important clinical problem is the cases labeled as fever of unknown origin (FUO, which often evade diagnosis. Objective: The present study was undertaken to find the cause of FUO in a tertiary care hospital of eastern India. Materials and Methods: This is a prospective study of inpatients, with regard to both clinical signs and investigations. Results: The main diagnosis in the end was tuberculosis, closely followed by hematological malignancy. A substantial number of cases remained undiagnosed despite all investigations. The provisional diagnosis matched with the final in around two thirds of the cases. While for younger patients leukemia was a significant diagnosis, for older ones, extra-pulmonary tuberculosis was a main concern. Interpretation: In India, infectious disease still remains the most important cause of fever. Thus the initial investigations should always include tests for that purpose in a case of FUO. Conclusion: Geographic variations and local infection profiles should always be considered when investigating a case of FUO. However, some of the cases always elude diagnosis, although the patients may respond to empirical therapy.

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

    Science.gov (United States)

    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.

  15. Nutritional status influences the length of stay and clinical outcomes in hospitalized patients in internal medicine wards

    Directory of Open Access Journals (Sweden)

    Ana Manuela Ordoñez

    2013-08-01

    Full Text Available Objective: The aim of this study was to investigate the relationship between the nutritional status (NS and clinical outcome and length of stay (LOS among patients admitted to the internal medicine ward. Methods: This is a retrospective observational study performed with the data of clinical patients collected during a one year period. The NS was assessed using: subjective global assessment (SGA, body mass index (BMI, triceps skinfold thickness (TST, muscle arm circumference (MAC and combined tools. Statistical analysis was performed with a confidence interval of 95% (p < 0.05. For categories comparison the chi-square test was used. To examine the association between length of stay and variables related to the NS Mann-Whitney and Kruskal-Wallis tests was used with multiple comparisons. Results: 396 patients were included in the study, 42.2% were over 60 years of age, what was associated with the presence of hypertension (p < 0.001, diabetes mellitus (p = 0.003 and required diet with modifications consistency (p = 0.003. According to combined diagnostic tools, 45.7% of patients were malnourished. Decreased food intake (p = 0.01, malnutrition according to SGA (p = 0.02 and MAC (p = 0.03 were associated with increased mortality. Patients with tertiary level of care (p = 0.01, decreased food intake (p = 0.001, who died (p = 0.004 and diagnosed with malnutrition by SGA (p = 0.001 and by the combined tools (p = 0.001 had a longer LOS. Conclusions: Patients who were malnourished by SGA and who presented decrease food intake at admission had longer LOS and poorer clinical outcomes (highest number of deaths. The diagnosis of malnutrition by MAC was also related to higher mortality.

  16. Knowledge about complementary, alternative and integrative medicine (CAM among registered health care providers in Swedish surgical care: a national survey among university hospitals

    Directory of Open Access Journals (Sweden)

    Bjerså Kristofer

    2012-04-01

    Full Text Available Abstract Background Previous studies show an increased interest and usage of complementary and alternative medicine (CAM in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result A total of 737 (42.0% questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in

  17. The effect of stratified nursing care on internal medicine hospitalized patients%分层护理关怀对内科住院患者的影响

    Institute of Scientific and Technical Information of China (English)

    柳美英

    2012-01-01

    Objective To analyze the effect of stratified nursing care on internal medicine hospitalized patients.Methods Patients in the department of internal medicine were treated with stratified nursing care after 4 days in hospital,the sleep status,quality of life and mood differences before and after implementation were compared.Results After nursing care was implemented,the score of sleep quality was 0.93 ± 0.18,sleep disturbance scored 0.63 ± 0.21,daytime function scored 0.47 ± 0.16; SAS scored 40.18 ± 4.92,SDS scored37.72 ± 5.26; QQL scored 198.33 ± 21.49.The sleep status,negative emotion and life quality of patients were improved,the difference was statistically significant ( P < 0.05 ).Conclusions Humanistic nursing concept should be blended into the routine nursing service,it can improve the quality of nursing.%目的 探讨分层护理关怀对内科住院患者的影响.方法 对内科住院患者住院后第4天实施分层护理关怀,比较实施前后患者睡眠状况、生活质量和负性情绪的差异.结果 患者实施分层护理关怀后,睡眠质量得分为0.93 ±0.18,睡眠紊乱得分为0.63 ±0.21,日间功能得分为0.47 ±0.16;SAS得分为40.18 ±4.92,SDS得分为37.72±5.26;QQL总评分为198.33±21.49.患者的睡眠状况、负性情绪和生活质量均较实施分层护理关怀前有所改善,差异有统计学意义(P<0.05).结论 将人文护理理念融入常规护理服务中,利于提高护理服务质量.

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

    Institute of Scientific and Technical Information of China (English)

    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

  19. 盐城市某医院2010~2011年中药注射剂应用分析%Application analysis of traditional Chinese medicine injection in a hospital in 2010 and 2011

    Institute of Scientific and Technical Information of China (English)

    高红燕; 陈迎平

    2012-01-01

    目的 分析医院中药注射剂的药物使用情况,探讨用药特点,为临床合理用药提供参考.方法 统计分析盐城市某院2010~2011年中药注射剂用药情况,比较中药注射剂的品种、年销售金额、用药频度、排序比等.结果 该院2010~2011年中药注射剂的销售金额、用量以及品种主要分布于心脑血管系统用药和补益用药中,心脑血管系统中药注射剂2010年和2011年销售总金额分别为1 457.36万元和1 248.59万元;分别占当年中药注射剂总销售金额的49.1%和45.51%.结论 该院心脑血管系统中药注射剂临床应用广泛,用药前景良好,中药注射剂在中医理论指导下使用较为规范合理.%Objective To analyse the application of traditional Chinese medicine injection, explore the medication characteristics and provide a reference to the hospital for the reasonable use of drugs. Methods The diseases the injection treated, medication frequency and medicine category of traditional Chinese medicine injected, and annual sales volume in our hospital in 2010 and 2011 were analyzed. Results The sales volume, amount and category of traditional Chinese medicine injection used in our hospital mainly distributed in the cardio - cerebrovascular diseases and for tonic use. The annual sales volumes of traditional Chinese medicine injections in cardio - cerebrovascular diseases in 2010 and 2011 were 14,573 ,600 yuan and 12 ,485 ,900 yuan respectively, accounting for 49.% and 45. 51 % of the total sales volume of traditional Chinese medicine injection. Conclusion Traditional Chinese medicine injections is widely used in cardio - cerebrovascular diseases and the prospect is fine. The use of traditional Chinese medicine injection in this hospital is comparatively proper and reasonable under the guidance of Chinese medicine theory.

  20. [A retrospective study on the incidence of chronic renal failure in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo (the capital city of Madagascar)].

    Science.gov (United States)

    Ramilitiana, Benja; Ranivoharisoa, Eliane Mikkelsen; Dodo, Mihary; Razafimandimby, Evanirina; Randriamarotia, Willy Franck

    2016-01-01

    Chronic renal failure is a global public health problem. In developed countries, this disease occurs mainly in the elderly, but in Africa it rather affects active young subjects. This disease need for expensive treatments in a low income country, because of its costs. Our aim is to describe the epidemiology of new cases of chronic renal failure in Madagascar. This is a retrospective, descriptive study of 239 patients with chronic renal failure over a 3 year period, starting from 1 January 2007 to 31 December 2009, in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo. The incidence was 8.51% among patients hospitalized in the Department. The average age of patients was 45.4 years with extremes of 16 and 82 years and a sex ratio 1,46. The main antecedent was arterial hypertension (59.8%). Chronic renal failure was terminal in 75.31% of the cases (n=180). The causes of chronic renal failure were dominated by chronic glomerulonephritis (40.1%), nephroangiosclerosis (35.5%). Hemodialysis was performed in 3 patients (1.26%), no patient was scheduled for a renal transplantation. Mortality rate in the Department was 28.87%. Chronic renal failure is a debilitating disease with a dreadful prognosis which affects young patients in Madagascar. Its treatment remains inaccessible to the majority of patients. The focus must be mainly on prevention, especially on early effective management of infections, arterial hypertension and diabetes to reduce its negative impacts on the community and public health. The project on renal transplantation: living donor, effective and less expensive treatment compared to hemodialysis could also be a good solution for these Malagasy young subjects.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Association of Academic Physiatrists

    Science.gov (United States)

    ... that enhance and improve research and education in academic physiatry. Search AAP Search » Gerard E. Francisco, MD , received the Sidney Licht Lectureship Award at the 10th International Society of Physical and Rehabilitation Medicine World Congress. Michael Boninger, MD , new Vice President ...

  3. 英汉医药学术语篇中作者自称语的对比研究%A Contrastive Study of Self-mentioning Markers between English and Chinese Academic Discourse of Medicine

    Institute of Scientific and Technical Information of China (English)

    刘跃良; 陈玮

    2016-01-01

    Based on self-built corpora,this study contrastively analyzes the use of self-mentioning markers in English and Chinese academic discourse of medicine. Results show that they occur in both type of discourse but differ greatly in the quantity and way of realization. The factors leading to these differences are discussed from the perspective of language,culture and academic traditions. The research results may benefit the English syllabus de-signing of graduate students in medical and pharmaceutical universities,and academic English writing and its teaching as well.%基于自建语料库对英汉医药学术语篇中作者自称语使用情况进行对比分析,发现在两种语篇中,都普遍用到作者自称语,但在使用数量和具体方式上,有很大的差异。造成这些差异的原因有语言上的,也有文化上的,还有学术常规方面的。此项研究结果对于医药院校研究生英语课程设置和学术英语写作教学有一定的启示。

  4. Analysis of the Utilization of Antineoplastic Chinese Patent Medicine in Our Hospital during the Period of 2008-2011%我院2008-2011年抗肿瘤口服中成药使用分析

    Institute of Scientific and Technical Information of China (English)

    郭玉霞; 张磊; 齐伟; 吴志恒

    2012-01-01

    OBJECTIVE: To evaluate the status quo of the utilization of antineoplastic Chinese patent medicine in our hospital and to promote rational use of drugs. METHODS: The consumption sum, DDDs.DDC and DUI of antineoplastic Chinese patent medicine in our hospital during the period of 2008—2010 were analyzed statistically. RESULTS: The variety of antineoplastic Chinese patent medicine in our hospital was stable during 2008—2011, the consumption sum of drugs increased year by year, suitable price and effective therapeutic efficacy of Chinese patent medicine took the lead on the list of DDDs and DDC. CONCLUSION: In our hospital, the utilization of antineoplastic Chinese patent medicine is rational on the whole. Comprehensive considerations including good effect and reasonable cost should be taken into account during clinical drug use.%目的:评价我院抗肿瘤口服中成药的使用现状,促进合理用药.方法:对我院2008-2011年抗肿瘤口服中成药的销售金额、用药频度(DDDs)、日用药金额(DDC)、药物利用指数(DUI)进行排序和分析.结果:我院2008-2011年抗肿瘤口服中成药品种基本固定,销售金额呈逐年上升趋势,疗效确切、价格适中的中成药DDDs、DDC、DUI排序靠前.结论:我院抗肿瘤中成药的应用基本合理,在临床用药过程中要综合考虑疗效和经济两方面.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Research Productivity of Sports Medicine Fellowship Faculty

    Science.gov (United States)

    Cvetanovich, Gregory L.; Saltzman, Bryan M.; Chalmers, Peter N.; Frank, Rachel M.; Cole, Brian J.; Bach, Bernard R.

    2016-01-01

    Background: Research productivity is considered an important factor in academic advancement in sports medicine. No study to date has evaluated academic productivity and correlates of academic rank for sports medicine fellowship faculty. Purpose: To describe the academic productivity of American Orthopaedic Society for Sports Medicine (AOSSM) fellowship program faculty and to determine the association between academic productivity, fellowship characteristics, and academic rank. Study Design: Descriptive epidemiology study. Methods: Characteristics of orthopaedic sports medicine fellowship programs were obtained from the AOSSM and program websites. Metrics of academic productivity (Hirsch index [h index], I-10 index, publications, citations, and number of publications in several journals) were obtained from Scopus. Statistical analyses were conducted to determine whether academic productivity differs with fellowship attributes and academic rank. Results: A total of 90 AOSSM sports medicine fellowship programs with 610 associated faculty members were identified. Faculty were predominantly male (94%), at academic medical centers (74%), members of AOSSM (71%), and sports medicine–fellowship trained (84%). Faculty had a median of 18 (range, 0-684) publications overall, including a median of 3 (range, 0-161) publications since 2012. All measures of academic productivity were significantly higher among faculty employed at academic medical centers compared with those not employed at academic centers (P Research productivity was higher among faculty employed at academic centers in the Northeast and Midwest regions and at programs with a larger number of fellows. PMID:28210650

  7. 现代医院中药管理现状总结与研究%The Summary and the Research Status of Traditional Chinese Medicine Management in Modern Hospital

    Institute of Scientific and Technical Information of China (English)

    王幸; 赵晓丽

    2015-01-01

    目的:探究现代医院中药管理现状。方法将2014年该院的中药管理情况作为对照组,该院于2014年应用现代医院中药管理理论与方式,并将该年的中药管理情况作为观察组,对比两组不合理处方率、患者的不良反应率、药物配制错误率等情况。结果观察组发生的不合理处方率、患者的不良反应率、药物配制错误率,分别是0.33%(4/1200)、0.50%(6/1200)、0.08%(1/1200),而对照组发生的不合理处方率、患者的不良反应率、药物配制错误率,则分别是1.25%(15/1200)、1.66%(20/1200)、0.75%(9/1200),二者间的差异具有统计学意义(P<0.05)。结论应用现代医院中药管理理论和方式,可以规范化医院的中药管理模式,提高医院的药物管理水平,为医院减少医药纠纷,为医院树立一个良好的形象,间接为医院增加了良好的社会评价和经济效益,应在各医院进行推广和使用。%Objective To explore the status of traditional Chinese medicine management in modern hospital. Methods As the con-trol group in our hospital since 2014 in our hospital of traditional Chinese medicine management, theory and application of modern hospital management mode of traditional Chinese medicine in 2014, and the Chinese medicine management this year as the obser-vation group, the adverse reaction were compared between the two groups of unreasonable prescription rate, the percentage of pa-tients, drug dispensing error rate etc. Results The adverse reactions of irrational prescriptions in observation group, the percentage of patients, the rate of drug dispensing error rate, respectively is 0.33%(4/1200), 0.50%(6/1200), 0.08% (1/1200), while the con-trol unreasonable adverse prescription group incidence, the percentage of patients, drug dispensing error rate, are 1.25%(15/1200), 1.66% (20/1200), 0.75% (9/1200), statistically significant differences between the two (P<0

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

    Science.gov (United States)

    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…

  9. Academic Blogging: Academic Practice and Academic Identity

    Science.gov (United States)

    Kirkup, Gill

    2010-01-01

    This paper describes a small-scale study which investigates the role of blogging in professional academic practice in higher education. It draws on interviews with a sample of academics (scholars, researchers and teachers) who have blogs and on the author's own reflections on blogging to investigate the function of blogging in academic practice…

  10. 中医医院护理组织文化现状调查%Investigation on the status of organizational culture in traditional Chinese medicine hospital

    Institute of Scientific and Technical Information of China (English)

    刘辉; 王艳冬; 谭玉华; 刘海娜; 何甜; 张建

    2016-01-01

    Objective To know the status of organizational culture in traditional Chinese medicine (TCM) hospital and provide construction suggestions for nursing managers.Methods A total of 300 registered nurses in TCM hospitals in Tianjin were investigated with the self-designed general information questionnaire and NCAT on nursing organizational culture. Unifactor variance analysis was used to analyze the influencing factors. Results The score of organizational culture of nursing in TCM hospital was (61.72±8.19), and was in the medium level. The team cooperation and communication dimension scored the highest, which was ( 23. 34 ± 3. 21);satisfaction dimension scored lowest, and was (6.42±2.00). Unifactor analysis found that the scores of satisfaction and professional commitment of nursing organizational culture was statistically significant with different age (P<0.05).Conclusions Nursing organizational culture is in the medium level. Nursing managers should strengthen the TCM hospital culture construction from the following three aspects:material, institute and spirit culture.%目的:了解中医医院护理组织文化现状,为护理管理者提供护理组织文化建设建议。方法采用一般情况调查表、中文版护理组织文化量表( NCAT)对天津市中医医院300名在职护士进行问卷调查,采用单因素方差分析法分析影响因素。结果中医医院护理组织文化总分为(61.72±8.19)分,处于中等水平。其中团队合作与沟通维度得分最高(23.34±3.21)分,满意维度得分最低(6.42±2.00)分。将一般资料进行单因素方差分析发现,不同年龄对中医医院护理组织文化满意、专业承诺维度差异有统计学意义( P<0.05)。结论中医医院护理组织文化处于中等水平,建议护理管理者从物质、制度、精神文化的角度加强中医医院护理组织文化建设。

  11. 军队医院主渠道药品社会化保障可行性%The Feasibilities of Socialization Support of the Main - Channel Medicine in the Military Hospital

    Institute of Scientific and Technical Information of China (English)

    戴柏华; 陈良乾; 杨鸿洋

    2011-01-01

    With the development of logistics support socialization reform in the army and the diversification of medicine, the main - channel medicine must be developed towards the socialization support. According to the study of the support mode of the main - channel medicine in military hospital, the author discussed the disadvantages of current support mode and analyzed the feasibility of socialization support mode.%随着军队后勤保障社会化改革的深入和药品品种多样化的发展,军队医院主渠道药品必然要向社会化保障发展.本文依据对军队医院主渠道药品供应保障模式的学习和认识,就现行保障模式的弊端,以及社会化保障的可能性进行分析.

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  13. [Science and research in academic plastic surgery in Germany].

    Science.gov (United States)

    Giunta, R E; Machens, H-G

    2009-12-01

    Plastic surgery has passed through a very positive evolution in the last decades on the solid fundament of constantly developing academic plastic surgery. Aim of this paper is an objective evaluation of the current status of academic plastic surgery regarding research topics, currently available ressources and scientific outcome based on a questionnaire. The return rate of the questionnaire in academic departments was 92%. Main topics in research besides wound healing were topics from regenerative medicine such as tissue engineering, biomaterials, genetherapy and angiogenesis with the main focus on skin and fat tissues. In the past five years a total of 25 million Euros of third party research grants were raised. Research relied mainly on interdisciplinary research facilities. Regarding the scientific outcome more than 200 scientific papers were published in basic science research journals having an impactfactor higher than two. These results clearly demonstrate that plastic surgery is scientifically highly productive in academic surroundings where independent departments are established. Considering that independent units of plastic surgery exist in a relatively small number of all 36 university hospitals in germany, it has to be claimed for further independent departments so to provide adequate research facilities for further evolution of academic plastic surgery.

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

    Directory of Open Access Journals (Sweden)

    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

  15. Present Situation of Cultivation Model on Academic Postgraduates of Chinese Medicine and Reform Strategy Based on Synergic Development of Medicine and Education%“医教协同”背景下中医学术型研究生培养模式现状及改革对策

    Institute of Scientific and Technical Information of China (English)

    贾永森; 杜晨光; 曹慧娟; 田福玲; 林清; 田春雨; 崔建美; 李继安

    2016-01-01

    在国家相关部委联合提出医教协同、全面提高临床医学人才实践能力的背景下,本文通过分析中医学术型研究生培养模式的现状,认为现有的培养模式主要存在的问题是研究生创新能力不足,并针对此问题提出了“两强化、一完善、两搭建”的培养模式改革对策,即强化导师队伍建设,强化学术能力培训,完善科研创新能力培养机制,搭建学术交流平台,搭建科研平台,同时还提出培养模式改革的目标是提高研究生的创新能力,使研究生能够解决与临床关系密切的中医科研、学术问题。%Based on the background that nationalministries and commissions put forward to idea on synergic development of medi-cine and education recently,and students of Clinical majors are expected to possess practical abilities and skills,the article focused on present situation of cultivation model on academic postgraduates of Chinese Medicine (APCM)and innovation strategy as well.Disad-vantage on present cultivation model on APCMis insufficiency of innovation ability.A new cultivation model is put forward,general-ized as “strengthening two aspects,improving one item and establishing two platforms”.The concrete measures are as follows:tutors should be trained and strengthened,academic abilities of APCMshould be cultivated,cultivation mechanism on research innovation a-bility of APCMshould be improved,and platforms on academic exchange and scientific research should be established.Reform aims at improving innovation ability of APCM.Scientific and academic questions related to clinical medicine are supposed to be solved based on the ability.

  16. 中药沐足加穴位按摩治疗住院患者睡眠障碍的效果观察%Effect of Chinese Medicine Foot Massage Plus Acupressure Therapy on Hospitalized Patients with Sleep Disorders

    Institute of Scientific and Technical Information of China (English)

    马新梅; 黄玉芬; 黄雪屏

    2012-01-01

    Objective To observe the clinical effect of traditional Chinese medicine foot massage plus acupressure treatment on improving sleep quality of hospitalized patients with sleep disorders. Methods According to syndrome differentiation in TCM, the appropriate methods of traditional Chinese medicine foot massage and acupressure therapy were applied among 125 patients with sleep disorders respectively. Patients' sleep quality before and after treatment was assessed by Pittsburgh Sleep Quality Index (PSQI). Results After treatment, the patients' scores of each factor and the total score of PSQI all decreased (P<0.05). Conclusion Traditional Chinese medicine foot massage and acupressure therapy can effectively improve the sleep quality of hospitalized patients.Objective To observe the clinical effect of traditional Chinese medicine foot massage plus acupressure treatment on improving sleep quality of hospitalized patients with sleep disorders. Methods According to syndrome differentiation in TCM, the appropriate methods of traditional Chinese medicine foot massage and acupressure therapy were applied among 125 patients with sleep disorders respectively. Patients' sleep quality before and after treatment was assessed by Pittsburgh Sleep Quality Index (PSQI). Results After treatment, the patients' scores of each factor and the total score of PSQI all decreased (P<0.05). Conclusion Traditional Chinese medicine foot massage and acupressure therapy can effectively improve the sleep quality of hospitalized patients.%目的 观察中药沐足加穴位按摩治疗睡眠障碍的效果.方法 选择125例住院睡眠障碍患者,根据体质辨证分型采取相应的沐足方和手法按摩足部穴位,用匹兹堡睡眠质量指数量表评定患者治疗前(入院第2天)和治疗后(入院第9天)的睡眠质量.结果 125例患者治疗后,患者睡眠质量明显改善,睡眠质量指数各因子评分和总评分均下降(P<0.05).结论 应用中药足浴加足部穴位按

  17. Structure and Activities of Nuclear Medicine in Kuwait.

    Science.gov (United States)

    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.

  18. Strategic business planning for internal medicine.

    Science.gov (United States)

    Ervin, F R

    1996-07-01

    The internal medicine generalist is at market risk with expansion of managed care. The cottage industry of Academic Departments of internal medicine should apply more business tools to the internal medicine business problem. A strength, weakness, opportunity, threat (SWOT) analysis demonstrates high vulnerability to the internal medicine generalist initiative. Recommitment to the professional values of internal medicine and enhanced focus on the master clinician as the competitive core competency of internal medicine will be necessary to retain image and market share.

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

    Science.gov (United States)

    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.

  20. Gender inequality in career advancement for females in Japanese academic surgery.

    Science.gov (United States)

    Okoshi, Kae; Nomura, Kyoko; Fukami, Kayo; Tomizawa, Yasuko; Kobayashi, Katsutoshi; Kinoshita, Koichi; Sakai, Yoshiharu

    2014-01-01

    During the past three decades, the participation of women in medicine has increased from 10.6% (1986) to 19.7% (2012) in Japan. However, women continue to be underrepresented in the top tiers of academic medicine. We highlight gender inequality and discuss the difficulties faced by female surgeons in Japanese academic surgery. Using anonymous and aggregate employment data of medical doctors at Kyoto University Hospital from 2009 and 2013, and a commercially-published faculty roster in 2012-2013, we compared gender balance stratified by a professional and an academic rank. The numbers of total and female doctors who worked at Kyoto University Hospital were 656 and 132 (20.1%) in 2009 and 655 and 132 (20.2%) in 2013, respectively. Approximately half the men (n = 281) were in temporary track and the rest (n = 242) were in tenure track, but only one fifth of women (n = 24) were in tenure track compared to 108 women in temporary track (p gender differences in leadership opportunities in Japanese academic surgery.

  1. 我院门诊2007-2011年中成药应用分析%Analysis of the Utilization of Chinese Patent Medicines in Outpatient Department in Our Hospital during 2007-2011

    Institute of Scientific and Technical Information of China (English)

    张碧华; 穆林; 金鹏飞; 蔡小兵

    2012-01-01

    目的:为临床合理用药提供参考.方法:对我院门诊中成药的销售金额及构成比、用药频度和科室用药分布情况进行统计分析.结果:我院门诊中成药的种类连续性较好,各类药销售金额及构成比相对固定,同时在临床各科室的用药集中度相对较低.结论:我院在用药品种的选择上基本能够满足临床需求,同时也兼顾了患者的经济承受能力,注重合理用药,保障了临床用药的安全、有效和经济.%OBJECTIVE: To analyze clinical utilization of Chinese patent medicines in outpatient department of our hospital during 2007-2011,and to provide reference for clinical rational drug use. METHODS: The utilization of Chinese patent medicines in outpatient department of our hospital was analyzed statistically in respect of consumption sum, constituent ratio, DDDs and departments distribution of drug use. RESULTS: The category continuity of Chinese patent medicines in outpatient department was fairly good. The consumption sum and constituent ratio for various drugs were relatively fixed, the concentration ratio of drug use were lower in clinical departments. CONCLUSIONS: The type selection of Chinese patent medicines in hospital meet the requirement of clinical treatments, and also need to consider the afford ability of patients and rational drug use so as to guarantee safe, effective and economical drug in the clinic.

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

    NARCIS (Netherlands)

    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

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

    NARCIS (Netherlands)

    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

  4. The evolution of academic performance in nine subspecialties of internal medicine: an analysis of journal citation reports from 1998 to 2010.

    Directory of Open Access Journals (Sweden)

    Yan Zhang

    Full Text Available BACKGROUND: Internal medicine includes several subspecialties. This study aimed to describe change trend of impact factors in different subspecialties of internal medicine during the past 12 years, as well as the developmental differences among each subspecialty, and the possible influencing factors behind these changes and differences. METHODS: Nine subspecialties of internal medicine were chosen for comparison. All data were collected from the Science Citation Index Expanded and Journal Citation Reports database. RESULTS: (1 Journal numbers in nine subspecialties increased significantly from 1998 to 2010, with an average increment of 80.23%, in which cardiac and cardiovascular system diseases increased 131.2% rank the first; hematology increased 45% rank the least. (2 Impact Factor in subspecialties of infectious disease, cardiac and cardiovascular system diseases, gastroenterology and hepatology, hematology, endocrinology and metabolism increased significantly (p6, hematology had the maximum proportion of 10%, nephrology and respiratory system disease had the minimum of 4%. Among the journal with low impact factor (IF<2, journal in nephrology and allergy had the most (60%, while endocrinology and metabolism had the least (40%. There were differences in median number of IF among the different subspecialties (p<0.05, in which endocrinology and metabolism had the highest, nephrology had the lowest. (4 The highest IF had a correlation with journal numbers and total paper numbers in each field. CONCLUSION: The IF of internal medicine journals showed an increasingly positive trend, in which gastroenterology and hepatology increase the most. Hematology had more high IF journals. Endocrinology and metabolism had higher average IF. Nephrology remained the lowest position. Numbers of journals and total papers were associated with the highest IF.

  5. Academics respond

    DEFF Research Database (Denmark)

    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...

  6. 2011-2014年广东省中医院珠海医院中药饮片和中药颗粒使用情况分析%Usage Analysis on Traditional Chinses Medicine Decoction Pieces and Granules in Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine During 2011-2014

    Institute of Scientific and Technical Information of China (English)

    孙毅东; 张美容; 廖银标; 林爱华

    2016-01-01

    Objective To provide references for reasonable procurement planning, TCM decoction pieces reserving and clinical medication guarantee by analyzing the usage of TCM decoction pieces and granules from 2011 to 2014 in Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine (hereinafter referred to as Zhuhai Hospital). Methods The sale data of TCM decoction pieces and granules during 2011-2014 in the database of Zhuhai Hospital were analyzed. Sales quantity, sales amount of the category and single pieces of TCM decoction pieces and granules ranking the first 10 were analyzed. Results The sales quantity and amount of TCM decoction pieces and granules were increasing from 2011 to 2014. The usage weight ratio and usage amount ratio between TCM decoction pieces and granules was stable. The top 10 categories and single pieces in sales quantity and amount were also stable. Conclusion Zhuhai Hospital has its own characteristics in TCM types, categories and dosage forms. TCM decoction pieces play an important part in clinical treatment in Zhuhai Hospital.%目的:通过分析广东省中医院珠海医院(以下简称“珠海医院”)2011-2014年中药饮片和中药颗粒的使用情况,为合理制定采购计划、储备饮片、保障临床用药提供依据。方法利用珠海医院信息系统数据库中的2011-2014年中药饮片及中药颗粒相关销售数据,统计珠海医院2011-2014年中药饮片和中药颗粒的的销售量、销售金额排序前10位的类别和单味药。结果2011-2014年珠海医院中药饮片和中药颗粒的年使用量、金额呈增长趋势。中药饮片与中药颗粒的用量比、金额比、年销售量排序前10位的分类及品种保持基本稳定。结论珠海医院在中药使用过程中对中药品种、类别及剂型的选择已形成自己的特点,中药饮片是珠海医院中医临床治疗疾病的主要药物。

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Is there a role for academic medical centers in emerging markets?

    Science.gov (United States)

    Wiener, Charles M; Thompson, Steven J; Wu, Sandford; Chellappa, Mohan; Hasham, Salim

    2012-01-01

    Governments in emerging markets face mounting challenges in managing health spending, building capability and capacity, modernizing ageing infrastructure, and investing in skills and resources. One path to overcoming these challenges is to establish new public-private models of health care development and delivery based on United States academic medical centers, whose missions are to advance medical education and clinical delivery. Johns Hopkins Medicine is a participant in the collaboration developing between the Perdana University Hospital and the Perdana University Graduate School of Medicine in Malaysia. These two organizations comprise an academic health science center based on the United States model. The Perdana project provides constructive insights into the opportunities and challenges that governments, universities, and the private sector face when introducing new models of patient care that are integrated with medical education, clinical training, and biomedical research.

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

    Directory of Open Access Journals (Sweden)

    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

  10. [Information and Communication Technology in medicine in Italy: problems and perspectives. A document by the "e-cardio" area of the Italian Association of Hospital Cardiologists (ANMCO)].

    Science.gov (United States)

    Mantero, Antonio; Posteraro, Alfredo; Giordano, Guido; Tonti, Gianni; Pinciroli, Francesco

    2013-12-01

    In Italy, health protection is an individual right protected by the article 32 of the Constitution, granted to everyone since 1978 by the foundation of the National Health Service. However, regionalization of the healthcare system has caused noticeable discrepancies among the different areas of the country. The use of the Information and Communication Technology (ICT) may be useful to solve them. The purpose of this document is to analyze the implementation of ICT in Italy, on the basis of the suggestions given by the Italian Association of Hospital Cardiologists (ANMCO). In 2010, the Italian government introduced the electronic health record (EHR), which includes a minimum core of essential documents that should be created and updated by general practitioners. The obvious limitations of this methodology become clear in the urgency-emergency clinical setting, where the availability of particular clinical data may influence both patient prognosis and cost reduction. Also the privacy rules, currently very restrictive, cause a drawback in reliability of the data reported in the EHR, thus arising the need for a balance shift from privacy to health rights at the level of both the individual and the community. A minimum core of mandatory clinical data to be included in the EHR should be defined. No formal indications for filling out the medical records are available and most few experiences concern "bureaucratic documents" on the diagnostic and therapeutic process. Conversely, we believe that medical records should become a diagnostic and therapeutic tool that makes health rights uniform across the country. Each medical record form should include the following features: a simple interface, a mandatory association of clinical findings and reports, data portability and accessibility, and adherence of the information to a minimal dataset. Additionally, medical records data should merge into a modified EHR available at any time and place through network access points with

  11. Academic Jibberish

    Science.gov (United States)

    Krashen, Stephen

    2012-01-01

    In this article, the author talks about academic jibberish. Alfie Kohn states that a great deal of academic writing is incomprehensible even to others in the same area of scholarship. Academic Jibberish may score points for the writer but does not help research or practice. The author discusses jibberish as a career strategy that impresses those…

  12. Academic writing

    Science.gov (United States)

    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.

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Occurrence and molecular characteristics of methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus pseudintermedius in an academic veterinary hospital.

    Science.gov (United States)

    Ishihara, Kanako; Shimokubo, Natsumi; Sakagami, Akie; Ueno, Hiroshi; Muramatsu, Yasukazu; Kadosawa, Tsuyoshi; Yanagisawa, Chie; Hanaki, Hideaki; Nakajima, Chie; Suzuki, Yasuhiko; Tamura, Yutaka

    2010-08-01

    Recently, methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus pseudintermedius (MRSP) have been increasingly isolated from veterinarians and companion animals. With a view to preventing the spread of MRSA and MRSP, we evaluated the occurrence and molecular characteristics of each in a veterinary college. MRSA and MRSP were isolated from nasal samples from veterinarians, staff members, and veterinary students affiliated with a veterinary hospital. Using stepwise logistic regression, we identified two factors associated with MRSA carriage: (i) contact with an identified animal MRSA case (odds ratio [OR], 6.9; 95% confidence interval [95% CI], 2.2 to 21.6) and (ii) being an employee (OR, 6.2; 95% CI, 2.0 to 19.4). The majority of MRSA isolates obtained from individuals affiliated with the veterinary hospital and dog patients harbored spa type t002 and a type II staphylococcal cassette chromosome mec (SCCmec), similar to the hospital-acquired MRSA isolates in Japan. MRSA isolates harboring spa type t008 and a type IV SCCmec were obtained from one veterinarian on three different sampling occasions and also from dog patients. MRSA carriers can also be a source of MRSA infection in animals. The majority of MRSP isolates (85.2%) carried hybrid SCCmec type II-III, and almost all the remaining MRSP isolates (11.1%) carried SCCmec type V. MRSA and MRSP were also isolated from environmental samples collected from the veterinary hospital (5.1% and 6.4%, respectively). The application of certain disinfection procedures is important for the prevention of nosocomial infection, and MRSA and MRSP infection control strategies should be adopted in veterinary medical practice.

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

    Science.gov (United States)

    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.

  16. Errors in medicine administration - profile of medicines: knowing and preventing

    OpenAIRE

    Reis,Adriano Max Moreira; Marques, Tatiane Cristina; Opitz,Simone Perufo; Silva,Ana Elisa Bauer de Camargo; GIMENES, Fernanda Raphael Escobar; Teixeira,Thalyta Cardoso Alux; LIMA, Rhanna Emanuela Fontenele; Cassiani, Silvia Helena De Bortoli

    2010-01-01

    OBJECTIVES: To describe the pharmacological characteristics of medicines involved in administration errors and determine the frequency of errors with potentially dangerous medicines and low therapeutic index, in clinical units of five teaching hospitals, in Brazil. METHODS: Multicentric study, descriptive and exploratory, using the non-participant observation technique (during the administration of 4958 doses of medicines) and the anatomical therapeutic chemical classification (ATC). RESULTS:...

  17. Experiencing hospitality: an exploratory study on the experiential dimensions of hospitality

    NARCIS (Netherlands)

    Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.

    2015-01-01

    What is hospitality? Only few academic articles tap into the meaning of the concept of hospitality. Especially academic investigation of hospitality from a guest perspective is scarce; the combination of ‘hospitality’ and ‘experience’ has received hardly any attention. The present paper describes a

  18. Development of a medical academic degree system in China

    Directory of Open Access Journals (Sweden)

    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

  19. Aligning clinical compensation with clinical productivity: design and implementation of the financial value unit (FVU) system in an academic department of internal medicine.

    Science.gov (United States)

    Stites, Steven; Steffen, Patrick; Turner, Scott; Pingleton, Susan

    2013-07-01

    A new metric was developed and implemented at the University of Kansas School of Medicine Department of Internal Medicine, the financial value unit (FVU). This metric analyzes faculty clinical compensation compared with clinical work productivity as a transparent means to decrease the physician compensation variability and compensate faculty equitably for clinical work.The FVU is the ratio of individual faculty clinical compensation compared with their total work relative value units (wRVUs) generated divided by Medical Group Management Association (MGMA) salary to wRVUs of a similar MGMA physician.The closer the FVU ratio is to 1.0, the closer clinical compensation is to that of an MGMA physician with similar clinical productivity. Using FVU metrics to calculate a faculty salary gap compared with MGMA median salary and wRVU productivity, a divisional production payment was established annually.From FY 2006 to FY 2011, both total faculty numbers and overall clinical activity increased. With the implementation of the FVU, both clinical productivity and compensation increased while, at the same time, physician retention rates remained high. Variability in physician compensation decreased. Dramatic clinical growth was associated with the alignment of clinical work and clinical compensation in a transparent and equable process.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  2. 预备役医院转化医学技术创新体系建设思考%Thoughts on the construction of the technical innovative system of translational medicine in reserve hospitals

    Institute of Scientific and Technical Information of China (English)

    邓军; 徐迪雄; 罗长坤

    2013-01-01

    新军事变革引领了卫勤保障模式的变革,促成了预备役医院的建设.转化医学以其“从基础到临床、从创新到实践、从研究到应用”的独特作用,切合了预备役医院“立足市场、面向战场”从理念到实践、从局部到整体、从要素到体系的方方面面和时空的全维需求.技术创新是转化医学的核心,也是满足日益增长的战时卫勤保障需求的根本途径.因此,大力加强转化医学技术创新体系建设,不仅为预备役医院平时建设指明新方向、注入新活力,更是实现平战快速转换、高效发挥医学救援能力的重要保证.%New military transformation leads to the transformation of the mechanism of military medical service,and stimulates the development of reserve hospitals.Based on its unique function of "from basic medicine to clinical medicine,from innovation to practice,from research to application",translational medicine combines the concept of "base on market and face battlefield",it has satisfied the need of an all-round development.Technical innovation is the core of translational medicine,it is also the basic way to meet the growing demand of medical support in war time.Thus,to strengthen the construction of the technical innovative system of translational medicine not only provides a new guidance to the development of reserve hospitals,but also offers an important guarantee to the realization of effective hospital mobilization and medical relief effort.

  3. 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

    Directory of Open Access Journals (Sweden)

    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

  4. Adrenal insufficiency from over-the-counter medicine as a cause of shock in rural area of Thailand: a study at Sisaket Provincial Hospital during October 2012--October 2013.

    Science.gov (United States)

    Kamrat, Nuttamon

    2015-04-01

    This retrospective study was carried out to estimate the prevalence of an adrenal crisis at a provincial hospital in Thailand over a period of 1 year, and also to explore the relationship between adrenal insufficiency and over-the-counter medicine (OTCM) ingestion. We recruited those patients admitted at Sisaket Hospital between October 2012 and October 2013 who were diagnosed with shock and adrenal insufficiency or adrenal crisis. Of 2,435 patients diagnosed with shock from all causes, 62 (2.55 %) were diagnosed with adrenal crisis, of whom 31 (50.0%) gave a history of OTCM ingestion. This study suggests adrenal crisis with shock is not that uncommon and that the use of OTCM may be the prime culprit.

  5. Academic Words and Academic Capitalism

    Directory of Open Access Journals (Sweden)

    Michael Billig

    2013-03-01

    Full Text Available 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.

  6. 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.

    Science.gov (United States)

    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 .

  7. [Disaster medicine].

    Science.gov (United States)

    Carli, Pierre; Telionri, Caroline

    2015-01-01

    For over 30 years, the French hospital and pre-hospital medical teams are trained in disaster medicine. In fact, they are regularly confronted with the management of multiple casualties in accidents or even terrorist attacks, and more rarely to large-scale disasters. The intervention of physicians of the EMS system (SAMU-SMUR) in the field allows an original healthcare organization: in an advanced medical post, the victims are triaged according to their severity and benefit if needed of initial resuscitation. SAMU medical regulating center then organize their transport and repartition in several hospitals put on alert. To cope with a mass casualty situation, the hospital also has a specific organization, the White Plan. This plan, initiated by the director, assisted by a medico-administrative cell crisis can mobilize all the resources of the institution. Personnel are recalled and the ability of emergency units is increased. Care, less urgent, other patients are postponed. There are many plans for responding to disasters. ORSEC plans of the ministry of Interior articulate with the ORSAN plans of the ministry of Health. This complementarity allows a global mobilization of public services in disasters or exceptional medical situations.

  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)

    Energy Technology Data Exchange (ETDEWEB)

    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. 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

    Directory of Open Access Journals (Sweden)

    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

  10. Public traditional Chinese medicine hospitals cost accounting informatization cross-sectional study%中医医院成本核算信息化基本情况调查

    Institute of Scientific and Technical Information of China (English)

    徐静晗; 陈越; 蒋艳; 张舜瑞; 程薇

    2014-01-01

    目的:了解中医医院成本核算信息化的基本情况。方法对全国各省、自治区、直辖市所有公立中医医院进行成本核算信息化现状网络在线调查,并对调查结果进行数据分析。结果参与调查的1588家中医医院中,78.65%的医院存在软件配备不全面问题;57.43%的医院存在软件接口之间无法实现信息共享问题;43.20%的医院存在软件功能落后问题。医院信息系统(Hospital Information System, HIS)的配备率为81.86%,会计核算软件的配备率为87.09%,成本核算软件配备率为39.11%,尚未配备任何软件的占5.42%。收入数据统计到科室的医院占95%;支出数据统计到科室占80%;固定资产折旧费统计到科室占73.05%;无形资产摊销、医疗风险基金统计到科室的比例分别为51.39%和52.77%。内部服务量数据可统计到医疗辅助科室的医院占比要高于后勤服务科室,前者为81.49%,后者为63.85%。结论中医医院成本核算系统软件配备率不高。医院信息化建设存在系统软件配备不全面,软件系统之间无法实现信息共享等问题。%Objective To understand the basic situation and existing problems of cost accounting information construction in the traditional Chinese medicine hospital. Methods We made a cross-sectional study of all traditional Chinese medicine hospitals cost accounting informatization, and then analyzed the results. Results In the survey of 1588 traditional Chinese medicine hospitals, there exists the problem with 78.65%for limited software;57.43%for not sharing between the systems;43.20%for outdated software. The occupancy rate was 81.86%for HIS system, 87.09%for the accounting software, 39.11%for cost accounting software, 5.42%for none. The proportion of hospitals was over 95% whose income data statistics to department;80% for spending data;73.05%for fixed assets depreciation cost;51.39%for amortization of intangible assets and

  11. 近代安徽教会医院对西医传播的作用分析——以芜湖弋矶山医院为例%Analyzing the Function of Church Hospital to the Spread of Western Medicine in Modern Anhui——Take Wuhu Hospital as an Example

    Institute of Scientific and Technical Information of China (English)

    杨珊珊; 张晓丽

    2016-01-01

    In 1830s, foreign missionaries came to China and began to take medical activities as a means to preach, that is the medical missionary process. The medical activities of the missionaries have made good achievements in promoting the spread of western medicine in China. This paper takes Wuhu hospital as an example to analyze the medical system, medical service and social assistance in Wuhu hospital and research the function of church hospital to the spread of western medicine.%19世纪30年代,外籍传教医生来到中国,开始了以医疗活动为手段,以传教为目的的"医学传教"历程.传教士的医学活动取得可喜的成果,促进了西医学在华传播,以安徽芜湖医院为例,分析芜湖医院的医疗制度、医疗服务以及社会救助方面的情况,研究近代教会医院对西医传播的作用.

  12. 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.

    Science.gov (United States)

    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.

  13. 我院开展药物咨询工作的回顾与思考%Review and Reflection of Medicine Consultation in Our Hospital

    Institute of Scientific and Technical Information of China (English)

    徐咏; 李晶

    2013-01-01

    目的:通过开展药物咨询服务工作,提高儿科用药的合理性和安全性.方法:收集我院2009年12月至2011年6月的药物咨询记录,对咨询的内容及方式进行回顾性分析.结果:患几家属的咨询内容以用法用量、不良反应及注意事项为主,医护人员主要咨询药品规格、药物相互作用、药事管理等;咨询方式主要以窗口咨询为主,其次为电话咨询和网络咨询.结论:药物咨询是儿科药学服务的重要内容.提高药物咨询服务水平,可以增强患几用药的依从性,促进合理用药,改善医患关系.%Objective: To improve the rationality and safety of drug use in the department of pediatrics through the development of medicine consultation service. Methods: The records of medicine consultation service during 2009 December to 2011 June were collected; and the contents and methods of medicine consultation were analyzed. Results: Children's parents were mainly concerned about administrations, dosages, adverse reactions and notes of drugs. The medical personnel were mainly concerned about drug specifications, drug interactions, pharmaceutical management, etc. The main method of medicine consultation was encounter consultation, followd by telephone consultation and network consultation. Conclusions: The medicine consultation is important content of pharmaceutical care in the department of pediatrics. Improving the service of medicine consultation can strengthen drug compliance in children, promote rational drug use, and improve doctor-patient relationship.

  14. Deaths in an academic medical center.

    Science.gov (United States)

    Lagman, Ruth L; Walsh, Declan; Kunkle, Chad; LeGrand, Susan B; Davis, Mellar P

    2006-12-01

    The number of inpatient deaths in a calendar year in an academic medical center was reviewed from a computerized database. The total number was 1222. The median length of hospital stay for those who died was 7 days (range, 1-190); 404 (33%) were 75 years or older. There were 678 (55%) males and 544 (45%) females. The pulmonary medicine service had the most deaths with 290 (24%) followed by hematology/oncology 230 (18%). The most common primary diagnoses in the decedents were subendocardial infarction 58 (5%), congestive heart failure 57 (5%), and pneumonia 45 (4%). The most common diagnostic-related groups (DRGs) were respiratory system disorders (475), 98 (8%); tracheostomy (483), 75 (6%); and heart surgery (110), 65 (5%). Frequent procedures done prior to death were mechanical ventilation (96 hours) 55 (5%), and tracheostomy 54 (4%). Invasive procedures were common. Forty-five percent of the predeath patient days were spent in intensive care units. Palliative medicine was involved in the care of 20% of all the decedents.

  15. The impact of the Tulane-HCA joint venture on academic and clinical missions.

    Science.gov (United States)

    Whitecloud, T S; Smathers, J E; Barrack, R L

    2001-10-01

    As with any joint venture in any given industry, positive and negative impacts are felt. Tulane University School of Medicine experienced impacts on its academic and clinical missions as a result of the joint venture between Tulane University and HCA, a for-profit public company. The laws of business had entered the halls of medicine. Although patients, personnel, and physicians experienced culture shock and inconveniences, Tulane University School of Medicine has been able to maintain viable training programs, and its faculty physicians have a hospital and corporately run clinics across the street. In addition, multidisciplinary centers of excellence, long spoken of in the academic realm, came to fruition through the corporate world. This may not have been the case, had Tulane University not entered into ajoint venture with HCA. Is it worth the effort? For Tulane University, whether one likes the entire package or not, the answer must be yes. The greatest impact is that the orthopaedic surgeons still are in a position to fulfill their academic and clinical missions.

  16. 京津冀著者医院管理论文文献计量学研究%BIBLIOMETRICS STUDY ON ACADEMIC PAPERS OF HOSPITAL MANAGEMENT OF THE AUTHOR IN ;BEIJING-TIANJIN-HEBEI

    Institute of Scientific and Technical Information of China (English)

    鲍冬旭; 杨涛; 栾奕

    2016-01-01

    院,总计147篇文章。结论根据对2010—2014年京津冀及其各地区医院管理论文年度数量、载文期刊、著者等情况结果研究分析,得出京津冀地区医院管理学科学术发展平稳,但是在作者群和发文期刊的影响力等方面仍存在诸多问题。%Objective To research the development of hospital management in Beijing-Tianjin- Hebei re-gions,and to provide valuable information for the hospital management,and to promote the innovation of hospital management and the coordinated development of health in Beijing-Tianjin- Hebei.Methods This research retrieved the hospital management literature in Beijing,Tianjin and Hebei from January 2010 to December 2014.And by checking sort of health management and domestic related databases,a database was established,and then the data was analyzed by using BICOMB2.0,SPSS13.0,and Microsoft Excel software.This research was focus on the annual number of areas,papers journals,authors,and identifying the intrinsic link from the data.Results ①During five years(2010-2014),the total amount of paper fo-cus on hospital management in Beijing-Tianjin-Hebei region was 12 160,which published in Beijing are-a,Tianjin and Hebei area were 8 161,1 354,and 2 645 respectively.The number of papers and the speed of the development of Beijing,Tianjin and Hebei on medical and health services were basically consistent, and there were obvious differences between the stages and the regions.②In Beijing,hospital management articles commonly published in"Chinese Hospital Dean","Chinese Hospital","Chinese Medical Record";In Tianjin,hospital management articles published most commonly in"China Urban and Rural Industrial","Tianjin Journal of Nursing" ,"Medical Equipment Magazine";In Hebei,hospital management articles published most commonly in journals of the"Hebei Medicine","Rational Drug Use" ,"Chinese Journal of Misdiagnosis".Journal papers scattered dozen professional journals cover only less than half of hospital

  17. Situation of Integrative Medicine in China:Results from a National Survey in 2004

    Institute of Scientific and Technical Information of China (English)

    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.

  18. Incidence and recognition of malnutrition in hospital.

    OpenAIRE

    1994-01-01

    OBJECTIVES--To determine incidence of malnutrition among patients on admission to hospital, to monitor their changes in nutritional status during stay, and to determine awareness of nutrition in different clinical units. DESIGN--Prospective study of consecutive admissions. SETTING--Acute teaching hospital. SUBJECTS--500 patients admitted to hospital: 100 each from general surgery, general medicine, respiratory medicine, orthopaedic surgery, and medicine for the elderly. MAIN OUTCOME MEASURES-...

  19. Analysis and Improvement Measures of Medicine Loss of Single Oral Dose Dispensing in Our Hospital%我院单剂量口服摆药药品损耗情况分析及改进措施

    Institute of Scientific and Technical Information of China (English)

    许晶晶; 袁明奎; 李景庄; 樊萍

    2013-01-01

    OBJECTIVE:To provide reference for minimizing drug loss.METHODS:By retrospective analysis,medicine loss of single oral dose dispensing in our hospital during Jul.2011-Jun.2012 were summarized,and the experiences were also summarized to formulate related measures,and then the effect of measures were re-evaluated.RESULTS & CONCLUSIONS:The causes of medicine loss can be classified into four types:dismounting peeling medicine loss (22.6%),splitting operating loss (25.1%),medicine packaging machine loss (32.1%),incorrect drug storage or out of date after dismounted (20.2 %).The ratio of destroyed tablets decreased from 3.72‰ to 1.55‰ through related improvement measure,including establishing perfect work system and operation standard,carrying our staff training and examination,improving working environment of medicine packaging machine,enhancing management of dismounted medicine,etc.It is suggested that pharmacists should strictly regulate the dismounting medicine process,sum up experience and implement different drugs dismounting and splitting method according to different pills during single oral dose dispensing process; strengthen validity and quality management of dismounted medicines; regularly strengthen the maintenance and overhaul of medicine packaging machine to reduce medicine loss caused by machine stoppage.%目的:为减少药品损耗提供参考.方法:回顾性分析我院2011年7月-2012年6月单剂量口服摆药过程中发生的药品损耗情况并进行归纳整理,总结经验并制订相关措施予以改进,再评价成效.结果与结论:损耗原因可归为拆零剥药损耗(22.6%)、分劈操作损耗(25.1%)、包药机包药损耗(32.1%)及拆零后药品保管不当或过期损耗(20.2%).通过建立完善的工作制度和操作规范、对人员进行培训考核、改善包药机的工作环境、加强拆零药品的管理等改进措施,使损耗片(粒)数占总摆药片(粒)数的比例从3.72‰降为1.55‰.

  20. National Center for Disaster Medicine and Public Health

    Data.gov (United States)

    Federal Laboratory Consortium — The National Center for Disaster Medicine and Public Health (NCDMPH) is an academic center tasked with leading federal, and coordinating national, efforts to develop...

  1. 上海市某三级中西医结合医院战略规划的制定%Strategic planning in a Chinese and western medicine integrated hospital in Shanghai

    Institute of Scientific and Technical Information of China (English)

    王杰宁; 林研; 纪颖; 薛迪

    2016-01-01

    目的:根据战略管理理论,在全面分析上海市某三级中西医结合医院(A医院)的内外环境基础上,制定A医院的发展战略。方法:收集现有资料,对A医院进行机构问卷调查和管理者焦点组访谈。结果:A医院发展面临机遇与挑战,内部发展既有优势也存在劣势;A医院初步制定了适应内外环境的战略规划。结论:A医院应继续发挥优势,增强医院的竞争能力,使医院发展符合国家、上海市和浦东新区医疗服务需要,满足人民群众的医疗服务需求。%Objective:To make a strategic plan for A hospital based on the theory of strategic management and comprehensive analysis on internal and external environments of one tertiary Chinese and western medicine integrated hospital(Hospital A)in Shanghai. Methods:Existing data were collected,a questionnaire survey was conducted,and focus group discussions of 31 hospital managers were made. Results:There were opportunities and threats in the external environments for the development of Hospital A,and there were strengths and weaknesses in the internal environments. Hospital A drafted a strategic plan according to internal and external environment. Conclusion:It is suggested that Hospital A continue to utilize its strengths and enhance its competitive competence in order to meet the medical needs of the country,Shanghai and Pudong New Area and to satisfy the patient demands for medical care.

  2. Extreme, expedition, and wilderness medicine.

    Science.gov (United States)

    Imray, Christopher H E; Grocott, Michael P W; Wilson, Mark H; Hughes, Amy; Auerbach, Paul S

    2015-12-19

    Extreme, expedition, and wilderness medicine are modern and rapidly evolving specialties that address the spirit of adventure and exploration. The relevance of and interest in these specialties are changing rapidly to match the underlying activities, which include global exploration, adventure travel, and military deployments. Extreme, expedition, and wilderness medicine share themes of providing best available medical care in the outdoors, especially in austere or remote settings. Early clinical and logistics decision making can often have important effects on subsequent outcomes. There are lessons to be learned from out-of-hospital care, military medicine, humanitarian medicine, and disaster medicine that can inform in-hospital medicine, and vice-versa. The future of extreme, expedition, and wilderness medicine will be defined by both recipients and practitioners, and empirical observations will be transformed by evidence-based practice.

  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

    Directory of Open Access Journals (Sweden)

    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. Personality, academic majors and performance

    DEFF Research Database (Denmark)

    Vedel, Anna; Thomsen, Dorthe Kirkegaard; Larsen, Lars

    2015-01-01

    Personality–performance research typically uses samples of psychology students without questioning their representativeness. The present article reports two studies challenging this practice. Study 1: group differences in the Big Five personality traits were explored between students (N = 1067......) in different academic majors (medicine, psychology, law, economics, political science, science, and arts/humanities), who were tested immediately after university enrolment. Study 2: six and a half years later the students’ academic records were obtained, and predictive validity of the Big Five personality...... traits and their subordinate facets was examined in the various academic majors in relation to Grade Point Average (GPA). Significant group differences in all Big Five personality traits were found between students in different academic majors. Also, variability in predictive validity of the Big Five...

  5. Evaluation of the effectiveness of postgraduate general medicine training by objective structured clinical examination---pilot study and reflection on the experiences of Kaohsiung Medical University Hospital.

    Science.gov (United States)

    Tsai, Jer-Chia; Liu, Keh-Min; Lee, Kun-Tai; Yen, Jo-Chu; Yen, Jeng-Hsien; Liu, Ching-Kuan; Lai, Chung-Sheng

    2008-12-01

    Objective structured clinical examination (OSCE) is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1) residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman) with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five-point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self-evaluation on performance by examinees revealed significantly lower global ratings on post-course OSCE (4.14 +/- 0.80 vs. 3.68 +/- 0.66; p OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 +/- 0.17 vs. 4.0 +/- 0.12, nonsignificant). However, a survey of the examinees completed at pre- and post-course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 +/- 0.09 vs. 3.7 +/- 0.18; p clinical reasoning performance, communication skills (giving bad news) and self-confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a rational and feasible assessment method for evaluating the effectiveness of our PGY general medicine training program. The quantitative data and qualitative information provide a foundation to improve the quality of the program design and evaluation

  6. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  7. Challenges in contemporary academic neurosurgery.

    Science.gov (United States)

    Black, Peter M

    2006-03-01

    Traditionally, the ideal academic neurosurgeon has been a "quadruple threat," with excellence in clinical work, teaching, research, and administration. This tradition was best exemplified in Harvey Cushing, who developed the field of neurosurgery 90 years ago. This paradigm will probably have to change as academic neurosurgeons face major challenges. In patient care, these include increasing regulatory control, increasing malpractice costs, consolidation of expensive care in academic centers, and decreasing reimbursement; in resident teaching, work hour limitations and a changing resident culture; in research, the increasing dominance of basic scientists in governmental funding decisions and decreased involvement of neurosurgeons in scientific review committees; and in administration, problems of relationships in the workplace, patient safety, and employment compliance in an increasingly bureaucratic system. To meet these challenges, the new academic neurosurgeon will probably not be a quadruple threat personally but will be part of a quadruple threat in a department and institution. Neurosurgeons in such a setting will have to work with hospital, medical school, and national and international groups to address malpractice, reimbursement, subspecialization, and training problems; find supplemental sources of income through grants, development funds, and hospital support; lead in the development of multidisciplinary centers for neuroscience, brain tumor, spine, and other initiatives; and focus on training leaders for hospital, regional, and national groups to reconfigure neurosurgery. Collaboration, flexibility, and leadership will be characteristic of the academic neurosurgeon in this new era.

  8. Software Program Reconstructions of Automatic Medicine Packing Machine in Our Hospital%我院全自动药品分包机的软件程序改造

    Institute of Scientific and Technical Information of China (English)

    邓思韵; 王玉紫; 梁嘉俊; 吴昭仪

    2016-01-01

    OBJECTIVE:To promote the working performace of automatic medicine packing machine in our hospital. METH-ODS:Combined with the problems we met in the use of the automatic medicine packing machine,the reconstructions of software functions,such as drug inventory management,drug identification,specific drug sub-package and document printing of non-pack-age drug,were introduced. Related indicators were compared before and after reconstruction. RESULTS:After the software recon-struction,compared with 2012,loss events of expire drug due to poor sales fell by 70% in 2013;drug dispensing errors related to medicine packing machine dropped by 1/2;the time of drug checking shortened by 1/5. CONCLUSIONS:The software program re-construction of automatic medicine packing machine can improve the work efficiency of pharmacy and the accuracy of drug dispens-ing,further guarantee the quality and safety of drugs,and meet the practical demand of our hospital.%目的:提升全自动药品分包机的工作性能.方法:结合在使用全自动药品分包机中遇到的实际问题,介绍我院在分包机库存管理、药品标识、特定药品分包、不分包药品单据打印这4个软件功能的改造情况,并比较改造前后的相关指标.结果:经改造分包机软件后,与2012年比较,2013年因机内药品滞销而过期的报损事件减少了70%;与分包机相关的药品配发差错减少1/2;药品核对时间缩短了1/5.结论:我院对全自动药品分包机的软件程序改造,有效提高了药房的工作效率与摆药的准确率,进一步确保了药品的质量安全,更切合我院的实际工作需求.

  9. Academic Libraries

    Science.gov (United States)

    Library Journal, 1970

    1970-01-01

    Building data is given for the following academic libraries: (1) Rosary College, River Forest, Illinois; (2) Abilene Christian College, Abilene, Texas; (3) University of California, San Diego, La Jolla, California. (MF)

  10. 品管圈在降低我院门诊药房药品过期损耗中的应用%Application of quality control circle in reducing the loss rate of expired medicine in our hospital

    Institute of Scientific and Technical Information of China (English)

    崔晋涛; 刘萍; 曹媛媛; 柴栋

    2014-01-01

    [ABSTRACT]Objective:To explore the effect of quality control circle (QCC) activity in reducing the medicine loss caused by expiration.Methods:Each step was carried out according to QCC. Speciifcally, brainstorming method was applied to analyze the reason of a high level for the expired medicine, ifshbone diagram and association graph were used to explore solutions and evaluate tangible results (reported loss rate of expired medicine), while radar diagram was adopted for assessing intangible outcomes (ability of QCC) and formulating standardized process.Results:The results strongly suggested that the major reasons for high loss rate of expired medicine were the inefifcient communication with doctors about medicine information, the careless omission in pharmacists' work, the frequent change of medicine speciifcation, producer, batch number and the commercial distribution of medicines which were close to the expired date, etc. Corresponding working system and many measures were brought into working process of medicine conservation to improve the situation. As a result, the reported loss rate of the expired drug decreased from 0.230% to 0.021%. Some remarkable elevations in terms of QCC skills, sense of responsibility, team spirit, capability of communication and coordination were registered. Conclusion: Implementation of QCC plays an important role in reducing ratio of the overdue medicines in our hospital.%目的:探讨品管圈活动对降低药品过期造成的药品损耗的效果。方法:成立品管圈,按照品管圈的步骤实施各项活动,运用头脑风暴法分析产生药品过期损耗高的原因,采取鱼骨图及关联图手法探讨解决的对策并实施,评价有形成果(过期药品报损率),采用雷达图评价无形成果(圈能力)。结果:我院过期药品损耗率高的主要原因是医生获得药品信息不.,药师工作有疏漏,频繁更换药品规格、厂家、批号及商业配送近效期药

  11. 2012-2014年上海长征医院抗肿瘤中药注射剂使用情况分析%Utilization of Antitumor Traditional Chinese Medicine Injections in Shanghai Changzheng Hospital during 2012-2014

    Institute of Scientific and Technical Information of China (English)

    刘震; 葛卫青; 陈万生; 陶霞

    2015-01-01

    目的:了解上海长征医院(以下简称“我院”)抗肿瘤中药注射剂的临床使用情况,为安全、有效、经济地使用抗肿瘤中药注射剂提供参考。方法:检索住院药房医院信息管理系统数据库,采用金额排序法和限定日剂量分析法对我院2012—2014年抗肿瘤中药注射剂的应用情况进行统计分析。结果:2012—2014年,我院抗肿瘤中药注射剂的销售金额和用药频度( DDDs)逐年增加,销售金额占各年中药注射剂总销售金额的比例分别为75.3%、72.9%、73.4%;3年来,康艾注射液的销售金额和DDDs均稳居首位。结论:近年来,抗肿瘤中药注射剂的使用量增长迅速,须加强用药管理和不良反应监测。%OBJECTIVE:To investigate the utilization of antitumor traditional Chinese medicine injections (ATCMI) in Shanghai Changzheng Hospital(hereinafter referred to as “our hospital”) during 2012-2014 period for references of clinical safe, effective and economical use of drugs.METHODS: The utilization data of ATCMI in our hospital during 2012-2014 were retrieved from hospital information management system for statistical analysis by ranking consumption sum and defined daily dose ( DDD) .RESULTS:The consumption sum of ATCMI in our hospital during 2012-2014 increased year by year, accounting for 75.3%, 72.9% and 73.4%, respectively of the total consumption sum of TCM injections.Kangai injection took the lead in terms of both consumption sum and DDDs over the 3 years.CONCLUSIONS:The consumption of antitumor traditional Chinese medicine injections witnessed a rapid increase in recent years.It is urgent to tighten management on drug use and monitoring on adverse drug reactions.

  12. Core competencies in internal medicine.

    Science.gov (United States)

    Porcel, José Manuel; Casademont, Jordi; Conthe, Pedro; Pinilla, Blanca; Pujol, Ramón; García-Alegría, Javier

    2012-06-01

    The working group on Competencies of Internal Medicine from the Spanish Society of Internal Medicine (SEMI) proposes a series of core competencies that we consider should be common to all European internal medicine specialists. The competencies include aspects related to patient care, clinical knowledge, technical skills, communication skills, professionalism, cost-awareness in medical care and academic activities. The proposal could be used as a working document for the Internal Medicine core curriculum in the context of the educational framework of medical specialties in Europe.

  13. 我国中医医院资源与经济运行情况简析%1003 -0743 (2011 )09-0051-03Resources and Economic Performance Analysis of Traditional Chinese Medicine Hospitals in China

    Institute of Scientific and Technical Information of China (English)

    孙晓东; 郑格琳; 陈思; 杨永生; 李金芳; 陈珞珈

    2011-01-01

    通过对2005-2009年我国中医医院机构、人员、床位、设备、房屋面积等基本信息,以及医院的收入、支出、资产与负债等经济运营情况进行讨论分析,了解目前中医医院的发展现状,提出建议.%Through analyzing organizations, personnel, sickbeds, equipments, housing area, income, expenses, assets, liabilities and other economic operation of traditional Chinese medicine hospitals in China from 2005 to 2009, development status of them is expected to known and some suggestions are proposed.

  14. 天津市儿童医院门诊中草药处方用药情况分析%Analysis of Outpatient Prescriptions of Chinese Herb Medicine in Tianjin Children's Hospital

    Institute of Scientific and Technical Information of China (English)

    孙燕燕

    2012-01-01

    Objective: To analyze the outpatient prescriptions of Chinese herb medicine in Tianjin Children's Hospital, and provide references for clinical rational drug use. Methods: Together 2,655 outpatient prescriptions of Chinese herb medicine, collected from November 2010 to April 2011 (three days at the beginning, middle and end of each month) , were investigated according to the relevant provisions of the ' prescription management' , the prescriptions were classified and statistically analyzed. Results: The top 25 most common used herbs were antitussive, expectorant and antiasthmatic drugs, followed by antipyretic. Conclusions: The children with asthma, cough, and sputum laden are the host using Chinese herb medicine treatment. It is suggested that for the promotion of rational Chinese herb medicine use, more attention should be paid to the dispensing and procurement of these types of Chinese herbs, and a practical prescription management method for Chinese herb medicine should be developed.%目的:统计天津市儿童医院中药房中草药处方用药,为临床合理用药提供参考.方法:收集2010年11月~2011年4月每月月初、月中、月末各3d的门诊处方2 655张,以《处方管理办法》中的相关规定为标准,对处方进行分类分析.结果:使用量最大的前25种饮片多为止咳化痰平喘药,其次为清热药.结论:咳嗽挟痰气喘的患儿是采用中草药治疗的主体,提示今后中草药的采购、调剂应有侧重,制定切实可行的中草药处方管理办法,以促进中草药的临床合理应用.

  15. Establishment and practice of diabetic specialized nursing team in grassroots traditional Chinese medicine hospital%基层中医院糖尿病专科护理小组的建立与实践

    Institute of Scientific and Technical Information of China (English)

    何锦坚; 雷慧

    2013-01-01

    目的 探讨基层中医院糖尿病专科护理小组的建立及实践效果.方法 成立糖尿病专科护理小组并组织培训,专科小组通过收集问题、护理会诊、护理查房、义诊活动等完善其运作模式.结果 护理会诊率、专科护理质量及患者满意度均提升(P<0.01).结论基层中医院糖尿病专科护理小组的成立及规范管理,可提高护理质量及患者满意度,有利于护理人才的培养,促进专科护理的发展.%Objective To explore the practice and effects of diabetic specialized nursing team in diabetic traditional Chinese medicine hospital.Methods Diabetic specialized nursing team was established and the members were trained.The operation mode included collecting problems,nursing consultation,nursing ward rounds and free clinic activities,etc.Results After the foundation of diabetic specialized nursing team,the rate of nursing consultation,specialized nursing quality and patient satisfaction all improved (P<0.01).Conclusion The establishment and standardized management of diabetic specialized nursing team in grassroots traditional Chinese medicine hospital can improve the nursing quality and patient satisfaction,and is beneficial for the training of nursing staffs and can promote the development of specialized nursing.

  16. The Problems and Strategies for Hospital Medicine Management and Cost Accounting%医院药品管理与成本核算存在问题及对策

    Institute of Scientific and Technical Information of China (English)

    韦健

    2013-01-01

    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.%  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。

  17. Infecção do trato urinário em pacientes internados em clínica médica de um hospital universitário | Urinary tract infection in hospitalized patients in internal medicine of a university hospital

    Directory of Open Access Journals (Sweden)

    Écila Campos Mota

    2017-02-01

    Full Text Available Objetivo: Avaliar a incidência e os fatores associados à infecção do trato urinário associados ao Cateter Vesical em adultos internados em clínica médica, bem como identificar a taxa de utilização, frequência do registro do pedido de inserção e retirada, adequação do uso em termos da indicação e do tempo de permanência do Cateter Vesical. Método: Trata-se de uma coorte prospectiva desenvolvida em um hospital universitário de Minas Gerais. Análises univariadas foram realizadas através do teste Qui-quadrado ou teste exato de Fisher para variáveis categóricas e teste não paramétrico de Mann-Whitney para variáveis numéricas. Resultados: Durante dez meses foram internados um total de 1.121 pacientes, desses, 63 (5,6% fizeram o uso do Cateter Vesical, correspondendo a 880 Cateter Vesical/dia. A incidência de Infecção do Trato Urinário associada ao Cateter Vesical foi de 31,7%. Os resultados identificaram associações positivas entre ocorrência de infecção do trato urinário com o tempo de permanência hospitalar e tempo de uso do Cateter Vesical. Conclusão: A conduta frente à indicação de uso do Cateter Vesical deve ser criteriosa, desde a avaliação da recomendação, inserção, manutenção e a sua retirada o mais brevemente possível, garantindo a segurança do paciente. ========================================================= Objective: The aim of this study was to evaluate the incidence and the factors related to catheter-associated urinary tract infection in adults who were hospitalized in the internal medicine service, and to identify catheter utilization rates, frequency of the register of order of insertion and removal, adequacy of use in terms of indication, and catheter vesical length of permanence. Method: This is a prospective cohort study conducted at a university hospital in Minas Gerais. Univariate analyses were performed using the chi-squared test or Fisher’s exact test for categorical

  18. Analysis on the reasons of medicine-return in a hospital pharmacy and corresponding countermeasures%某医院病房药房退药原因分析及对策

    Institute of Scientific and Technical Information of China (English)

    张海荣; 艾登滨

    2014-01-01

    目的:分析某医院病房药房退药原因,提出解决对策,减少患者用药隐患。方法对某医院病房2013年7月~12月的退药品种和原因进行统计和分析。结果每个科室都有退药,其中退药平均每月3万元以上的科室依次是ICU、普外科、神经内科、呼吸科、肝胆外科,占本科用药的比例前5名的依次为ICU6.82%、消化科3.62%、呼吸科3.02%、心内科2.97%、肾内科2.68%。结论各种原因导致退药,有些原因如医嘱录入错误等为主观原因,可通过加强责任心和增加复核等减小出现频率;部分原因如患者死亡、过敏等为客观原因,是无法避免的。%Objective This paper aims to analyze the reasons of returning medicines in a hospital pharmacy, puts forward countermeasures, so as to reduce the hidden danger in the use of medication. Methods The specific method is to count and analyze what kinds of medicines were returned in a hospital pharmacy from July to December of 2013 and discuss what the reasons are. Results The analysis shows that medicine-returned takes place in all departments. In some of these departments the sum of refunded money amounts to 30,000 RMB. They are ranked in accordance with the refunded total as follows:ICU, general surgery department, neurology department, respiratory department, and hepatic surgery department. The top 5 departments which rank high according to the proportions of the returned medicines to the sold medicines are as follows:ICU(6.82%), gastroenterology department(3.62%), respiratory department(3.02%), cardiology department(2.97%), and nephrology department(2.68%). Conclusions Various causes contribute to the phenomenon of medicine-returned. There are some subjective reasons, such as errors in inputting doctor’s prescriptions. These can be improved by intensifying the sense of responsibility and double-checking all the figures. Some reasons are objective, such as the death or the allergy of the

  19. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  20. The application of hospitality elements in hospitals.

    Science.gov (United States)

    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.

  1. 浙江省中医医院信息化建设现状分析及建议%Analysis of current situation of informatization construction at Traditional Chinese Medicine Hospitals in Zhejiang Province and suggestions

    Institute of Scientific and Technical Information of China (English)

    杨伟吉

    2013-01-01

    Based on a questionnaire survey , field visit and investigation of informatization construction of the 89 Traditional Chinese Medicine hospitals in Zhejiang , this paper summarizes the achievements made in informatization construction in these hospitals .By using the statistics , it analyzes the problems and shortages regarding informatization awareness , capital investment , management mode , overall planning , industry standard and talents training . Finally it puts forward corresponding countermeasures and solutions .%通过问卷调查,结合实地考察,在调查浙江省89所中医医院信息化建设情况的基础上,对全省中医医院信息化建设的成果给予总结,通过统计数据分析了在信息化认识、资金投入、管理模式、整体规划、行业标准、人才培养等方面存在的问题和不足,并提出相应对策和解决方法。

  2. Management of the Validity Period of Drugs in Pharmacy of Tonghua Traditional Chinese Medicine Hospital%通化市中医院西药房药品的有效期管理

    Institute of Scientific and Technical Information of China (English)

    张桂英

    2016-01-01

    目的:探讨如何加强医院西药房药品的有效期管理.方法:介绍吉林省通化市中医院(以下简称"我院")采用专业电脑软件管理联合人工管理措施,对医院西药房药品的有效期进行管理的方法.结果与结论:通过计算机软件,可对医院西药房药品库存及消耗情况进行查询,设置药房药品的上、下限,对药房未消耗药品进行查询,对药房药品批号及药品有效期进行查询,以及对药房药品有效期进行预警;辅以人工管理措施,严格检查进入药房药品的有效期,划分区域、责任到人,利用好有色标签,加强口服摆药的有效期管理,可以较好地实现对西药房药品的有效期管理.%OBJECTIVE:To investigate how to strengthen the management of the validity period of drugs in hospital pharmacy .METHODS:Professional computer software combined with manual management measures were adopted in the management of the validity period of drugs in hospital pharmacy of Jilin Tonghua Traditional Chinese Medicine Hospital(hereinafter referred to as "our hospital").RESULTS&CONCLUSIONS: The inventory and consumption of drugs in hospital pharmacy could be inquired through the computer software; the upper and lower pharmacy drugs could be set;and unused drugs , batch number and validity period of drugs also could be inquired; early-warning of validity period of drugs could be set .Combined with artificial management measures , validity period of drugs were checked strictly before entering the pharmacy , each person took responsibility for each area , color labels were used in this management .It is necessary to strengthen the validity period of oral drugs , which could help to realize the valid management of drugs in pharmacy .

  3. Expatriate academics

    DEFF Research Database (Denmark)

    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 fill...... some of the gaps. Design/methodology/approach – A questionnaire was directed electronically towards expatriate academics occupying regular positions in science faculty departments in universities in northern Europe. Findings – Results showed that job clarity was the dominating job factor with strong...... relationships with all of the five investigated work outcome variables, work adjustment, work performance, work effectiveness, job satisfaction, and time to proficiency. Job conflict and job freedom had an association with some of the work outcome variables but not with all of them. Neither workload nor job...

  4. Development strategy of traditional Chinese medicine hospitals and the path of transformation mode%中医医院发展的战略转型模式与路径探讨

    Institute of Scientific and Technical Information of China (English)

    史文川; 丁政; 赵宁; 朱佩枫; 魏鲁霞; 申俊龙

    2012-01-01

    In recent years, traditional Chinese medicine hospitals in China has been enjoying good policy and social economic environmentand are catching the best opportunities for development. While, there are also problems such as the ambiguous strategic transformation ideas. The causes of strategic transformation in traditional Chinese hospital have been analyzed in aspects of health economic driven, public interest oriented health system reform and the need of social management innovation. An new mode of strategic transformation based on Resource-Based View and Strategic Alliance Theory in traditional Chinese medical hospital has been presented and the path of transformation has been discussed in aspects of organization mechanism, driven mechanism and constraint mechanism.%当前我国中医医院进入历史最佳发展机遇期,政策、社会经济利好局面持续显现,但同时中医医院发展也存在战略转型思路不清晰等问题.从卫生经济学动因、新医改公益性导向、社会管理创新的需要三个方面分析了中医医院战略转型的动因,提出基于资源基础观和战略联盟理论构建中医医院战略转型新模式,并从组织机制、驱动机制、约束机制等方面探索中医医院发展的战略转型路径.

  5. The Effect of Medicinal Education on Adherence Taking Warfarin in Acute Coronary Syndrome (ACS and Atrial Fibrilation (AF Patients at PKU Muhammadiyah Yogyakarta Hospital

    Directory of Open Access Journals (Sweden)

    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.

  6. 我院病房退药情况及相关用药差错分析%Analysis of Returned Medicine and Related Medication Errors in Our Hospital

    Institute of Scientific and Technical Information of China (English)

    关颖卓; 邵宏

    2011-01-01

    OBJECTIVE: To investigate medication workflow and to analyze the situation of returned medicines and that resulted from medication errors.METHODS: The medication workflow was designed by means of direct observation.The number of returned medicine application, types and influencing factors of returned medicine in wards from Jan.to Jun.in 2010 were analyzed retrospectively.Returned medicines resulted from medication error was analyzed according to ASHP medication error classification.RESULTS: Medication workflow of our hospital involved 6 kinds of staff, such as physicians, nurse and pharmacist.There were 13 links of medication workflow, such as physician diagnosis, drug selection of physician and medication order entering.There were some unreasonable links and excessive intermediate link.Returned medicine of wards occupied 10.44% of average number of inpatient prescription.Main reasons of returned medicine were drug withdrawal or change, patient discharge and patient death, etc.Returned medicines resulted from medication error accounted for 6.45%.The types of medication error were prescribing error, compliance error and others.Main reasons of medication error were system defect and lacking of effective communication between patients and medical staff.CONCLUSION: It is suggested to improve medication workflow and strengthen the communication among physicians, nurses and patients to reduce and aviod the occurrence of drugs returned to pharmacy.%目的:探讨我院用药流程,分析病房退药情况及因用药差错导致退药的情况.方法:用直接观察法.绘制我院用药流程图,并对2010年1-6月内病房退药申请单的数量、退药品种数、退药影响因素等进行回顾性分析,参照美国卫生系统药师协会(ASHP)用药差错分类,重点分析因用药差错导致的退药.结果:我院用药流程涉及人员有医师、护士、药师等6类,环节有医师诊断、医师选药、医师录入医嘱等13个,存在部分环节

  7. 呼吸内科住院患者口腔感染调查及危险因素分析%Risk factors for oral infections in hospitalized patients of department of respiratory medicine

    Institute of Scientific and Technical Information of China (English)

    谢云; 诸兰艳; 范杜

    2014-01-01

    目的:了解呼吸内科住院患者口腔感染的感染率、病原菌分布及其相关危险因素,为防治呼吸内科住院患者口腔感染提供科学依据。方法回顾性调查医院呼吸内科2010年1月-2011年12月收治的2908例住院患者临床资料,对口腔感染危险因素进行单因素分析,并对差异有统计学意义的因素行 logistic多因素回归分析,所有数据采用SPSS 11.0软件进行统计分析。结果呼吸内科住院患者口腔感染55例,感染率为1.9%;其中以口腔假丝酵母菌属感染最多见,占72.73%,检出病原菌以白色假丝酵母菌为主,占84.21%;单因素及 logistic多因素回归分析表明,恶性肿瘤和吸入激素是口腔感染的独立危险因素。结论呼吸内科住院患者口腔感染感染率较高,以口腔黏膜假丝酵母菌感染最为常见,医护人员应根据其特点采取有效措施加以预防控制。%OBJECTIVE To investigate the incidence of oral infections in hospitalized patients of department of respiratory medicine ,distribution of pathogens ,and related risk factors so as to provide guidance for prevention of oral infections .METHODS The clinical data of 2 908 patients who were hospitalized in the department of respirato-ry medicine from Jan 2010 to Dec 2011 were retrospectively investigated ,then the univariate analysis was conduc-ted for the risk factors for the oral infections ,the multivariate logistic regression analysis was performed for the factors that had significant differences ,and all the data were analyzed with the use of SPSS 11 .0 software . RESULTS The oral infections occurred in 55 cases of hospitalized patients with the infection rate of 1 .9% ,among which 72 .73% were infected with oral Candida .Candida albicans was the predominant species of pathogen , accounting for 84 .21% .The univariate analysis and multivariate logistic regression analysis indicated that the malignant tumor and inhaled

  8. Aerospace Medicine

    Science.gov (United States)

    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.

  9. Nuclear Medicine.

    Science.gov (United States)

    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)

  10. Utilization of Chinese patent medicines for respiratory system in Beijing Hospital during 2008 -2010%2008-2010年北京医院呼吸系统用中成药用药研究

    Institute of Scientific and Technical Information of China (English)

    张碧华; 高素强; 金鹏飞

    2012-01-01

    目的:对近3年北京医院(以下简称我院)呼吸系统用中成药的临床用药情况进行研究,了解该类中成药的用药特点和变化趋势,以期为临床合理用药提供参考.方法:对我院2008-2010年呼吸系统用中成药的销售金额及构成比、用药频度(defined daily dose system,DDDs)和科室用药分布情况进行统计分析.结果:我院呼吸系统用中成药的销售金额呈现逐年上升趋势,各类药的销售金额及构成比相对固定,其中止咳平喘剂和解表剂分列第一和第二位,在临床各科室的用药集中度相对较低.结论:中成药在呼吸系统疾病的防治中有着重要的地位.医院所选择的用药品种应基本能够满足临床需求,同时也需兼顾患者的经济承受能力,注重合理用药,以保障临床用药的安全、有效和经济.%Objective; To investigate the clinical utilization status of Chinese patent medicines for respiratory system in Beijing Hospital during recent three years and the use characteristics and development tendency, so as to provide references for rational drug use. Methods: The Chinese patent medicines for respiratory system between 2008 and 2010 were statistically analyzed in respects of consumption sum and drug categories, defined daily dose system (DDDs) and use characteristics in different departments. Results: The consumption sum of Chinese patent medicines for respiratory system increased year by year during 2008 -2010. The consumption sum and constituent ratio for various drugs were relatively fixed, antitussive and antiasthmatic drugs and diaphoretic drugs were the first leading two places, and the concentration ratio of drug use was lower in clinical departments. Conclusion; Traditional Chinese medicines play an important role in the therapy of respiratory system diseases. The use of Chinese patent medicines in hospital should meet the requirements of clinical treatments, and also needs to consider the affording ability of

  11. Monitoring of hand hygiene of medical personnel in traditional Chinese medicine hospital%中医院医务人员手卫生监测

    Institute of Scientific and Technical Information of China (English)

    徐玉燕; 吴春明; 赖冬红

    2013-01-01

    目的 了解温州市中医院医务人员手卫生现状,研究影响手卫生的因素.方法 通过问卷调查、现场观察和考核、手卫生采样监测的方法,对医院医务人员手卫生情况进行了调查.结果 335名医务人员对手卫生知识掌握较好,但手卫生执行存在一些不足;其中洗手依从率为44.6%,洗手合格率为93.8%,手卫生采样监测合格率为89.8%,且医师执行效果明显不如护士(P<0.05).结论 医院医务人员手卫生执行状况有待提升,应加强培训和制度管理,提高医务人员手卫生执行情况,特别是医师的手卫生依从率.%OBJECTIVE To investigate the current status of hand hygiene of medical personnel in Wenzhou Traditional Chinese Medical Hospital and research the influencing factors of hand hygiene. METHODS Questionnaires, on-site observations and hand hygiene sampling inspecion were used to investigate the knowledge and compliance of hand hygiene of medical personnel in the hospital. RESULTS The 335 hospital personnel would have a good understanding of hand hygiene, but there existed some shortages in their hand hygiene implementation. The compliance rate of hands-washing was 44. 6 %, the qualified rate of hands-washing was 93. 8% and the qualified rate of hand hygiene sampling monitoring was 89.8% , and the implementation effect of the nurses was better than that of the doctors (P<0. 05). CONCLUSION The implementation of hand hygiene of the medical personnel needs to be further improved, and it is necessary to strengthen the training and system management so as to improve the implementation of hand hygiene, especially the hand hygiene compliance.

  12. Risk factors and nursing interventions to hospital-acquired pneumonia in geriatric respiratory medicine department%老年呼吸内科医院获得性肺炎危险因素分析及护理干预

    Institute of Scientific and Technical Information of China (English)

    赵丽萍; 来纯云

    2013-01-01

    目的 探讨老年呼吸内科住院患者发生医院获得性肺炎(HAP)的相关危险因素及护理干预.方法 采用回顾性研究方法对2010年3月-2011年12月老年呼吸内科186例住院患者进行分析.结果 186例患者中,发生HAP 38例占20.4%,未发生HAP 148例占79.6%,老年呼吸内科HAP发生的危险因素包括:高龄、免疫抑制状态、长期卧床、鼻饲、机械通气、侵人性操作、不恰当使用抗菌药物.结论 针对老年呼吸内科中HAP常见的发病危险因素采取相应的护理干预,从而在一定程度上减少HAP的发病.%OBJECTIVE To explore the related risk factors for hospital-acquired pneumonia (HAP) in the geriatric respiratory medicine department and nursing interventions.METHODS A total of 186 patients who enrolled the geriatric respiratory medicine department from Mar 2010 to Dec 2011 were investigated respectively.RESULTS Among the 186 cases,HAP occurred in 38 patients with the incidence rate of 20.4%,HAP did not occur in 148 (79.6%) patients,The advanced age,immunosuppression state,prolonged bed rest,nasogastric feeding,mechanical ventilation,invasive operation,and inappropriate use of antibiotics were the risk factors for the HAP in geriatric respiratory medicine department.CONCLUSION The corresponding nursing interventions should be taken in accordance with the common risk factors for the HAP in the geriatric respiratory medicine department so as to reduce the incidence of HAP in a certain degree.

  13. Analysis of consultation characteristics for elderly patients in the department of psychosomatic medicine in Hospital of TCM%中医医院老年患者心身医学科会诊特点分析

    Institute of Scientific and Technical Information of China (English)

    裴音; 张捷; 陈杰; 范竹青

    2012-01-01

    Objective To analyze the characteristics of consultation for elderly patients in the department of psychosomatic medicine of our hospital. Methods 157 elderly patients accepting consultation in the department of psychosomatic medicine were analyzed. The aspects of analysis included the departments and reasons for consultations,and diagnoses after consultation. Results The most common diseases were cardiovascular, cerebrovascular and digestive diseases in elderly patients complicated with mental disorders;the most common reason for consultation is associated with sleep disorders;the most common diagnoses of consultation is the mixed anxiety-depressive disorder;high risk of delirium was increased in elderly patients. Conclusion Diagnosis and treatment of psychiatric-related diseases provided by the department of psychosomatic medicine for many patients,at the same time,Consultation in Dept. of Psychiatry is also necessary. Therefore, the department of psychosomatic medicine as a bridge can strengthen the link providing comprehensive services for patients.%目的 了解老年患者心身医学科会诊特点.方法 选取我院心身医学科进行会诊的老年患者157例,对会诊科室、会诊原因、会诊后诊断进行分析.结果 伴发精神障碍的老年患者以心脑血管病及消化系统疾病入院最为常见;伴发睡眠障碍为最常见的申请会诊原因;焦虑抑郁共病为最常见的会诊诊断;老年患者出现谵妄的概率较高.结论 院内心身医学科可以为更多的患者提供精神科相关诊治,精神科专科会诊仍十分必要,心身医学科可以加强二者之间的联系,为患者提供更全面的服务.

  14. Academic Cloning.

    Science.gov (United States)

    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…

  15. Emergency medicine in Dubai, UAE

    OpenAIRE

    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.

  16. Emergency medicine in Dubai, UAE.

    Science.gov (United States)

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-08-18

    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.

  17. Academic Words and Academic Capitalism Academic Words and Academic Capitalism

    Directory of Open Access Journals (Sweden)

    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.

  18. Hospitals; hospitals13

    Data.gov (United States)

    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. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    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...

  20. Radiological Protection Situation Analysis of Nuclear Medicine Department in A Hospital%某医院核医学科放射卫生防护分析

    Institute of Scientific and Technical Information of China (English)

    李宁; 肖国有; 廖光星; 杨鸿宇; 王洪良; 杨志; 邓李燕; 陆静佳

    2015-01-01

    目的:根据国家规定的有关标准,对某核医学科的放射防护情况进行分析与评价,并依据辐射防护最优化原则,给出更为合理的防护建议。方法通过现场监测,使用 BH3103 X-γ便携式巡测仪进行空气比释动能率的测量,X-γ剂量率仪进行辐射剂量率的测量,并估算出工作人员得附加年剂量、患者剂量及通风橱内1 h 换气次数。结果该核医学科科室内外的环境辐射水平在0.10~0.35μGy/h,工作人员的年附加剂量为:分装人员全身为0.11 mSv ;手为2.12 mSv。注射人员全身为0.89 mSv ;手为5.12 mSv。摆位人员全身为0.82 mSv。患者剂量在4.5~5.9 mSv。通风橱检测结果符合防护要求。结论该核医学科的辐射防护监测结果符合国家规定的相关标准要求,放射防护管理较完善。%Objective To analyze and evaluate the radiological protection situation of nuclear medicine department according to national standards on the basis of radiation protection optimization principle,then more reasonable protective suggestions are given. Methods Using BH3103X-γ portable survey instrument to measure the air kerma rate and X-γ dose rate to measure radiation dose rate in the case of field monitoring,then using the data to estimate the workers’additional dose、patients’radiation dose and air change times in a hour. Results The environmental radiation level of the nuclear medicine department’s indoor and outdoor were between 0.10 to 0.35 μGy/h,the workers’additional dose in a year as fol ows :the whole body of repackaging worker was 0.11 mSv and hands were 2.12 mSv,the whole body of injection worker is 0.89 mSv and hands were 5.12 mSv,the whole body of placement worker was 0.89 mSv,the patients’radiation dose were between 4.5 to 5.9 mSv. The test results conform to the protection requirements of the fume hood. Conclusion The radiation protection test results of the nuclear medicine department are

  1. Brief hospitalizations of elderly patients

    DEFF Research Database (Denmark)

    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...

  2. European regulatory tools for advanced therapy medicinal products.

    Science.gov (United States)

    Flory, Egbert; Reinhardt, Jens

    2013-12-01

    Increasing scientific knowledge and technical innovations in the areas of cell biology, biotechnology and medicine resulted in the development of promising therapeutic approaches for the prevention and treatment of human diseases. Advanced therapy medicinal products (ATMPs) reflect a complex and innovative class of biopharmaceuticals as these products are highly research-driven, characterised by innovative manufacturing processes and heterogeneous with regard to their origin, type and complexity. This class of ATMP integrates gene therapy medicinal products, somatic cell therapy medicinal products and tissue engineering products and are often individualized and patient-specific products. Multiple challenges arise from the nature of ATMPs, which are often developed by micro, small and medium sized enterprises, university and academia, for whom regulatory experiences are limited and regulatory requirements are challenging. Regulatory guidance such as the reflection paper on classification of ATMPs and guidelines highlighting product-specific issues support academic research groups and pharmaceutical companies to foster the development of safe and effective ATMPs. This review provides an overview on the European regulatory aspects of ATMPs and highlights specific regulatory tools such as the ATMP classification procedure, a discussion on the hospital exemption for selected ATMPs as well as borderline issues towards transplants/transfusion products.

  3. 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

    Directory of Open Access Journals (Sweden)

    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

  4. Perspective: Academic obstetrics-gynecology departments in the city of Philadelphia: are the wheels coming off?

    Science.gov (United States)

    Croft, Damien J

    2011-03-01

    Maternity care in Philadelphia is in an unprecedented and precarious situation, as all the community hospitals that once provided maternity care services have either closed completely or stopped providing maternity services. Six academic medical centers (AMCs) in the city of Philadelphia now provide care to a population of 1.5 million requiring increasingly complex and expensive maternity care, at the same time as insurance premiums and the malpractice crisis in Pennsylvania peaked. The AMCs are able to continue providing maternity care to this population that includes a large proportion of poor, minority, and un- or underinsured patients thanks to government subsidization of resident education, the services provided by resident physicians, and the influx of government and industry research funds, but the financial outlook of academic obstetrics-gynecology departments in this city is dire. Obstetric academic medicine in Philadelphia has come to more closely resemble a "big wheel" tricycle than Flexner's "three-legged stool." Clinical medicine is the driver (the large front wheel and pedal) pulling along education and research, the two smaller wheels in the back. A maternity care alliance is needed in Philadelphia allowing area AMCs to pool and trade resources, reduce costs, improve quality and innovation, and share risks. Philadelphia may serve as an early warning for other cities and AMCs around the country and has the opportunity to serve as a model for how to overcome these serious challenges.

  5. Traditional complementary and alternative medicine: knowledge, attitudes and practices of health care workers in HIV and AIDS clinics in Durban hospitals.

    Science.gov (United States)

    Mbutho, Nozuko P; Gqaleni, Nceba; Korporaal, Charmaine M

    2012-01-01

    Traditional complementary and alternative medicine (TCAM) has been reported to be commonly used among individuals with HIV and AIDS disease. However a lack of communication between health care workers (HCWs) and patients as well as between HCWs and TCAM practitioners has been identified as one of the challenges that may adversely affect treatment of HIV and AIDS patients. With improved and sustained communication HCWs, patients and TCAM practitioners would be able to make informed decisions with regards to best treatment practices based on the knowledge of what is safe, effective and what is not. In order to establish a baseline understanding of the current status of interaction and communication between HCWs and TCAM profession in Durban, South Africa, the purpose of the study was to investigate the knowledge, attitudes and practices of HCWs in the HIV and AIDS clinics towards TCAM professions. Data was collected by means of anonymous self-administered questionnaire which was distributed to HCWs in the HIV and AIDS clinics. Out of 161 HCWs in the HIV and AIDS clinics 81 HCWs returned the questionnaires resulting in 50% response rate. The results showed that participants did not possess a basic knowledge of TCAM. Out of 81 participants 23 (28%) scored zero in a true or false knowledge assessment question.

  6. Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)

    OpenAIRE

    Quiroga Rodrigo; Meneses Lidia; Bussmann Rainer W

    2012-01-01

    Abstract Background The aim of this study was to document the types of diseases treated by the use of medicinal plants, their main applications and also to have a report of the major diseases treated at the Hospital of San Pablo de Huacareta (Chuquisaca Bolivia). Methods We conducted semi-structured interviews on the use medicinal plants with 10 local informants, and categorized the kinds of diseases treated by traditional medicine. We obtained reports of cases treated at the Hospital of Huac...

  7. The influencing factors of responsibility nurses ˊ work engagement in Traditional Chinese Medicine hospitals%中医医院责任护士工作投入相关因素分析

    Institute of Scientific and Technical Information of China (English)

    汤娟娟; 余兰仙; 王俊杰; 王玲

    2015-01-01

    Objective To investigate the status and influencing factors of responsibility nursesˊwork engagement in Traditional Chinese Medicine hospitals, thus to provide preference to make management policies. Methods A total of 527 responsibility nurses from 3 3A-level Traditional Chinese Medicine hospitals were investigated using the general information questionnaire and the Chinese version of Utrecht Work Engagement Scale( UWES). Results The total score of work engagement was 31. 00,and the dimension scores from high to low were vigor(40. 69%),dedication(38. 67%)and absorption(35. 00%). There were sig-nificant difference on the score of work engagement with different years of nursing,professional title,position,departments and physical condition(P ﹤ 0. 01 or P ﹤ 0. 05). The main influencing factors of work engagement were departments and physical condition. Conclusion The nursesˊwork engagement in Traditional Chinese Medicine hospitals is in the middle level,and has great room to improve. Managers should pay attention to nurseˊs physical condition and the department working characteristics,take effective measures to enhance nursesˊwork engagement and improve the quality of nursing.%目的调查中医医院责任护士工作投入现状和影响因素,为临床制订针对性的管理政策提供依据。方法采用一般资料调查表、Utrecht工作投入量表中文版,对3所三级甲等中医医院527名责任护士进行调查。结果中医医院责任护士工作投入总分中位数为31.00分,3个维度按得分率由高到低排序为活力(40.69%)、专注(38.67%)、奉献(35.00%);不同护龄、职称、职务、科别、身体状况的责任护士工作投入得分比较差异具有统计学意义(P﹤0.01或P﹤0.05);科别和身体状况是影响中医医院责任护士工作投入的主要因素。结论中医医院责任护士工作投入处于中等水平,有较大提升空间,管理者应关注责任护士的身

  8. Engineering in translational medicine

    CERN Document Server

    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.

  9. Analysis of 10863 cases of osteoarthritis treatment of traditional Chinese medicine hospital%中医医院10863例骨关节炎治疗分析

    Institute of Scientific and Technical Information of China (English)

    王利洋; 阮履强; 周军

    2013-01-01

    along with the in-depth study of the pathogenesis of osteoarthritis, through comprehensive intervention treatment of osteoarthritis, it possible to slow or reverse disease progression. This paper collected in our hospital in recent 10 years in patients with osteoarthritis and treatment were retrospectively analyzed, seeking a more reasonable for the patients with osteoarthritis, indeed, effective treatment.%随着对骨关节炎发病机制的深入研究,通过综合治疗对骨关节炎进行干预,延缓或逆转疾病进程成为可能。本文收集了近10年来我院收治的骨关节炎患者治疗方法并进行回顾性分析,希望为骨关节炎患者寻求更合理、确实、有效的治疗方案。

  10. Practice and experience of performance assessment and compensation management in secondary hospital of traditional Chinese medicine%二级中医医院绩效考核与薪酬体系管理的实践与体会

    Institute of Scientific and Technical Information of China (English)

    吕久来; 王晓薇

    2014-01-01

    Comprehensive performance assessment and performance salary system focusing on service quality and quantity is a core countermeasure of personnel system reform in healthcare reform. Combined with hospital situations of Huairou traditional Chinese medicine, by performance assessment reform, a complete performance compensation system reflects the characters of traditional Chinese medicine includes post character, technology, risk, quantity and quality is designed to improve medical quality and efficiency, reduce patient's economic burden.%在当前医药卫生体制改革的进程中,实行以服务质量及岗位工作量为主的综合绩效考核和岗位绩效工资制度是医疗机构人事制度改革的一个侧重点。怀柔区中医医院结合自身实际,通过绩效考核改革医院内部分配制度,将职工的绩效薪酬与工作岗位性质、工作技术难度、风险程度、工作数量与质量等工作业绩紧密结合,形成了一套完整的体现中医特色服务价值的绩效薪酬体系,提高了医疗质量和服务效率,减轻了群众负担。

  11. Academic Practice

    DEFF Research Database (Denmark)

    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......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...

  12. German hospital database-allocation of patients to appropriate hospitals.

    Science.gov (United States)

    Schneider, Rita; Reiners, Christoph

    2010-06-01

    Effective response to radiological emergencies requires information about available qualified hospitals and defined methods to timely allocate patients to appropriate hospitals. In Germany, updated information about hospitals concerning their qualification and willingness to treat radiological emergency patients is not summarized. The objectives were to identify qualified hospitals, assess hospital capacities and treatment capabilities, to examine willingness to respond to various radiological emergencies and to develop a concept for matching patients to hospitals. A Germany-wide combined postal/Web survey of 99 selected hospitals conducted in 2007 covered relevant organizational characteristics, hospital resources, treatment expertise, and the willingness to accept radiological emergency patients by a self-reported written questionnaire with 57 items. Survey results were documented in a Microsoft Access database. A database-driven Web application was developed to allocate patients to hospitals. Of 99 hospitals, 69 responded and 54 indicated their willingness to accept radiological emergency patients. 17,512 total hospital beds, 2,084 intensive care, and 170 reverse isolation beds were reported. Availability of laboratory and in-patient departments ranged from 14 radiobiology to 47 laboratory medicine departments and from 13 burn care to 52 trauma surgery departments. 48 and 40 hospitals stated treatment competence for local and whole body external exposure, respectively. 34 and 29 hospitals reported treatment expertise for contamination and incorporation, respectively. In this publication baseline data of qualified hospitals concerning capacities and competence to manage radiological emergency patients are presented, and an allocation concept for radiological emergency patients is provided.

  13. Epidemiological study on neurosis of internal medicine outpatient department in general hospital%大连市综合医院内科门诊神经症流行病学调查

    Institute of Scientific and Technical Information of China (English)

    孙月吉; 杜娟; 宛思莹; 刘启贵; 刘凤英; 曲芳; 陈锦波

    2008-01-01

    目的 了解综合科医院内科门诊神经症的发生率,探讨神经症发生特点.方法 采用了整群分层抽样方法,2006年7~8月,连续收集了3所大连市三级甲等综合科医院门诊病人600人.经神经症筛查量表筛查出阳性者,同时行DSM-Ⅳ确立诊断,符合诊断者309名作为研究对象.结果 内科门诊神经症病人的检出率约为57.43%(309例),非神经症约为42.56%(229例);其中焦虑210例,约占神经症总数的68%;广泛性焦虑115例,约37%;惊恐障碍67例,约占神经症总数的21.7%;抑郁伴发惊恐障碍28例,约占占神经症总数的9.6%.抑郁伴发广泛性焦,约占总数的14.2%.其他神经症患者83例,约占神经症总数的26.8%.重度抑郁障碍患者占总样本的3%;神经症患者不同诊断组之间的睡眠时间、累计就诊次数、累计医疗费用和累计就诊时间等均差异有显著性(P<0.01).自认病情态度和对内科医生诊断治疗的满意程度,各组之间差异有显著性(P=0.000).所调查的各组患者所经历的特殊检查(P=0.034)以及有无镇静止痛药物治疗均差异有显著性(P=0.000).结论 综合性医院内科门诊患者的精神障碍问题严重,其中以神经症为最常见.焦虑障碍在综合性医院内科门诊最常见.%Objective To investigate the prevalence status of neurosis among outpatients in internal medicine department of general hospital, and to find some characteristics of the neurosis. Methods 600 outpatients visiting the internal medicine department were investigated ,and they are from 3 general hospital in Dalian:seeond I-Iospital,Jinzhou hospital and second teaching hospital affiliated to Dalian medical university. 309 neurosis were selected with neurosis screening scale, and met the DSM-IV. Results Higher prevalence (57.43%) was found in neurosis of general hospital. The results showed that the prevalence rate of anxiety disorder is 68% within the neurosis, which included general anxiety (37.00%) and

  14. [Laboratory medicine in Taiwan].

    Science.gov (United States)

    Chen, J S

    1998-07-01

    Laboratory medicine and hospital central laboratory system were adopted in Taiwan after World War II. In medical schools, laboratory medicine or clinical pathology teaching is allocated to junior students. Three years of clinical pathology or four years of anatomical pathology training is required for pathology resident. Recent trend indicates that both the hospitals and the young doctors favor the five years combined C.P. (two-years) and A.P. (three years) training program. At present, 75 clinical pathologists and 213 anatomical pathologists are qualified. Approximately 70% of them work in medical centers and medical schools. Consequently, the medium and small size hospitals suffer from serious shortage of pathologist. Studies during the part 50 years indicate substantial difference in the improvement of laboratory medicine and central laboratory before and after 1975. Significant improvement in the working space, facility, equipment, staff, quality control and productivity was evident after 1975. The three health care policies contributing to the overall improvement are: 1. hospital accreditation project, 2. medical care network plan, and 3. medical specialist system.

  15. Radiation Safety in Nuclear Medicine Procedures.

    Science.gov (United States)

    Cho, Sang-Geon; Kim, Jahae; Song, Ho-Chun

    2017-03-01

    Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

  16. Hospital Compare

    Data.gov (United States)

    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...

  17. HCAHPS - Hospital

    Data.gov (United States)

    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...

  18. The evolution of sports medicine in Singapore.

    Science.gov (United States)

    Tan, Benedict

    2013-10-01

    Sports medicine is a relatively new subspecialty in Singapore. This commentary chronicles its evolution in Singapore from 1969, through various milestones, to the present day. The first sports medicine clinic in Singapore was established in 1971 at Farrer Park. Notable institutions that followed include the Sports Medicine and Research Centre (1973), Soldier Performance Centre, Changi Sports Medicine Centre (2003), Singapore Sports Medicine Centre (2006), and other multidisciplinary centres of restructured hospitals. Formal groundwork to establish sports medicine as a subspecialty began in 2005, with its first trainee commencing traineeship at the Changi Sports Medicine Centre in 2007, and culminated in the subspecialty register at the beginning of 2011. Also captured in this discussion are the broader scopes of sports medicine, including military sports medicine, the sports sciences, exercise medicine, and event medical coverage.

  19. Relation between academic yield and stress in medical students

    OpenAIRE

    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...

  20. ACADEMIC TRAINING

    CERN Multimedia

    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

  1. Ancient medicine--a review.

    Science.gov (United States)

    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.

  2. Organizational models of emerging academic health science centers in England.

    Science.gov (United States)

    Ovseiko, Pavel V; Davies, Stephen M; Buchan, Alastair M

    2010-08-01

    Recent government policy initiatives to foster medical innovation and high-quality care in England have prompted academic and clinical leaders to develop new organizational models to support the tripartite Flexnerian mission of academic medicine. Medical schools and health care providers have responded by aligning their missions and creating integrated governance structures that strengthen their partnerships. In March 2009, the government officially designated five academic-clinical partnerships as England's first academic health science centers (AHSCs). As academic-clinical integration is likely to continue, future AHSC leaders could benefit from an analysis of models for organizing medical school-clinical enterprise relationships in England's emerging AHSCs. In addition, as the United States ponders health systems reform and universal coverage, U.S. medical leaders may benefit from insight into the workings of academic medicine in England's universal health system. In this article, the authors briefly characterize the organization and financing of the National Health Service and how it supports academic medicine. They review the policy behind the designation of AHSCs. Then, the authors describe contrasting organizational models adopted in two of the newly designated AHSCs and analyze these models using a framework derived from U.S. literature. The authors conclude by outlining the major challenges facing academic medicine in England and offer suggestions for future research collaborations between leaders of AHSCs in the United States and England.

  3. 42 CFR 482.53 - Condition of participation: Nuclear medicine services.

    Science.gov (United States)

    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...

  4. Herbal Medicine

    Science.gov (United States)

    ... 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. ...

  5. Folk Medicine

    Science.gov (United States)

    ... Lead Poisoning Prevention Training Center (HHLPPTC) Training Tracks Folk Medicine Recommend on Facebook Tweet Share Compartir Jump ... products Lead has been found in some traditional (folk) medicines used by East Indian, Indian, Middle Eastern, ...

  6. Summary of the 2008 Evidence-based Chinese Medicine(EBCM) Workshop

    Institute of Scientific and Technical Information of China (English)

    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

  7. [SPORT MEDICINE].

    Science.gov (United States)

    Constantini, Naama; Mann, Gideon

    2016-06-01

    Sports Medicine is a relatively new subject in medicine and includes a variety of medical and paramedical fields. Although sports medicine is mistakenly thought to be mainly for sports professionals/athletes, it actually encompasses the entire population, including the active and non-active healthy populations, as well as the sick. Sports medicine also engages amateur sportsmen and strives to promote physical activity and quality of life in the general population. Hence, the field involves all ages from childhood to old age, aiming to preserve and support every person at every age. Sports medicine, which started developing in the 19th century, is today a specialty, primary or secondary, in many countries, while in others it is a fellowship or under the jurisdiction of local or sports authorities. In Israel, the field exists since the 1950's and is advanced. The Sports Medicine Society founded a 3-year course of continued education in sport medicine as part of the Tel-Aviv University Faculty of Medicine. Later on, a fellowship in general Sports Medicine and in Orthopedic Sports Medicine were developed within the Israel Medical Association. A year ago, Israel formally became a member of the global "Exercise is Medicine" foundation, and under this title promotes education for health care providers on exercise prescription. The understanding of the importance of physical activity and fitness as part of a healthy lifestyle is increasing in Israel, as well as the number of amateur athletes, and the profession of sports medicine takes a big part in this process.

  8. Nuclear medicine therapy

    CERN Document Server

    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.

  9. Wittgenstein, medicine and neuropsychiatry

    Directory of Open Access Journals (Sweden)

    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.

  10. Wittgenstein, medicine and neuropsychiatry.

    Science.gov (United States)

    Teive, Hélio A G; Silva, Guilherme Ghizoni; Munhoz, Renato P

    2011-08-01

    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).

  11. 中医院急诊科护士团队效能的调查分析%Survey and Analysis of Nurses' Team Efficacy of Emergency Department in Chinese Medicine Hospital

    Institute of Scientific and Technical Information of China (English)

    谭益冰; 江淑聘

    2014-01-01

    Objective To know the level of nurses' team efficacy of emergency department in Chinese medicine hospital and explore its affected factors. Methods Cluster sampling was used, and general data questionnaire and team efficiency scale were used. Results 102 subjects were recruited, the total score of team efficacy was 4.34±0.73, belonged to 86.8%level;The differences in several groups, such as age (F = 7.18, P <0.05), working time (F = 2.93, P <0.05) and working department (t = 4.39, P <0.05) were statistically significant. Conclusions Nurses of emergency department in Chinese medicine have good team efficiency, especially in team work efficiency and responsibility. The team efficacy of nurses in middle class and who haven't been fixed up to certain department should be strengthened.%目的:了解中医院急诊科护士团队效能的水平,探讨其影响因素。方法采用整群抽样,使用一般资料调查表及《团队效能量表》对广州市某两家三甲中医院急诊科护士进行调查。结果共调查102人,中医院急诊科护士团队效能总分(4.34±0.73)分,水平为86.8%;不同年龄(F=7.18,P<0.05)、工作时间(F=2.93,P<0.05)及定科情况(t=4.39,P<0.05)组的总分差异具有统计学意义。结论中医院急诊科护士具有良好的团队效能,体现在团队工作效率与责任感;需加强“夹心层”及未定科护士的团队效能。

  12. The future of general medicine.

    Science.gov (United States)

    Firth, John

    2014-08-01

    It is a truth universally acknowledged that there is a problem with general medicine. Physicians have become increasingly specialised over the past 30 years or so, and specialist care has produced increasingly better outcomes for some patients. The patients left behind are looked after by general medicine, where demand is increasing, operational priority within hospitals is low, there is little professional kudos and recruitment is suffering. Three recent reports - Hospitals on the Edge?, the Future Hospital Commission report, and the Shape of Training report - have described the problems, but not articulated compelling solutions. Here, I discuss what is good about general medicine, what is bad and make suggestions for improvement. These involve getting specialities to take responsibility for care of appropriate admissions automatically and without delay, giving general physicians control over the service that they provide, and using well-chosen financial drivers to support movement in the right direction.

  13. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  14. ACADEMIC TRAINING

    CERN Multimedia

    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

  15. 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

    Directory of Open Access Journals (Sweden)

    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

  16. Analyzing the Relationship of Geographic Mobility and Institutional Prestige to Career Advancement of Women in Academic Medicine Pursuing Midcareer-, Senior-, or Executive-Level Administrative Positions: Implications for Career Advancement Strategies

    Science.gov (United States)

    McLean, Marsha Renee

    2010-01-01

    The purpose of this study was to explore the relationship of geographic mobility and institutional prestige to career advancement defined as administrative promotions of women seeking midcareer-, senior-, or executive-level positions at academic health centers (AHCs) and their medical schools or in non-AHC related medical schools in the United…

  17. Chinese Academic Journal(CA J- CD) International Version Starts to Be Published for Overseas

    Institute of Scientific and Technical Information of China (English)

    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.

  18. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Making clinical academic careers more attractive: views from questionnaire surveys of senior UK doctors

    OpenAIRE

    Lambert, TW; Smith, F; Goldacre, MG

    2015-01-01

    Objectives To report on doctors’ reasons, as expressed to our research group, for choosing academic careers, and on factors that would make a career in clinical academic medicine more attractive to them. Design Postal, email and web questionnaires Participants 6936 UK-trained doctors who graduated in 1996, 1999 and 2000 Main Outcome Measures Open-ended comments about a career in clinical academic medicine. Results Of doctors who provided reasons for pursuing a ...

  20. The 2017 International Joint Working Group recommendations of the Indian College of Cardiology, the Academic College of Emergency Experts, and INDUSEM on the management of low-risk chest pain in emergency departments across India.

    Science.gov (United States)

    Chauhan, Vivek; Shah, Pavitra Kotini; Galwankar, Sagar; Sammon, Maura; Hosad, Prabhakar; Beeresha; Erickson, Timothy B; Gaieski, David F; Grover, Joydeep; Hegde, Anupama V; Hoek, Terry Vanden; Jarwani, Bhavesh; Kataria, Himanshu; LaBresh, Kenneth A; Manjunath, Cholenahally Nanjappa; Nagamani, A C; Patel, Anjali; Patel, Ketan; Ramesh, D; Rangaraj, R; Shamanur, Narendra; Sridhar, L; Srinivasa, K H; Tyagi, Shweta

    2017-01-01

    There have been no published recommendations for the management of low-risk chest pain in emergency departments (EDs) across India. This is despite the fact that chest pain continues to be one of the most common presenting complaints in EDs. Risk stratification of patients utilizing an accelerated diagnostic protocol has been shown to decrease hospitalizations by approximately 40% with a low 30-day risk of major adverse cardiac events. The experts group of academic leaders from the Indian College of Cardiology and Academic College of Emergency Experts in India partnered with academic experts in emergency medicine and cardiology from leading institutions in the UK and USA collaborated to study the scientific evidence and make recommendations to guide emergency physicians working in EDs across India.

  1. Improving patient safety in transfusion medicine: contemporary challenges and the roles for bedside and laboratory biovigilance in addressing them

    Directory of Open Access Journals (Sweden)

    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

  2. Biomedical innovation in academic institutions: mitigating conflict of interest.

    Science.gov (United States)

    Nelsen, Lita L; Bierer, Barbara E

    2011-09-14

    As universities and research hospitals move increasingly toward translational research and encouragement of entrepreneurship, more attention must be paid to management of conflicts of interest (COIs) if the public trust is to be maintained. Here, we describe COI policies at two institutions that aim to structure an academic environment that encourages innovation while protecting academic values.

  3. Abstracts From the Proceedings of the 2015 Annual Meeting of the Clerkship Directors of Internal Medicine (CDIM).

    Science.gov (United States)

    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

  4. Analysis of Prescriptions in the Outpatient Pharmacy of Traditional Chinese Medicine in Xi'an Medical College Baoji Hospital from 2010 to 2012%2010-2012年西安医学院附属宝鸡医院门诊中成药处方点评

    Institute of Scientific and Technical Information of China (English)

    史丽娟

    2015-01-01

    OBJECTIVE:To improve the quality of the outpatient prescriptions of Chinese patent medicine in the outpatient pharmacy of traditional Chinese medicine and promote the rational use of traditional Chinese medicine . METHODS:4 965 outpatient prescriptions of Chinese patent medicine in the outpatient pharmacy of traditional Chinese medicine in Xi'an Medical College Baoji Hospitals ( hereinafter referred to as “our hospital”) from 2010 to 2012 period were analyzed statistically in accordance with “hospital prescription review management practices ( Trial )” and “Prescription Management Methods” issued .RESULTS: Of a total of 4 965 prescriptions reviewed , 4725 ( 95.21%) were qualified prescriptions versus 240 unqualified prescriptions .The unqualified prescriptions manifested mainly as discrepancies between diagnosis and medication , repeated drug use , unreasonable in usage or dosage forms , and nonstandard in prescription writing etc .CONCLUSIONS:The writing of the outpatient prescriptions of Chinese patent medicine in the outpatient pharmacy of traditional Chinese medicine of our hospital is far from standard , and the rational use of drugs remains to be strengthened .%目的:提高门诊药房的中成药处方质量,促进中成药的合理使用。方法:随机抽取西安医学院附属宝鸡医院(以下简称“我院”)2010-2012年门诊中成药处方4965张,参考2010年《医院处方点评管理规范(试行)》和《处方管理办法》对处方进行点评。结果:共抽查的4965张处方中,合格处方4725张,不合格处方240张,处方合格率为95.17%。不合格处方主要表现为用药与诊断不符,重复用药,剂型、剂量及用法不合理,书写不规范等。结论:我院处方书写欠规范,合理用药水平有待加强。

  5. 南宁市传染病医院重症医学科患者现状调查%Investigation on present situation of patients in Department of Critical Care Medicine in Infectious Disease Hospital of Nanning City

    Institute of Scientific and Technical Information of China (English)

    林艳荣; 吴锋耀; 刘升; 韦静

    2016-01-01

    ObjectiveTo investigate the current situation of intensive care unit (ICU) inpatients in Infectious Disease Hospital of Nanning to provide a reference for the prevention and control of infectious diseases and construction and development of ICU in such a hospital.Methods The clinical data of inpatients from January 2011 to December 2015 in the Infectious Disease Hospital Affiliated to Guangxi Medical University (that is the Fourth People's Hospital of Nanning City) were retrospectively analyzed, and the distributions of patients with various diseases, ages, of the characteristics of children severe infectious diseases in ICU, the numbers of patients with infectious diseases in general ward and ICU, the average time and daily cost of hospitalization and mortality were conducted.Results During 2011 to 2015, 855 cases in ICU were treated, including 709 cases of infectious diseases, 146 cases of non-infectious disease. The top 5 infectious diseases were ranked as follows: tuberculosis, human acquired immune deficiency syndrome (AIDS), hand-foot-mouth disease (HFMD), viral hepatitis, tetanus, accounting for 96.47% of the total infectious disease inpatients in ICU; there were 25 cases of other legal infectious diseases, accounting for 3.53%, including dengue fever, measles, malaria, chicken pox, mumps, rabies, typhoid fever, paratyphoid fever, scrub typhus, bacillary dysentery, leptospirosis, human infections with highly pathogenic H7N9 avian influenza, epidemic hemorrhagic fever, A H1N1 influenza, and besides, critically ill patients carrying virus (viral hepatitis B and AIDS) in 7 pregnant women, 22 surgical patients, and 117 patients with internal medicine diseases were also admitted and treated. The top 4 infectious diseases causing deaths in ICU were tuberculosis, AIDS, viral hepatitis and HFMD: The infectious diseases with top 6 high mortalities in ICU were as follows: rabies, viral hepatitis, AIDS, tuberculosis and tetanus. The age range was wide in this study

  6. Medication safety during your hospital stay

    Science.gov (United States)

    Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety ... Medication safety means you get the right medicine, the right dose, at the right times. During your ...

  7. Analysis of the Utilization of National Essential Medicines in a Cancer Hospital of Shandong Province in the First Half Year of 2014%山东省某肿瘤医院2014年上半年国家基本药物使用分析

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    OBJECTIVE:To provide reference for the further implementation of national essential medicines. METHODS:The drugs consumption data of outpatients and inpatients in our hospital from Jan. 1 to Jun. 30,2014 were statistically analyzed. RE-SULTS:Variety numbers of national essential medicines in our hospital occupied 37.38%(228/610) in total drugs variety numbers of the whole hospital,consumption sum of national essential medicines occupied 9.80%(817.02 million yuan/8 338.12 million yu-an) in all drugs consumption sum. The first 20 national essential medicines listed in consumption sum were mainly anti-cancer drugs and water,electrolyte and acid-base balance regulation drugs. CONCLUSIONS:In the utilization of national essential medi-cines,variety proportion and consumption sum ratio in our hospital are relatively low. It is suggested to make clear the use require-ments of national essential medicines in cancer hospitals to make more reasonable and scientific selection of anti-tumor medicines in National Essential Medicines List and reasonably increase the assistant medicines related to the treatment of neoplastic diseases;hos-pitals should take effective measures to promote the usage rate of national essential medicines.%目的:为进一步贯彻落实国家基本药物制度提供参考。方法:对我院2014年1月1日-6月30日门诊及住院患者药品消耗数据进行统计、分析。结果:我院国家基本药物品种数占全院药品总品种数的37.38%(228/610),国家基本药物销售金额占全院药品总销售金额的9.80%(817.02万元/8338.12万元)。销售金额排序前20位的国家基本药物品种中,抗肿瘤药与调节水、电解质及酸碱平衡药占主导。结论:我院在使用国家基本药物的品种比例和金额比例上偏低。建议相关部门应明确国家基本药物在肿瘤专科医院的配备使用要求,使国家基本药物目录中抗肿瘤药物品种的遴选更具合理性、科

  8. Complementary and Alternative Medicine: A Survey of Its Use in Pediatric Oncology

    Directory of Open Access Journals (Sweden)

    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.

  9. [Expedition medicine].

    Science.gov (United States)

    Donlagić, Lana

    2009-01-01

    Expedition and wildeness medicine is a term that combines rescue medicine, sport medicine as well as more specific branches as polar or high altitude medicine. It is being intensively studied both at the reaserch institutes and on expeditions. Ophtalmologists are concentrated on the reaserch of HARH (High Altitude Retinal Hemorrhage), neurologists on HACE reaserch (High Altitude Cerebral Edema), psychologists are developing tests to decsribe cognitive functions and many physicians are being trained to work in extreme enviroment. The result of all this effort are numerous new findings in pathophysiology and therapy of altitude illness, increased security on expedition and further development of expeditionism.

  10. Exploration and Practice of the Construction of Clinical Skill Simulated Training Center in Chinese Medicine Hospital%中医院临床技能模拟训练中心建设探索与实践

    Institute of Scientific and Technical Information of China (English)

    郎森艳; 高云; 苏春燕; 蒋科卫; 陈志强; 唐先平; 许慧荣; 张磊; 周晓宁

    2015-01-01

    目的:总结中国中医科学院望京医院建立临床技能模拟训练中心的经验,示范和推广中医临床模拟技能训练的规范化教学。方法结合临床技能训练的教学特点、教学大纲、教学进度等内容,在广泛收集文献的基础上,建立其标准操作规程及实训流程的草案,组织各临床学科资深专家进行意见征询、现场调研、讨论修订。结果制定了科学的临床技能实训功能模块划分规则,以及各模拟训练系统的标准操作规程和各功能模块间的实训流程,在此基础上制定临床技能模拟训练中心各项规章制度,完成模拟训练系统管理数据库,制定训练室培养方案;各模拟训练系统操作考核标准。结论临床技能模拟训练中心的建立,既提高了我院的实训教学水平,又培养了学生实践能力、创新意识和开拓精神,对其他中医院校建立临床实训中心起到了示范作用。%Objective To sum up the experience in the construction of clinical skill simulated training center established in Wangjing Hospital of China Academy of Chinese Medical Sciences so as to demonstrate and promote the normalized the clinical skill simulated training in TCM, Methods In line with the teaching characters,teaching outline and teaching schedule of clinical skill training,on the basis of extensive literature collection,the draft of the standard practice instruction and practice training procedure was set up, The academic senior clinical experts were organized for opinion consultation,field research and discussion and revision, Results The module division rule of scientific clinical skill training function,the standard practice instruction of each simulated training system and practice training flow path in each function module were formulated, On the basis,the regulatory framework of clinical skill simulated training center was developed ,the administration database of simulated training

  11. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study.

    Science.gov (United States)

    Gorski, Stanislaw; Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina; Grodzicki, Tomasz

    2017-01-01

    Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy internal medicine ward.

  12. Hospitality within hospital meals –

    DEFF Research Database (Denmark)

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg

    2016-01-01

    Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...... fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future...

  13. 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

    Directory of Open Access Journals (Sweden)

    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

  14. Analysis on the Differences between Academic Degree Postgraduate and Professional Degree Postgraduate for Traditional Chinese Medicine and the Current Situation%中药学学术学位硕士和专业学位硕士的区别及现状分析

    Institute of Scientific and Technical Information of China (English)

    高洁; 张庆芝; 章涤凡

    2014-01-01

    There are significant differences between academic degree postgraduate and professional degree postgraduate in cul-tivation objective, specific learning requirement and cultivation method. For high-level talent cultivation in traditional Chinese medicine,the two types have their irreplaceable positions and roles respectively, the former emphasizes on academic research and the latter emphasizes practical skills. Currently,there are some problems in both of them, but after continuous exploration and improvement, the situation will be gradually improved.%学术学位硕士和专业学位硕士在人才培养目标、具体学习要求、培养方法等方面存在很大差异,对于中药学高层次人才培养而言,两种培养类别均有不可取代的地位和作用,一种强调学术研究,一种强调实践技能。目前两种培养类别各自都还存在一些问题,但经过不断的探索和改进,将得到逐步的完善。

  15. A RANDOMIZED CONTROLLED TRIAL ON THE EFFICACY OF MEDHYA RASAYANA TABLET ON ACADEMIC STRESS AND PERFORMANCE IN SCHOOL CHILDREN

    Directory of Open Access Journals (Sweden)

    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

  16. 医院药房常见拆零药品的稳定性分析与管理%Stability analysis and management of the common dismantle medicines in hospital pharmacy

    Institute of Scientific and Technical Information of China (English)

    宋伟

    2014-01-01

    To explore the stability analysis and management method of the common dismantle medicines vitamin B1 and acetaminophen tablets in hospital pharmacy.Methods:Vitamin B1 and acetaminophen tablets were separately arranged to take samples in a specified environment.The content of drugs was measured at 0,14,28,56 and 84 days.Results:After 28 days of experiment,the average amount determination result of vitamin B1 was 92.83%,and it had already been reached the standard critical value range.The determination result at 56 days reached 96.14%,and it had shown that the determination result did not meet the standards or had abnormal changes.The content change of acetaminophen tablets was not obvious.It was also in the qualified range after 84 days.Conclusion:Dismantle medicines should be based their pharmaceutical properties to select the corresponding drug packaging materials and storage environment,at the same time, we should pay attention to indicate its validity in the outer packing of repackaged drug.%目的:探讨医院药房常见拆零药品维生素B1、对乙酰氨基酚片的稳定性分析与管理方法。方法:将维生素B1、对乙酰氨基酚片在规定环境下进行分装留样,在第0、14、28、56以及84天内对于药品的含量进行测定。结果:维生素B1片在实验第28天之后的测定中,其平均标示量测定结果92.83%,已经达到标准的临界值范围,并且在第56天的测定时,测定结果达到了96.14%,已经显示其不符合标准或者已经发生异常变化;对乙酰氨基酚片含量变化并不明显,在84天后也处于合格范围内。结论:拆零药品应根据各自的药品性质选择相对应的药品包装材料和存放环境,同时注意在分装药品的外包装上注明其有效期。

  17. [Sport medicine].

    Science.gov (United States)

    Epstein, Yoram

    2012-02-01

    It is only since the late 20th century that Sport and Exercise Medicine has emerged as a distinct entity in health care. In Israel, sports medicine is regulated by a State Law and a sport physician is certified after graduating a structured program. In the past, sports medicine was related to the diagnosis and treatment of injuries encountered by top athletes. In recent years, the scope of sport medicine has broadened to reflect the awareness of modern society of the dangers of physical inactivity. In this perspective the American College of Sport Medicine (ACSM) recently launched a program--"Exercise is Medicine", to promote physical activity in order to improve health and well-being and prevention of diseases through physical activity prescriptions. This program is from doctors and healthcare providers, adjusted to the patient or trainee. The sport physician does not replace a medical specialist, but having a thorough understanding about the etiology of a sport-related injury enables him to better focus on treatment and prevention. Therefore, Team Physicians in Elite Sport often play a role regarding not only the medical care of athletes, but also in the physiological monitoring of the athlete and correcting aberrations, to achieve peak physical performance. The broad spectrum of issues in sport and exercise medicine cannot be completely covered in one issue of the Journal. Therefore, the few reports that are presented to enhance interest and understanding in the broad spectrum of issues in sports and exercise medicine are only the tip of the iceberg.

  18. Emergency medicine in the United Arab Emirates

    OpenAIRE

    Fares, Saleh; Irfan, Furqan B; Corder, Robert F; Al Marzouqi, Μuneer Abdulla; Al Zaabi, Ahmad Hasan; Idrees, Marwa Mubarak; Abbo, Michael

    2014-01-01

    It has been a decade since emergency medicine was recognized as a specialty in the United Arab Emirates (UAE). In this short time, emergency medicine has established itself and developed rapidly in the UAE. Large, well-equipped emergency departments (EDs) are usually located in government hospitals, some of which function as regional trauma centers. Most of the larger EDs are staffed with medically or surgically trained physicians, with board-certified emergency medicine physicians serving as...

  19. Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban Underserved.

    Science.gov (United States)

    Berz, Jonathan P B; Gergen Barnett, Katherine A; Gardiner, Paula; Saper, Robert B

    2015-11-01

    The Preventive Medicine Residency Program collaborated with the Department of Family Medicine's Program for Integrative Medicine and Health Disparities at Boston Medical Center to create a new rotation for preventive medicine residents starting in autumn 2012. Residents participated in integrative medicine group visits and consults, completed an online curriculum in dietary supplements, and participated in seminars all in the context of an urban safety net hospital. This collaboration was made possible by a federal Health Resources and Services Administration grant for integrative medicine in preventive medicine residencies and helped meet a need of the program to increase residents' exposure to clinical preventive medicine and integrative health clinical skills and principles. The collaboration has resulted in a required rotation for all residents that continues after the grant period and has fostered additional collaborations related to integrative medicine across the programs.

  20. 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

    Directory of Open Access Journals (Sweden)

    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.